Chapter 1: Changes With Aging
1. Mrs. Smith, 75 years old, reports that she is weak, has difficulty urinating, and is dehydrated.
Although she is afebrile, the nurse conducts a thorough physical examination, including urinalysis and
complete blood count (CBC). The total assessment is necessary because:
1. All body systems interact, and symptoms could indicate a variety of diagnoses.
2. The symptoms are vague and may be signs of aging.
3. There may be other signs or symptoms more indicative of the condition.
4. Mrs. Smith may not be reporting all significant information. - 1. Answer: 1
Page: 2
Feedback
1.
The clinician must be aware that all the systems interact and, in doing so, can increase the older
person's vulnerability to illness/disease.
2.
The nurse must not attribute symptoms only to the aging process.
3.
There may be comorbidities accompanying this condition.
4.
Assumptions of not reporting properly may not be true.
2. A patient with renal disease has blood work drawn, and the results show an increase in serum
creatinine. The nurse practitioner needs to know which of the following laboratory values before
ordering medications?
1. CBC
2. Culture and sensitivity of the urine
3. Creatinine clearance
4. Uric acid levels - 2. Answer: 3
Page: 3
Feedback
1.
A CBC will not evaluate kidney function for a patient with renal disease.
2.
, A culture and sensitivity test reflects the presence of an infection and the antibiotic to which the
organism is sensitive.
3.
The calculation of creatinine clearance provides an estimation of renal function.
4.
Uric acid level is elevated in the presence of gout.
3. Which of the following statements is true regarding diagnostic testing?
1. A test is ordered for a specific purpose.
2. A test is the most invasive available.
3. There is no need to discuss results with the patient.
4. If a test is needed, it should be ordered regardless of risk to the patient. - 3. Answer:
1 Page: 3
Feedback
1.
The nurse practitioner should have a plan for the use of each test result value obtained.
2.
When considering which laboratory tests to order, it is worth remembering the doctrine primum nonnocere—
first, do no harm.
3.
Once laboratory tests are available for review, tests results should be discussed with the patient, with
abnormal test results interpreted for the aging individual and addressed with the patient and caregivers.
4.
Any risks involved in laboratory testing must be considered concerning the patient's clinical condition
and weighed against the test's expected benefits.
4. Janey, 25 years old, may experience arthritis differently than 65-year-old Mrs. Johnson because:
1. The body undergoes physiological changes with aging.
2. A healthy body does not experience significant changes as one gets older.
3. Older patients do not feel any systemic symptoms, such as malaise and weight loss.
4. Even though the same joints are usually affected, age makes it feel different. - 4. Answer: 1
Page: 5
Feedback
1.
Knowledge of the bimodality of age onset of certain disease conditions will aid the advanced practice
nurse in avoiding misdiagnosis or delay in diagnosis due to lack of recognition.
2.
1. Mrs. Smith, 75 years old, reports that she is weak, has difficulty urinating, and is dehydrated.
Although she is afebrile, the nurse conducts a thorough physical examination, including urinalysis and
complete blood count (CBC). The total assessment is necessary because:
1. All body systems interact, and symptoms could indicate a variety of diagnoses.
2. The symptoms are vague and may be signs of aging.
3. There may be other signs or symptoms more indicative of the condition.
4. Mrs. Smith may not be reporting all significant information. - 1. Answer: 1
Page: 2
Feedback
1.
The clinician must be aware that all the systems interact and, in doing so, can increase the older
person's vulnerability to illness/disease.
2.
The nurse must not attribute symptoms only to the aging process.
3.
There may be comorbidities accompanying this condition.
4.
Assumptions of not reporting properly may not be true.
2. A patient with renal disease has blood work drawn, and the results show an increase in serum
creatinine. The nurse practitioner needs to know which of the following laboratory values before
ordering medications?
1. CBC
2. Culture and sensitivity of the urine
3. Creatinine clearance
4. Uric acid levels - 2. Answer: 3
Page: 3
Feedback
1.
A CBC will not evaluate kidney function for a patient with renal disease.
2.
, A culture and sensitivity test reflects the presence of an infection and the antibiotic to which the
organism is sensitive.
3.
The calculation of creatinine clearance provides an estimation of renal function.
4.
Uric acid level is elevated in the presence of gout.
3. Which of the following statements is true regarding diagnostic testing?
1. A test is ordered for a specific purpose.
2. A test is the most invasive available.
3. There is no need to discuss results with the patient.
4. If a test is needed, it should be ordered regardless of risk to the patient. - 3. Answer:
1 Page: 3
Feedback
1.
The nurse practitioner should have a plan for the use of each test result value obtained.
2.
When considering which laboratory tests to order, it is worth remembering the doctrine primum nonnocere—
first, do no harm.
3.
Once laboratory tests are available for review, tests results should be discussed with the patient, with
abnormal test results interpreted for the aging individual and addressed with the patient and caregivers.
4.
Any risks involved in laboratory testing must be considered concerning the patient's clinical condition
and weighed against the test's expected benefits.
4. Janey, 25 years old, may experience arthritis differently than 65-year-old Mrs. Johnson because:
1. The body undergoes physiological changes with aging.
2. A healthy body does not experience significant changes as one gets older.
3. Older patients do not feel any systemic symptoms, such as malaise and weight loss.
4. Even though the same joints are usually affected, age makes it feel different. - 4. Answer: 1
Page: 5
Feedback
1.
Knowledge of the bimodality of age onset of certain disease conditions will aid the advanced practice
nurse in avoiding misdiagnosis or delay in diagnosis due to lack of recognition.
2.
