Question : The major impact of the physiological changes that occur with
aging is:
Student Reduced physiological reserve
Answer:
Reduced homeostatic mechanisms
Impaired immunological response
All of the above
Instructor The major impact of all of these physiological changes can be highlighted
Explanation: with three primary points. First, there is a reduced physiological reserve of
most body systems, particularly cardiac, respiratory, and renal. Second, there
are reduced homeostatic mechanisms that fail to adjust regulatory systems
such as temperature control and fluid and electrolyte balance. Third, there is
impaired immunological function: infection risk is greater, and autoimmune
diseases are more prevalent. (Kennedy-Malone 3)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 2 of 2
Comments:
Question 2. Question : Men have faster and more efficient biotransformation of drugs and
this is thought to be due to:
Student Less obesity rates than women
Answer:
Prostate enlargement
Testosterone
Less estrogen than women
Instructor Men have faster and more efficient biotransformation, presumably because
Explanation: of serum testosterone. Conditions of increased or decreased liver perfusion
alter the overall level of the drug that is absorbed and how it is metabolized.
(Kennedy-Malone 5)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
, Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 2 of 2
Comments:
Question 3. Question : The cytochrome p system involves enzymes that are generally:
Student Inhibited by drugs
Answer:
Induced by drugs
Inhibited or induced by drugs
Associated with decreased liver perfusion
Instructor Biotransformation occurs in all body tissues but primarily in the liver,
Explanation: where enzymatic activity (cytochrome P [CYP] system) alters and
detoxifies the drug and prepares it for excretion. (Kennedy-Malone 5)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 2 of 2
Comments:
Question 4. Question : Functional abilities are best assessed by:
Student Self-report of function
Answer:
Observed assessment of function
A comprehensive head-to-toe examination
Family report of function
Instructor Two well-established tools used to evaluate function in older adults are the
Explanation: Katz Activities of Daily Living Scale (Katz et al., 1963) and the Lawton and
, Brody scale for Instrumental Activities of Daily Living (Lawton & Brody,
1969). It is important to be cautious about self-report of function (rather than
direct observation of function) and to ask, “Do you …?” instead of “Can you
…?” in order to determine if patients actually perform the activity.
(Kennedy-Malone 40)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 2 of 2
Comments:
Question 5. Question : Iron Deficiency Anemia (IDA) is classified as a microcytic,
hypochromic anemia. This classification refers to which of the
following laboratory data?
Student Answer: Hemoglobin and Hematocrit
Mean Corpuscular Volume (MCV) and Mean Corpuscular
Hemoglobin (MCH)
Serum ferritin and serum iron
Total iron binding capacity and transferrin saturation
Instructor RBC indices reveal an MCV (mean corpuscular volume/RBC size) that
Explanation: will be decreased to <80 fL in adults; MCH (mean corpuscular
hemoglobin/RBC color) will show hypochromia or pale cells; RBC
distribution width (RDW)/volume variation will be increased.
(Kennedy-Malone page 519)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank.
Advanced Practice Nursing in the Care of Older Adults. F.A. Davis
Company, 2014-01-14. VitalBook file.
Points Received: 0 of 2
Comments:
, Question 6. Question : When interpreting laboratory data, you would expect to see the
following in a patient with Anemia of Chronic Disease (ACD):
Student Hemoglobin <12 g/dl, MCV decreased, MCH decreased
Answer:
Hemoglobin >12 g/dl, MCV increased, MCH increased
Hemoglobin <12 g/dl, MCV normal, MCH normal
Hemoglobin >12 g/dl, MCV decreased, MCH increased
Instructor Hemoglobin (Hgb): <12 g/dL (120 g/L) women <13 g/dL (130 g/L) men
Explanation: Rarely <10 g/dL (100 g/L) Mean corpuscular volume: 80–96 mcm3
(normocytic) Mean corpuscular hemoglobin Normochromic (normal color)
RBC distribution width: normal (Kennedy-Malone page 517)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 0 of 2
Comments:
Question 7. Question : The pathophysiological hallmark of ACD is:
Student Depleted iron stores
Answer:
Impaired ability to use iron stores
Chronic uncorrectable bleeding
Reduced intestinal absorption of iron
Instructor The pathophysiological hallmark of ACD is a disregulation of iron
Explanation: homeostasis, characterized by an increased uptake and retention of iron
within the cells of the reticuloendothelial system (liver/spleen), resulting in
decreased RBC production. Essentially, iron is present but inaccessible for
use in the production of Hgb with the erythrocytes (Bross et al., 2010). A
shortened RBC survival is also a contributing factor to ACD. (Kennedy-
Malone page 516-517)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
aging is:
Student Reduced physiological reserve
Answer:
Reduced homeostatic mechanisms
Impaired immunological response
All of the above
Instructor The major impact of all of these physiological changes can be highlighted
Explanation: with three primary points. First, there is a reduced physiological reserve of
most body systems, particularly cardiac, respiratory, and renal. Second, there
are reduced homeostatic mechanisms that fail to adjust regulatory systems
such as temperature control and fluid and electrolyte balance. Third, there is
impaired immunological function: infection risk is greater, and autoimmune
diseases are more prevalent. (Kennedy-Malone 3)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 2 of 2
Comments:
Question 2. Question : Men have faster and more efficient biotransformation of drugs and
this is thought to be due to:
Student Less obesity rates than women
Answer:
Prostate enlargement
Testosterone
Less estrogen than women
Instructor Men have faster and more efficient biotransformation, presumably because
Explanation: of serum testosterone. Conditions of increased or decreased liver perfusion
alter the overall level of the drug that is absorbed and how it is metabolized.
(Kennedy-Malone 5)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
, Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 2 of 2
Comments:
Question 3. Question : The cytochrome p system involves enzymes that are generally:
Student Inhibited by drugs
Answer:
Induced by drugs
Inhibited or induced by drugs
Associated with decreased liver perfusion
Instructor Biotransformation occurs in all body tissues but primarily in the liver,
Explanation: where enzymatic activity (cytochrome P [CYP] system) alters and
detoxifies the drug and prepares it for excretion. (Kennedy-Malone 5)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 2 of 2
Comments:
Question 4. Question : Functional abilities are best assessed by:
Student Self-report of function
Answer:
Observed assessment of function
A comprehensive head-to-toe examination
Family report of function
Instructor Two well-established tools used to evaluate function in older adults are the
Explanation: Katz Activities of Daily Living Scale (Katz et al., 1963) and the Lawton and
, Brody scale for Instrumental Activities of Daily Living (Lawton & Brody,
1969). It is important to be cautious about self-report of function (rather than
direct observation of function) and to ask, “Do you …?” instead of “Can you
…?” in order to determine if patients actually perform the activity.
(Kennedy-Malone 40)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 2 of 2
Comments:
Question 5. Question : Iron Deficiency Anemia (IDA) is classified as a microcytic,
hypochromic anemia. This classification refers to which of the
following laboratory data?
Student Answer: Hemoglobin and Hematocrit
Mean Corpuscular Volume (MCV) and Mean Corpuscular
Hemoglobin (MCH)
Serum ferritin and serum iron
Total iron binding capacity and transferrin saturation
Instructor RBC indices reveal an MCV (mean corpuscular volume/RBC size) that
Explanation: will be decreased to <80 fL in adults; MCH (mean corpuscular
hemoglobin/RBC color) will show hypochromia or pale cells; RBC
distribution width (RDW)/volume variation will be increased.
(Kennedy-Malone page 519)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank.
Advanced Practice Nursing in the Care of Older Adults. F.A. Davis
Company, 2014-01-14. VitalBook file.
Points Received: 0 of 2
Comments:
, Question 6. Question : When interpreting laboratory data, you would expect to see the
following in a patient with Anemia of Chronic Disease (ACD):
Student Hemoglobin <12 g/dl, MCV decreased, MCH decreased
Answer:
Hemoglobin >12 g/dl, MCV increased, MCH increased
Hemoglobin <12 g/dl, MCV normal, MCH normal
Hemoglobin >12 g/dl, MCV decreased, MCH increased
Instructor Hemoglobin (Hgb): <12 g/dL (120 g/L) women <13 g/dL (130 g/L) men
Explanation: Rarely <10 g/dL (100 g/L) Mean corpuscular volume: 80–96 mcm3
(normocytic) Mean corpuscular hemoglobin Normochromic (normal color)
RBC distribution width: normal (Kennedy-Malone page 517)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
01-14. VitalBook file.
Points Received: 0 of 2
Comments:
Question 7. Question : The pathophysiological hallmark of ACD is:
Student Depleted iron stores
Answer:
Impaired ability to use iron stores
Chronic uncorrectable bleeding
Reduced intestinal absorption of iron
Instructor The pathophysiological hallmark of ACD is a disregulation of iron
Explanation: homeostasis, characterized by an increased uptake and retention of iron
within the cells of the reticuloendothelial system (liver/spleen), resulting in
decreased RBC production. Essentially, iron is present but inaccessible for
use in the production of Hgb with the erythrocytes (Bross et al., 2010). A
shortened RBC survival is also a contributing factor to ACD. (Kennedy-
Malone page 516-517)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-
