Deck 3: Physiologic Changes

Question 1

What are Heberden nodes?

A) Yellow longitudinal lines in the nails
B) Thickened discolored fingernails
C) Darkened areas under the fingernail
D) Bony enlargements of distal joints of the fingers

Answer 1

Bony enlargements of distal joints of the fingers

Question 2

What is a cause of pernicious anemia?

A) An iron deficiency
B) A deficiency of vitamin B₁₂
C) Low serum potassium level
D) Blood loss

Answer 2

A deficiency of vitamin B₁₂

Question 3

The nurse is accompanying a group of older adults on a July 4th outing to monitor heat prostration. What factor is related to heat intolerance in the older adult?

A) An increase in melanin
B) A reduction of perspiration
C) A reduction in body temperature
D) Increased capillary fragility

Answer 3

A reduction of perspiration

Question 4

What would be the most helpful response to a 70-year-old postmenopausal woman who asks whether her hormone replacement therapy (HRT) will prevent bone loss?

A) "No. HRT is not helpful after the age of 60."
B) "Yes. HRT will prevent bone loss but can cause a stroke, heart attack, or breast cancer."
C) "No. HRT is reliant on some natural estrogen production from the ovaries."
D) "Yes. HRT is a widely accepted therapy for prevention of bone loss."

Question 5

Which care plan modification would be the most beneficial for a 62-year-old woman who is suffering from a flare in her rheumatoid arthritis?

A) Increase fluid intake
B) Schedule several rest periods to balance activity
C) Reduce salt in the diet
D) Assist with rigorous finger extension exercises

Question 6

Which symptom would be a characteristic of a stage I pressure ulcer on an older adult's coccyx?

A) Clear blister
B) Nonblanchable area of erythema
C) Scaly abraded area
D) Painful reddened area

Question 7

The nurse cautions the Certified Nursing Assistants (CNAs) to use care when transferring or handling older adults. The nurse understands that the vascular fragility of the older adult can result in which of the following conditions?

A) Altered blood pressure
B) Pressure ulcers
C) Pruritus
D) Senile purpura

Question 8

A person with Parkinsons disease has a nursing diagnosis of "nutrition, less than body requirements related to difficulty swallowing." What change would the nurse make in the nursing care plan?

A) Feed the patient at each meal.
B) Place the patient in a semi-Fowler position for mealtime.
C) Offer a thick, high-nutrition shake as a snack.
D) Encourage the patient to drink a sip of water after each bite of solid food.

Question 9

A 75-year-old male is worried that his wartlike dark macules with distinct borders are melanomas. What would be the most likely cause for the macules?

A) Senile lentigo
B) Cutaneous papillomas
C) Seborrheic keratoses
D) Xerosis

Question 10

What is the pathophysiology of a myocardial infarct?

A) A portion of the myocardium necroses and scars over.
B) The coronary vessels are narrowed during the attack.
C) The ischemic myocardium causes pain during the attack but is able to regenerate.
D) There is damage to the myocardium but no serious alteration of cardiac output.

Question 11

A 70-year-old woman asks, "How in the world can my bones be brittle when I eat all the right foods?" Which response by the nurse would be the most informative?

A) "Calcium loss is expected in the older adult."
B) "Calcium is continuously withdrawn from bone for nerve and muscle function."
C) "Smoking and alcohol consumption speed calcium loss from the bones."
D) "Walking and standing increase calcium loss from the bone."

Question 12

The Certified Nursing Assistant (CNA) caring for an older adult asks if the yellow, waxy, crusty lesions on the patient's axilla and groin are contagious. Which response shows the nurse's understanding for the cause of the lesions?

A) "Yes. It is cellulitis caused by bacteria."
B) "No. It is seborrheic dermatitis caused by excessive sebum."
C) "Yes. It is an indication of scabies."
D) "No. It is the lesion seen with basal cell carcinoma."

Question 13

Why would a nurse lead a group of postmenopausal women on a daily 15-minute "walking tour" through the long-term care facility?

A) To improve bone strength
B) To orient them to their surroundings
C) To improve their socialization
D) To increase their appetite

Question 14

A 70-year-old woman complains, "I weigh exactly the same as I did when I wore a size 10 and now I can barely squeeze into a size 16." Which statement by the nurse would most correctly explain the size change to the woman?

A) "Metabolism in the older adult creates increased adipose tissue."
B) "Postmenopausal women gain adipose tissue related to loss of calcium."
C) "Decrease in muscle mass is replaced with adipose tissue."
D) "Kyphosis causes a redistribution of weight."

Question 15

A person who experienced a hemorrhagic cardiac vascular accident (CVA) to the left hemisphere would demonstrate which type of symptoms?

A) Language disturbances
B) Poor impulse control
C) Inappropriate affect
D) Confabulation

Question 16

What is the pathophysiology of emphysema?

A) Constriction of the bronchial tree, excessive mucus, and nonproductive cough
B) Calcification of the alveoli and a dry cough
C) Overinflation of the alveoli, making them ineffective for gas exchange
D) Inflammation of the trachea and bronchioles, excessive mucus, and productive cough

Question 17

Which of the following assessments are the cardinal signs and symptoms of congestive heart failure?

A) Dyspnea and edema
B) Myocardial pain and hypotension
C) Ventricular arrhythmias and cyanosis
D) Atrial arrhythmias and polycythemia

Question 18

What would be an acceptable alteration in the plan of care for a patient with a hiatal hernia who is experiencing gastrointestinal reflux?

A) Encouraging the patient to lie down after meals
B) Drinking two full glasses of liquid after the evening meal
C) Eating smaller, more frequent meals
D) Using caffeine drinks to assist with digestion

Question 19

The nurse assesses a diabetic patient and finds the patient to be pale, edematous, and listless with a blood urea nitrogen (BUN) level of 35 mg/dL and a creatinine level of 4 mg/dL. What would the results of the nursing assessment indicate?

A) Diverticulitis
B) Congestive heart failure
C) Chronic renal failure
D) Benign prostatic hypertrophy

Question 20

Why does the nurse modify the environment to keep it warmer for the older adult?

A) A change in the metabolic rate
B) Decreased subcutaneous tissue
C) Changes in the musculoskeletal system
D) A weakened peripheral vascular system

Question 21

What should be avoided by an 82-year-old man with rosacea? (Select all that apply.)

A) Stress
B) Dairy products
C) Sun exposure
D) Spicy foods
E) Alcohol consumption

Question 22

An 80-year-old extended-care resident comes to the nurse asking for a bandage for a bleeding, dark pigmented mole with irregular shape and border. What does the nurse suspect?

A) Melanoma
B) Basal cell carcinoma
C) Cutaneous papilloma
D) Senile lentigo

Question 23

The nurse is aware that children with __________ have the treatment and care needs of persons of advanced age.

Question 24

How should the nurse provide written discharge instructions for a patient with macular degeneration?

A) Write the instructions in bold print.
B) Adjust the table and light to assist the patient to use peripheral vision to read.
C) Place written document directly in front of the patient to read.
D) Read the document to the patient.

Question 25

Arrange these common diseases of the older adult in order of their mortality rate. (Separate letters by a comma and space as follows: A, B, C, D)

A) Cancer
B) Pneumonia
C) Stroke
D) Chronic obstructive pulmonary disease (COPD)
E) Heart disease

Question 26

When a 75-year-old male resident in an extended-care facility tells the nurse he wants to build up the muscles in his arms, the nurse recommends a(n) __________ exercise program.

Question 27

What is a symptom of inadequate insulin coverage in a patient with diabetes mellitus type I?

A) Diminished urine output
B) Ketones in the urine
C) Shallow and slow respirations
D) Extreme diaphoresis

Question 28

What vitamins are necessary to support ossification? (Select all that apply.)

A) A
B) B?
C) C
D) D
E) E

Question 29

The 75-year-old resident in a long-term care facility complains of muscle pain while riding a stationary bicycle. The nurse explains that the discomfort is related to the buildup of __________ __________ in the muscle.

Question 30

What age-related changes in the respiratory system explain why the older adult is at risk for infection? (Select all that apply.)

A) Reduced ciliary movement
B) Decrease in alveolar elasticity
C) Pooling of secretions
D) Flattened diaphragm
E) Calcification of costal cartilage

Question 31

What factors influence the timing and extent of age-related changes? (Select all that apply.)

A) Health maintenance
B) Ethnicity
C) Heredity
D) Attitude
E) Environment

Question 32

What are risk factors for osteoporosis? (Select all that apply.)

A) Menopause
B) Smoking
C) White female
D) Excessive high-impact exercise
E) Long-term use of phenytoin (Dilantin)