Deck 1: Changes With Aging

Question 1

Mr.Adams is 90 years old.In the last few months he appears unable to comply with the health-care plan developed by the nurse practitioner.The nurse practitioner considers which of the following reasons for noncompliance when updating his home care plan? Select all that apply.
1)Polypharmacy
2)Treatment burden
3)Attending multiple appointments
4)Affording complex drug regimens
5)Cognitive ability only

Answer 1

1, 2, 3, 4

Question 2

A 70-year-old man is seeing a nurse practitioner because he is feeling weak and dizzy.The nurse practitioner is discussing a care plan with him and makes which of the following statements? Select all that apply.
1)I want to order a test for your heart to evaluate its function.
2)I will perform a thorough examination of your functional abilities.
3)I will order a blood sugar test to check for diabetes.
4)Many older people feel this way.It is to be expected.
5)I will assess you for the presence of other conditions.

Answer 2

1, 2, 3, 5

Question 3

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.

Answer 3

1

Question 4

The nurse practitioner performs a thorough systemic examination of a patient who reports diarrhea and pain in the upper left quadrant of the abdomen.One possible diagnosis would be:
1)Hirschsprung's disease
2)Pancreatitis
3)Appendicitis
4)Gastrointestinal inflammatory bowel disease (GIBD)

Question 5

An elderly couple is discussing health concerns with the nurse practitioner.The couple is concerned that each of their individual blood studies show different results.One set of test results shows a significant decrease in blood sugar, but the test results of the partner does not show an equal decrease.Their physician does not seem concerned, and the couple is wondering why.How is it best for the nurse practitioner to respond? Select all that apply.
1)Studies show that each person's pattern of chemical make-up is different.
2)There is no difference between one person's range of blood results and that of any other person.
3)Each person's chemical make-up is the same as that of others of the same gender and age group.
4)Many factors affect an individual's chemical make-up.
5)Ranges of the values provided by the laboratory are correct for any age.

Question 6

Mrs.Smith is 75 years old and has had type 2 diabetes for 30 years.She sees her nurse practitioner on a regular basis.Mrs.Smith asks the nurse practitioner why her treatment has not been changed, even though her laboratory values are seemingly out of normal range.Which of the following are best? Select all that apply.
1)A decision to make changes must be based on a pattern and not on one set of laboratory results.
2)The normal range charts are based on patients younger than 75 years.
3)Currently, it is too expensive to change your treatment.
4)Comparing new results with your prior results gives a more accurate picture.
5)Normal values for laboratory tests differ as one gets older.

Question 7

The nurse practitioner is examining an 85-year-old man with reports of abdominal pain, weakness, and loss of appetite.Which is the most likely condition to be tested for and ruled out?
1)Neoplasms and carcinomas
2)Partial seizure
3)Sarcopenia
4)Hirschsprung's disease

Question 8

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

Question 9

For individuals over 65 years old, the most common morbidities are related to:
1)Heart disease, arthritis
2)Respiratory problems, cancer
3)Diabetes, stroke
4)All of these are common morbidities.

Question 10

The nurse practitioner is leading a class of seniors over age 65 years and is teaching about nutritional needs.One of the men asks why, even though he eats correctly according to the standards presented, he still feels weaker than he did 10 years ago.He also wonders why he gets more infections than he used to.Which of the following are helpful ? Select all that apply.
1)I suggest that you exercise a little more than you are currently doing.
2)Some people experience a decrease in reserve energy.
3)For some people, the immune system weakens.
4)More viruses are being spread throughout the community.
5)I suggest that you see your primary caregiver for extensive testing.

Question 11

A gerontological patient is being examined for a report of pain in the shoulder.The nurse practitioner completes a thorough systemic examination because:
1)Older patients with one morbidity often express difficulties in general.
2)Arthritis of the shoulder is accompanied by other neurological symptoms.
3)Older patients with arthritis often experience pain in lower extremities.
4)The patient may not report significant signs and symptoms.

Question 12

Adam, 70 years old, is admitted for possible myasthenia gravis (MG).The nurse practitioner knows that MG is commonly seen in women between 20 and 40 years old.Adam, however, is experiencing an ocular form of MG, has dysphonia, and does not have any thymus abnormalities.Adam asks why the nurse is concerned about MG since he is older and this is a "young person's disease." Which of the following are the best ? Select all that apply.
1)We need to assess for anything, just in case.
2)Some diseases show up in two different age and gender groups.
3)Older people often experience weakness, and we must rule out other conditions.
4)Your insurance will cover this, and we want to rule out as much as possible.
5)Signs and symptoms of illness are the same for each disease regardless of age.

Question 13

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.

Question 14

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.

Question 15

An older woman is seen in the ambulatory clinic for a routine checkup.The patient asks about results of her blood work compared to last year's results.How is it best for the clinician to respond? Select all that apply.
1)They are likely to be the same if you have had no diseases since then.
2)Blood work results may be different just because of your aging process.
3)Your results may be different because the body changes with disease and medications you are taking.
4)Blood work is not a reliable indicator of health because many things can affect your health that may not show up in the results of your blood work.
5)There is likely no significant difference as your body remains stable in its functioning.