Advanced Practice Nursing in the Care of Older Adults – 3rd Edition Kennedy-Malone, Graduate Nursing Program – Complete Test Bank

TEST BANK ADVANCED PRACTICE NURSING IN THE CARE
OF OLDER ADULTS 3RD EDITION KENNEDY-MALONE

,1. Mrs. Smith, 75 years old, reports that she is weak, has difficulty urinating, and is dehydrated.
Although she is afebrile, the nursing attendant conducts a thorough physical examination, including
urinalysisand 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.
ACCURATE ANSWER:->1 Pg: 2



Reasoning
:->>> 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 nursing attendant must not attribute symptoms only to the
agingprocess. 3.
There may be comorbidities accompanying this condition.
4.
Assumptions of not reporting properly may not be true.

2.A hospital client with renal disease has blood work drawn, and the results show an increase in
serum creatinine. The nursing attendant 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. ACCURATE
ANSWER:->3Pg: 3


Reasoning
:->>> 1.
A CBC will not evaluate kidney function for a hospital client 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 hospital client.
4. If a test is needed, it should be ordered regardless of risk to the hospital client. –
5. 3. ACCURATE ANSWER:->1 Pg: 3


Reasoning
:->>> 1.
The nursing attendant practitioner should have a plan for the use of each test
result valueobtained. 2.
When considering which laboratory tests to order, it is worth remembering the doctrine primum no nnocere—
first, do no harm.
3.
Once laboratory tests are available for review, tests results should be discussed with the hospital
client, with abnormal test results interpreted for the aging individual and addressed with the hospital
client and nursing attendants.4.
Any risks involved in laboratory testing must be considered concerning the hospital client's clinical
conditionand 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 hospital clients 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.
ACCURATE ANSWER:->1 Pg: 5


Reasoning
:->>> 1.
Knowledge of the bimodality of age onset of certain disease conditions will aid the advanced practicenursing
attendant in avoiding misdiagnosis or delay in diagnosis due to lack of recognition.
2.
Symptoms of rheumatoid arthritis may be different depending on the age of the hospital client.

, 3.
Younger hospital clients may not experience constitutional symptoms such as fever, malaise, weight loss,
anddepression.
4.
In late-onset rheumatoid arthritis, the joint involvement is more often in the larger joints.

5. The nursing attendant 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 - 5. ACCURATE
ANSWER:->1Pg: 4


Reasoning
:->>> 1.
Certain diseases, such as neoplasms and carcinomas, are more common in the elderly, and an
understanding of the epidemiology is critical in the interpretation.
2.
Partial seizure is more common in early old age.
3.
Sarcopenia is more common in early old age.
4.
Hirschsprung's disease is most common in infancy.

6. 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. - 6.
ACCURATE ANSWER:->4 Pg: 5


Reasoning
:->>> 1.
Heart disease is one of the common morbidities.
2.
Cancer is common in the general population; however, specific types are more common in the older
hospital client.
3.
Diabetes is common in hospital clients over 40 years of age.