m m m m m m m
E OF OLDER ADULTS 3RD EDITION KENNEDY-MALONE
m m m m m m
,1. Mrs.mSmith,m75myearsmold,mreportsmthatmshemismweak,mhasmdifficultymurinating,mandmismdehydrated.
mAlthoughmshemismafebrile,mthemnursingmattendantmconductsmamthoroughmphysical mexamination,mincludi
ngmurinalysismandmcompletembloodmcountm(CBC).mThemtotalmassessmentmismnecessarymbecause:
1. Allmbodymsystemsminteract,mandmsymptomsmcouldmindicatemamvarietymofmdiagnoses.
2. Themsymptomsmaremvaguemandmmaymbemsignsmofmaging.
3. Theremmaymbemothermsignsmormsymptomsmmoremindicativemofmthemcondition.
4. Mrs.mSmithmmaymnotmbemreportingmallmsignificantminformation.m
-m1.mmACCURATEmANSWER:->1mPg:m2
Reasoning
:->>>m1.
Themclinicianmmustmbemawaremthatmallmthemsystemsminteractmand,minmdoingmso,mcanmincreasemthemoldermp
erson'smvulnerabilitymtomillness/disease.
2.
Themnursingmattendantmmustmnotmattributemsymptomsmonlymtomth
emagingmprocess.m3.
Theremmaymbemcomorbiditiesmaccompanyingmthismconditio
n.m4.
Assumptionsmofmnotmreportingmproperlymmaymnotmbemtrue.
2. Amhospitalmclientmwithmrenalmdiseasemhasmbloodmworkmdrawn,mandmthemresultsmshowmanmincre
aseminmserummcreatinine.mThemnursingmattendantmpractitionermneedsmtomknowmwhichmofmthemfoll
owingmlaboratorymvaluesmbeforemorderingmmedications?
1. CBC
2. Culturemandmsensitivitymofmthemurine
3. Creatininemclearance
4. Uricmacidmlevelsm-
m2.mmACCURATEmANSWER:->3m Pg:m3
Reasoning
:->>>m1.
AmCBCmwillmnotmevaluatemkidneymfunctionmformamhospitalmclientmwithmre
nalmdisease.m2.
,Amculturemandmsensitivitymtestmreflectsmthempresencemofmanminfectionmandmthemantibioticmtomwhichmthemo
rganismmismsensitive.
3.
Themcalculationmofmcreatininemclearancemprovidesmanmestimationmofmrenalmfuncti
on.m4.
Uricmacidmlevelmismelevatedminmthempresencemofmgout.
3.mWhichmofmthemfollowingmstatementsmismtruemregardingmdiagnosticmtesting?
1. Amtestmismorderedmformamspecificmpurpose.
2. Amtestmismthemmostminvasivemavailable.
3. Theremismnomneedmtomdiscussmresultsmwithmthemhospitalmclient.
4. Ifmamtestmismneeded,mitmshouldmbemorderedmregardlessmofmriskmtomthemhospitalmclient.m–
5. 3.mmACCURATEmANSWER:->1mPg:m3
Reasoning
:->>>m1.
Themnursingmattendantmpractitionermshouldmhavemamplanmformthemusemofmeachmtest
mresult mvaluemobtained.m2.
Whenmconsideringmwhichmlaboratorymtestsmtomorder,mitmismworthmrememberingmthemdoctrinemprimummnomnnoce
re—mfirst,mdomnomharm.
3.
Oncemlaboratorymtestsmaremavailablemformreview,mtestsmresultsmshouldmbemdiscussedmwithmthemhospital
mclient,mwithmabnormalmtestmresultsminterpretedmformthemagingmindividualmandmaddressedmwithmthemhosp
italmclientmandmnursingmattendants.m4.
Anymrisksminvolvedminmlaboratorymtestingmmustmbemconsideredmconcerningmthemhospitalmclient'smclinic
almconditionmandmweighedmagainstmthemtest'smexpectedmbenefits.
4.mJaney,m25myearsmold,mmaymexperiencemarthritismdifferentlymthanm65-year-oldmMrs.mJohnsonmbecause:
1. Thembodymundergoesmphysiologicalmchangesmwithmaging.
2. Amhealthymbodymdoesmnotmexperiencemsignificantmchangesmasmonemgetsmolder.
3. Oldermhospitalmclientsmdomnotmfeelmanymsystemicmsymptoms,msuchmasmmalaisemandmweightmloss.
4. Evenmthoughmthemsamemjointsmaremusuallymaffected,magemmakesmitmfeelmdifferent
.m-m4.mmACCURATEmANSWER:->1mPg:m5
Reasoning
:->>>m1.
Knowledgemofmthembimodalitymofmagemonsetmofmcertainmdiseasemconditionsmwillmaidmthemadvancedmpracticemn
ursingmattendantminmavoidingmmisdiagnosismormdelayminmdiagnosismduemtomlackmofmrecognition.
2.
Symptomsmofmrheumatoidmarthritismmaymbemdifferentmdependingmonmthemagemofmthemhospitalmclient.
, 3.
Youngermhospitalmclientsmmaymnotmexperiencemconstitutionalmsymptomsmsuchmasmfever,mmalaise,mweightmlos
s,mandmdepression.
4.
Inmlate-onsetmrheumatoidmarthritis,mthemjointminvolvementmismmoremoftenminmthemlargermjoints.
5. Themnursingmattendantmpractitionermismexaminingmanm85-year-
oldmmanmwithmreportsmofmabdominalmpain,mweakness,mandmlossmofmappetite.mWhichmismthemmost
mlikelymconditionmtombemtestedmformand mruledmout?
1. Neoplasmsmandmcarcinomas
2. Partialmseizure
3. Sarcopenia
4. Hirschsprung'smdiseasem-
m5. mmACCURATEmANSWER:->1m Pg:m4
Reasoning
:->>>m1.
Certainmdiseases,msuchmasmneoplasmsmandmcarcinomas,maremmoremcommonminmthemelderly,mandmanmund
erstandingmofmthemepidemiologymismcriticalminmtheminterpretation.
2.
Partialmseizuremismmoremcommonminmearlymoldma
ge.m3.
Sarcopeniamismmoremcommonminmearlymoldma
ge.m4.
Hirschsprung'smdiseasemismmostmcommonminminfancy.
6. Formindividualsmoverm65myearsmold,mthemmostmcommonmmorbiditiesmaremrelatedmto:
1. Heartmdisease,marthritis
2. Respiratorymproblems,mcancer
3. Diabetes,mstroke
4. Allmofmthesemaremcommonmmorbidities.m-
m6. mmACCURATEmANSWER:->4mPg:m5
Reasoning
:->>>m1.
Heartmdiseasemismonemofmthemcommonmmorbiditi
es.m2.
Cancermismcommonminmthemgeneralmpopulation;mhowever,mspecificmtypesmaremmoremcommonminmthemold
ermhospitalmclient.
3.
Diabetesmismcommonminmhospitalmclientsmoverm40myearsmofmage.