NUR 321 CHAPTER QUESTIONS WITH ACCURATE
ANSWERS
A 76-year-old patient tells the nurse that he notices he is having trouble hearing,
especially in large groups. He continues to say he cannot always tell where the
sound is coming from, and the words often sound "mixed up." The nurse should
suspect which of the following as the cause for this change?
1. Atrophy of the apocrine glands
2. Cilia in the ear becoming coarse and stiff
3. Nerve degeneration in the inner ear
4. Scarring of the tympanic membrane correct answer 3. Nerve degeneration in
the inner ear
Rationale: Sensorineural hearing loss is a manifestation of problems within the
inner ear. Sound is transmitted to the inner ear, but problems with the cochlea
and auditory nerve (eighth cranial nerve) create sound distortion.
A 78-year-old patient is admitted to the emergency department (ED) via
emergency medical service (EMS) with complaints of severe diarrhea with
resultant weakness and signs of dehydration. Discussion with the significant other
reveals that the patient continuously eats spoiled foods. Which of the following
may be most directly related to this patient's behavior?
1. Damage to cranial nerve I
2. Damage to cranial nerve II
3. Damage to cranial nerve III
4. Damage to cranial nerve IV correct answer 1. Damage to cranial nerve I
,Rationale: Structural alterations of the upper airway, olfactory tract and bulb,
hippocampus, amygdaloid complex, and hypothalamus also have been observed
in older adults as contributing factors for diminished sense of smell, or hyposmia.
Although hyposmia may be due to age-related changes, it might also be the result
of olfactory nerve damage, which is cranial nerve I, because this nerve is the sole
innervation for smell.
A 78-year-old patient with Type 2 diabetes mellitus is 30 pounds overweight and
has an HbA1c of 8.5, a high serum LDL level, and a high serum triglyceride level.
Which oral antihyperglycemic agent would the nurse anticipate that he would be
taking?
1. Acarbose/Precose (Alpha-glucosidase inhibitors)
2. Glyburide/Micronase (Sulfonylurea)
3. Metformin/Glucophage (Biguanide)
4. Rosiglitazone/Avandia (Thiazolidinediones) correct answer 3.
Metformin/Glucophage (Biguanide)
Rationale: Metformin reduces HbA1c levels by 1% to 2% with additional benefits
of mild weight loss and improvement in lipid profiles. Sulfonylureas have an
increased risk of causing hypoglycemia in the elderly. A side effect of Avandia is
weight loss. Alpha-glucosidase inhibitors generally are used by patients
experiencing only postprandial hyperglycemia.
A baccalaureate prepared nursing student is reviewing career options available
after graduation. The student has a longstanding interest in the care of older
adults. The nurse is interested in pursuing opportunities related to practitioner
,roles. Which statements regarding this potential career option are correct? Select
all that apply.
1. A baccalaureate prepared nurse may become a gerontological nurse
practitioner after working at least two years in an applicable setting.
2. The master's degree is the minimum educational preparation required of a
geriatric nurse practitioner.
3. The doctoral degree is the minimum educational preparation required to
become a geriatric nurse practitioner.
4. Some advanced practice nurses may have prescriptive authority.
5. Certification in gerontological nursing is the same as geriatric nurse
practitioner. correct answer 2,4
Rationale: A nurse practitioner is at least master's prepared, and will soon require
doctoral preparation. In some states nurse practitioners have prescriptive
authority. Being certified is different than being licensed as a nurse practitioner.
A client develops severe inflammation of the lower extremity. Which of the
following foods should be included in the diet for this client?
1. Leafy, green vegetables and fluids
2. Carrots and other yellow vegetables
3. Grains, breads, and fluids
4. Citrus fruits, protein, and fluids correct answer 4. Citrus fruits, protein, and
fluids
, Rationale: The diet of the client with inflammation should be high in vitamin C to
aid in the synthesis of collagen, protein to aid in the formation of blood cells and
tissue, and fluids to remove metabolic waste and rehydrate the client.
A client is at the physician's office for an annual physical examination. During the
examination, the client voices resignation about the inevitable changes in his
physical condition as a result of his diabetes. Which of the following responses by
the nurse is most appropriate?
1. "Unfortunately, the changes you are seeing associated with your diabetes are
unavoidable."
2. "What concerns you most?"
3. "Diabetes is a permanent health concern experienced by many of your peers."
4. "Your own behaviors will have the greatest impact on your condition." correct
answer 4. "Your own behaviors will have the greatest impact on your condition."
Rationale: The course of diabetes may be heavily impacted by the behaviors of
the client. Potential changes relating to compliance with diet and medication
regimen will influence the outcome of this chronic disease. While it is important
to investigate the client's concerns this does not exceed the importance of
providing accurate information to the client. Diabetes is a health concern for
many older adults but it may be easily modified or managed with the correct
treatment.
A client reports to the nurse that he has been experiencing dryness of the mouth.
Which of the following medications that the client reports taking at home may be
precipitating this symptom?
1. Hydrochlorithiazide (HCTZ)
ANSWERS
A 76-year-old patient tells the nurse that he notices he is having trouble hearing,
especially in large groups. He continues to say he cannot always tell where the
sound is coming from, and the words often sound "mixed up." The nurse should
suspect which of the following as the cause for this change?
1. Atrophy of the apocrine glands
2. Cilia in the ear becoming coarse and stiff
3. Nerve degeneration in the inner ear
4. Scarring of the tympanic membrane correct answer 3. Nerve degeneration in
the inner ear
Rationale: Sensorineural hearing loss is a manifestation of problems within the
inner ear. Sound is transmitted to the inner ear, but problems with the cochlea
and auditory nerve (eighth cranial nerve) create sound distortion.
A 78-year-old patient is admitted to the emergency department (ED) via
emergency medical service (EMS) with complaints of severe diarrhea with
resultant weakness and signs of dehydration. Discussion with the significant other
reveals that the patient continuously eats spoiled foods. Which of the following
may be most directly related to this patient's behavior?
1. Damage to cranial nerve I
2. Damage to cranial nerve II
3. Damage to cranial nerve III
4. Damage to cranial nerve IV correct answer 1. Damage to cranial nerve I
,Rationale: Structural alterations of the upper airway, olfactory tract and bulb,
hippocampus, amygdaloid complex, and hypothalamus also have been observed
in older adults as contributing factors for diminished sense of smell, or hyposmia.
Although hyposmia may be due to age-related changes, it might also be the result
of olfactory nerve damage, which is cranial nerve I, because this nerve is the sole
innervation for smell.
A 78-year-old patient with Type 2 diabetes mellitus is 30 pounds overweight and
has an HbA1c of 8.5, a high serum LDL level, and a high serum triglyceride level.
Which oral antihyperglycemic agent would the nurse anticipate that he would be
taking?
1. Acarbose/Precose (Alpha-glucosidase inhibitors)
2. Glyburide/Micronase (Sulfonylurea)
3. Metformin/Glucophage (Biguanide)
4. Rosiglitazone/Avandia (Thiazolidinediones) correct answer 3.
Metformin/Glucophage (Biguanide)
Rationale: Metformin reduces HbA1c levels by 1% to 2% with additional benefits
of mild weight loss and improvement in lipid profiles. Sulfonylureas have an
increased risk of causing hypoglycemia in the elderly. A side effect of Avandia is
weight loss. Alpha-glucosidase inhibitors generally are used by patients
experiencing only postprandial hyperglycemia.
A baccalaureate prepared nursing student is reviewing career options available
after graduation. The student has a longstanding interest in the care of older
adults. The nurse is interested in pursuing opportunities related to practitioner
,roles. Which statements regarding this potential career option are correct? Select
all that apply.
1. A baccalaureate prepared nurse may become a gerontological nurse
practitioner after working at least two years in an applicable setting.
2. The master's degree is the minimum educational preparation required of a
geriatric nurse practitioner.
3. The doctoral degree is the minimum educational preparation required to
become a geriatric nurse practitioner.
4. Some advanced practice nurses may have prescriptive authority.
5. Certification in gerontological nursing is the same as geriatric nurse
practitioner. correct answer 2,4
Rationale: A nurse practitioner is at least master's prepared, and will soon require
doctoral preparation. In some states nurse practitioners have prescriptive
authority. Being certified is different than being licensed as a nurse practitioner.
A client develops severe inflammation of the lower extremity. Which of the
following foods should be included in the diet for this client?
1. Leafy, green vegetables and fluids
2. Carrots and other yellow vegetables
3. Grains, breads, and fluids
4. Citrus fruits, protein, and fluids correct answer 4. Citrus fruits, protein, and
fluids
, Rationale: The diet of the client with inflammation should be high in vitamin C to
aid in the synthesis of collagen, protein to aid in the formation of blood cells and
tissue, and fluids to remove metabolic waste and rehydrate the client.
A client is at the physician's office for an annual physical examination. During the
examination, the client voices resignation about the inevitable changes in his
physical condition as a result of his diabetes. Which of the following responses by
the nurse is most appropriate?
1. "Unfortunately, the changes you are seeing associated with your diabetes are
unavoidable."
2. "What concerns you most?"
3. "Diabetes is a permanent health concern experienced by many of your peers."
4. "Your own behaviors will have the greatest impact on your condition." correct
answer 4. "Your own behaviors will have the greatest impact on your condition."
Rationale: The course of diabetes may be heavily impacted by the behaviors of
the client. Potential changes relating to compliance with diet and medication
regimen will influence the outcome of this chronic disease. While it is important
to investigate the client's concerns this does not exceed the importance of
providing accurate information to the client. Diabetes is a health concern for
many older adults but it may be easily modified or managed with the correct
treatment.
A client reports to the nurse that he has been experiencing dryness of the mouth.
Which of the following medications that the client reports taking at home may be
precipitating this symptom?
1. Hydrochlorithiazide (HCTZ)
