Exam (elaborations) ADVANCED PRACTICE NURSING IN THE CARE OF OLDER ADULTS EDITION 2 TESTBANK LATEST 2021

Exam (elaborations) ADVANCED PRACTICE NURSING IN THE CARE OF OLDER ADULTS EDITION 2 TESTBANK LATEST 2021 Older Adults / Edition 2 TESTBANK Chapter 1. Changes With Aging Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The major impact of the physiological changes that occur with aging is: A. Reduced physiological reserve B. Reduced homeostatic mechanisms C. Impaired immunological response D. All of the above ____ 2. The strongest evidence regarding normal physiological aging is available through: A. Randomized controlled clinical trials B. Cross-sectional studies C. Longitudinal studies D. Case-control studies ____ 3. All of the following statements are true about laboratory values in older adults except: A. Reference ranges are preferable B. Abnormal findings are often due to physiological aging C. Normal ranges may not be applicable for older adults D. Reference values are not necessarily acceptable values ____ 4. Biochemical individuality is best described as: A. Each individual’s variation is often much greater than that of a larger group B. The unique biochemical profile of a selected population C. The truly “normal” individual—falling within average range D. Each individual’s variation is often much smaller than that of a larger group ____ 5. Polypharmacy is best described as taking: A. More than nine medications per day B. More than five medications per day C. Even a single medication if there is not a clear indication for its use D. When a drug is given to treat the side effect of another drug ____ 6. Pharmacokinetic changes with aging are reflective of: A. What the drug does to the body B. What the body does to the drug C. The effect at the site of action and the time and intensity of the drug D. D. The side effects commonly associated with the drug ____ 7. All the following statements are false about drug absorption except: A. Antacids increase the bioavailability of digitalis B. Gastric acidity decreases with age Advanced Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK C. Anticholinergics increase colonic motility D. Underlying chronic disease has little impact on drug absorption ____ 8. All of the following statements are true about drug distribution in the elderly except: A. Drugs distributed in water have lower concentration B. Drugs distributed in fat have less intense, more prolonged effect C. Drugs highly protein bound have greater potential to cause an adverse drug reaction D. The fastest way to deliver a drug to the action site is by inhalation ____ 9. Men have faster and more efficient biotransformation of drugs and this is thought to be due to: A. Less obesity rates than women B. Prostate enlargement C. Testosterone D. Less estrogen than women ____ 10. The cytochrome p system involves enzymes that are generally: A. Inhibited by drugs B. Induced by drugs C. Inhibited or induced by drugs D. Associated with decreased liver perfusion ____ 11. A statement not shown to be true about pharmacodynamics changes with aging is: A. Decreased sensitivity to oral anticoagulants B. Enhanced sensitivity to central nervous system drugs C. Drug responsiveness can be influenced by patient activity level D. There is a decreased sensitivity to beta blockers ____ 12. Atypical presentation of disease in the elderly is reflected by all the following except: A. Infection without fever B. Depression without dysphoric mood C. Myocardial infarction with chest pain and diaphoresis D. Cardiac manifestations of thyroid disease ____ 13. Functional abilities are best assessed by: A. Self-report of function B. Observed assessment of function C. A comprehensive head-to-toe examination D. Family report of function MULTIPLE CHOICE 1.ANS: D PTS: 1 2.ANS: C PTS: 1 3.ANS: B PTS: 1 4.ANS: D PTS: 1 5.ANS: C PTS: 1 6.ANS: B PTS: 1 7.ANS: D PTS: 1 8.ANS: A PTS: 1 9.ANS: C PTS: 1 10.ANS: C PTS: 1 11.ANS: A PTS: 1 12.ANS: C PTS: 1 13.ANS: B PTS: 1 Chapter 2. Health Promotion Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The leading cause of death in elderly travelers worldwide is: A.Cardiovascular disease B.Infections C.Accidents D.Malaria ____ 2. Which of the following should be avoided in countries where food and water precautions are to be observed? A.Hot coffee B.Bottled water C.Salad buffet D.Unpeeled bananas ____ 3. What insect precautions are not necessary to prevent insect-borne diseases in the tropics? A.Using 100% DEET on the skin to prevent bites B.Treating clothes with permethrin C.Covering up exposed skin to lessen biting surface D.Taking malaria pills as directed for areas at risk for malaria ____ 4. An example of secondary prevention you could recommend/order for older adults would be to: A. Check for fecal occult blood B. Wear seat belts in the car C. Provide foot care for a diabetic patient D. Administer a tetanus shot ____ 5. Ali is a 72-year-old man who recently came to the U.S. from Nigeria. He reports having BCG (bacille Calmette-Guerin) vaccination as a child. Which of the following is correct regarding a tuberculin skin test? A. It should not be done at all. B. It should be read as smaller than it really is. C. Vaccination history is irrelevant; read as usual. D. It should be read as larger than it really is. ____ 6. A 72-year-old woman and her husband are on a cross-country driving vacation. After a long day of driving, they stop for dinner. Midway through the meal, the woman becomes very short of breath, with chest pain and a feeling of panic. Which of the following problems is most likely? A. Pulmonary edema B. Heart failure C. Pulmonary embolism D. Pneumonia ____ 7. Ivan W. is a 65-year-old man who is new to your practice. He has a history of COPD, CAD, hypertension, and type 2 diabetes mellitus. He has had no immunizations since his discharge from the military at age 25. Childhood diseases included chickenpox, measles, mumps, and “German measles.” He presents for a disease management visit. Which of the following immunizations would you recommend for Ivan? A. MMR, influenza, pneumococcal, Zostavax B. Influenza, pneumococcal, PPD, Hepatitis B C. Tdap, pneumococcal, influenza, Zostavax D. Hepatitis B, influenza, pneumococcal, Hepatitis A ____ 8. Leo L. is a 62-year-old African American male who comes for an initial visit to your practice. Personal health history includes smoking 1 pack/day since age 11, consuming a case of beer (24 bottles) every weekend, and working as an assembler (sedentary job) for the past 10 years. Family history in first-degree relatives includes hypertension, high cholesterol, heart attack, and type 2 diabetes mellitus. Leo’s BMI is 32; BP today is 130/86. You order a fasting glucose, lipid profile, and return visit for BP check. This is an example of: A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Health profiling ____ 9. A local chapter of a nurse practitioner organization has begun planning a community-based screening for hypertension at a local congregate living facility. This population was selected on the basis of: A. A predicted decreased incidence of high blood pressure in this population B. A recognized element of high risk within this group C. Readily available treatment measures D. Achieving an administrative goal for the congregate living facility ____ 10. Performing range of motion exercises on a client who has had a stroke is an example of which level of prevention? A. Primary prevention B. Tertiary prevention C. Secondary prevention D. Rehabilitation prevention ____ 11. The nurse practitioner demonstrates an understanding of primary prevention of falling among the elderly through which management plan? A. Evaluate a need for assistive devices for ambulation after the client has been injured from a fall. B. Provide resources to correct hazards contributing to falls in the home environment. C. Reinforce the need to use prescribed eyeglasses to prevent further injury from falls. D. Provide information about medications, side effects, and interactions. ____ 12. An example of an active strategy of health promotion for an individual to accomplish would be: A. Maintaining clean water in the local environment B. Introducing fluoride into the water C. Beginning a stress management program D. Maintaining a sanitary sewage system ____ 13. You are working with an older male adult with a long history of alcohol abuse and a 30-year history of smoking. In recommending an intervention for this client, your responsibility is to: A. Make the individual abandon his own health practices and follow your recommendations B. Register the patient for a local intervention program and secure payments C. Promote positive change in lifestyle choices D. Identify the barriers that the client will encounter ____ 14. The four main domains of clinical preventive services that the practitioner will provide are: A. Counseling interventions, screening tests, immunizations, and chemoprophylaxis B. Counseling intervention, screening tests, immunizations, and education C. Counseling interventions, transportation, screening tests, and immunizations D. Screening tests, brief psychotherapy, immunizations, and chemoprophylaxis ____ 15. Which organism that can be prevented by immunization is most often responsible for an infectious “outbreak” in the nursing home setting? A. Haemophilus influenza B. Streptococcus C. Influenza A D. Mycobacterium tuberculosis ____ 16. What is the appropriate method for tuberculosis screening of an older adult entering a nursing home? A. 5 tuberculin units intramuscular PPD injection and if negative repeat with same dose one week later B. 5 tuberculin units intradermal PPD injection and if negative repeat with same dose one week later C. Chest x-ray at the same time of PPD testing D. 5 tuberculin units intradermal PPD injection and if positive repeat same dose in one week MULTIPLE CHOICE 1.ANS: C PTS: 1 2.ANS: C PTS: 1 3.ANS: A PTS: 1 4.ANS: A PTS: 1 5.ANS: C PTS: 1 6.ANS: C PTS: 1 7.ANS: C PTS: 1 8.ANS: B PTS: 1 9.ANS: B PTS: 1 10.ANS: B PTS: 1 11.ANS: D PTS: 1 12.ANS: C PTS: 1 13.ANS: C PTS: 1 14.ANS: A PTS: 1 15.ANS: C PTS: 1 16.ANS: B PTS: 1 Chapter 3. Exercise in Older Adults Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Exercise recommended for older adults should include activities that: A. Conserve energy B. Restrict flexibility C. Strengthen muscles D. Are anaerobic in nature ____ 2. Preferred amount of exercise for older adults is: A. 10 minutes of physical activity each morning B. 30 minutes per day of aerobic activity five times a week C. Any increase in physical activity over a sedentary lifestyle D. 60 minutes per day that includes 30 minutes of aerobic activity and 30 minutes of weight training five times a week ____ 3. Which of the following medical conditions is not considered restrictive for engaging in physical activity? A. A.Unstable angina B. Dehydration C. Depression D. Uncontrolled tachycardia ____ 4. The best recommendation for a patient who states they have no equipment to exercise would be: A. Sign a contract for a year’s membership to a local gym B. Borrow free weights from grandchildren C. Have a personal trainer come to the home three times a week D. Improvise with recommended objects at home that can be used ____ 5. When the nurse practitioner recommends exercise for a sedentary older adult, which of the following pieces of advice should be considered for all types of exercise? A. Only use equipment recommended by physical trainers B. Start low and go slow C. Only group exercise is beneficial to someone who has not been active in a long A. time D. Focus only on one type of exercise for the first few months 1. ANS: C PTS: 1 2. ANS: D PTS: 1 3. ANS: C PTS: 1 4. ANS: D PTS: 1 5. ANS: B PTS: 1 Chapter 4. Comprehensive Geriatric Assessment Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The evidence reflects that comprehensive geriatric assessment should be conducted: A. On all individuals 65 and older B. On all individuals 75 and older C. By an inter-disciplinary team of professionals D. Targeting the vulnerable and frail elderly ____ 2. Evidence-based geriatric assessment instruments available to the clinician: A. Are largely screening instruments to detect a condition B. Largely do not exist and if they do they have limited clinical utility C. Include screening, evaluation, and measurement instruments in multiple domains D. Have applicability in the outpatient but not the inpatient setting ____ 3. When interviewing the older adult with a suspected dementia, it is most important that: A. Mental status be evaluated first in order to determine if the patient is a reliable historian B. The examiner use short simple questions and recognize non-verbal signs of discomfort C. Postpone the mental status evaluation for the following visit and establish a rapport first D. The clinician get in contact with a family member to obtain the history ____ 4. Which is not considered a dimension of symptomatology? A. Onset B. Physical signs C. Location D. Absence of associated symptoms ____ 5. The best approach to taking the health history is to: A. Start with an open-ended question B. Start with the review of systems C. Focus on the chief complaint D. Complete the history before conducting the examination ____ 6. A review of the evidence relative to screening of the elderly reveals the highest evidence rating for: A. Vision screening B. Mammography screening C. Hearing screening D. Dementia screening ____ 7. Assessment of vital signs in the elderly reflect: A. Errors in blood pressure measurement are rare with automated recording devices B. Shortness of breath in the elderly is rare in the older, deconditioned, and immobile patient C. Older adults prefer a 0-10 pain rating scale D. Older adults could be septic with a temperature within normal limits ____ 8. What statement is true about nutrition intake in the elderly? A. Deficiencies in protein intake are common with aging. B. Malnutrition is the most common nutritional disorder among the elderly living in the community. C. Increased caloric consumption is needed as one ages. D. The serum albumin is a good reflection of protein stores. ____ 9. What is reflective of functional decline in older adults? A. Functional decline is synonymous with advanced age. B. Some individuals die of “old age” but have maintained an active and healthy lifestyle. C. Instrumental activities of daily living are preserved longer than activities of daily living. D. It is always possible to prevent functional deterioration. ____ 10. The leading cause of traumatic death in the elderly is due to: A. Motor vehicle accidents B. Pedestrian injuries C. Falls D. Burns ____ 11. Timing of the get-and-go test enhances its sensitivity. The process should take less than: A. Thirty seconds B. Sixteen seconds C. Sixty seconds D. Ten seconds ____ 12. A validated tool for assessing cognitive function specific to dementia is: A. Mini-cog B. Confusion assessment method C. Yesavage GDS scale D. NuDesc ____ 13. The medical outcome study short form 36 remains the gold standard of quality of life instruments. It measures: A. Mental and social domains B. Social domain C. Physical, mental, and social domains D. Physical domain MULTIPLE CHOICE 1. ANS: D PTS: 1 2. ANS: C PTS: 1 3. ANS: B PTS: 1 4. ANS: B PTS: 1 5. ANS: A PTS: 1 6. ANS: C PTS: 1 7. ANS: D PTS: 1 8. ANS: A PTS: 1 9. ANS: B PTS: 1 10. ANS: C PTS: 1 11. ANS: B PTS: 1 12. ANS: A PTS: 1 13. ANS: C PTS: 1 Chapter 5. Symptoms and Syndromes Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The term “geriatric syndrome” is best described as: A. A condition that has multiple underlying factors and involves multiple systems B. A condition that has a discreet etiology that is difficult to pinpoint C. Significant progress has been made in understanding geriatric syndromes, especially falls and delirium D. Therapeutic management of a geriatric syndrome can be accomplished once a specific diagnosis is made ____ 2. The anal wink reflex is used to test: A. Rectal prolapse B. Sensation and pudental nerve function C. Baseline and squeeze sphincter tone D. Fissures and fistulas ____ 3. Atypical presentation of acute coronary syndrome is: A. Most common in Hispanic females B. More common in men C. Most common in African American men D. More common in females ____ 4. What disease can mimic and often co-exists with myocardial infarctions in elders with coronary artery disease? A. Hypertension B. Esophageal disease C. Diabetic gastroparesis D. Vascular disease ____ 5. Thoracic aortic dissection presents typically as: A. Sharp stabbing pain in the mid thorax B. Pleuretic chest pain and dyspnea C. Severe retrosternal chest pain that radiates to the back and both arms D. Unilateral pleuretic chest pain and dyspnea ____ 6. Medications known to contribute to constipation include all of the following except: A. Stimulant laxatives B. Anticholinergic drugs C. Broad-spectrum antibiotics D. Iron ____ 7. Bordetella pertussis is best characterized by: A. Sub-acute cough lasting greater than two weeks B. Acute cough associated with a coryzal symptom C. Chronic cough with post-nasal drip D. Non-productive acute cough ____ 8. The routine testing of tuberculosis should occur in all of the following vulnerable populations except: A. Nursing home residents B. Prison inmates C. Hospitalized elderly D. Immune-compromised patients ____ 9. Which of the following statements about fluid balance in the elderly is false? A. Total body water decreases with age. B. Thirst response decreases as a person ages. C. African Americans have higher rates of dehydration than white Americans. D. Assessment of skin turgor at the sternum is a reliable indicator of dehydration in the elderly. ____ 10. Distinguishing delirium from dementia can be problematic since they may co-exist. The primary consideration in the differential is: A. Performance on the Mini Mental Status Exam B. The Confusion Assessment is negative C. Rapid change and fluctuating course of cognitive function D. The presence of behavioral symptoms with cognitive impairment ____ 11. Presbystasis is best described as: A. Impairment in vestibular apparatus that causes dizziness B. Age-related disequilibrium of unknown pathology characterized by a gradual onset of difficulty walking C. The loss of high frequency tones with aging that can impair sensation D. A disorder of the inner ear characterized by vertigo ____ 12. If dizziness has a predictable pattern associated with it, the clinician should first consider: A. Hypoglycemia B. Psychogenic etiology C. Cardiovascular cause D. Neurogenic cause ____ 13. All of the following are considered as contributors to dysphagia except: A. Anticholinergics B. Drugs that increase reflux symptoms C. Inadequate intake of fluids with medications and meals D. Smooth muscle relaxants ____ 14. Evidence shows that the most important predictor of a fall is: A. Prior history of a fall B. Cognitive impairment C. Gait and balance disturbance D. Proximal muscle weakness ____ 15. The most cost-effective interventions used to prevent falls are: A. Use of sitters B. Use of alarms (bed, chair, monitors) C. Tai Chi exercises D. Home modifications and vitamin D supplements ____ 16. Chronic fatigue syndrome is best described as: A. Fatigue that is constant, lasting more than three months B. Fatigue lasting longer than six months and not relieved by rest C. Fatigue that waxes and wanes over a period of three months D. Total exhaustion with inability to get out of bed ____ 17. Which form of headache is bilateral? A. Cluster B. Tension C. Migraine