ATI Learning System Gerontology
practice quiz w/rationales already
passed
A nurse is caring for an older adult client who has pneumonia. Which of the following
physiologic changes associated with aging places the client at a greater risk for pneumonia?
A. Decreased anterior-posterior diameter
B. Increased diameter of the small airways
C. Decreased number of cilia
D. Increased alveolar surface area ✔✔C. Decreased number of cilia
Decreased anterior-posterior diameterA physiologic change associated with aging is a
calcification of the bronchial and costal (rib) cartilage and diminished chest wall compliance,
leading to an increase in the anterior-posterior diameter. The resultant reduced total lung capacity
puts the client at increased risk for hypoxemia.
Increased diameter of the small airwaysA physiologic change associated with aging is a
decreased diameter of the small airways. However, the diameter of the large airways does
increase with age, and these two factors combined can lead to an increase in dead space, gas
trapping, and ventilation-perfusion imbalance.
Decreased number of ciliaMY ANSWERA physiologic change associated with aging is a
decreased number of cilia. This, along with a less effective cough, leads to diminished efficiency
of the normal defense mechanisms for clearing the airway, putting the client at increased risk for
infection, such as pneumonia.
,Increased alveolar surface areaA physiologic change associated with aging is an increase in the
size of the alveolar ducts and respiratory bronchioles, leading to a decrease in the alveolar
surface area. Consequently, there is less surface area for gas exchange to occur, putting the client
at an increased risk for hypoxemia.
A nurse us contributing to the plan of care for a client who had a recent stroke and a history of
gastroesophageal reflux disease (GERD). For which of the following disorders should the nurse
plan to monitor this client?
A. Duodenal ulcer disease
B. Aspiration pneumonia
C. Viral pneumonia
D. Esophageal varices ✔✔B. Aspiration pneumonia
Duodenal ulcer diseaseThe acidity of stomach contents that reflux back into the esophagus
results in an inflamed esophagus, not duodenum, which is a section of the small intestine. With
duodenal ulcer disease, there are ulcers in the duodenum, usually associated with stress, COPD,
pancreatic disease, and chronic renal failure.
Aspiration pneumonia- results in reflux of gastric secretions from the stomach into the lower
esophagus. When regurgitation occurs, the client is at high risk for pneumonia. Pneumonia
occurs due to aspiration of gastric contents into the airway. This client is at increased risk for
dysphagia due to the stroke and history of GERD; therefore, the nurse should monitor closely for
aspiration pneumonia.
,Viral pneumonia- The cause of viral pneumonia is an inhaled virus that settles in the lungs.
GERD does not increase the risk of viral pneumonia.
Esophageal varices occur in clients who have portal hypertension, usually due to hepatic
cirrhosis.
A nurse is caring for an older adult client. Which of the following physiologic changes
associated with aging can affect medication dosage in this client?
A. Increased glomerular filtration rate
B. Decreased body fat
C. Decreased gastric motility
D. Decreased gastric pH ✔✔C. Decreased gastric motility
Increased glomerular filtration rate- The aging process results in a decreased glomerular filtration
rate and causes the medications to filter at a slower rate, causing them to remain in the body
longer.
Decreased body fat- Body fat increases with aging. Medications that are stored in adipose tissue
will have an increased tissue concentration, decreased plasma concentration, and a longer
duration in the body.
Decreased gastric motility- Decreased gastric motility results in medications remaining in the
digestive tract for longer periods of time, leading to slow absorption of the medication. The
provider might have to allow for a longer time for medication onset and peak by extending the
length of time between doses.
, Decreased gastric pH- With aging, gastric pH increases, becoming more alkaline. The nurse
should avoid giving preparations that neutralize gastric secretions if a low gastric pH is required
for medication absorption.
A nurse is reviewing the medical record of a client who is postmenopausal and has osteoporosis.
The client has a new prescription for alendronate sodium. Which of the following findings in the
client's history should the nurse recognize is a contradiction to this medication?
A. Glaucoma
B. Paget's disease
C. Esophageal stricture (achalasia)
D. Long-term corticosteriod use ✔✔C. Esophageal stricture (achalasia)
This indicates for delayed esophageal emptying.
Glaucoma is a degenerative eye disease where increased intraocular pressure causes damage to
the optic nerve. It is not a contraindication to the use of alendronate sodium.
Paget's disease is a metabolic bone disease that involves bone destruction and regrowth that
results in deformity. Medical treatment with a bisphosphonate, such as alendronate sodium, is
considered first-line therapy.
Esophageal achalasia- Clients who have a history of esophageal abnormalities, such as stricture
or achalasia, have delayed esophageal emptying, which greatly increases the client's risk for
esophageal erosion, bleeding, and perforation. Alendronate sodium is a bisphosphonate, which
prevents or slows weakening of bone. It is used to prevent and treat postmenopausal
osteoporosis. The nurse should instruct the client to wait at least 30 min after taking alendronate
practice quiz w/rationales already
passed
A nurse is caring for an older adult client who has pneumonia. Which of the following
physiologic changes associated with aging places the client at a greater risk for pneumonia?
A. Decreased anterior-posterior diameter
B. Increased diameter of the small airways
C. Decreased number of cilia
D. Increased alveolar surface area ✔✔C. Decreased number of cilia
Decreased anterior-posterior diameterA physiologic change associated with aging is a
calcification of the bronchial and costal (rib) cartilage and diminished chest wall compliance,
leading to an increase in the anterior-posterior diameter. The resultant reduced total lung capacity
puts the client at increased risk for hypoxemia.
Increased diameter of the small airwaysA physiologic change associated with aging is a
decreased diameter of the small airways. However, the diameter of the large airways does
increase with age, and these two factors combined can lead to an increase in dead space, gas
trapping, and ventilation-perfusion imbalance.
Decreased number of ciliaMY ANSWERA physiologic change associated with aging is a
decreased number of cilia. This, along with a less effective cough, leads to diminished efficiency
of the normal defense mechanisms for clearing the airway, putting the client at increased risk for
infection, such as pneumonia.
,Increased alveolar surface areaA physiologic change associated with aging is an increase in the
size of the alveolar ducts and respiratory bronchioles, leading to a decrease in the alveolar
surface area. Consequently, there is less surface area for gas exchange to occur, putting the client
at an increased risk for hypoxemia.
A nurse us contributing to the plan of care for a client who had a recent stroke and a history of
gastroesophageal reflux disease (GERD). For which of the following disorders should the nurse
plan to monitor this client?
A. Duodenal ulcer disease
B. Aspiration pneumonia
C. Viral pneumonia
D. Esophageal varices ✔✔B. Aspiration pneumonia
Duodenal ulcer diseaseThe acidity of stomach contents that reflux back into the esophagus
results in an inflamed esophagus, not duodenum, which is a section of the small intestine. With
duodenal ulcer disease, there are ulcers in the duodenum, usually associated with stress, COPD,
pancreatic disease, and chronic renal failure.
Aspiration pneumonia- results in reflux of gastric secretions from the stomach into the lower
esophagus. When regurgitation occurs, the client is at high risk for pneumonia. Pneumonia
occurs due to aspiration of gastric contents into the airway. This client is at increased risk for
dysphagia due to the stroke and history of GERD; therefore, the nurse should monitor closely for
aspiration pneumonia.
,Viral pneumonia- The cause of viral pneumonia is an inhaled virus that settles in the lungs.
GERD does not increase the risk of viral pneumonia.
Esophageal varices occur in clients who have portal hypertension, usually due to hepatic
cirrhosis.
A nurse is caring for an older adult client. Which of the following physiologic changes
associated with aging can affect medication dosage in this client?
A. Increased glomerular filtration rate
B. Decreased body fat
C. Decreased gastric motility
D. Decreased gastric pH ✔✔C. Decreased gastric motility
Increased glomerular filtration rate- The aging process results in a decreased glomerular filtration
rate and causes the medications to filter at a slower rate, causing them to remain in the body
longer.
Decreased body fat- Body fat increases with aging. Medications that are stored in adipose tissue
will have an increased tissue concentration, decreased plasma concentration, and a longer
duration in the body.
Decreased gastric motility- Decreased gastric motility results in medications remaining in the
digestive tract for longer periods of time, leading to slow absorption of the medication. The
provider might have to allow for a longer time for medication onset and peak by extending the
length of time between doses.
, Decreased gastric pH- With aging, gastric pH increases, becoming more alkaline. The nurse
should avoid giving preparations that neutralize gastric secretions if a low gastric pH is required
for medication absorption.
A nurse is reviewing the medical record of a client who is postmenopausal and has osteoporosis.
The client has a new prescription for alendronate sodium. Which of the following findings in the
client's history should the nurse recognize is a contradiction to this medication?
A. Glaucoma
B. Paget's disease
C. Esophageal stricture (achalasia)
D. Long-term corticosteriod use ✔✔C. Esophageal stricture (achalasia)
This indicates for delayed esophageal emptying.
Glaucoma is a degenerative eye disease where increased intraocular pressure causes damage to
the optic nerve. It is not a contraindication to the use of alendronate sodium.
Paget's disease is a metabolic bone disease that involves bone destruction and regrowth that
results in deformity. Medical treatment with a bisphosphonate, such as alendronate sodium, is
considered first-line therapy.
Esophageal achalasia- Clients who have a history of esophageal abnormalities, such as stricture
or achalasia, have delayed esophageal emptying, which greatly increases the client's risk for
esophageal erosion, bleeding, and perforation. Alendronate sodium is a bisphosphonate, which
prevents or slows weakening of bone. It is used to prevent and treat postmenopausal
osteoporosis. The nurse should instruct the client to wait at least 30 min after taking alendronate
