Older Adults Ch. 1 – 11 Questions with Answers
Mrs. Smith, who is 75 years old, reports that she is weak, has difficulty urinating, and is dehydrated.
Although she is afebrile, the nurse conducts a thorough physical examination including urinalysis and
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. - correct answers1. All body systems
interact, and symptoms could indicate a variety of diagnoses.
*The clinician must be aware that all the systems interact and, in doing so, can increase the older adult's
vulnerability to illness/disease.
A patient with renal disease has blood work drawn, and the results show an increase in serum
creatinine. Which of the following laboratory values does the advanced practice registered nurse (APRN)
need to know before ordering medications?
1. Complete blood count
2. Culture and sensitivity of the urine
3. Creatinine clearance
4. Uric acid levels - correct answers3. Creatinine clearance
*The calculation of creatinine clearance provides an estimation of renal function.
Which of the following statements is true regarding diagnostic testing?
1. A test is ordered for a specific purpose.
2. More invasive tests are the best option.
3. There is no need to discuss results with the patient.
4. If a test is needed, it should be ordered regardless of risk to the patient. - correct answers1. A test is
ordered for a specific purpose.
,*The APRN should have a plan for the use of each test result value obtained.
Janey, who is 25 years old, may experience arthritis differently than 65-year-old Mrs. Johnson because:
1. The body undergoes physiological changes with aging, which changes how diseases present.
2. A healthy body does not experience significant changes as one gets older.
3. Older adults do not feel any constitutional symptoms, such as malaise and weight loss.
4. Even though the same joints are usually affected, age makes arthritis pain feel different. - correct
answers1. The body undergoes physiological changes with aging, which changes how diseases present.
*Knowledge of the bimodality of age onset of certain disease conditions, such as knowing that the same
disease may present differently in a 25 year old versus a 65 year old, will aid the APRN in avoiding
misdiagnosis or delay in diagnosis due to lack of recognition.
The APRN is examining an 85-year-old man with reports of vague abdominal symptoms, new onset
constipation, and somatic complaints. These symptoms may be an atypical presentation of which illness?
1. Depression
2. Heart failure
3. Hypothyroidism
4. Malignancy - correct answers1. Depression
1. The older adult may have atypical presentations of some conditions. These symptoms may be atypical
presentation of depression.
2. Atypical presentation of heart failure in the older adult may include anorexia, confusion, and nocturia.
3. Atypical presentation of hypothyroidism may include confusion and agitation, new onset of anorexia,
and ataxia.
4. Atypical presentation of malignancies may be new or worsening back pain secondary to metastases
from slow growing breast masses or silent masses of the bowel.
,A gerontological patient is being examined for a report of pain in the shoulder. The APRN completes a
thorough systemic examination because:
1. Older adults with one morbidity often express difficulties in general.
2. Arthritis of the shoulders can be accompanied by other neurological symptoms.
3. Older adults with arthritis often experience pain in the lower extremities.
4. The older adult may not report significant signs and symptoms. - correct answers1. Older adults with
one morbidity often express difficulties in general.
1. Older patients with late-onset RA experience joint involvement more often in the larger joints such as
the shoulder, and they also experience systemic symptoms such as fever, malaise, weight loss, and
depression.
2. Older adults may express symptoms in any other physical systems.
3. Patients more often experience arthritis in smaller joints.
4. A thorough examination will detect objective indicators.
The APRN performs a thorough systemic examination of a patient who reports melena, weight loss,
intermittent confusion, and dyspepsia. The older adult denies abdominal pain. One possible diagnosis
would be:
1. Pneumonia
2. Ulcerative colitis
3. Appendicitis
4. Peptic ulcer disease - correct answers4. Peptic ulcer disease
1. Pneumonia in the older adult may present with mild cough, tachycardia and tachypnea, anorexia, and
other atypical symptoms.
2. Diarrhea is associated with ulcerative colitis.
3. Appendicitis is more common in younger patients than in older patients. The older adult may
experience pain in the right lower abdomen that becomes diffuse.
4. Peptic ulcer disease is manifested differently in a bimodal pattern. It presents in the older adults with
no abdominal pain, melena, dyspepsia, anorexia, confusion, and other atypical symptoms.
, An older woman is being seen in the ambulatory clinic for a routine check-up. The patient asks about
results of her blood work compared to last year's results. Which response is best for the clinician to
offer?
1. They are likely to be the same if you have had no diseases since then.
2. Your results may be different because the body changes with disease and medications you are taking.
3. Blood work is not a reliable indicator of health because many things can affect your health that may
not show up in the results of your blood work.
4. There is likely no significant difference if your body remains stable in its functioning. - correct
answers2. Your results may be different because the body changes with disease and medications you are
taking.
1. Biochemical individuality variation is often much smaller than variation within the larger group.
2. Disease, nutrition, and medications affect health in older adults.
3. Although abnormal laboratory findings are often attributed to old age, rarely are they true aging
changes.
4. Many factors can influence laboratory value interpretation in the older adult, including the
physiological changes with aging, the prevalence of chronic disease, changes in nutritional and fluid
intake, lifestyle (including activity), and the medications taken.
For individuals over 65, the most common morbidities are related to which of the following? Select all
that apply.
1. Heart disease
2. Respiratory problems
3. Diabetes
4. Cancer
5. Stroke - correct answersAnswer: 1, 2, 3, 4, 5
*The most common comorbidities are related to heart disease, arthritis, respiratory problems, cancer,
diabetes, and stroke.
Mrs. Smith, who is 75 years old, reports that she is weak, has difficulty urinating, and is dehydrated.
Although she is afebrile, the nurse conducts a thorough physical examination including urinalysis and
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. - correct answers1. All body systems
interact, and symptoms could indicate a variety of diagnoses.
*The clinician must be aware that all the systems interact and, in doing so, can increase the older adult's
vulnerability to illness/disease.
A patient with renal disease has blood work drawn, and the results show an increase in serum
creatinine. Which of the following laboratory values does the advanced practice registered nurse (APRN)
need to know before ordering medications?
1. Complete blood count
2. Culture and sensitivity of the urine
3. Creatinine clearance
4. Uric acid levels - correct answers3. Creatinine clearance
*The calculation of creatinine clearance provides an estimation of renal function.
Which of the following statements is true regarding diagnostic testing?
1. A test is ordered for a specific purpose.
2. More invasive tests are the best option.
3. There is no need to discuss results with the patient.
4. If a test is needed, it should be ordered regardless of risk to the patient. - correct answers1. A test is
ordered for a specific purpose.
,*The APRN should have a plan for the use of each test result value obtained.
Janey, who is 25 years old, may experience arthritis differently than 65-year-old Mrs. Johnson because:
1. The body undergoes physiological changes with aging, which changes how diseases present.
2. A healthy body does not experience significant changes as one gets older.
3. Older adults do not feel any constitutional symptoms, such as malaise and weight loss.
4. Even though the same joints are usually affected, age makes arthritis pain feel different. - correct
answers1. The body undergoes physiological changes with aging, which changes how diseases present.
*Knowledge of the bimodality of age onset of certain disease conditions, such as knowing that the same
disease may present differently in a 25 year old versus a 65 year old, will aid the APRN in avoiding
misdiagnosis or delay in diagnosis due to lack of recognition.
The APRN is examining an 85-year-old man with reports of vague abdominal symptoms, new onset
constipation, and somatic complaints. These symptoms may be an atypical presentation of which illness?
1. Depression
2. Heart failure
3. Hypothyroidism
4. Malignancy - correct answers1. Depression
1. The older adult may have atypical presentations of some conditions. These symptoms may be atypical
presentation of depression.
2. Atypical presentation of heart failure in the older adult may include anorexia, confusion, and nocturia.
3. Atypical presentation of hypothyroidism may include confusion and agitation, new onset of anorexia,
and ataxia.
4. Atypical presentation of malignancies may be new or worsening back pain secondary to metastases
from slow growing breast masses or silent masses of the bowel.
,A gerontological patient is being examined for a report of pain in the shoulder. The APRN completes a
thorough systemic examination because:
1. Older adults with one morbidity often express difficulties in general.
2. Arthritis of the shoulders can be accompanied by other neurological symptoms.
3. Older adults with arthritis often experience pain in the lower extremities.
4. The older adult may not report significant signs and symptoms. - correct answers1. Older adults with
one morbidity often express difficulties in general.
1. Older patients with late-onset RA experience joint involvement more often in the larger joints such as
the shoulder, and they also experience systemic symptoms such as fever, malaise, weight loss, and
depression.
2. Older adults may express symptoms in any other physical systems.
3. Patients more often experience arthritis in smaller joints.
4. A thorough examination will detect objective indicators.
The APRN performs a thorough systemic examination of a patient who reports melena, weight loss,
intermittent confusion, and dyspepsia. The older adult denies abdominal pain. One possible diagnosis
would be:
1. Pneumonia
2. Ulcerative colitis
3. Appendicitis
4. Peptic ulcer disease - correct answers4. Peptic ulcer disease
1. Pneumonia in the older adult may present with mild cough, tachycardia and tachypnea, anorexia, and
other atypical symptoms.
2. Diarrhea is associated with ulcerative colitis.
3. Appendicitis is more common in younger patients than in older patients. The older adult may
experience pain in the right lower abdomen that becomes diffuse.
4. Peptic ulcer disease is manifested differently in a bimodal pattern. It presents in the older adults with
no abdominal pain, melena, dyspepsia, anorexia, confusion, and other atypical symptoms.
, An older woman is being seen in the ambulatory clinic for a routine check-up. The patient asks about
results of her blood work compared to last year's results. Which response is best for the clinician to
offer?
1. They are likely to be the same if you have had no diseases since then.
2. Your results may be different because the body changes with disease and medications you are taking.
3. Blood work is not a reliable indicator of health because many things can affect your health that may
not show up in the results of your blood work.
4. There is likely no significant difference if your body remains stable in its functioning. - correct
answers2. Your results may be different because the body changes with disease and medications you are
taking.
1. Biochemical individuality variation is often much smaller than variation within the larger group.
2. Disease, nutrition, and medications affect health in older adults.
3. Although abnormal laboratory findings are often attributed to old age, rarely are they true aging
changes.
4. Many factors can influence laboratory value interpretation in the older adult, including the
physiological changes with aging, the prevalence of chronic disease, changes in nutritional and fluid
intake, lifestyle (including activity), and the medications taken.
For individuals over 65, the most common morbidities are related to which of the following? Select all
that apply.
1. Heart disease
2. Respiratory problems
3. Diabetes
4. Cancer
5. Stroke - correct answersAnswer: 1, 2, 3, 4, 5
*The most common comorbidities are related to heart disease, arthritis, respiratory problems, cancer,
diabetes, and stroke.
