OLDER ADULTS CH. 1 – 11 EXAM
WITH COMPLETE SOLUTIONS
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. -ANS1. 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 -ANS3. 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. -ANS1. 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. -ANS1. 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 -ANS1. 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. -ANS1. 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 -ANS4. 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. -
ANS2. 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 -ANSAnswer: 1, 2, 3, 4, 5
*The most common comorbidities are related to heart disease, arthritis, respiratory
problems, cancer, diabetes, and stroke.
A 70-year-old man is seeing an APRN because he is feeling weak and dizzy. The
APRN is discussing a care plan with him and should make which of the following
statements? Select all that apply.
1. I want to order a test for your heart to evaluate its function.
2. I will perform a thorough examination of your functional abilities.
3. I will order a blood sugar test to check for diabetes.
4. I want to wait to order further tests. Many older adults feel this way, but it may
resolve.
5. I will assess you for the presence of other conditions. -ANSAnswer: 1, 2, 3, 5
1. A complete assessment will help differentiate signs of aging from disease.
2. All systems interact and can affect an existing condition.
3. Identifying underlying conditions will avoid undertreatment.
4. Attributing symptoms to aging can contribute to depression in an older adult.
Furthermore, failing to take action at this time risks undertreating the client.
5. There are changes in the sympathetic response that contribute to the orthostasis and
falls as well as lack of hypoglycemic response.
The APRN is leading a class of older adults over age 65 years old and is teaching about
nutritional needs. One of the men asks why, even though he eats correctly according to
the standards presented, he still feels weaker than he did 10 years ago. He also
wonders why he gets more infections than he used to. Which of the following answers
are helpful? Select all that apply.
1. I suggest that you exercise a little more than you are currently doing.
2. Older adults experience a decrease in reserve energy.
3. Older adults have immune system weakness.
4. More viruses are being spread throughout the community.
5. I suggest that you see your primary care giver for extensive testing. -ANSAnswer: 2,
3, 5
1. Improved nutrition may not be the factor affecting the health of the older adult.
2. Many factors can influence the health of older adults, including lifestyle and
medications.
3. Many factors can influence the health of older adults, including changes in the
immune system.
4. Viruses and other infections are not the only considerations for infections.
5. Biochemical individuality is important in detecting asymptomatic abnormalities in
older adults. Significant homeostatic disturbances in the same individual may be
WITH COMPLETE SOLUTIONS
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. -ANS1. 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 -ANS3. 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. -ANS1. 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. -ANS1. 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 -ANS1. 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. -ANS1. 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 -ANS4. 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. -
ANS2. 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 -ANSAnswer: 1, 2, 3, 4, 5
*The most common comorbidities are related to heart disease, arthritis, respiratory
problems, cancer, diabetes, and stroke.
A 70-year-old man is seeing an APRN because he is feeling weak and dizzy. The
APRN is discussing a care plan with him and should make which of the following
statements? Select all that apply.
1. I want to order a test for your heart to evaluate its function.
2. I will perform a thorough examination of your functional abilities.
3. I will order a blood sugar test to check for diabetes.
4. I want to wait to order further tests. Many older adults feel this way, but it may
resolve.
5. I will assess you for the presence of other conditions. -ANSAnswer: 1, 2, 3, 5
1. A complete assessment will help differentiate signs of aging from disease.
2. All systems interact and can affect an existing condition.
3. Identifying underlying conditions will avoid undertreatment.
4. Attributing symptoms to aging can contribute to depression in an older adult.
Furthermore, failing to take action at this time risks undertreating the client.
5. There are changes in the sympathetic response that contribute to the orthostasis and
falls as well as lack of hypoglycemic response.
The APRN is leading a class of older adults over age 65 years old and is teaching about
nutritional needs. One of the men asks why, even though he eats correctly according to
the standards presented, he still feels weaker than he did 10 years ago. He also
wonders why he gets more infections than he used to. Which of the following answers
are helpful? Select all that apply.
1. I suggest that you exercise a little more than you are currently doing.
2. Older adults experience a decrease in reserve energy.
3. Older adults have immune system weakness.
4. More viruses are being spread throughout the community.
5. I suggest that you see your primary care giver for extensive testing. -ANSAnswer: 2,
3, 5
1. Improved nutrition may not be the factor affecting the health of the older adult.
2. Many factors can influence the health of older adults, including lifestyle and
medications.
3. Many factors can influence the health of older adults, including changes in the
immune system.
4. Viruses and other infections are not the only considerations for infections.
5. Biochemical individuality is important in detecting asymptomatic abnormalities in
older adults. Significant homeostatic disturbances in the same individual may be
