Advanced Practice Nursing in the Care of Older Adults, Exams of Nursing

Download Advanced Practice Nursing in the Care of Older Adults and more Exams Nursing in PDF only on Docsity! DNP701 Advanced Practice Nursing in the Care of Older Adults 2024-2025 Edition. Questions and Correct, Verified Answers. Graded A+ . Adam, 70 years old, is admitted for possible myasthenia gravis (MG). The nurse practitioner knows that MG is commonly seen in women between 20 and 40 years old. Adam, however, is experiencing an ocular form of MG, has dysphonia, and does not have any thymus abnormalities. Adam asks why the nurse is concerned about MG since he is older and this is a "young person's disease." Which of the following are the best answers? Select all that apply. 1. We need to assess for anything, just in case. 2. Some diseases show up in two different age and gender groups. 3. Older people often experience weakness, and we must rule out other conditions. 4. Your insurance will cover this, and we want to rule out as much as possible. 5. Signs and symptoms of illness are the same for each disease regardless of age. - ANSAnswer: 2, 3 Page: 5 Feedback 1. Ordering more tests than needed violates the principle of "Do no harm." 2. MG is bimodal and can be found in younger women, as well as in both men and women. 3. Knowledge of the bimodality of age onset of certain disease conditions will aid the nurse practitioner in avoiding misdiagnosis or delay in diagnosis due to lack of recognition. 4. There should be a need for ordering a test and value attributed to the results. 5. The manifestations of illness and disease in the elderly can be very different, even if the underlying pathological process is the same as in younger individuals. . For individuals over 65 years old, the most common morbidities are related to: 1. Heart disease, arthritis 2. Respiratory problems, cancer 3. Diabetes, stroke 4. All of these are common morbidities - ANSAnswer: 4 Page: 5 Feedback 1. Heart disease is one of the common morbidities. 2. Cancer is common in the general population; however, specific types are more common in the older patient. 3. Diabetes is common in patients over 40 years of age. 4. Heart disease, cancer, and diabetes combined are the most common morbidities in older patients. . Janey, 25 years old, may experience arthritis differently than 65-year-old Mrs. Johnson because: 1. The body undergoes physiological changes with aging. 2. A healthy body does not experience significant changes as one gets older. 3. Older patients do not feel any systemic symptoms, such as malaise and weight loss. 4. Even though the same joints are usually affected, age makes it feel different. - ANSAnswer: 1 Page: 5 Feedback 1. Knowledge of the bimodality of age onset of certain disease conditions will aid the advanced practice nurse in avoiding misdiagnosis or delay in diagnosis due to lack of recognition. 2. Symptoms of rheumatoid arthritis may be different depending on the age of the patient. 3. Younger patients may not experience constitutional symptoms such as fever, malaise, weight loss, and depression. 4. In late-onset rheumatoid arthritis, the joint involvement is more often in the larger joints. . Mrs. Smith is 75 years old and has had type 2 diabetes for 30 years. She sees her nurse practitioner on a regular basis. Mrs. Smith asks the nurse practitioner why her treatment has not been changed, even though her laboratory values are seemingly out of normal range. Which of the following answers are best? Select all that apply. 1. A decision to make changes must be based on a pattern and not on one set of laboratory results. A patient with renal disease has blood work drawn, and the results show an increase in serum creatinine. The nurse practitioner needs to know which of the following laboratory values before ordering medications? 1. CBC 2. Culture and sensitivity of the urine 3. Creatinine clearance 4. Uric acid levels - ANSAnswer: 3 Page: 3 Feedback 1. A CBC will not evaluate kidney function for a patient with renal disease. 2. A culture and sensitivity test reflects the presence of an infection and the antibiotic to which the organism is sensitive. 3. The calculation of creatinine clearance provides an estimation of renal function. 4. Uric acid level is elevated in the presence of gout. An elderly couple is discussing health concerns with the nurse practitioner. The couple is concerned that each of their individual blood studies show different results. One set of test results shows a significant decrease in blood sugar, but the test results of the partner does not show an equal decrease. Their physician does not seem concerned, and the couple is wondering why. How is it best for the nurse practitioner to respond? Select all that apply. 1. Studies show that each person's pattern of chemical make-up is different. 2. There is no difference between one person's range of blood results and that of any other person. 3. Each person's chemical make-up is the same as that of others of the same gender and age group. 4. Many factors affect an individual's chemical make-up. 5. Ranges of the values provided by the laboratory are correct for any ag - ANSAnswer: 1, 4 Page: 2, 3 Feedback 1. Individuals experience smaller variations in laboratory work than from the others in the same age group. 2. There are wider variations of laboratory results within a group of older people. 3. Laboratory values are determined by more than age and gender. 4. Laboratory values may vary as a result of nutrition, activity, and emotional status. 5. The reference values presented for the older adult cohort are not necessarily correct for the individual due to biochemical individuality. An older woman is seen in the ambulatory clinic for a routine checkup. The patient asks about results of her blood work compared to last year's results. How is it best for the clinician to respond? Select all that apply. 1. They are likely to be the same if you have had no diseases since then. 2. Blood work results may be different just because of your aging process. 3. Your results may be different because the body changes with disease and medications you are taking. 4. 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. 5. There is likely no significant difference as your body remains stable in its functioning. - ANSAnswer: 2, 3 Page: 4, 5 Feedback 1. Biochemical individuality variation is often much smaller than variation within the larger group. 2. The aging process and decline in organ function may affect the health of elders. 3. Disease, nutrition, and medications affect the health of elders. 4. Although abnormal laboratory findings are often attributed to old age, rarely are they true aging changes. 5. Many factors can influence laboratory value interpretation in the elderly, including the physiological changes with aging, the prevalence of chronic disease, changes in nutritional and fluid intake, lifestyle (including activity), and the medications that are taken. Mr. Adams is 90 years old. In the last few months he appears unable to comply with the health-care plan developed by the nurse practitioner. The nurse practitioner considers which of the following reasons for noncompliance when updating his home care plan? Select all that apply. 1. Polypharmacy 2. Treatment burden 3. Attending multiple appointments 4. Affording complex drug regimens 5. Cognitive ability only - ANSAnswer: 1, 2, 3, 4 Page: 5 Feedback 1. As a patient ages, this correlates with more medications having been ordered. 2. Patients with multimorbidity are known to have a treatment burden in terms of understanding and self-care management of their conditions. 3. Patients with multimorbidity are known to have a treatment burden in terms of understanding and self-care management of their conditions. 4. This burden entails affording complex drug regimens. 5. Though cognitive ability may be a factor, there is much more to consider when noncompliance is an issue. The nurse practitioner is examining an 85-year-old man with reports of abdominal pain, weakness, and loss of appetite. Which is the most likely condition to be tested for and ruled out? 1. Neoplasms and carcinomas 2. Partial seizure 3. Sarcopenia 4. Hirschsprung's disease. - ANSAnswer: 1 Page: 4 Feedback 1. Certain diseases, such as neoplasms and carcinomas, are more common in the elderly, and an understanding of the epidemiology is critical in the interpretation. 2. Partial seizure is more common in early old age. 3. Sarcopenia is more common in early old age. 4.