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Test Bank Advanced Practice Nursing in the Care of Older Adults 2nd edition Kennedy-Malone Test Bank | Advanced
Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone
Advanced Practice Nursing in the
Care of 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 is 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
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Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone

Advanced Practice Nursing in the

Care of 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 is 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

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone D. (^) The side effects commonly associated with the drug

  1. All the following statements are false about drug absorption except: A. (^) Antacids increase the bioavailability of digitalis B. (^) Gastric acidity decreases with age C. (^) Anticholinergics increase colonic motility D. (^) Underlying chronic disease has little impact on drug absorption
  2. (^) 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
  3. (^) 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
  4. (^) 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
  5. 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
  6. 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
  7. 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

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone

  1. 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
  2. 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.
  3. 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
  4. 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
  5. 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 ( 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
  6. 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

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone C. (^) Readily available treatment measures D. (^) Achieving an administrative goal for the congregate living facility

  1. 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
  2. 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.
  3. 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
  4. 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
  5. 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
  6. (^) 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
  7. 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

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone

Chapter 2: Health Promotion

Answer Section

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.
  17. Exercise recommended for older adults should include activities that: A. (^) Conserve energy B. (^) Restrict flexibility C. (^) Strengthen muscles D. (^) Are anaerobic in nature
  18. 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
  19. Which of the following medical conditions is not considered restrictive for engaging in physical activity? A. (^) Unstable angina

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone B. (^) Dehydration C. (^) Depression D. (^) Uncontrolled tachycardia

  1. 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
  2. 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 time D. (^) Focus only on one type of exercise for the first few months

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone 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

  1. 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
  2. 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
  3. 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.
  4. 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.
  5. The leading cause of traumatic death in the elderly is due to: A. (^) Motor vehicle accidents B. (^) Pedestrian injuries C. (^) Falls D. (^) Burns
  6. 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
  7. A validated tool for assessing cognitive function specific to dementia is: A. (^) Mini-cog B. (^) Confusion assessment method C. (^) Yesavage GDS scale

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone D. (^) NuDesc

  1. 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

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone

  1. (^) 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
  2. (^) 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
  3. (^) Medications known to contribute to constipation include all of the following except: A. (^) Stimulant laxatives B. (^) Anticholinergic drugs C. (^) Broad-spectrum antibiotics D. (^) Iron
  4. 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
  5. 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
  6. 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.
  7. 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
  8. Presbystasis^ is^ best^ described^ as: A. (^) Impairment in vestibular apparatus that causes dizziness

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone 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

  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. Which form of headache is bilateral? A. (^) Cluster B. Tension C. Migraine D. Acute angle closure glaucoma
  7. Microscopic hematuria is defined as: A. (^) Twenty or more RBCs on a urine sample B. (^) Three or more RBCs on a urine sample C. (^) Twenty or more RBCs on three or more samples of urine D. (^) Three or more RBCs on three or more samples of urine
  8. Risk factors associated with the finding of a malignancy in a patient with hemoptysis include all of the following except:

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone B. (^) Purposeful excessive ambulatory behavior C. (^) Risk-seeking behavior in the cognitively impaired D. (^) A result of boredom in those with dementia

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone

Chapter 5: Symptoms and Syndromes

Answer Section

MULTIPLE CHOICE Chapter 6. Skin and Lymphatic Disorders Multiple Choice Identify the choice that best completes the statement or answers the question.

  1. Which of the following dermatological conditions results from reactivation of the dormant varicella virus? A. (^) Tinea versicolor B. (^) Seborrheic keratosis
  2. ANS: A PTS: 1
  3. ANS: B PTS: 1
  4. ANS: D PTS: 1
  5. ANS: B PTS: 1
  6. ANS: C PTS: 1
  7. ANS: C PTS: 1
  8. ANS: A PTS: 1
  9. ANS: C PTS: 1
  10. ANS: D PTS: 1
  11. ANS: C PTS: 1
  12. ANS: B PTS: 1
  13. ANS: A PTS: 1
  14. ANS: D PTS: 1
  15. ANS: A PTS: 1
  16. ANS: D PTS: 1
  17. ANS: B PTS: 1
  18. ANS: B PTS: 1
  19. ANS: D PTS: 1
  20. ANS: D PTS: 1
  21. ANS: A PTS: 1
  22. ANS: B PTS: 1
  23. ANS: B PTS: 1
  24. ANS: C PTS: 1
  25. ANS: C PTS: 1
  26. ANS: A PTS: 1
  27. ANS: D PTS: 1
  28. ANS: B PTS: 1

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone

  1. Patients who have an underlying tinea infection to the cellulitis should also be treated with which one of the following? A. (^) An anti-fungal medication B. (^) Topical steroids C. (^) Oral steroids D. (^) Zinc oxide
  2. Identify the type of malignant melanoma that is associated with the Hutchinson’s sign of the cuticle of the finger. A. (^) Lentigo maligna B. (^) Acral lentiginous C. (^) Nodular D. (^) Superficial spreading malignant melanoma
  3. A smooth round nodule with a pearly gray border and central induration best describes which skin lesion? A. (^) Seborrheic keratosis B. (^) Malignant melanoma C. (^) Herpes zoster D. (^) Basal cell carcinoma
  4. Cellulitis is a deep skin infection involving the dermis and subcutaneous tissues. The nurse practitioner suspects cellulitis in a 70-year-old Asian diabetic male presenting with reddened edematous skin around his nares. Which statement below will the nurse practitioner use in her decision-making process for the differential diagnosis pertaining to reddened edematous skin? A. (^) Cellulitis is two times more common in women B. (^) Facial cellulitis is more common in people > C. (^) There is low incidence of cellulitis in patients with diabetes D. (^) Cellulitis is only a disease of the lower extremities of patients with known arterial insufficiency
  5. An 82-year-old female has a “pimple” on his nose that occasionally bleeds and may have increased in size in the past year. The lesion is a 0.7-cm, dome-shaped, umbilicated papule with pearly translucence. There is also a hemorrhagic crust covering the central portion. Which of the following is the most likely diagnosis? A. (^) Squamous cell carcinoma B. (^) Basal cell carcinoma C. (^) Keratocanthoma D. (^) Sebaceous hyperplasia
  6. Which of the following is generally not a first-line treatment for post herpetic neuralgia? A. (^) Intrathecal methylprednisolone B. (^) Gabapentin C. (^) 5% lidocaine patch D. (^) Topical capsaicin
  7. A nursing home resident with a Stage 4 pressure ulcer that extends to the muscle layer and has significant undermining with heavy exudate should be treated with:

Practice Nursing in the Care of Older Adults / Edition 2 TESTBANK_Kennedy-Malone A. (^) Dry gauze dressings B. (^) Duoderm C. (^) Chemical debridement D. (^) Calcium alginate dressings

  1. Which of the following descriptions accurately documents cellulitis? A. (^) Cool, erythematous, shiny hairless extremity with decreased pulse B. (^) Scattered, erythematous ring-like lesions with clear centers C. (^) Clearly demarcated, raised erythematous area of face D. (^) Diffusely inflamed skin that is warm and tender to palpation
  2. Asymmetrical bi-color lesion with irregular border measuring 8 mm is found on the right lower arm of an adult patient. This assessment finding is consistent with: A. (^) Melanoma B. (^) Basal cell carcinoma C. (^) Leukoplakia D. (^) Senile lentigines
  3. Which of the following descriptions best illustrates assessment findings consistent with tinea capitis? A. (^) Circular erythematous patches with papular, scaly annular borders and clear centers B. (^) Inflamed scaly dry patches with broken hairs C. (^) Web lesions with erythema and scaling borders D. (^) Scaly pruritic erythematous lesions on inguinal creases
  4. A hyperkeratatotic nodule formed as the result of exposure of the foot to moisture from perspiration is called: A. (^) Hard corn B. (^) Tinea pedis C. (^) Soft corn D. (^) Plantar warts (verrucae)
  5. A 64-year-old male presents with an exacerbation of psoriasis. His social history includes 50-year two packs a day of cigarettes and a six-pack a week of beer. He states he had a recent sore throat, which he attributes to minding his young grandson. He reports that until recently the pruritis was only minimal. His BMI is 37. Which of the following factors most likely contributed to the acute presentation of psoriasis? A. (^) Alcohol abuse B. (^) Smoking C. (^) Streptococcal infection D. (^) Obesity
  6. Treatment of complicated cellulitis of the lower extremity resulting from an anaerobe requires all of the following except: A. (^) Extended antibiotic medication lasting at least 7-10 days B. (^) Topical antifungal medication C. (^) Inquiry when last tetanus toxoid booster was given D. (^) Elevation of limb and consideration of compression bandaging