Question 1

Aging ordinarily leads to decreases in which of the following?&#10;A) Creatinine clearance and insulin secretion&#10;B) Blood carbon dioxide and saliva production&#10;C) Left ventricle-wall thickness and skin healing time&#10;D) Serum triiodothyronine (T?) and gastric pepsin

Accepted Answer

Serum T? and pepsin secretion both decrease with aging.Creatinine clearance declines,but insulin secretion normally remains stable.Saliva production decreases,but blood carbon dioxide normally remains unchanged.Left ventricle-wall thickness and skin healing time both increase with aging.

Question 2

Name the theory of aging that suggests that the adverse physical effects of aging are the result of a gradual loss of control mechanisms in the pituitary and hypothalamus.&#10;A) Free-radical theory&#10;B) Programmed theory&#10;C) Stochastic theory&#10;D) Neuroendocrine theory

Accepted Answer

The neuroendocrine theory attributes aging to gradual changes in or the loss of the mechanisms that control the organs through chemical signals.The free-radical theory attributes aging to the accumulation of destructive products of metabolic oxidation.The programmed theory attributes aging to cells exhausting a predetermined number of replications.A stochastic theory attributes aging to the accumulation of random damage to DNA and other molecules.

Question 3

Which age-related change contributes to anorexia and weight loss in the older adult?&#10;A) Excessive saliva&#10;B) Fewer taste buds&#10;C) Wearing dentures&#10;D) Softened tooth enamel

Accepted Answer

The number of taste buds declines with age and can decrease the enjoyment of food,which can result in less motivation to eat and a resulting weight loss or loss of appetite.Saliva production tends to decrease with age.As long as dentures fit properly and the wearer practices good oral hygiene,wearing dentures does not necessarily contribute to anorexia and weight loss.Older adults tend to lose enamel.

Question 4

The nurse assigns the diagnosis of Nutrition Imbalance: less than body requirements for an older adult.Which age-associated intestinal problem does the nurse apply to plan goals and interventions to improve this adult's nutritional status?

A) Less intrinsic factor secretion
B) Short, broad small intestinal villi
C) Decreased gastric smooth muscle
D) Decreased large intestinal motility

Accepted Answer

Villi of the small intestine shorten and widen with age and,as a result,become less functional,which contributes to malabsorption of nutrients; despite a healthy diet,nutrients are absorbed primarily in the small intestines.The concept of malabsorption is what the nurse uses to plan care; this nursing diagnosis refers to the inability of the body to absorb nutrients as a result of biological factors.Decreased intrinsic factor secretion leads to pernicious anemia as a result of the inability to absorb vitamin B?? in the stomach.Gastric smooth muscle is not present in the intestines.Decreased large intestine motility is an age-associated problem; however,it should have no impact on absorption in the small intestine.

Question 5

During a nursing assessment,an older adult tells the nurse about increasing loss of balance.Further assessment indicates musculoskeletal changes.Which patient teaching should the nurse implement to address musculoskeletal reasons for the loss of balance?

A) Exercise with light weights.
B) Stand on one foot at a time while supported.
C) Train with the use of sit-ups.
D) Work out in a swimming pool.

Accepted Answer

The loss of balance from a musculoskeletal perspective is usually due to a loss of core muscle strength,thus the nurse suggests standing on one foot at a time while holding onto a chair back,if necessary,and working to increase the duration of the exercise.Lifting weights helps increase muscle strength.Sit-ups are contraindicated for older adults because they put tremendous amounts of stress on the lumbar spine.Low-impact aerobic exercise helps improve conditioning and endurance.

Question 6

Which change in the skin is abnormal in an older person?&#10;A) Thinner and more fragile skin&#10;B) Red, swollen 3-day-old wound&#10;C) Greater number of freckles&#10;D) Loss of hair on the extremities

Accepted Answer

Although the skin of an older person may require 48 to 72 hours to mount an initial inflammatory response to a wound,increasing redness after that time,particularly with purulent discharge,is a sign of infection.This change is normal as ridges in the skin are lost.Melanin distribution becomes more uneven with age.Hair is commonly lost from the legs and other areas of older adults.Hair loss from the legs is not a sign of peripheral vascular disease.

Question 7

An older man who paints houses for a living has had a myocardial infarction (MI).Which intervention should the nurse implement to prevent adverse health effects from his occupational history?&#10;A) Provide low-cholesterol diet meals.&#10;B) Avoid substances that are hepatotoxic.&#10;C) Promote coughing and deep breathing.&#10;D) Analyze the electrocardiogram's rhythm.

Accepted Answer

The nurse implements coughing and deep breathing because of the older man's history of exposure to environmental toxins from the paint vapor.Therefore to promote oxygenation and ventilation and to prevent atelectasis and pneumonia,the nurse instructs him to cough and deep breathe at regular intervals.Hypercholesterolemia is a common co-morbidity with coronary artery disease; if his total cholesterol is greater than 200 mg/dl,then the nurse should provide a low-cholesterol diet.Inhalation of paint vapor over a long period has adverse effects primarily on the lungs.However,some hepatotoxic substances are used in health care,such as immunosuppressants and aminoglycoside antibiotics,and must be given to this individual with caution.Because he had a MI,the nurse closely monitors the heart's rhythm to detect ventricular dysrhythmias,tachycardia,and other potentially harmful rhythms,but such abnormal rhythms are unlikely to be directly related to his occupational history.

Question 8

An older adult who recently had surgery complains of pain at the level of 3 out of 10 and constipation during the postoperative primary care visit.Which intervention should the nurse implement to first facilitate elimination?

A) Encourage the use of a laxative.
B) Review the medication list.
C) Promote fiber in the diet.
D) Suggest added fluid intake.

Accepted Answer

The nurse begins by reviewing the medication list to find substances that are likely to cause constipation such as opioid analgesics and antidepressants,among others.If the patient is taking an opioid analgesic and because the patient rates the pain as 3 out of 10,then a change in pain medication can help relieve constipation.The use of a laxative can be contraindicated and is the therapy of last resort for constipation caused by factors other than opioid analgesics.Promoting fiber in the diet is a reasonable intervention but can be made unnecessary by omitting the opioid analgesic.Increasing fluid intake is a reasonable nursing intervention for older adults with and without constipation,but it can be unnecessary for this older adult.

Question 9

The Healthy People 2020 document identified which goals for immunizations?&#10;A) Increase percentage of persons who receive a seasonal influenza immunization; 65 years of age or over and living in the community&#10;B) Increase percentage of persons who are vaccinated against herpes zoster, 60 years of age or over&#10;C) Increase percentage of persons who are vaccinated against pneumococcal disease; 65 years of age or over and living in the community&#10;D) Increase percentage of persons who are vaccinated against human papillomavirus (HPV); 60 years of age or over

Accepted Answer

According to the Healthy People 2020 document,the goals are to increase the percentage of persons who receive a seasonal influenza immunization; 65 years of age or over and living in the community; to increase the percentage of persons who are vaccinated against herpes zoster,60 years of age or over; and to increase the percentage of persons who are vaccinated against pneumococcal disease; 65 years of age or over and living in the community.Increasing the percentage of persons vaccinated against HPV,60 years of age or over,is not a goal.After age 27 years,an immunization for HPV is not recommended.

Question 10

An older female patient is reading a large-print magazine and states that reading is difficult for her in the evening.Which intervention should the nurse implement?&#10;A) Put a high-intensity lamp at the head of her bed.&#10;B) Explain to her that the gray-yellow ring around her cornea, arcus senilis, is interfering with visual acuity.&#10;C) Put more powerful tubes in the fluorescent room lights.&#10;D) Examine her retinas for signs of damage.

Accepted Answer

The pupil becomes gradually smaller with age; therefore the eye requires three times as much light.A high-intensity light on the object of interest is more effective than increasing the overall room illumination.The arcus senilis does not affect vision.The patient is describing a gradual overall change,not the more localized or sudden effects of macular degeneration or retinal detachment.

Question 11

The nurse administers an antibiotic and naproxen to an older woman.Which laboratory test result should the nurse monitor to gauge the older adult's response to the medication?&#10;A) Urine creatinine&#10;B) Indirect bilirubin&#10;C) Serum creatinine&#10;D) Total hemoglobin

Accepted Answer

The answer of The nurse administers an antibiotic and naproxen...

Question 12

When caring for an older man patient,the nurse is aware that which changes are associated with the male reproductive system and aging?&#10;A) Testes soften&#10;B) Seminiferous tubules thicken&#10;C) Sperm count decreases&#10;D) Ejaculation is slower

Accepted Answer

The answer of When caring for an older man patient,the...

Question 13

The nurse cares for an older adult who has a prealbumin level of 10 mg/dl and an infection in a large wound.Which intervention is the nurse's priority?&#10;A) Monitor temperature and leukocytes.&#10;B) Provide assistance with meal planning.&#10;C) Provide high-quality protein in the diet.&#10;D) Maintain oxygen saturation above 95%.

Accepted Answer

The answer of The nurse cares for an older adult...

Question 14

The latest trends in medicine encourage health care providers to prescribe nutrient-dense foods and exercise to prevent or delay the shortening of telomeres.On which biological theory of aging are these practices based?

A) Genetic research
B) Caloric restriction
C) Pacemaker theory
D) Cross-link theory

Accepted Answer

The answer of The latest trends in medicine encourage health...

Question 15

Decreased functioning of which physical structure is likely to result in decreased metabolism in older adults?&#10;A) Kidney&#10;B) Thyroid gland&#10;C) Brain&#10;D) Skeleton

Accepted Answer

The answer of Decreased functioning of which physical structure is...

Question 16

The nurse designs a group exercise program at a senior center.Which room should the nurse choose for the program?&#10;A) Room with a beautiful hardwood floor tastefully appointed with throw rugs&#10;B) Spacious room with no windows but with fluorescent lighting and a natural stone floor&#10;C) Room with a hardwood floor and large windows overlooking a garden area&#10;D) End room with a linoleum floor and a fan for ventilation to compensate for the room's broken air conditioner

Accepted Answer

The answer of The nurse designs a group exercise program...

Question 17

Which factor(s)associated with aging contribute(s)to the high incidence of type 2 diabetes mellitus in older adults?&#10;A) Fewer T-lymphocytes&#10;B) Less lean muscle mass&#10;C) Decreased thyroid function&#10;D) Decreased physical activity&#10;E) Left ventricular hypertrophy&#10;F)Decreased insulin sensitivity

Accepted Answer

The answer of Which factor(s)associated with aging contribute(s)to the high...

Question 18

During a walk,an older man suffers a laceration from a broken tree branch.Rank the nurse's interventions in order,beginning with the most important intervention.&#10;A) Flush and cleanse the wound well.&#10;B) Investigate a possible safety hazard.&#10;C) Instruct him to keep the wound covered.&#10;D) Verify a current tetanus immunization.&#10;E) none of the above

Accepted Answer

The answer of During a walk,an older man suffers a...

Deck 5: Theories of Aging and Physical Changes