TEST BANK FOR Advanced Practice Nursing
in the Care of Older Adults, 3rd Edition
by Laurie Kennedy-Malone, Verified Chapters 1 - 23, Complete
,Answers at the end of the Chapter
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 adultsexcept:
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
D. The side effects commonly associated with the drug
7. 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
8. 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
9. Men have faster and more efficient biotransformation of drugs and
this is thought tobe due to:
A. Less obesity rates than women
B. Prostate enlargement
C. Testosterone
D. Less estrogen than women
10. 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
11. 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
, 12. 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
13. 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
Chapter 1: Changes with Aging
Answer Section
MULTIPLE CHOICE
1. ANS: D PTS: 1
2. ANS: C PTS: 1
,3. ANS: B PTS: 1
4. ANS: D PTS: 1
5. ANS: C PTS: 1
6. ANS: B PTS: 1
7. ANS: D PTS: 1
8. ANS: A PTS: 1
9. ANS: C PTS: 1
10. ANS: C PTS: 1
11. ANS: A PTS: 1
12. ANS: C PTS: 1
13. ANS: B PTS: 1
, Chapter 2. Health Promotion
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The leading cause of death in elderly travelers worldwide is:
A. Cardiovascular disease
B. Infections
C. Accidents
D. Malaria
2. Which of the following should be avoided in countries where food and water precautions are to be
observed?
A. Hot coffee
B. Bottled water
C. Salad buffet
D. Unpeeled bananas
3. What insect precautions are not necessary to prevent insect-borne diseases in the tropics?
A. Using 100% DEET on skin to prevent bites
B. Treating clothes with permethrin
C. Covering up exposed skin to lessen biting surface
D. Taking malaria pills as directed for areas at risk for malaria
, 4. 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 theca
C. Provide foot care for a diabetic patient
D. Administer a tetanus shot
5. 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.
6. 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
7. 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 yourecommend 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
8. 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 (24
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
9. 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
thebasis of:
A. A predicted decreased incidence of high blood pressure in this population
B. A recognized element of high risk within this group
, C. Readily available treatment measures
D. Achieving an administrative goal for the congregate living facility
10. 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
11. 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
beeninjured from 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.
12. 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
nk 13. 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 choice
D. Identify the barriers that the client will encounter
14. 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
15. 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
16. 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
