Advanced Nursing Practice: Chronic Illness in Older Adults
Exam Questions
Course Introduction
This course explores the advanced nursing roles and interventions required for managing chronic illnesses in older adults. Students will examine the complex interactions of physiological changes associated with aging, comorbid conditions, and psychosocial factors that affect health and quality of life in this population. Emphasis is placed on evidence-based assessment, care planning, and collaboration with interdisciplinary teams to optimize outcomes. The course also covers ethical decision-making, patient education, self-management strategies, and family-centered care, equipping nurses to deliver holistic and culturally competent care to older adults with chronic conditions.
Recommended Textbook
Advanced Practice Nursing in the Care of Older Adults 1st Edition by Laurie Kennedy Malone
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19 Chapters
312 Verified Questions
312 Flashcards
Source URL: https://quizplus.com/study-set/3891
2
Chapter 1: Changes With Aging
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) 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
Answer: B
Q2) 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
Answer: C
Q3) 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
Answer: D
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3
Chapter 2: Health Promotion
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16 Verified Questions
16 Flashcards
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Sample Questions
Q1) 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 permetherin
C) Covering up exposed skin to lessen biting surface
D) Taking malaria pills as directed for areas at risk for malaria
Answer: A
Q2) 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
Answer: C
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Chapter 3: Exercise in Older Adults
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5 Verified Questions
5 Flashcards
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Sample Questions
Q1) 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
Answer: D
Q2) Which of the following medical conditions is not considered restrictive for engaging in physical activity?
A) Unstable angina
B) Dehydration
C) Depression
D) Uncontrolled tachycardia
Answer: C
Q3) Exercise recommended for older adults should include activities that:
A) Conserve energy
B) Restrict flexibility
C) Strengthen muscles
D) Are anaerobic in nature
Answer: C
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Chapter 4: Comprehensive Geriatric Assessment
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) 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
Q2) Evidence-based geriatric assessment instruments available to the clinician:
A) Are largely screening instruments to detect a condition
B) Largely do not exist and if they do they have limited clinical utility
C) Include screening,evaluation,and measurement instruments in multiple domains
D) Have applicability in the outpatient but not the inpatient setting
Q3) 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
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6
Chapter 5: Symptoms and Syndromes
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) 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
Q2) Lipedema is best described as:
A) Bilateral accumulation of interstitial fluid
B) Bilateral distribution of fat in the lower extremities
C) Fluid retention caused by a compromised lymphatic system
D) Lipid molecules that break down and cause fluid retention
Q3) Medications known to contribute to constipation include all of the following except:
A) Stimulant laxatives
B) Anticholinergic drugs
C) Broad-spectrum antibiotics
D) Iron
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Chapter 6: Skin and Lymphatic Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) 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
Q2) 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 >55
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
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Chapter 7: Head, neck, and Face Disorders
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Sensory impairment (vision and hearing)in the elderly is associated with:
A) Impaired quality of life
B) Decreased function
C) Increased mortality
D) All of the above
Q2) Causes of sensorineural hearing loss include:
A) Ototoxicity
B) Ménière's disease
C) Otosclerosis
D) Inner ear fistula
Q3) Which of the following conditions is the leading cause of blindness in the United States?
A) Macular degeneration
B) Diabetic retinopathy
C) Glaucoma
D) Cataracts
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9
Chapter 8: Chest Disorders
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) Aortic regurgitation requires medical treatment for early signs of CHF with:
A) Beta blockers
B) ACE inhibitors
C) Surgery
D) Hospitalization
Q2) A 55-year-old post-menopausal woman with a history of hypertension complains of jaw pain on heavy exertion.There were no complaints of chest pain.Her ECG indicates normal sinus rhythm without ST segment abnormalities.Your plan may include:
A) Echocardiogram
B) Exercise stress test
C) Cardiac catheterization
D) Myocardial perfusion imaging
Q3) Ischemic heart disease is:
A) Defined as imbalance between oxygen supply and demand.
B) Frequently is manifested as angina.
C) Leading cause of death in the elderly.
D) All of the above.
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10
Chapter 9: Peripheral Vascular Disorders
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) The clinician should begin the peripheral vascular exam with:
A) Auscultation of the carotid arteries
B) Checking for peripheral edema
C) Auscultation of the heart
D) Palpation of the upper extremity arteries
Q2) The imaging gold standard for lymphedema is:
A) Lymphosonogram
B) Lymphoscintigraphy
C) Lymphoangiogram
D) CT scan
Q3) The major cause of death after an abdominal aortic aneurysm repair is:
A) AAA rupture
B) Hemorrhage
C) Renal failure
D) Myocardial infarction
Q4) A thorough vascular exam includes all of the following except:
A) Cardiac exam
B) Reproductive organ exam
C) Peripheral vascular exam
D) Cranial nerve exam
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Chapter 10: Abdominal Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) A 62-year-old client presents with a complaint of fever,pain,and burning on urination.Difficulty urinating with dribbling has been increasing in the past few days.He has a feeling of pressure in his groin.On examination,his prostate is tender,boggy,and warm.A stat urinalysis reveals the presence of leukocytes and bacteria.He is allergic to sulfa drugs.His weight is 70 kg and his last serum creatinine was 1.0.While awaiting the culture and sensitivity,the nurse practitioner begins empiric treatment with which of the following?
A) Trimethoprim/sulfamethroxazole DS bid x 2 weeks
B) Ampicillin 250 mg PO q day for 10 days
C) Nitrofurantoin 100 mg Q 12 hours for 7 days
D) Ciprofloxacin 500 mg Q 12 hours for 14 days
Q2) An obese middle-aged client presents with a month of nonproductive irritating cough without fever.He also reports occasional morning hoarseness.What should the differential include?
A) Atypical pneumonia
B) Peptic ulcer disease
C) Gastroesophageal reflux
D) Mononucleosis (Epstein-Barr)
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Chapter 11: Urological and Gynecological Disorders
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) The nurse practitioner is evaluating a patient's pelvic muscle strength by digital examination.This is performed when:
A) A male patient complains of nocturia and dribbling
B) The nurse practitioner needs to confirm a cystocele or stress incontinence
C) The patient reports sudden loss of large amounts of urine or urge incontinence
D) The nurse practitioner suspects overflow incontinence
Q2) In the diagnosis of acute bacterial prostatitis,a midstream urine culture is of benefit.To be diagnostic,the specimen should reveal how many white blood cells per high-power field?
A) Five
B) Ten
C) Fifteen
D) Twenty
Q3) All of the following antimicrobials may be indicated in chronic bacterial prostatitis except:
A) Ciprofloxacin
B) Levofloxacin
C) Trimethoprim
D) Azithromycin
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Page 13
Chapter 12: Musculoskeletal Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) The best method of verifying a diagnosis of gout in a joint is which of the following:
A) Radiographic examination of the joint with two views
B) Ultrasound
C) Palpation
D) Joint aspiration and polarized-light microscopy
Q2) In providing health teaching related to dietary restrictions,the nurse practitioner should advise a patient with gout to avoid which of the following dietary items:
A) Green leafy vegetables
B) Beer,sausage,fried seafood
C) Sugar
D) Gluten and bread items
Q3) When examining the spine of an older adult you notice a curvature with a sharp angle.This is referred to as a:
A) Gibbus
B) Scoliosis
C) Kyphosis
D) Lordosis
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Chapter 13: Central and Peripheral Nervous System Disorders
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) An elderly patient has had a CVA in the anterior cerebral circulatory system (frontal lobe).What symptoms are most likely expressed?
A) Neglect of body and difficulty organizing space
B) Wernicke's aphasia (difficulty understanding speech)
C) Disorders of behavior and cognition
D) Bilateral motor and sensory problem
Q2) A 78-year-old female presents with a seizure that occurred over the weekend.In selecting the most important diagnostics for this presentation,it is important to know that the least common site of seizures in the elderly is:
A) Cerebellum
B) Frontal lobe
C) Temporal lobe
D) Parietal lobe
Q3) The most common neurological cause of seizures in an older adult is:
A) Alzheimer's disease
B) Multiple sclerosis
C) Stroke
D) Peripheral neuropathy
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Chapter 14: Endocrine, metabolic, and Nutritional Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) A 62-year-old female complains of fatigue and lack of energy.Constipation has increased and the patient has gained ten pounds in the past 3 months.Depression is denied although the patient reports a lack of interest in usual hobbies.Vital signs are within normal limits and the patient's skin is dry and cool.Which of the following must be included in the differential?
A) Hyperthyroidism
B) Hypothyroidism
C) Hyperparathyroidism
D) Grave's disease
Q2) Which of the following nutritional indicators is not an indication of poor nutritional status in an older person?
A) Albumin of < 3.5 g/dl
B) Body mass index of 25
C) Total cholesterol < 150 mg/dl
D) Loss of 10% body weight in 180 days
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16
Chapter 15: Hematological and Immune System Disorders
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) The main focus of treatment of patients with ACD is:
A) Replenishing iron stores
B) Providing for adequate nutrition high in iron
C) Management of the underlying disorder
D) Administration of monthly vitamin B<sub>12</sub> injections
Q2) Education of patient and family regarding ACD includes discussion of all of the following except:
A) Early prevention of chronic conditions through healthy lifestyle measures
B) Importance of adherence to the treatment plan for management of chronic conditions
C) Explaining the ACD is mainly attributed to the aging process
D) Importance of regular follow-up to monitor responses to treatments
Q3) The primary mode of HIV transmission in the U.S.is:
A) Blood transfusion
B) Men having sex with men
C) Heterosexual contact
D) Needle sharing
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Chapter 16: Psychological Disorders
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15 Flashcards
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Sample Questions
Q1) The proposed mechanism by which diphenhydramine causes delirium is:
A) Serotinergic effects
B) Dopaminergic effects
C) Gabanergic effects
D) Anticholinergic effects
Q2) Which of the following is the most appropriate screening tool for delirium?
A) Lawton Scale of Instrumental Activities of Daily Living
B) Confusion Assessment Method
C) Folstein's Mini-Mental Status Examination
D) Montreal Cognitive Assessment
Q3) The prevalence of depression in nursing home residents is greater than adults living in the community.
A) 1-2 times
B) 2-3 times
C) 3-4 times
D) 5 times
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18
Chapter 17: Nutritional Support in the Older Adult
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) Feedings via PEG tube can safely begin hours after PEG tube placement,barring any contraindications.
A) 2 hours
B) 6 hours
C) 24 hours
D) 48 hours
Q2) Which of the following is not considered a benefit of high protein supplements added to diets of hospitalized older adults?
A) Improved grip strength
B) Increased weight
C) Overall increased intake of food
D) Reduced readmissions to the hospital
Q3) The use of feeding gastrostomy tubes at the end of life in Alzheimer's disease patients has been associated with:
A) Prolongation of life
B) Aspirational pneumonia
C) Increase in decubitus ulcer rate
D) Reversal of any clinical signs of failure to thrive
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19
Chapter 18: Chronic Illness and the Advanced Practice
Registered Nurse Aprn
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) Which statement about chronic mental disorders is false?
A) The numbers are projected to increase in the next decade
B) Individuals with mental health problems actually have a decreased risk of medical problems
C) The number of older adults with addiction problems is projected to increase in the next decade
D) Nearly half of individuals with dementia are not diagnosed prior to hospitalization
Q2) Transitional care is best described as:
A) A set of actions to ensure the coordination and continuity of care across sites/settings
B) The care received in transit from one site of care to another
C) A discharge-planning model
D) Long-term acute care that provides the transition from hospital to long-term care or home
Q3) All of the following criteria define frailty except:
A) Unintentional weight loss >10 pounds in the past year
B) Slow walking speed
C) Stooped posture
D) Self-reported exhaustion
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Chapter 19: Palliative Care and End-Of-Life Care
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16 Verified Questions
16 Flashcards
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Sample Questions
Q1) The tasks of grieving include all of the following except:
A) Acknowledge the reality of death
B) Work through the pain of grief
C) Begin to disengage
D) Restructure relationships
Q2) The best description of complicated grief is:
A) Chronic,delayed,exaggerated,masked,or disenfranchised
B) Experience of shock during notification of the death
C) When grief is actually experienced before the death of a loved one
D) A physical illness develops soon after death of a loved one
Q3) The highest level of evidence with the use of adjuvant analgesics is with:
A) Tricyclic antidepressants avoided due to high adverse events
B) Therapeutic trials before discontinuing drugs
C) Patient with fibromyalgia are candidates for adjuvant analgesics
D) Neuropathic pain patients are candidates for adjuvant analgesia
Q4) Pain at the end of life is most often due to all of the following except:
A) Musculoskeletal disorders
B) Headache
C) Cancer pain
D) Neuropathic pain
Page 21
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