Chronic Disease Management in Older Adults
Exam Materials
Course Introduction
This course provides an in-depth exploration of chronic disease management specifically tailored for older adults, focusing on the unique physiological, psychological, and social considerations of this population. Students will examine the most prevalent chronic conditions affecting older adults, such as diabetes, cardiovascular diseases, arthritis, and respiratory disorders, as well as evidence-based strategies for their assessment, prevention, and management. Emphasis is placed on interdisciplinary care approaches, patient education, medication management, health promotion, and the role of family and community support. Through case studies and current research, students will develop practical skills to enhance quality of life and functional independence for older adults living with chronic illnesses.
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
Page 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) 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
Answer: A
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Page 3
Chapter 2: Health Promotion
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16 Verified Questions
16 Flashcards
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Sample Questions
Q1) 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
Answer: A
Q2) 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
Answer: C
Q3) The leading cause of death in elderly travelers worldwide is:
A) Cardiovascular disease
B) Infections
C) Accidents
D) Malaria
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) 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
Answer: D
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) 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
Q2) 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
Q3) The best approach to taking the health history is to:
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
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Chapter 5: Symptoms and Syndromes
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) 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
Q2) The anal wink reflex is used to test:
A) Rectal prolapse
B) Sensation and pudental nerve function
C) Baseline and squeeze sphincter tone
D) Fissures and fistulas
Q3) Presbystasis is best described as:
A) Impairment in vestibular apparatus that causes dizziness
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
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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) 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)
Q2) 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
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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) One of the first-line treatments in patients with allergic rhinitis is the use of nasal corticosteroid sprays.What is the anticipated onset of symptom relief with the use of these medications?
A) Two weeks or more
B) Immediate
C) 1 to 2 days
D) A minimum of one week
Q2) You have a patient complaining of vertigo and want to know what could be the cause.Knowing there are many causes for vertigo,you question the length of time the sensation lasts.She tells you several hours to days and is accompanied by tinnitus and hearing loss.You suspect which of the following conditions?
A) Ménière's disease
B) Benign paroxysmal positional vertigo
C) TIA
D) Migraine
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Chapter 8: Chest Disorders
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) Which of the following statements is true concerning anti-arrhythmic drugs?
A) Amiodarone is the only one not associated with increased mortality and it has a very favorable side effect profile.
B) Both long-acting and short-acting calcium channel blockers are associated with an increased risk of cardiovascular morbidity and mortality.
C) Most anti-arrhythmics have a low toxic/therapeutic ratio and some are exceedingly toxic.
D) Anti-arrhythmic therapy should be initiated in the hospital for all patients.
Q2) In mitral stenosis,p waves may suggest:
A) Left atrial enlargement
B) Right atrial enlargement
C) Left ventricle enlargement
D) Right ventricle enlargement
Q3) Aortic regurgitation requires medical treatment for early signs of CHF with:
A) Beta blockers
B) ACE inhibitors
C) Surgery
D) Hospitalization
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Chapter 9: Peripheral Vascular Disorders
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) Known risk factors for lymphedema include all of the following except:
A) Osteoarthritis
B) Rheumatoid arthritis
C) Obesity
D) Venous ulcer disease
Q2) Exercise is an essential element of peripheral arterial disease management primarily because:
A) It encourages weight loss,as being overweight is a contributing factor to PAD
B) Evidence shows exercise reduces smoking
C) Collateral vessels are strengthened
D) It improves aerobic capacity
Q3) When should surgical options for peripheral arterial disease be considered?
A) Immediately after the diagnosis since the prognosis without revascularization is poor
B) After two weeks of pentoxifylline (Trental)therapy
C) Pain is not relieved with rest
D) Pain limits the patient's lifestyle or ulceration occurs
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11
Chapter 10: Abdominal Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Your 70-year-old patient has gastroesophageal reflux disease (GERD).After a trial of lifestyle modifications and antacids,the patient continues to have occasional mild heartburn after occasional meals and at night.The most appropriate next action is:
A) Prokinetic agents
B) H<sub>2</sub> antagonists
C) Proton pump inhibitors
D) Surcralfate
Q2) 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
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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) All of the following antimicrobials may be indicated in chronic bacterial prostatitis except:
A) Ciprofloxacin
B) Levofloxacin
C) Trimethoprim
D) Azithromycin
Q2) In acute prostatitis,an exam of the prostate may find the gland to be:
A) Nodular
B) Cool and pliable
C) Swollen and tender
D) Asymmetrical
Q3) Which ethnic group has the highest incidence of prostate cancer?
A) Asians
B) Hispanics
C) African Americans
D) American Indians
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13
Chapter 12: Musculoskeletal Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Which of the following best describes the pain associated with osteoarthritis?
A) Constant,burning,and throbbing with an acute onset?
B) Dull and primarily affected by exposure to cold and barometric pressure
C) Begins upon arising and after prolonged weight bearing and/or use of the joint
D) Begins in the morning but decreases with activity
Q2) Patients with osteoarthritis of the hip and knee often have a distinguishable gait described as:
A) Ataxic
B) Festinating
C) Antalgic
D) Steppage
Q3) You have ordered a CBC for your patient you suspect has polymyalgia rheumatica (PMR).Which two clinical findings are common in patients with PMR?
A) Neutropenia and hypochromic,normocytic anemia
B) Normochromic,normocytic anemia and thrombocytosis
C) Microcytic,hypochromic anemia and reticulocytopenia
D) Macrocytic,hyperchromic anemia and leukocytopenia
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Page 14
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 older male patient is experiencing acute onset of right-sided weakness,slurred speech,and confusion.What should the nurse practitioner do promptly?
A) Administer an aspirin by mouth
B) Evaluate for stroke and arrange transport to the hospital right away
C) Do a thorough medication review and stat blood sugar
D) Order an EKG and administer O<sub>2</sub> by cannula immediately
Q2) An older adult female patient had a stroke.What symptoms are not usually expressed by patients who have had a vertebrobasilar stroke?
A) Vertigo
B) Ataxia
C) Dysarthria
D) Monocular blindness
Q3) Which of the following assessment findings is commonly noted in a client with advanced Parkinson's disease?
A) Macrographia
B) Micrographia
C) Ataxic gait
D) Increased arm swing
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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) An elderly client presents with a new onset of feeling her heart race and fatigue.An EKG reveals atrial fibrillation with rate >110.The patient also has a new fine tremor of both hands.Which of the following would the nurse practitioner suspect?
A) Hypothyroidism
B) Hyperthyroidism
C) Congestive heart failure
D) Type 2 diabetes mellitus
Q2) Which is a "cardinal feature" of failure to thrive?
A) Decline in toileting ability
B) Gait disturbance
C) Poor nutritional status
D) Spiritual distress
Q3) When evaluating the expected outcome for a hypothyroid elderly patient placed on levothyroxine,the nurse practitioner will:
A) Assess a weekly TSH
B) Assess the TSH in 4-6 weeks
C) Ask the patient if the symptoms have subsided and adjust dosage accordingly
D) Decrease the dosage should a cardiac event occur
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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 pathophysiological hallmark of ACD is:
A) Depleted iron stores
B) Impaired ability to use iron stores
C) Chronic uncorrectable bleeding
D) Reduced intestinal absorption of iron
Q2) When interpreting laboratory data,you would expect to see the following in a patient with Anemia of Chronic Disease (ACD):
A) Hemoglobin <12 g/dl,Mean Corpuscular Volume (MCV)decreased,Mean Corpuscular Hemoglobin (MCH)decreased
B) Hemoglobin >12 g/dl,Mean Corpuscular Volume (MCV)increased,Mean Corpuscular Hemoglobin (MCH)increased
C) Hemoglobin <12 g/dl,Mean Corpuscular Volume (MCV)normal,Mean Corpuscular Hemoglobin (MCH)normal
D) Hemoglobin >12 g/dl,Mean Corpuscular Volume (MCV)decreased,Mean Corpuscular Hemoglobin (MCH)increased
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17
Chapter 16: Psychological Disorders
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) The comorbid psychiatric problem with the highest frequency in dementia is:
A) Anxiety
B) Depression
C) Agitation and aggression
D) Psychosis
Q2) The proposed mechanism by which diphenhydramine causes delirium is:
A) Serotinergic effects
B) Dopaminergic effects
C) Gabanergic effects
D) Anticholinergic effects
Q3) A consistent finding in delirium,regardless of cause,is:
A) Dopamine deficiency
B) Serotinergic toxicity
C) Acetylcholine deficiency
D) Reduction in regional cerebral perfusion
Q4) The majority of depressed older adults remain untreated because of:
A) Misdiagnosis
B) Social stigma
C) Environmental barriers
D) All of the above
Page 18
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Chapter 17: Nutritional Support in the Older Adult
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) An 87-year-old female previously independent comes to the ER with 2 days of difficulty swallowing,productive cough,and dyspnea.History includes hypertension and atrial fibrillation.She has a low-grade fever and increased blood pressure.Physical examination and chest radiography are consistent with consolidation in left lower lobe.On bedside testing,she immediately sputters and coughs after drinking a small amount of water from a cup.There are no other neurological signs.Labs: Mild dehydration and WBC increased.MRI reveals a new small brain-stem infarction and mild generalized cerebral atrophy.Treatment for aspiration pneumonia is instituted.Five days later a speech therapy consult was ordered to evaluate swallowing.No improvement has been noted and formal evaluation shows aspiration with most consistencies of food and liquid.Which of the following is the best recommendation?
A) Careful oral feeding
B) Hospice
C) Gastrostomy feeding
D) Nasogastric feeding
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Chapter 18: Chronic Illness and the Advanced Practice
Registered Nurse Aprn Available
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Sample Questions
Q1) The legislation signed in March 2010 with provisions for addressing chronic disease was:
A) Accountable Care Organization Act
B) Independence at Home Act
C) Patient Protection and Affordable Care Act
D) Patient Centered Medical Home Act
Q2) 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
Q3) Inter-professional care is distinguished from other models of team-based care in that:
A) Independent providers share information
B) Expert advice is shared from one provider to another
C) Different disciplines work under one leader
D) Shared leadership and accountability is a primary focus
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Page 20
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 highest level of evidence to support interventions at the end of life is with:
A) Opioids for pain control
B) Hyocsyamine for respiratory secretions
C) Stimulant laxatives for treating constipation
D) Opioids for dyspnea
Q2) Evidence reflects the primary obstacle to implementing palliative care in the long-term care setting include all of the following except:
A) Inadequate communication between decision makers
B) Failure to recognize futile treatments
C) Lack of advance directives
D) Lack of sufficient staff
Q3) Pharmacological interventions for dyspnea include all of the following except:
A) Antitussives
B) Inhaled anesthetics
C) Sedatives
D) Anxiolytics
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