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Advanced Practice Nursing in the Care of Older Adults 1st Edition By BY KENNEDY AND FLETCHER – Test Bank
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Chapter 5: Symptoms and Syndromes
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The term “geriatric syndrome” is best described as:
| A. | A condition that has multiple underlying factors and involves multiple systems |
| B. | A condition that has a discreet etiology that is difficult to pinpoint |
| C. | Significant progress has been made in understanding geriatric syndromes, especially falls and delirium |
| D. | Therapeutic management of a geriatric syndrome can be accomplished once a specific diagnosis is made |
____ 2. 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 |
____ 3. Atypical presentation of acute coronary syndrome is:
| A. | Most common in Hispanic females |
| B. | More common in men |
| C. | Most common in African American men |
| D. | More common in females |
____ 4. 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 |
____ 5. 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 |
____ 6. Medications known to contribute to constipation include all of the following except:
| A. | Stimulant laxatives |
| B. | Anticholinergic drugs |
| C. | Broad-spectrum antibiotics |
| D. | Iron |
____ 7. 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 |
____ 8. 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 |
____ 9. 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. |
____ 10. 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 |
____ 11. 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 |
____ 12. 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 |
____ 13. 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 |
____ 14. 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 |
____ 15. 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 |
____ 16. 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 |
____ 17. Which form of headache is bilateral?
| A. | Cluster |
| B. | Tension |
| C. | Migraine |
| D. | Acute angle closure glaucoma |
____ 18. 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 |
____ 19. Risk factors associated with the finding of a malignancy in a patient with hemoptysis include all of the following except:
| A. | Male sex |
| B. | Smoking history |
| C. | Over age 40 |
| D. | Childhood asthma |
____ 20. Recent weight loss is defined as:
| A. | loss of >10 pounds over the past 3-6 months |
| B. | loss of >2 pounds a week |
| C. | 5% weight loss in three months |
| D. | 10% weight loss in one year |
____ 21. The most common cause of disability in the elderly is due to:
| A. | Diabetes |
| B. | Arthritis |
| C. | Heart disease |
| D. | Chronic obstructive pulmonary disease |
____ 22. 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 |
____ 23. Drug-induced pruritus is distinguished because it:
| A. | Occurs soon after a new drug is taken |
| B. | Usually is a generalized rash |
| C. | May occur right after the drug is taken or months later |
| D. | Usually involves localized circumscribed lesions |
____ 24. A form of syncope that is more common in the elderly than younger adults is:
| A. | Vasovagal |
| B. | Carotid sinus sensitivity |
| C. | Orthostatic hypotension |
| D. | Arrhythmias |
____ 25. All of the following statements about tremor are true except:
| A. | The most common tremor is the Parkinson tremor |
| B. | Most individuals with tremor do not seek medical attention |
| C. | Psychogenic tremor is uncommon |
| D. | Tremor is more prevalent in whites than blacks |
____ 26. Overflow incontinence is usually associated with:
| A. | Loss of urine that occurs with urgency |
| B. | Cognitive impairment |
| C. | Weak pelvic floor muscles |
| D. | Bladder outlet obstruction |
____ 27. Wandering is best described as:
| A. | Aimless excessive ambulatory behavior |
| B. | Purposeful excessive ambulatory behavior |
| C. | Risk-seeking behavior in the cognitively impaired |
| D. | A result of boredom in those with dementia |
Chapter 5: Symptoms and Syndromes
Answer Section
MULTIPLE CHOICE
- ANS: A PTS: 1
- ANS: B PTS: 1
- ANS: D PTS: 1
- ANS: B PTS: 1
- ANS: C PTS: 1
- ANS: C PTS: 1
- ANS: A PTS: 1
- ANS: C PTS: 1
- ANS: D PTS: 1
- ANS: C PTS: 1
- ANS: B PTS: 1
- ANS: A PTS: 1
- ANS: D PTS: 1
- ANS: A PTS: 1
- ANS: D PTS: 1
- ANS: B PTS: 1
- ANS: B PTS: 1
- ANS: D PTS: 1
- ANS: D PTS: 1
- ANS: A PTS: 1
- ANS: B PTS: 1
- ANS: B PTS: 1
- ANS: C PTS: 1
- ANS: C PTS: 1
- ANS: A PTS: 1
- ANS: D PTS: 1
- ANS: B PTS: 1
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