Gerontological Nursing 7th Edition Eliopoulos Test Bank
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Chapter 27 Endocrine Function
|1.||Which of the following older adults is most likely experiencing the effects of age-related changes to endocrine function?|
|A)||A 71-year-old woman whose circadian rhythms are disrupted due to decreased melatonin production by her pineal gland|
|B)||A 78-year-old woman whose pancreas is releasing insufficient amounts of insulin, resulting in hyperglycemia|
|C)||A 67-year-old man who is experiencing hyperthermia and insomnia due to increased thyroid activity|
|D)||A 69-year-old man who has experienced decreased sexual responsiveness due to a large decline in testosterone production|
|2.||A diabetes nurse is providing an educational in-service to nurses who provide care on a geriatric, subacute medical unit of a hospital. Which of the following teaching points related to diagnosing diabetes in older adults is most accurate?|
|A)||“Older adults with a new onset of diabetes will be hungry and thirsty with copious urine output.”|
|B)||“Because of an absence of signs and symptoms in older adults with diabetes, diagnosis can be very difficult.”|
|C)||“Older persons can often display signs and symptoms of diabetes that are very different from those in younger adults.”|
|D)||“Pancreatic biopsy is often required in order to determine a definitive diagnosis of diabetes in the elderly.”|
|3.||A 71-year-old man has been diagnosed with type 2 diabetes based on the results of his glucose tolerance test during his current hospital stay. His care team has prescribed oral glimepiride to begin the same day. Which of the following guidelines should the patient’s nurse use in the administration of the new drug?|
|A)||Administer the drug 30 minutes before each meal, beginning the drug with a low dose.|
|B)||Give the glimepiride only if blood glucose exceeds 200 mg/dL (11.1 mmol/L).|
|C)||Give an increased dose initially in order to establish a therapeutic serum concentration of the drug.|
|D)||Hold the drug if the patient exhibits signs and symptoms of hyperglycemia.|
|4.||Which of the following statements best conveys the relationship between hyperglycemia and glycosuria in older adults?|
|A)||Older adults’ kidneys tolerate higher glucose levels, so hyperglycemia does not necessarily result in glycosuria.|
|B)||Because older adults often display atypical signs and symptoms of diabetes, glycosuria coupled with hyperglycemia is considered the most accurate source of a definitive diagnosis.|
|C)||Decreased renal filtration capacity in older individuals causes their urine to normally contain more glucose than that of younger adults.|
|D)||Glycosuria is considered a pathological finding in younger adults but a normal finding in older adults.|
|5.||During patient education of a 71-year-old woman who has a recent diagnosis of diabetes, the nurse emphasizes the importance of consistently maintaining blood glucose levels within the normal range rather than simply reacting to high or low levels. Which of the following tests is most likely to gauge the consistency of the woman’s blood sugar control over time?|
|A)||Random blood glucose|
|D)||Glucose tolerance test (GTT)|
|6.||Mr. U, aged 71, has asked the home care nurse that regularly performs visits to his apartment about ways that he might be able to control his type 2 diabetes using exercise. How should the nurse respond to Mr. U’s query?|
|A)||“Exercise is very beneficial for diabetes control, but if it’s too vigorous it can lead to rebound hyperglycemia that is dangerous.”|
|B)||“Confirm with your doctor, but it’s likely best to maintain a low activity levels to keep your glucose levels within normal range.”|
|C)||“Exercise can be an excellent substitute for oral antihyperglycemic medications.”|
|D)||“It’s important to have an exercise plan that is appropriate specifically for you, because you don’t want to bring on hypoglycemia by exercising too hard.”|
|7.||Which of the following statements by patients on a geriatric medicine unit would be considered suggestive of hypothyroidism? Select all that apply.|
|A)||“I’ve never been prone to constipation in the past, but lately I’m only having a bowel movement every 3 or 4 days.”|
|B)||“I’m having a terrible time getting to sleep at night and I keep waking up early.”|
|C)||“Lately I just can’t manage to stay warm no matter how high I keep the thermostat.”|
|D)||“I’ve always been a cheerful person but now I can’t shake this blue feeling.”|
|E)||“I feel like I just don’t have the energy that I normally do.”|
|8.||Based on a 77-year-old male patient’s signs and symptoms, the care team suspects that he has an overactive thyroid gland. Which of the following components of assessment is most likely to yield information that is central to the diagnosis?|
|A)||A review of the man’s medication regimen, specifically addressing the use of cardiac medications|
|B)||Measurement of the patient’s respiration rate, breath sounds, and oxygen saturation|
|C)||Blood work that focuses on liver function|
|D)||Echocardiography and assessment of cardiac function|
|9.||After blood work that indicated an HDL level of 53 mg/dL (low), an LDL level of 144 mg/dL (high), and triglycerides of 252 mg/dL (high), a 73-year-old male client states that he has “bigger things to worry about than that.” How can the nurse best respond to the man’s dismissal of these laboratory findings?|
|A)||“It would be beneficial for you to have lower cholesterol levels to reduce your chances of getting diabetes.”|
|B)||“Elevated cholesterol levels like yours carry a real risk of angina and heart attack.”|
|C)||“This is most likely related to the medications you take, and changing them will hopefully take care of the problem.”|
|D)||“I’d encourage you to consider these results carefully, because they could lead to kidney disease if they’re not corrected.”|
|10.||A 72-year-old woman who has long maintained an active lifestyle is eager to correct her recent diagnosis of mild hyperlipidemia. Which of the following measures should the nurse first suggest?|
|A)||Discussion of angioplasty with her physician|
|B)||Use of statin drugs|
|C)||Exercise and careful monitoring of blood glucose levels|
|D)||Use of the American Heart Association’s step 1 diet, coupled with exercise|
|11.||With aging, the endocrine system experiences changes that can be diverse and interrelated. Which of the following statements accurately describes an effect of aging on the endocrine system and its hormones?|
|A)||The action of water-soluble hormones on body cells increases|
|B)||The endocrine system’s ability to regulate body activities decreases|
|C)||The response of body cells to hormones increases|
|D)||Hormones become more concentrated|
|12.||Early diagnosis of diabetes in the elderly is often difficult because the classic symptoms of diabetes may be absent. What is the most reliable indicator of diabetes in the elderly?|
|A)||High blood glucose level|
|C)||High urinary glucose level|
|13.||Before having a blood sugar test, a patient must avoid drugs that affect blood glucose level. In analyzing a patient’s blood glucose level, the nurse should be aware of any drugs the patient is taking. Which of the following drugs may lower a patient’s blood sugar level?|
|D)||Monoamine oxidase inhibitors|
|14.||Patients with newly diagnosed diabetes are often fearful and nervous about coping with the disease. Only some of their fears are unfounded. Which of these concerns is undeniably true?|
|A)||“I will have to make lifestyle changes.”|
|B)||“I can’t learn to inject myself with insulin.”|
|C)||“I will eventually have to enter a nursing home.”|
|D)||“I can’t afford a special diet.”|
|15.||Diabetes is prevalent in nursing home populations. A nurse in such a home recognizes that which of the following are symptoms of hypoglycemia characteristic of the elderly?|
|A)||Tachycardia and restlessness|
|B)||Poor sleep patterns and slurred speech|
|C)||Perspiration and anxiety|
|D)||Poor sleep patterns and anxiety|
|16.||An elderly woman complains to her beautician about feeling tired and chilly and having dry skin and coarse hair. Instead of selling her an expensive beauty preparation, the beautician advises her to see a doctor. What is the first disorder for which the physician is likely to have her tested?|
|D)||Peripheral vascular disease|
|17.||An elderly man in very good health has a lipid screening during a visit to his nurse practitioner. He is tested for triglyceride level, high-density lipoprotein level (HDL), and low-density lipoprotein level (LDL). What values should a nurse evaluate as desirable for him?|
|A)||Triglycerides less than 200 mg/dL, HDL more than 60 mg/dL, LDL less than 160 mg/dL|
|B)||Triglycerides less than 200 mg/dL, HDL more than 60 mg/dL, LDL less than 100 mg/dL|
|C)||Triglycerides less than 200 mg/dL, HDL more than 100 mg/dL, LDL less than 130 mg/dL|
|D)||Triglycerides less than 100 mg/dL, HDL more than 60 mg/dL, LDL less than 160 mg/dL|
|18.||A patient with a diagnosis of coronary artery disease is hospitalized. When he fills out a form to request the next day’s meals, the items he includes are oatmeal with raisins, fried chicken, fruit juice, and wine. Which food choice should a nurse identify as being potentially harmful for him?|
|A)||Oatmeal with raisins|
|19.||The elderly population has a high incidence of hyperglycemia. Compared with younger people, what makes the elderly more vulnerable to this disorder?|
|B)||Improved diagnostic tests|
|20.||Exercise has multiple health benefits for nearly everyone. Why should a patient with diabetes be advised to exercise with caution?|
|A)||The resting heart rate is lowered.|
|B)||Hypoglycemia may occur.|
|C)||The heart rate is temporarily increased.|
|D)||The absorption of insulin is lowered.|
|21.||Older people are subject to a long list of complications from diabetes, so the disease must be strictly managed. Which of the following statements is true about diabetes and its complications?|
|A)||Hyperglycemia is associated with anxiety and insomnia.|
|B)||Unmanaged hyperglycemia can cause tachycardia and heart arrhythmias.|
|C)||Ketoacidosis can cause gangrene in the limbs and lead to eventual amputation.|
|D)||Diabetes can eventually damage nearly every body system.|
|22.||At a routine visit to her physician, Mrs. Z reports that she no longer has the constipation that has troubled her for years and that she now has normal bowel movements. Mrs. Z’s physician would most likely suspect that this patient has:|
|7.||A, C, D, E|