Question 1

A 91-year-old client learns that his urine protein is 8.2 mg/100 mL.When asked to explain the significance of the result, the nurse replies:

Accepted Answer

A) "It may be elevated because of a urinary tract infection." 
B) "The result is not significant since it's within normal limits." 
C) "The level is usually elevated in people your age." 
D) "Mild chronic renal failure causes a decrease in urine protein." 
A) "It may be elevated because of a urinary tract infection." 
B) "The result is not significant since it's within normal limits." 
C) "The level is usually elevated in people your age." 
D) "Mild chronic renal failure causes a decrease in urine protein." A

Question 2

An older adult client is experiencing symptoms commonly associated with hyperglycemia (diabetes mellitus).Which laboratory test is most reliable for detecting hyperglycemia in older adults?

Accepted Answer

A) A serum glucose drawn after at least 6 hours of fasting 
B) An oral glucose tolerance test 
C) An early morning urine test for glucose 
D) A 24-hour urine glucose test 
A) A serum glucose drawn after at least 6 hours of fasting 
B) An oral glucose tolerance test 
C) An early morning urine test for glucose 
D) A 24-hour urine glucose test B

Question 3

A 66-year-old client has a decreased calcium level.The nurse anticipates a(n):

Accepted Answer

A) elevated sodium level. 
B) elevated phosphorus level. 
C) decreased magnesium level. 
D) decreased serum glucose level. 
A) elevated sodium level. 
B) elevated phosphorus level. 
C) decreased magnesium level. 
D) decreased serum glucose level. B

Question 4

An older adult client has an elevated prostate-specific antigen ( PSA ) level.The nurse shares with him that a diagnosis of prostate cancer would be confirmed with an analysis of his:

Accepted Answer

A) alkaline phosphatase level. 
B) acid phosphatase level. 
C) serum amylase level. 
D) uric acid level. 
A) alkaline phosphatase level. 
B) acid phosphatase level. 
C) serum amylase level. 
D) uric acid level.

Question 5

The nurse helps minimize an older adult client's risk of developing pernicious anemia by:

Accepted Answer

A) suggesting supplementing vitamin A. 
B) encouraging regular intake of citrus. 
C) identifying iron rich foods. 
D) suggesting supplementing vitamin B12 
A) suggesting supplementing vitamin A. 
B) encouraging regular intake of citrus. 
C) identifying iron rich foods. 
D) suggesting supplementing vitamin B12

Question 6

On assessing the laboratory data of your older adult client, the nurse notes that his serum potassium level is 5.3 mmol/L.Based on this information, the nurse:

Accepted Answer

A) asks whether he has been using a nonsteroidal antiinflammatory drug. 
B) determines whether he is receiving a diuretic that promotes potassium loss. 
C) suggests several potassium-rich foods to supplement his potassium intake. 
D) monitors his urinary output for possible fluid retention. 
A) asks whether he has been using a nonsteroidal antiinflammatory drug. 
B) determines whether he is receiving a diuretic that promotes potassium loss. 
C) suggests several potassium-rich foods to supplement his potassium intake. 
D) monitors his urinary output for possible fluid retention.

Question 7

The nurse is caring for an 88-year-old client who was admitted to the long-term care facility after a recent conviction of driving while intoxicated.On reviewing the laboratory work and observing a low folic acid level, the nurse:

Accepted Answer

A) increases the client's caloric intake. 
B) performs a dietary assessment on the client. 
C) provides the client with sodium-rich foods. 
D) immediately notifies the client's physician. 
A) increases the client's caloric intake. 
B) performs a dietary assessment on the client. 
C) provides the client with sodium-rich foods. 
D) immediately notifies the client's physician.

Question 8

The nurse suspects that an acute postoperative infectious process may be developing in your older adult client.What abnormal finding best supports this suspicion?

Accepted Answer

A) a thrombocyte count of 40,000/mm3. 
B) decreasing erythrocyte sedimentation rate of 10 to 20 mm/hr. 
C) increasing C-reactive protein level. 
D) increased partial prothrombin time. 
A) a thrombocyte count of 40,000/mm3. 
B) decreasing erythrocyte sedimentation rate of 10 to 20 mm/hr. 
C) increasing C-reactive protein level. 
D) increased partial prothrombin time.

Question 9

An 83-year-old client has a pressure ulcer that is resistant to healing despite aggressive therapy.The nurse suspects the need for a protein supplement based on a(n):

Accepted Answer

A) serum creatinine level of 1.1 mg/dL. 
B) acid phosphate level of 0.9 U/L. 
C) folate level of 18.2 ng/mL. 
D) serum albumin level of 3.1 g/dL. 
A) serum creatinine level of 1.1 mg/dL. 
B) acid phosphate level of 0.9 U/L. 
C) folate level of 18.2 ng/mL. 
D) serum albumin level of 3.1 g/dL.

Question 10

The nurse explains to an older client that the assessment of her thyroid health will require both a physical examination as well as laboratory test because:

Accepted Answer

A) thyroid studies are less accurate in older adults. 
B) symptoms are similar to those caused by various infections. 
C) it can be present without producing overt symptoms. 
D) T3 levels are normally increased in aging. 
A) thyroid studies are less accurate in older adults. 
B) symptoms are similar to those caused by various infections. 
C) it can be present without producing overt symptoms. 
D) T3 levels are normally increased in aging.

Question 11

The leukocyte count of an older adult client is elevated.The nurse shows the best understanding of the effect of aging on body function when:

Accepted Answer

A) checking the client for drug allergies before requesting an antibiotic prescription. 
B) asking that the client's temperature be taken before notifying the physician. 
C) encouraging the client to drink several glasses of water and then repeat the laboratory tests. 
D) having the client produce a urine sample and requesting a stat urinalysis. 
A) checking the client for drug allergies before requesting an antibiotic prescription. 
B) asking that the client's temperature be taken before notifying the physician. 
C) encouraging the client to drink several glasses of water and then repeat the laboratory tests. 
D) having the client produce a urine sample and requesting a stat urinalysis.

Question 12

A 71-year-old client has a cholesterol level of 182 mg/dL.The nurse anticipates a(n):

Accepted Answer

A) elevated A1C level. 
B) elevated troponin level. 
C) similar triglyceride level. 
D) similar blood urea nitrogen level. 
A) elevated A1C level. 
B) elevated troponin level. 
C) similar triglyceride level. 
D) similar blood urea nitrogen level.

Exam 21: Laboratory and Diagnostic Tests

A 91-year-old client learns that his urine protein is 8.2 mg/100 mL.When asked to explain the significance of the result, the nurse replies:

An older adult client is experiencing symptoms commonly associated with hyperglycemia (diabetes mellitus).Which laboratory test is most reliable for detecting hyperglycemia in older adults?

A 66-year-old client has a decreased calcium level.The nurse anticipates a(n):

An older adult client has an elevated prostate-specific antigen ( PSA ) level.The nurse shares with him that a diagnosis of prostate cancer would be confirmed with an analysis of his:

The nurse helps minimize an older adult client's risk of developing pernicious anemia by:

On assessing the laboratory data of your older adult client, the nurse notes that his serum potassium level is 5.3 mmol/L.Based on this information, the nurse:

The nurse is caring for an 88-year-old client who was admitted to the long-term care facility after a recent conviction of driving while intoxicated.On reviewing the laboratory work and observing a low folic acid level, the nurse:

The nurse suspects that an acute postoperative infectious process may be developing in your older adult client.What abnormal finding best supports this suspicion?

An 83-year-old client has a pressure ulcer that is resistant to healing despite aggressive therapy.The nurse suspects the need for a protein supplement based on a(n):

The nurse explains to an older client that the assessment of her thyroid health will require both a physical examination as well as laboratory test because:

The leukocyte count of an older adult client is elevated.The nurse shows the best understanding of the effect of aging on body function when:

A 71-year-old client has a cholesterol level of 182 mg/dL.The nurse anticipates a(n):

Overview of Gerontologic Nursing

Theories of Aging

Legal and Ethical Issues

Gerontologic Assessment

Cultural Influences

Family Influences

Socioeconomic and Environmental Influences

Health Promotion and Illnessdisability Prevention

Health Care Delivery Settings and Older Adults

Nutrition

Sleep and Activity

Safety

Intimacy and Sexuality

Mental Health

Pain

Infection

Chronic Illness and Rehabilitation

Substance Abuse

Cancer

Loss and End-Of-Life Issues

Pharmacologic Management

Cardiovascular Function

Respiratory Function

Endocrine Function

Gastrointestinal Function

Musculoskeletal Function

Urinary Function

Cognitive and Neurologic Function

Integumentary Function

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