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NR 601 Midterm Exam Study guide (Version 2), NR 601 Question Bank NR601 Test Bank

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Chapter 1: Changes with Aging Answers At the end Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The major impact of the physiological changes that occur with aging is: A. Reduced physiological reserve B. Reduced homeostatic m...

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  • July 26, 2022
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NR 601 Midterm Exam Study guide (Version 2), NR 601 Question Bank NR601 Test Bank
NSG6420 1


Gerontology Class….

Week 1:

1. Question :

The major impact of the physiological changes that occur with aging is:

Reduced physiological reserve

Reduced homeostatic mechanisms

Impaired immunological response

CORRECT All of the above

Instructor Explanation: The major impact of all of these physiological changes can be
highlighted with three primary points. First, there is a reduced physiological reserve of most body
systems, particularly cardiac, respiratory, and renal. Second, there are reduced homeostatic mechanisms
that fail to adjust regulatory systems such as temperature control and fluid and electrolyte balance.
Third, there is impaired immunological function: infection risk is greater, and autoimmune diseases are
more prevalent. (Kennedy-Malone 3)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of
Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file.



Question 2. Question :

Men have faster and more efficient biotransformation of drugs and this is thought to be due to:

Less obesity rates than women

Prostate enlargement

CORRECT Less estrogen than women

Instructor Explanation: Men have faster and more efficient biotransformation, presumably
because of serum testosterone. Conditions of increased or decreased liver perfusion alter the overall
level of the drug that is absorbed and how it is metabolized. (Kennedy-Malone 5)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of
Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file.



Question 3. Question :

The cytochrome p system involves enzymes that are generally:

Inhibited by drugs

, NSG6420 2


Induced by drugs

CORRECT Inhibited or induced by drugs

Associated with decreased liver perfusion

Instructor Explanation: Biotransformation occurs in all body tissues but primarily in the liver,
where enzymatic activity (cytochrome P [CYP] system) alters and detoxifies the drug and prepares it for
excretion. (Kennedy-Malone 5)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of
Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file.



Question 4. Question :

Functional abilities are best assessed by:

Self-report of function

CORRECT Observed assessment of function

A comprehensive head-to-toe examination

Family report of function

Instructor Explanation: Two well-established tools used to evaluate function in older adults are
the Katz Activities of Daily Living Scale (Katz et al., 1963) and the Lawton and Brody scale for
Instrumental Activities of Daily Living (Lawton & Brody, 1969). It is important to be cautious about self-
report of function (rather than direct observation of function) and to ask, “Do you …?” instead of “Can
you …?” in order to determine if patients actually perform the activity. (Kennedy-Malone 40)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of
Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file.



Question 5. Question :

Iron Deficiency Anemia (IDA) is classified as a microcytic, hypochromic anemia. This classification refers
to which of the following laboratory data?

Hemoglobin and Hematocrit

CORRECT Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH)

Serum ferritin and serum iron

Total iron binding capacity and transferrin saturation

, NSG6420 3


Instructor Explanation: RBC indices reveal an MCV (mean corpuscular volume/RBC size) that will
be decreased to <80 fL in adults; MCH (mean corpuscular hemoglobin/RBC color) will show hypochromia
or pale cells; RBC distribution width (RDW)/volume variation will be increased.

(Kennedy-Malone page 519)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of
Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file.



Question 6. Question :

When interpreting laboratory data, you would expect to see the following in a patient with Anemia of
Chronic Disease (ACD):

Hemoglobin <12 g/dl, MCV decreased, MCH decreased

Hemoglobin >12 g/dl, MCV increased, MCH increased

CORRECT Hemoglobin <12 g/dl, MCV normal, MCH normal

Hemoglobin >12 g/dl, MCV decreased, MCH increased

Instructor Explanation: Hemoglobin (Hgb): <12 g/dL (120 g/L) women <13 g/dL (130 g/L) men
Rarely <10 g/dL (100 g/L) Mean corpuscular volume: 80–96 mcm3 (normocytic) Mean corpuscular
hemoglobin Normochromic (normal color) RBC distribution width: normal (Kennedy-Malone page 517)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of
Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file.



Question 7. Question :

The pathophysiological hallmark of ACD is:

Depleted iron stores

CORRECT Impaired ability to use iron stores

Chronic uncorrectable bleeding

Reduced intestinal absorption of iron

Instructor Explanation: The pathophysiological hallmark of ACD is a disregulation of iron
homeostasis, characterized by an increased uptake and retention of iron within the cells of the
reticuloendothelial system (liver/spleen), resulting in decreased RBC production. Essentially, iron is
present but inaccessible for use in the production of Hgb with the erythrocytes (Bross et al., 2010). A
shortened RBC survival is also a contributing factor to ACD. (Kennedy-Malone page 516-517)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of
Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file.

, NSG6420 4




Question 8. Question :

The main focus of treatment of patients with ACD is:

Replenishing iron stores

Providing for adequate nutrition high in iron

CORRECT Management of the underlying disorder

Administration of monthly vitamin B12 injections

Instructor Explanation: Treatment: Treatment of ACD focuses on management of the underlying
disorder. Iron supplementation is of no benefit in ACD, except in cases of coexisting IDA. A therapeutic
trial of iron supplementation of no longer than 1 month may be useful in delineating between ACD and
IDA. In ACD, there would be no hematological response to iron therapy (Chen & Gandhi, 2004).
(Kennedy-Malone page 518)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of
Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file.



Question 9. Question :

In addition to the complete blood count (CBC) with differential, which of the following laboratory tests is
considered to be most useful in diagnosing ACD and IDA?



Student Answer: Serum iron

Total iron binding capacity

Transferrin saturation

CORRECT Serum ferritin

Instructor Explanation: Treatment: Treatment of ACD focuses on management of the underlying
disorder. Iron supplementation is of no benefit in ACD, except in cases of coexisting IDA. A therapeutic
trial of iron supplementation of no longer than 1 month may be useful in delineating between ACD and
IDA. In ACD, there would be no hematological response to iron therapy (Chen & Gandhi, 2004).
(Kennedy-Malone page 518)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of
Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file



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