Chapter 07: Gerontological Alterations

Chapter 07: Gerontological Alterations

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction. Age-related changes in myocardial pumping ability may be evidenced by

ANS:  B

Collagen is the principal noncontractile protein occupying the cardiac interstitium. Because myocardial collagen content increases with age, increased myocardial collagen content renders the myocardium less compliant and may be responsible for increased loading of blood vessels.

2. Age-related pulmonary changes that may affect this patient include

ANS:  B

Respiratory muscle function is affected by skeletal muscle and peripheral muscle strength. During aging, skeletal muscle progressively atrophies, and its energy metabolism decreases, which may partially explain the declining strength of the respiratory muscles.

3. A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction. Dopamine 3 mcg/kg/min has been ordered for this patient. What nursing implications should be considered when administering this drug to an older patient?

ANS:  D

Reduced drug-metabolizing capacity is caused by a decline in activity of the drug-metabolizing enzyme system, microsomal ethanol oxidizing system, and decrease in total liver blood flow. Medications that depend on the cytochrome P450 group of liver enzymes are most affected because age-associated changes cause as much as a 50% decline in enzymatic function.

4. A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction. When caring for this patient, the nurse will give increased attention to skin integrity because of the

ANS:  C

Ecchymotic areas may be seen because of decreased protective subcutaneous tissue layers, increased capillary fragility, and flattening of the capillary bed, predisposing older adults to developing ecchymoses. Medications and physiologic factors may result in an augmented bleeding tendency and appearance of ecchymotic areas; nevertheless, consideration should be given to the possibility of older adult abuse if ecchymosis is widespread or in unusual areas.