Chapter 11 Pearson Custom For Older Adult Nursing Care By Nancy J.Brown And Linda

Chapter 11 Pearson Custom For Older Adult Nursing Care By Nancy J.Brown And Linda

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The nurse is aware that the older adult client is more prone to developing infections than the younger adult primarily due to a change in what gland of the aging endocrine system?

1. Thymus
2. Pineal
3. Adrenal
4. Pituitary

Correct Answer: 1

Rationale 1: Correct. The thymus gland is responsible for releasing T-lymphocytes, which control the body’s immune response. It shrinks 90% and does not produce any more T-lymphocytes by age 60.

Rationale 2: The pineal gland produces melatonin, which is involved primarily with sleep, not immune response.

Rationale 3: The adrenal gland produces hormones involved in the body’s stress response, not immune response.

Rationale 4: The pituitary gland produces hormones involved in growth, thyroid functioning and reproductive activities, not immune response.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging related to the endocrine system.

 

Question 2

Type: MCSA

An older adult client at a health fair obtains a finger-stick for a capillary blood sugar reading from a nurse. There is a reading of 150 mg/dL, fasting. When advising this client on what steps to take next, the nurse keeps in mind that older adults are predisposed to Type II diabetes mellitus due to what age-related change in the endocrine system?

1. Shrinkage of the thymus gland
2. Insulin resistance of body tissues
3. Decreased pituitary functioning
4. Decreased thyroid hormone secretions

Correct Answer: 2

Rationale 1: The thymus gland is involved with the immune response, not with blood glucose levels. Insulin resistance is the age-related change associated with diabetes mellitus.

Rationale 2: Correct. Insulin resistance as a result of aging predisposes the older adult to development of Type II diabetes mellitus.

Rationale 3: The pancreas, not the pituitary, is involved in insulin production and glucose control in the body. Insulin resistance is the age-related change associated with diabetes mellitus.

Rationale 4: The pancreas, not the thyroid, is involved in insulin production and glucose control in the body. Insulin resistance is the age-related change associated with diabetes mellitus.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging related to the endocrine system.

 

Question 3

Type: MCSA

What expected change in the older adult’s endocrine system makes it especially important for the nurse to pay attention to an older adult client’s electrolyte lab values when the client is either ill or has had surgery?

1. Delayed release of insulin from the pancreas
2. Secretion of less melatonin by the pineal gland
3. A decrease in production of aldosterone
4. Halting of the production of progesterone

Correct Answer: 3

Rationale 1: Delayed release of insulin from the pancreas predisposes the older adult client to diabetes type II, not to electrolyte imbalances.

Rationale 2: Secretion of less melatonin by the pineal gland affects the older adult’s sleep pattern, not electrolyte imbalances.

Rationale 3: Correct. Because of a decrease in aldosterone, altered regulation of sodium, chloride, and potassium occurs. Hyperkalemia is possible, as well as other electrolyte imbalances.

Rationale 4: The halting of the production of progesterone in older adult females is involved with menopause, not electrolyte imbalances.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging related to the endocrine system.

 

Question 4

Type: MCSA

An older adult client has been diagnosed as being pre-diabetic. The client asks for advice from the nurse on how to keep this condition from becoming diabetes. What response by the nurse contains accurate information?

1. “There really is not anything that you can do at this point. If you are already pre-diabetic, then chances are you will become diabetic very soon. You really need to watch your blood sugars very closely.”
2. “You need to go ahead and purchase a glucose monitor and keep track of your blood sugars first thing in the morning and after each meal.”
3. “Basically this condition is caused by the slowing of your basal metabolic rate. If you increase this with exercise, you’ll be able to prevent diabetes.”
4. “There are several changes that you can make in terms of your diet, the amount of exercise and stress in your life, and how much you weigh. Working on these areas can lower your risk for developing diabetes.”

Correct Answer: 4

Rationale 1: It is untrue to say the client can do nothing. There are lifestyle changes that the older adult can make to affect modifiable risk factors (obesity, diet, stress, and exercise) and to lower the chance of developing Type II diabetes mellitus.

Rationale 2: Although it would not be a bad suggestion for the client to keep track of his or her blood sugars, this response does not answer the client’s question concerning preventative measures.

Rationale 3: This statement is not completely accurate. The thyroid gland is responsible for one’s basal metabolic rate, and lack of exercise is a modifiable risk factor for diabetes, but other factors contribute to onset of Type II diabetes mellitus.

Rationale 4: Correct. Lifestyle changes can affect modifiable risk factors (obesity, diet, stress, and exercise) and can lower the chance of developing Type II diabetes mellitus.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Discuss methods of health promotion for the endocrine system.