Patho Unit 8 Chapter 19 Degenerative Changes in Aging
Which statement correctly describes osteogenesis imperfecta, or brittle bone disease?
Osteogenesis imperfecta is caused by deficiencies in the synthesis of type I collagen.
Gastrointestinal elimination in older adults is often characterized by which common symptom?
Constipation
Which vascular changes can occur in older adults because of the increase in blood pressure during the aging process?
Decreased elasticity in arterial connective tissue
To help diagnose problems in cognitive function, many nursing facilities utilize the Mini-Mental State Examination (MMSE) tool. Which of the following statements accurately describes this tool?
It is a brief, objective tool that will assess memory, orientation and attention.
A daughter is concerned because her elderly parent has been diagnosed with osteomalacia. The daughter asks the nurse why this happened. The best response would be that:
intestinal absorption slows as natural aging occurs.
An older adult client is admitted for the treatment of pneumonia. The nurse notes the home medications include nasal calcitonin, vitamin D, and calcium chloride. Which disease process is this client likely treating with these medications?
osteoporosis
The nurse is caring for an older adult client at increased risk for fall-related injury. Which additional condition contributes to this risk?
osteoporosis
The educator of a geriatric unit is orienting new staff and is teaching strategies on communicating with older adults with impaired hearing. Which teaching point is most appropriate?
"Ensure that the hearing aid is in place, turned on, and properly functioning."
The adult child of a client with end-stage Alzheimer disease asks the nurse if Alzheimer disease can be passed on to him or her. What is the nurse's most accurate response?
"Research supports a possible genetic link with an early onset."
The nurse is assessing an older adult client with altered renal function. Which other finding(s) should the nurse anticipate? (Select all that apply.) -Decline in proximal tubular function -Increased renal mass -Decreased glomerular filtration rate -Increased renin and aldosterone levels -Reduced renal blood flow
-Decreased glomerular filtration rate -Decline in proximal tubular function -Reduced renal blood flow
The community health nurse is teaching a class of older adult clients about prevention of injury and illness. Which topic(s) should the nurse cover during the teaching? (Select all that apply..) -Cancer screening -Weight control -Smoking cessation -Exercise -Protein restriction
-Exercise -Weight control -Cancer screening -Smoking cessation
The nurse is performing a skin assessment for an older adult client. Which age-related finding(s) should the nurse anticipate? (Select all that apply.) -Dry, wrinkled appearance -Clubbing of the fingernails -Decreased elasticity -Varied skin pigmentation -Rough, raised skin lesions
-Varied skin pigmentation -Decreased elasticity -Dry, wrinkled appearance
A client newly diagnosed with osteoporosis asks, "Why do I need to take this vitamin D tablet if I get outside almost every day?" Which statement(s) is accurate for the nurse to share with this client? Select all that apply. -Calcium supplements only regulate calcium metabolism. -Drinking milk is not for everyone. -Vitamin D increases bone remodeling. -High calcium levels do not coincide with bone health. -Vitamin D helps promote intestinal absorption of calcium.
-Vitamin D increases bone remodeling. -Vitamin D helps promote intestinal absorption of calcium.
The nurse discusses age-related histological changes in the brain with a client and their family. Which topic(s) will the nurse include? Select all that apply. -embolic features in arteries -dehydration of cerebral ventricles -amyloid in vascular tissue -lipofuscin pigment in nerve cells -loss of brain mass
-amyloid in vascular tissue -lipofuscin pigment in nerve cells
A client's family member is reporting changes in their adult parent. Which manifestation(s) indicates to the nurse that the client is experiencing impaired neurologic function? Select all that apply. -ringing in the ears (tinnitus) -slowed reaction time, especially when driving -faster but stiffer gait -mild forgetfulness -prolonged time to complete activities of daily living
-prolonged time to complete activities of daily living -slowed reaction time, especially when driving -mild forgetfulness
A family has brought an older adult parent to the clinic with concerns of cognitive decline. The nurse notes that which clinical manifestation(s) places this client in stage 3 Alzheimer disease? Select all that apply. -requires assistance in day-to-day activities -altered memory of where everyday items are located -regularly misplaces valuable objects -forgetfulness of familiar words -withdrawn personality -difficulty with reading retention
-regularly misplaces valuable objects -difficulty with reading retention
While reviewing the client's medical records, which physiologic change(s) does the nurse note as common and expected in an older adult client? Select all that apply. -sagging and wrinkling of the skin -decreased peristalsis in the gastrointestinal tract -decreased blood flow to lower extremities -less mobility in joints -heightened antigen responsiveness
-sagging and wrinkling of the skin -less mobility in joints -decreased blood flow to lower extremities -decreased peristalsis in the gastrointestinal tract
The nurse is performing an assessment on a new female client. Which finding(s) indicate to the nurse the client is at risk for osteoporosis? Select all that apply. -does not drink or eat dairy products -performs limited weight-bearing exercises -is postmenopausal -smokes 2 packs/day of cigarettes -eats fast-food meals 4 to 5 times each week -drinks 1 to 2 glasses of wine each week
-smokes 2 packs/day of cigarettes -performs limited weight-bearing exercises -is postmenopausal -does not drink or eat dairy products
A nurse is caring for an older adult client. Which health history condition(s) is relevant to older adult clients based on stochastic theories of aging? Select all that apply. -difficulty seeing objects that are far away -previously repaired heart defect -overexposure to the sun rays causing skin changes -excessive intake of alcoholic beverages on a daily basis -stiff knee joints due to a fall that injured the cartliage
-stiff knee joints due to a fall that injured the cartliage -overexposure to the sun rays causing skin changes -excessive intake of alcoholic beverages on a daily basis
The nurse is reviewing the health histories of four clients. Select the client most at risk for developing secondary osteoporosis.
A 60-year-old female taking prednisone for asthma
The first manifestation that a client has osteoporosis is when presenting with which condition?
A bone fracture
Which best describes metatarsus adductus?
An adducted forefoot that gives the foot a kidney-shaped appearance
A client with confirmed low bone density asks the nurse if there is anything she can to decrease the risk of trauma. The best response would be:
Brisk walking three times per week on a flat surface
The nurse is caring for a client considering hormone treatment for osteoporosis. Which treatment does the nurse expect?
Calcitonin
Which measures should a public health nurse recommend to middle-aged women to reduce their chances of developing osteoporosis later in life?
Calcium supplementation and regular weight-bearing activity
An increase in the level of receptor activator of nuclear factor kappa-β ligand (RANKL) results in which physiologic activity?
Changes in the rate of bone remodeling
A client with Alzheimer disease (AD) is forgetful and has started to lose interest in social activities. Which treatment routine would be beneficial for the client?
Donepezil
A 70-year-old female client tells the health care provider she is concerned because she is getting shorter and her posture is not as good as it used to be. The provider completes an assessment of her spine and notes a loss of height in the vertebral column and kyphosis. This assessment would be recognized as:
Dowager hump
Osteoporosis is a disease caused by demineralization of bone. What is the clinical method of choice for diagnosing osteoporosis?
Dual-energy x-ray absorptiometry (DXA) of the spine and hip
The nurse suspects a newborn may have developmental dysplasia of the hip (DDH) based on which assessment finding?
Gluteal fold asymmetry
The pediatric nurse is caring for a client exhibiting scleroderma, alopecia, loss of subcutaneous fat and muscle, and skeletal dysplasia. For which condition should the nurse anticipate treatment?
Hutchinson-Gilford Progeria Syndrome (HGPS)
The nurse is reviewing the laboratory results of an older adult client with a diagnosis of water retention. Which additional condition should the nurse anticipate?
Hyponatremia
A nurse is assessing an older adult with reports of constipation, for which the client often takes over-the-counter medications. What assessment should the nurse perform to address the etiology of the client's problem?
Medication regimen for drugs like anticholinergic agents or calcium
The nurse is assessing a female client's risk for osteoporosis. Which factor places this client at greatest risk?
Menopause
In considering a definition of aging, a 76-year-old male would be classified into which of the following subgroups?
Middle-old
Which statement demonstrates and supports the stochastic free radical theory of aging?
Mitochondria DNA may become damaged from reactive oxygen species (ROS).
A child with a diagnosis of Legg-Calvé-Perthes disease will exhibit which defect in the bone?
Necrosis of the proximal femoral head
An adult female client describes the pain in her hand as having an audible grinding and cracking sound, especially in her thumb with the inability to open a jar. The health care provider suspects the client has which type of joint disease?
Osteoarthritis
A physiotherapist (PT) at an assisted living facility for older adults is leading an exercise class for the residents. Part of the PT's introductory class is an explanation of the health problems that can be mitigated by physical activity and those which are considered inevitabilities of the aging process. Which of the following phenomena would the PT most justifiably characterize as modifiable?
Overall reduction in muscle strength.
Which of the following pathophysiological processes would a clinician most likely expect in a client with a diagnosis of dementia rather than delirium?
Plaques have developed between neurons and neurofibrillary tangles have developed within neurons.
Which structural change can contribute to mixed sensorimotor deficit?
Polyneuropathies involving demyelination of peripheral nerves
Multiple theories have attempted to explain the biology of aging. Which of the following theories proposes that aging is caused by random events or from environmental influences?
Stochastic
A postmenopausal client questions the nurse about the diagnosis of osteoporosis. Which statement describes the pathology of osteoporosis?
The process of bone renewal after menopause is slowed in relation to the occurrence of bone breakdown.
One of the residents in a long-term care facility has developed numbness, tremor, and gross lack of coordination of muscle movements in their lower limbs. The nurse knows that his may be caused by:
Vitamin B12 deficiency.
A female older adult client asks, "Why, all of a sudden, is my metabolism so out of control and causing me to gain weight?" The nurse will base the response on which physiologic principle?
altered neuroendocrine response of hypothalamic-pituitary axis
The family of an older adult reports increasing inability to perform basic activities of daily living. After evaluation, the client is diagnosed with Alzheimer disease. What intervention will be implemented to slow cognitive decline?
cholinesterase inhibitors
When administering prescribed medication to a client with Alzheimer disease, which drug should be questioned by the nurse?
ropinirole, a dopamine agonist