Chapter 45 Patho

1. After reviewing the single photon emission computed tomography (SPECT) report of a client who has dementia with Lewy bodies, a nurse anticipates delusional behavior in the client. In which area of the brain does the nurse observe hyperperfusion? 1. Parietal region 2. Occipital region 3. Frontal cortex region 4. Both A and B 2. The MRI and PET scan reports of an older client show cerebral atrophy in the frontal and temporal lobes. Which condition does the nurse suspect in the client? 1. Pick’s disease 2. Vascular dementia 3. Alzheimer’s disease 4. Dementia with Lewy bodies 3. Which statement by the spouse of an older client made a nurse suspect Pick’s disease in the client? 1. “My partner frequently eats paper products.” 2. “My partner has short-term memory loss.” 3. “My partner has tremors and difficulty in walking.” 4. “My partner tells me that she can see our dead ancestors daily.” 4. While reviewing the medical history of a client with diabetes, a nurse finds that the client has impaired renal function. Which medication in the client’s prescription does the nurse suspect to be replaced? 1. Aspirin 2. Metformin 3. Insulin lispro 4. None of the above 5. An older client is diagnosed with chronic renal failure. Which comorbid disease in the client does a nurse suspect to be the cause for this condition? 1. Esophagitis 2. Atherosclerosis 3. Diabetes mellitus 4. Both C and B 6. What is multicausality? 1. The decreased ability of a cell to repair damage 2. The progressive loss of a cell’s ability to replicate over time 3. The combination of internal processes and environmental influences 4. Weakening of both the innate and adaptive immune system with increasing age 7. A registered nurse is teaching a group of student nurses about the factors that diminish the ability to mount a febrile response in older clients. Which statement made by a student nurse indicates the need for further teaching? 1. “Decreased vasodilation reduces the ability to cause fever.” 2. “Decreased subcutaneous fat reduces the ability to cause fever.” 3. “Decreased ability to raise blood pressure reduces the ability to cause fever.” 4. “Decreased responsiveness of the hypothalamus reduces the ability to cause fever.” 8. Which theory explains apoptosis of the ovary? 1. Immunosenescence theory 2. Telomere shortening theory 3. Programmed aging of the cell 4. Damaged-based theory of aging 9. Which condition is associated with the buildup of tau protein in the brain? 1. Vascular dementia 2. Parkinson’s disease 3. Alzheimer’s disease 4. Frontotemporal dementia quizmasters 10. An older client is frequently complaining of constipation to a nurse. Which age-related change in the gastrointestinal system does the nurse suspect to be the cause? 1. Stomach lining atrophies 2. Diminished amount of lactase enzyme 3. Loss of strength of the lower esophageal sphincter 4. Denervation in the distal portion of the gastrointestinal tract 11. While reviewing the case file of an older client, a nurse finds that the client’s vitamin B12 deficiency is untreated. Which change in the nervous system does the nurse suspect to cause gait instability and paresthesias in the client? 1. Degeneration of neurons 2. Lack of acetylcholine in the hippocampus lobe 3. Abnormalities in the basal ganglia of the midbrain 4. Demyelination of the dorsal columns of the spinal cord 12. A registered nurse is teaching a group of students about functional consequences of physiological aging on the cardiovascular system. Which statement made by a student nurse indicates the need for further teaching? 1. “An increased risk of arrhythmias is due to changes in conductive tissues.” 2. “The heart of an older client may have some degree of diastolic dysfunction.” 3. “A higher response of baroreceptors in arterioles is seen with increasing age.” 4. “A decreased ability of arteries to vasodilate is associated with free radical damage of cell membranes.” 13. The x-ray of a client shows kyphosis with collapse of the intervertebral discs. Which changes would a nurse anticipate in this client? 1. Increased stiffness of the chest wall 2. Decreased strength of respiratory muscles 3. Increased anteroposterior diameter of the chest 4. Less oxygen diffusion into the pulmonary capillaries 14. An older client who is on medications for hypertension has ankle edema and reflux esophagitis. Which medication in the client’s report does the nurse expect to be replaced? 1. Diuretics 2. ACE inhibitors 3. Calcium channel blockers 4. Both A and C 15. Which change in the integumentary system of older clients is responsible for difficulties in thermoregulation? 1. Loss of sweat glands 2. Fewer sebaceous glands 3. Decreased function of melanocytes 4. Increased fragility of small blood vessels in the skin 16. While reviewing the prescription of an older client with dementia, a nurse finds that the client is on carbidopa/levodopa. Which type of dementia does the nurse suspect in this client? 1. Vascular dementia 2. Alzheimer’s dementia 3. Frontotemporal dementia 4. Dementia with Lewy bodies 17. Flattened villi of the intestine in older adults causes 1. Pain in the lower quadrant of the abdomen. 2. Indigestion, gas accumulation, and diarrhea. 3. Changes in the composition of the intestinal flora. 4. Decreased transport of nutrients into the bloodstream. 18. A nurse observes that an older client with dementia demonstrates antisocial behavior and loss of social skills. Which therapy would the nurse most likely find in the client’s prescription? 1. Antidepressants 2. Antipsychotic drugs 3. Antiplatelet drugs 4. Acetylcholinesterase inhibitors Multiple Response Identify one or more choices that best complete the statement or answer the question. 19. Which classes of medication are beneficial to manage the cognitive decline in a client with vascular dementia? Select all that apply. 1. Antipsychotics 2. Antidepressants 3. Antiplatelet medications 4. Antilipidemia medications 5. Acetylcholinesterase inhibitors 20. Which heart tissues are more prone to connective tissue infiltration in older clients? Select all that apply. 1. Aorta 2. Carotid artery 3. Bundle of His 4. Sinoatrial node 5. Atrioventricular node 21. Which changes in the renal system are associated with increasing age of an individual? Select all that apply. 1. Less excretion of glucose 2. High specific gravity of urine 3. Low levels of serum creatinine 4. High levels of blood urea nitrogen 5. Less excretion of water from the bloodstream 22. Which changes in the neurotransmitters are seen with increasing age? Select all that apply. 1. Increased glutamate levels 2. Decreased serotonin levels 3. Decreased dopamine levels 4. Increased B-endorphins levels 5. Decreased gamma-aminobutyric acid (GABA) quizmasters 23. Which age-related changes in the respiratory system are responsible for an increased susceptibility to pneumonia in older clients? Select all that apply. 1. Weaker cough reflex 2. Diminished gag reflux 3. Calcified costal cartilage 4. Osteopenia in the vertebrae 5. Increased stiffness of the thoracic cage 24. Which changes in an older client result in presbycusis? Select all that apply. 1. Loss of color vision 2. Degradation of ganglia 3. Collapse of basement membrane 4. Deterioration of the organ of Corti 5. Weakening of the immune system 25. What are the symptoms of dementia with Lewy bodies? Select all that apply. 1. Delusions 2. Visual hallucinations 3. Resting tremors 4. Loss of social skills 5. Compulsive oral behavior