AGPNP PREP Exam 58 Questions with Verified Answers
senile lentiginesCORRECT ANSWER Senile Lentigines (liver spots), which are brown macules found on
... [Show More] the backs of the hands, forearms, and face caused by localized mild epidermal hyperplasia in association with increased numbers of melanocytes and increased melanin production.
Sebaceous gland hyperplasiaCORRECT ANSWER Sebaceous gland hyperplasia is found especially on the forehead and nose, with a raised area from 1 to 3 mm in size with a central pore.
PetechiaeCORRECT ANSWER Petechiae are reddish, purple spots (usually 1-2 mm) of bleeding under the skin that may occur from numerous causes.
Senile purpuraCORRECT ANSWER Senile purpura is commonly found, characterized by purple macules (not petechiae) appearing on the backs of the hands or on the forearms that result from blood that has extravasated through capillaries due to a loss of skin elasticity.
ChloasmaCORRECT ANSWER Chloasma is hyperpigmentation occurring on the face of a pregnant woman
FrailtyCORRECT ANSWER Frailty (also known as failure to thrive) is a common clinical syndrome in older adults. Common findings with the condition of frailty are low grip strength, slowed walking speed, low physical activity, unintentional weight loss, decreased lean body mass (sarcopenia), osteopenia, cognitive impairment, and anemia. Frailty can leave a patient vulnerable to falls, functional decline, disability, disease, and death.
Providing a previsit screening tool or questionnaire to allow the older adolescent to identify and write down concerns prior to the start of the visit is a helpful open-ended approach to assist the adult-gerontology primary care nurse practitioner to phrase questions in an appropriate way to promote a sense of partnership that encourages communication.CORRECT ANSWER TRUE
Adolescents may be reluctant to talk, and have a clear need for confidentiality.CORRECT ANSWER TRUE
Use of a gentle confrontational approach when the adolescent is silent or unable to express specific words about physical changes occurring.CORRECT ANSWER FALSE
A healthy adult patient should be able to repeat a series of how many numbers?CORRECT ANSWER When assessing immediate recall or new learning, a healthy adult patient without cognitive decline should be able to repeat a series of 5-8 numbers.
The adult-gerontology primary care nurse practitioner selects which assessment tool to evaluate balance and gait problems in older adult patients?CORRECT ANSWER The Tinetti Balance and Gait Evaluation is an activity-based test that asks the patient to perform tasks, such as sitting and rising from a chair, turning, and bending. It requires no more than 15 to 20 minutes to perform.
the timed "Up and Go" testCORRECT ANSWER assesses balance and gait speed
The Instrumental Activities of Daily Living Scale assesses...CORRECT ANSWER The Instrumental Activities of Daily Living Scale assesses complex tasks such as shopping, laundry, and food preparation.
The Index of Independence of Activities of Daily Living determines what?CORRECT ANSWER The Index of Independence of Activities of Daily Living helps identify daily activities with which the patient needs assistance.
Katz IndexCORRECT ANSWER helps identify daily activities with which the patient needs assistance
The Seven Minute Screen (7MS)CORRECT ANSWER The Seven Minute Screen (7MS) is a quick and common test used to assess temporal orientation, enhanced cued recall, clock drawing, and verbal fluency.
The adult-gerontology primary care nurse practitioner is constructing a pedigree chart during a clinical visit. What is the purpose of obtaining a pedigree diagram?CORRECT ANSWER Genetic and familial health problems
The following tests can be used to assess cognitive impairment and dementia:CORRECT ANSWER The Folstein Mini-Mental State Examination, the Mini-Cog screen for dementia, the Short Portable Mental Status Questionnaire, the AD8 Dementia Screening Interview, and the Montreal Cognitive Assessment (MoCa).
What is a pedigree chart?CORRECT ANSWER A pedigree chart is a diagram of family information using a standardized set of symbols (squares representing males and circles females). A dark symbol is used to indicate someone affected with a genetic condition, and unfilled symbols for those who are unaffected; carriers of a condition are often indicated by a gray symbol. The pedigree chart should have at least three generations noted. The pedigree chart is an important component of a family history and can provide information regarding diseases that are transmitted or occur in family generations. It can be used as a diagnostic tool to help guide decisions about genetic testing for the patient and at-risk family members.
In assessing the nutritional status of an older adult patient, the adult-gerontology primary care nurse practitioner identifies the common physiologic change in the gastrointestinal system to beCORRECT ANSWER Decreased hydrochloric acid, which occurs with aging, leads to decreased absorption of iron and vitamin B12. Excessive growth of certain bacteria (bacterial overgrowth syndrome) becomes more common with age and can lead to pain, bloating, and weight loss.
Common physiologic changes in the gastrointestinal system of an older adult patient includeCORRECT ANSWER Decreased hydroelectric acid, which occurs with aging, leads to decreased absorption of iron and vitamin B12.
Excessive growth of certain bacteria (bacterial overgrowth syndrome) becomes more common with age and can lead to pain, bloating, and weight loss.
Bacterial overgrowth may also lead to decreased absorption of certain nutrients, such as vitamin B12, iron, and calcium.
The stomach cannot accommodate as much food (because of decreased elasticity).
The rate at which the stomach empties food into the small intestine decreases with aging.
Fat absorption will decrease
Peristalsis decreases
clinical findings would indicate a deviation from the normal age-related changes in the neurologic system that may have some diagnostic significance for the older patient?CORRECT ANSWER Decreased ability to maintain balance may indicate a cerebellar complication. The other findings (decreased sense of touch, diminished ankle tendon reflex, and decreased short-term memory are normal age-related changes.
myopiaCORRECT ANSWER nearsightedness
hyperopiaCORRECT ANSWER farsightedness
astigmatismCORRECT ANSWER distorted vision at all distances
presbyopiaCORRECT ANSWER farsightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and old age.
constitutional symptoms include:CORRECT ANSWER A constitutional symptom is defined as a symptom that affects the general well-being or general status of a patient. Examples include weight loss, shaking, chills, fever, pain, and vomiting. Constitutional symptoms tend to be nonspecific to a particular disease and because of this, they are not useful in diagnosis of conditions as non-constitutional symptoms.
The following screening tools are available for the adult-gerontology primary care nurse practitioner to use to assess for polypharmacy in the older adult patient:CORRECT ANSWER Medication Appropriateness Index (MAI)
Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP)
Beers List
Beers' ListCORRECT ANSWER Beers' List of Inappropriate drugs for Older Adults
Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP)CORRECT ANSWER to use to assess for polypharmacy in the older adult patient:
Medication Appropriateness Index (MAI)CORRECT ANSWER the MAI may serve as a valuable tool for measuring potentially inappropriate prescribing in older adults.
A normal physiologic change of the respiratory system that occurs with aging?CORRECT ANSWER Hyperresonance
Age-related changes result in an increase in the residual lung volume (RV) and decrease in the forced vital capacityCORRECT ANSWER TRUE
When assessing the dehydration status of an older adult, poor skin turgor resulting from aging may be provide unreliable physical assessment evidence because...CORRECT ANSWER changes in skin collagen and loss of skin elasticity with aging, poor skin turgor, which is often used as a sign of dehydration in younger individuals, is unreliable in older adults.
Signs of dehydration in the older adult include...CORRECT ANSWER body temperature elevation due to dehydration or the elevation may be a result of an inflammatory or infectious process. Mucous membranes are often not noticeably dry until severe dehydration is present. The tongue may be swollen and furrowed in the older adult who is dehydrated.
Common age-related changes in the GI system include...CORRECT ANSWER increased adipose tissue, decreased liver size, reduced motility and peristalsis, decreased acid secretions and motor activity of the stomach, and decreased glomerular filtration rate.
The OARS ADL Scale is...CORRECT ANSWER The Older Americans Resources and Services (OARS) Activities of Daily Living (ADL) Scale is the more appropriate screening tool for identifying at-risk populations.
What is the Bennet Social Isolation ScaleCORRECT ANSWER is used to evaluate social interactions and resources
Mini-Mental State ExaminationCORRECT ANSWER The Mini-Mental State Examination is used to evaluate memory, orientation, and attention.
The Norton ScaleCORRECT ANSWER The Norton Scale is used to evaluate pressure ulcer risk.
Ineffective water conservation and Decreased thirst drive and the older adultCORRECT ANSWER As an individual ages, dehydration becomes a more prevalent problem because of ineffective water conservation and Decreased thirst drive and the older adult
In the older adult population, which group is considered the fastest growing cohort?CORRECT ANSWER 85 years and older
As an individual ages, which physiologic change would affect responses to pharmacologic agents?CORRECT ANSWER Medications are often protein bound (not fat bound); albumin decreases with age. A low albumin level decreases the number of protein-binding sites, causing an increase in the amount of free drug in the plasma. Drug overdose may occur in older adult patients.
The number one cause of accidental death in patients older than 65 years of age is:CORRECT ANSWER Falls are the major cause of morbidity and mortality in the older adult. A fall is often the precipitating event for a cascade of problems leading to death.
Complications from falls include ...CORRECT ANSWER Fractures, pneumonia, pressure ulcers, pain, and immobility.
What are the normal physiologic changes in the thyroid gland that occur with aging?CORRECT ANSWER There is usually adequate secretion of TSH and a normal serum concentration of T4. Aging may produce fibrosis and increased nodularity, but overall the thyroid function remains within normal limits.
The aging process causes what normal physiologic changes in the heart?CORRECT ANSWER Heart size stays the same, and the valves thicken and become rigid secondary to fibrosis and sclerosis.
Pulmonary physiologic changes commonly associated with the aging process include ...CORRECT ANSWER A decrease in the vital capacity, along with a 50% increase in residual volume, occurs during the aging process. Other aging changes include a less effective cough, impaired ciliary action, and weaker respiratory muscles. Increased AP diameter is associated with aging and in chronic obstructive pulmonary disease. PO2 usually decreases, but PCO2 usually remains unchanged or slightly increased.
As patients age, it becomes particularly important to encourage an increased intake of:CORRECT ANSWER Decreased hydrochloric acid, which occurs with aging, leads to decreased absorption of iron and vitamin B12 and is related to loss of intrinsic factor. Older adults are considered at risk for vitamin D deficiency, which contributes to osteoporosis. Bone loss that occurs with aging is related to low calcium.
True or False:
The senile lentigo is a gray-brown, irregular, macular lesion on sun-exposed areas of the face, arms, and hands that are normal skin lesions.CORRECT ANSWER TRUE
Common abnormal skin lesions in the older adult includes...CORRECT ANSWER Seborrheic dermatitis
Senile keratosis
Squamous cell
Normal vision changes that occur with aging include...CORRECT ANSWER Increased sensitivity to glare and sunlight, diminished color vision with colors appearing faded, difficulty in focusing on objects close-up, need for more light for reading, and decreased tear production.
A sudden decrease or loss of peripheral vision can be indicative of what condition which requires immediate treatment by an ophthalmologist.CORRECT ANSWER a detached retina
As an individual ages how is REM sleep affected?CORRECT ANSWER REM sleep decreases
What is a general principle regarding drug absorption in the older adult?CORRECT ANSWER With aging, the rate of absorption is slowed due to delayed gastric emptying and reduced splanchnic blood flow.
When treating an infection in the older adult, the adult-gerontology primary care nurse practitioner must consider that:CORRECT ANSWER Immune function declines with age.
The diminished immunity of the older adult can be attributed to a decline in:CORRECT ANSWER T-cell function
The adult-gerontology primary care nurse practitioner understands that as the patient ages changes occur in the cells of the immune system. Which statement reflects these changes?CORRECT ANSWER There is an increased ability to respond to infections with previously produced "remembered" antibodies. [Show Less]