Gerontological Nurse Test Chronic Disease Management in the Elderly 2 — Questions and Answers
Question 1: A nurse is teaching an older adult patient with heart failure about the 'rule of 5' for fluid restriction. The patient should report weight gain of more than how many pounds in 24 hours?
- 1 pound in 24 hours
- 2–3 pounds in 24 hours (Correct answer)
- 5 pounds in 24 hours
- 10 pounds in 24 hours
Correct answer: 2–3 pounds in 24 hours
A weight gain of 2–3 pounds in 24 hours in a heart failure patient typically indicates significant fluid retention and warrants prompt notification of the healthcare provider.
Question 2: Which age-related change in the older adult contributes most to increased risk for hypoglycemia when using insulin or sulfonylureas?
- Increased glucagon response to hypoglycemia
- Impaired hypoglycemic awareness and diminished counterregulatory hormone response (Correct answer)
- Enhanced hepatic glucose production
- Increased renal threshold for glucose
Correct answer: Impaired hypoglycemic awareness and diminished counterregulatory hormone response
Older adults often have blunted awareness of hypoglycemic symptoms and a diminished counterregulatory hormone response, making hypoglycemia both more likely and harder to detect.
Question 3: An older adult with atrial fibrillation is anticoagulated with warfarin. Which INR range represents the therapeutic target for stroke prevention in this condition?
- 1.0–1.5
- 1.5–2.0
- 2.0–3.0 (Correct answer)
- 3.5–4.5
Correct answer: 2.0–3.0
The therapeutic INR range of 2.0–3.0 is recommended for atrial fibrillation to balance stroke prevention against bleeding risk in older adults.
Question 4: An older adult patient with Parkinson's disease is at increased risk for aspiration pneumonia primarily due to:
- Reduced cough reflex and dysphagia from motor dysfunction (Correct answer)
- Immunosuppressive medications used to treat Parkinson's
- Decreased appetite leading to malnutrition
- Increased gastric acid production
Correct answer: Reduced cough reflex and dysphagia from motor dysfunction
Parkinson's disease causes progressive motor dysfunction affecting swallowing muscles and reduces the protective cough reflex, making aspiration of food, liquid, or saliva common.
Question 5: Which complication of long-term corticosteroid use in older adults requires routine bone health monitoring and preventive treatment?
- Hypokalemia-induced cardiac arrhythmias
- Glucocorticoid-induced osteoporosis and fracture risk (Correct answer)
- Renal tubular acidosis
- Peripheral neuropathy
Correct answer: Glucocorticoid-induced osteoporosis and fracture risk
Long-term corticosteroid use suppresses osteoblast activity and accelerates bone resorption, placing older adults at high risk for glucocorticoid-induced osteoporosis and fragility fractures.
Question 6: A nurse is educating an older adult with hypertension on dietary modifications. The DASH diet primarily recommends:
- High fat intake with restricted carbohydrates
- Increased fruits, vegetables, low-fat dairy, and reduced sodium (Correct answer)
- High-protein diet with no sodium restrictions
- Elimination of all fats and dairy products
Correct answer: Increased fruits, vegetables, low-fat dairy, and reduced sodium
The DASH (Dietary Approaches to Stop Hypertension) diet emphasizes fruits, vegetables, low-fat dairy, whole grains, lean proteins, and reduced sodium to lower blood pressure.
Gerontological Nurse Test Chronic Disease Management in the Elderly 2
A nurse is teaching an older adult patient with heart failure about the 'rule of 5' for fluid restriction.
The patient should report weight gain of more than how many pounds in 24 hours?