Question : The major impact of the physiological changes that occur with

aging is:

Student

Answer:

Reduced physiological reserve

Reduced homeostatic mechanisms

Impaired immunological response

All of the above

Instructor

Explanation:

The major impact of all of these physiological changes can be highlighted

with three primary points. First, there is a reduced physiological reserve of

most body systems, particularly cardiac, respiratory, and renal. Second, there

are reduced homeostatic mechanisms that fail to adjust regulatory systems

such as temperature control and fluid and electrolyte balance. Third, there is

impaired immunological function: infection risk is greater, and autoimmune

diseases are more prevalent. (Kennedy-Malone 3)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced

Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-

01-14. VitalBook file.

Points Received: 2 of 2

Comments:

Question 2. Question : Men have faster and more efficient biotransformation of drugs and

this is thought to be due to:

Student

Answer:

Less obesity rates than women

Prostate enlargement

Testosterone

Less estrogen than women

Instructor

Explanation:

Men have faster and more efficient biotransformation, presumably because

of serum testosterone. Conditions of increased or decreased liver perfusion

alter the overall level of the drug that is absorbed and how it is metabolized.

(Kennedy-Malone 5)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced 

Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-

01-14. VitalBook file.

Points Received: 2 of 2

Comments:

Question 3. Question : The cytochrome p system involves enzymes that are generally:

Student

Answer:

Inhibited by drugs

Induced by drugs

Inhibited or induced by drugs

Associated with decreased liver perfusion

Instructor

Explanation:

Biotransformation occurs in all body tissues but primarily in the liver,

where enzymatic activity (cytochrome P [CYP] system) alters and

detoxifies the drug and prepares it for excretion. (Kennedy-Malone 5)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced

Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-

01-14. VitalBook file.

Points Received: 2 of 2

Comments:

Question 4. Question : Functional abilities are best assessed by:

Student

Answer:

Self-report of function

Observed assessment of function

A comprehensive head-to-toe examination

Family report of function

Instructor

Explanation:

Two well-established tools used to evaluate function in older adults are the

Katz Activities of Daily Living Scale (Katz et al., 1963) and the Lawton and 

Brody scale for Instrumental Activities of Daily Living (Lawton & Brody,

1969). It is important to be cautious about self-report of function (rather than

direct observation of function) and to ask, “Do you …?” instead of “Can you

…?” in order to determine if patients actually perform the activity.

(Kennedy-Malone 40)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced

Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-

01-14. VitalBook file.

Points Received: 2 of 2

Comments:

Question 5. Question : Iron Deficiency Anemia (IDA) is classified as a microcytic,

hypochromic anemia. This classification refers to which of the

following laboratory data?

Student Answer: Hemoglobin and Hematocrit

Mean Corpuscular Volume (MCV) and Mean Corpuscular

Hemoglobin (MCH)

Serum ferritin and serum iron

Total iron binding capacity and transferrin saturation

Instructor

Explanation:

RBC indices reveal an MCV (mean corpuscular volume/RBC size) that

will be decreased to <80 fL in adults; MCH (mean corpuscular

hemoglobin/RBC color) will show hypochromia or pale cells; RBC

distribution width (RDW)/volume variation will be increased.

(Kennedy-Malone page 519)

Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank.

Advanced Practice Nursing in the Care of Older Adults. F.A. Davis

Company, 2014-01-14. VitalBook file