Which of the following clinical findings among older adults is most likely to be viewed as a normal part of aging?
90 year old female whose blood urea nitrogen (BUN) is rising
81 year old male whose serum creatinine level has increased sharply since his last blood work
80 year old male whose dipstick urine reveals protein is present
78 year old female whose GFR has been steadily declining over several years
The Correct Answer is D
A. 90-year-old female whose blood urea nitrogen (BUN) is rising: An isolated rise in BUN can indicate dehydration, gastrointestinal bleeding, or renal impairment. While BUN may increase slightly with age, a significant rise should not be dismissed as normal aging and warrants further investigation.
B. 81-year-old male whose serum creatinine level has increased sharply since his last blood work: A sharp increase in creatinine is not typical with aging and may suggest acute kidney injury or worsening chronic kidney disease. In older adults, even small creatinine changes can be significant due to reduced muscle mass.
C. 80-year-old male whose dipstick urine reveals protein is present: Proteinuria is not a normal part of aging and may indicate underlying kidney damage, hypertension, or diabetes. Even trace amounts of protein in the urine of older adults should prompt further evaluation to rule out nephropathy.
D. 78-year-old female whose GFR has been steadily declining over several years: A gradual decline in glomerular filtration rate (GFR) is expected with aging due to nephron loss and reduced renal perfusion. This change is a normal physiologic part of aging, provided there are no abrupt drops or accompanying signs of renal disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. This option incorrectly matches the terms: cholelithiasis refers to gallstones, not stones in the common bile duct; cholecystitis is inflammation of the gallbladder, not the common bile duct; choledocholithiasis refers to stones in the common bile duct, not inflammation.
B. This option reverses definitions: cholangitis is inflammation of the common bile duct, not gallstones; cholecystitis is inflammation of the gallbladder, not stones in the common bile duct; choledocholithiasis refers to stones in the common bile duct, not inflammation.
C. This option mislabels choledocholithiasis as inflammation of the common bile duct, but it actually refers to stones in the common bile duct; cholecystitis is inflammation of the gallbladder, not stones in the common bile duct; cholangitis is inflammation of the common bile duct, not the gallbladder.
D. This option correctly matches the terms: cholelithiasis means gallstones; choledocholithiasis refers to stones in the common bile duct; cholangitis is inflammation of the common bile duct; cholecystitis is inflammation of the gallbladder.
Correct Answer is B
Explanation
A. Proteus mirabilis: While Proteus mirabilis is a recognized cause of UTIs, especially in catheterized patients or those with structural abnormalities, it is not the most common pathogen overall.
B. Escherichia coli: E. coli is by far the most common pathogen responsible for urinary tract infections, accounting for approximately 80–90% of uncomplicated UTIs due to its ability to adhere to the uroepithelium with fimbriae.
C. Staphylococcus saprophyticus: This organism is a common cause of UTIs in sexually active young women, but overall it is much less prevalent than E. coli across all age groups and sexes.
D. Klebsiella pneumoniae: Although K. pneumoniae can cause UTIs, particularly in hospitalized or immunocompromised patients, it is not as frequently encountered as E. coli in community-acquired cases.
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