Chapter 24: Endocrine and Immune Disorders Touhy: Ebersole & Hess' Toward Healthy Aging, 9th Edition MULTIPLE CHOICE 1. A client is newly diagnosed with type 2 diabetes mellitus. Which diagnostic test will best
evaluate the management plan prescribed for this client? a. A yearly funduscopic examination by an ophthalmologist b. Regular foot examinations by a podiatrist c. Quarterly hemoglobin A 1C d. Biannual cholesterol testing ANS: C
Quarterly or biannual hemoglobin A 1C (Hb A 1C ) is designed to provide information regarding the averaged glucose levels for a 3-month period of time. The periodic measurement of a glycated hemoglobin test (Hb A 1C ) is the best measure of ongoing glycemic control. Eye examinations are important, but proper blood sugar control will help prevent the damaging effects of diabetes to the eyes. Proper foot care is important, but good blood sugar control will help prevent the damaging effects of diabetes on the feet. Biannual cholesterol testing is not relevant to the evaluation of type 2 diabetes mellitus. DIF: Cognitive Level: Applying REF: p. 313 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Physiological Adaptation 2. Which is the most likely reason that type 2 diabetes mellitus is often difficult to diagnose in
older adults? a. Presenting symptoms occur very quickly. b. The disease rarely occurs in older adults. c. The classic symptoms may not be present in older adults. d. There are no recognizable symptoms; it is a “silent killer.” ANS: C
The symptoms are also often masked by normal aging changes and conditions common in older adults. Polydipsia often does not occur due to the decreased thirst mechanism in older adults, polyphagia is often not recognized due to normal appetite declines associated with aging, and polyuria is often not recognized due to frequent urinary tract infections in older adults. Presenting symptoms usually occur very slowly. Type 2 diabetes mellitus is very common in older adults. There are symptoms of diabetes mellitus in older adults; however, they may be different than those seen in younger adults. DIF: Cognitive Level: Applying REF: pp. 309–310 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Physiological Adaptation 3. Hyperglycemia is harder to detect in older adults due to which of the following? a. There is a higher tolerance for elevated levels of circulating glucose in older
adults. b. Older adults tend to metabolize glucose at a faster rate than younger adults. c. Fingerstick glucose monitoring is inaccurate in older adults.
