Adult Development & Aging: Biopsychosocial Perspectives Canadian Edition Test Bank Whitbourne

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Adult Development and Aging: Biopsychosocial Perspectives Canadian Edition Test Bank Whitbourne

CHAPTER 5 Health and Prevention

Lecture guidelines

As with the previous chapter, there is extensive biological material in this chapter. However, many of the topics lend themselves to discussions within the framework of the biopsychosocial perspective, as these diseases show significant sociocultural variations. The material should be divided into two to three lectures, with an entire lecture devoted to Alzheimer’s disease, which is a major interest for most of the students in the course. The slides contain many illustrations and clarifications that will allow the instructor to move through the technical aspects of this material relatively quickly. More time can then be spent on discussions focused on psychological issues such as ways that people can prevent these diseases and the ways that these diseases interact with identity processes. Distinctions between normal aging and disease can also be made at frequent points throughout the lectures.

Videos and films

Given the explosion of interest in health in all areas of the media, it should be very easy for instructors to find videotape segments to illustrate lecture material. Cancer, heart disease, AIDS, musculoskeletal diseases, and Alzheimer’s disease are major areas of focus in many television news programs, magazines, and PBS or Discovery Channel documentaries. The problem is not finding these resources, but deciding on which ones to use.

Here are several good choices: ABC’s “Life to 150” with Barbara Walters: http://abcnews.go.com/Health/Longevity/

For the lecture on dementia, there is an excellent scene from “The Notebook” in which Noah and Allie have dinner and a brief dance in the nursing home that highlights the features of the symptoms of Alzheimer’s Disease (provide a handkerchief alert if you plan to show this scene).

NOVA Science Now also has an excellent segment on Alzheimer’s disease featuring the research of Tanzi and collaborators on genetic contributions (http://www.tvguide.com/tvshows/nova-sciencenow/videos-season-4/294165)

See the webpage for the Canadian Alzheimer’s Society as well as your local provincial association for reference materials including recent films and videos.

Discussion questions

Key concepts in health and prevention

  • Why do variations exist by sex and race in chronic diseases?
  • What are the relative contributions of genetics and environmental factors in causing differential rates of diseases across age, sex, and racial subgroups of adults?
  • Can you define the major chronic diseases in your own words?
  • How do chronic diseases differ from changes associated with normal aging?

Diseases of the cardiovascular system

  • If you found out that you were at risk for heart disease based on your genetic predisposition, what steps would you take to lower chances of developing the disease?
  • Why do you think so many people fit the technical definition of “obese”? Why is the prevalence of obesity so high among First Nation and Aboriginal people in Canada?
  • Who is most likely to take advantage of preventive efforts to avoid heart disease?
  • How might public health efforts be better directed at reducing the risk for heart disease in this country?

Cancer

  • What are the most common forms of cancer?
  • Why do people ignore the evidence linking certain behavioral lifestyle choices to cancer risk?
  • How can prevention strategies be made more effective in helping adults to avoid the risks of cancer?
  • Do you know people with cancer? What has their treatment process been like?

Disorders of the musculoskeletal system

  • How does osteoarthritis differ from rheumatoid arthritis?
  • What measures can people take to prevent osteoarthritis?
  • How does the disease of osteoporosis differ from normal age-related changes in bone?
  • What do you think about the advisability of taking hormone replacement therapy to prevent osteoporosis compared to other preventive measures?

Diabetes

  • How does Type 1 diabetes differ from Type 2?
  • How can the spread of diabetes be slowed through education?
  • What measures can be taken to motivate people to comply with treatment of Type 2 diabetes?
  • Why might it be difficult to encourage people to watch their diet and exercise patterns as a way of controlling diabetes?
  • Why is diabetes considered an epidemic health issue in Canada as well as other countries? Review the prevalence and risks among First Nation and Aboriginal people in Canada.

Respiratory diseases

  • Are anti-smoking advertisements successful in reducing the rate of cigarette smoking in the Canadian population? How could they be made more effective?

Neurocognitive disorders

  • What is the difference between dementia and Alzheimer’s disease?
  • What are the political implications of the published prevalence rates of Alzheimer’s disease?
  • What will be the implications of discovering the genetic causes of Alzheimer’s disease?
  • If genetics are thought to be such a strong influence on Alzheimer’s disease, how can we explain the findings from the studies showing environmental effects?
  • If a test is developed that can predict whether a person has a high chance of developing Alzheimer’s disease, would you want to take that test and find out the results?
  • What would be the effects on society of discovering a medical cure for Alzheimer’s disease?
  • Do you know anyone who is a caregiver for a person with Alzheimer’s disease? What are the daily challenges this person faces?
  • Clarify that there are forms of dementia other than Alzheimer’s disease and that some are reversible.
  • Why is it important to distinguish Alzheimer’s disease from other forms of dementia?
  • Why might a depressed person appear to have Alzheimer’s disease?
  • Why is it important to differentiate Alzheimer’s disease from delirium?

Test Bank

Multiple Choice

  1. The World Health Organization defines health as having which qualities?
  2. a) Absence of any physical limitations
  3. b) Lack of a disease or infirmity
  4. c) Complete physical, mental, and social well-being
  5. d) Ability to complete tasks of daily living

Answer: c

Section Reference: Definitions and Prevalence

  1. Health professionals use the individual’s ability to complete the tasks of bathing, dressing, transferring, using the toilet, and eating to assess:
  2. a) overall health status.
  3. b) activities of daily living.
  4. c) biopsychosocial competence.
  5. d) executive functioning.

Answer: b

Section Reference: Definitions and Prevalence

  1. The behavioral risk factors for chronic diseases in later adulthood include tobacco smoking, unhealthy diet, physical inactivity, and:
  2. a) lack of close relationships.
  3. b) low income and education.
  4. c) inaccessibility of transportation.
  5. d) harmful use of alcohol.

Answer: d

Section Reference: Definitions and Prevalence

  1. According to the Public Health Agency of Canada (2010) , approximately ______% of seniors, those 65 and older, were diagnosed with arthritis and rheumatism.
  2. a) 64
  3. b) 44
  4. c) 34
  5. d) 24

Answer: b

Section Reference: Definitions and Prevalence

  1. In the disease known as ________________, the heart cannot distribute enough blood throughout the body to reach the major organs, causing the tissues to swell with fluid.
  2. a) congestive heart failure
  3. b) cerebrovascular insufficiency
  4. c) transient ischemia
  5. d) chronic hypertension

Answer: a

Section Reference: Diseases of the Cardiovascular System

  1. In which health condition does the individual develop general thickening and hardening of the arteries?
  2. a) Arteriogenesis.
  3. b) Myocardial infarction.
  4. c) Arteriosclerosis.
  5. d) Coronary heart disease

Answer: c

Section Reference: Diseases of the Cardiovascular System

  1. The number one cause of death worldwide , that can also cause chronic disability among older adults , is:
  2. a) arthritis
  3. b) heart disease
  4. c) cancer
  5. d) stroke

Answer: b

Section Reference: Diseases of the Cardiovascular System

  1. The country with the highest percentage of obesity in the world is:
  2. a) Finland.
  3. b) Russia.
  4. c) Bulgaria.
  5. d) United States.

Answer: d

Section Reference: Diseases of the Cardiovascular System

  1. Among First Nation and Aboriginal people, the thrifty gene effect is considered:
  2. a) Protective for skin cancer.
  3. b) A risk for skin cancer.
  4. c) Protective for obesity.
  5. d) A risk for obesity. .

Answer: d

Section Reference: Diseases of the Cardiovascular System

  1. A 66-year-old man was told by his physician that he has metabolic syndrome. This means that he meets which of the following criteria?
  2. a) Waist circumference of 35 inches.
  3. b) Blood pressure of 110-120.
  4. c) Fasting glucose below 4.5 mml/ L
  5. d) HDL cholesterol of greater than 40 mg/dL

Answer: d

Section Reference: Diseases of the Cardiovascular System

  1. A true Mediterranean diet would include relatively little of which type of food?
  2. a) Nuts
  3. b) Milk
  4. c) Grains
  5. d) Fish

Answer: b

Section Reference: Diseases of the Cardiovascular System

  1. A prospective study of BMI and cancer risk showed that a high BMI is associated with a greater risk of which type of cancer?
  2. a) Skin
  3. b) Lymphoma
  4. c) Lung
  5. d) Esophagus

Answer: d

Section Reference: Cancer

  1. In general, guidelines for receiving cancer screening recommend that patients undergo systematic tests:
  2. a) on an annual basis for all cancers.
  3. b) only as indicated by research guidelines.
  4. c) approximately once every 10 years.
  5. d) more frequently after the age of 60.

Answer: b

Section Reference: Cancer

  1. The highest rates of stomach and colon cancer are found among which racial/ethnic group?
  2. a) Whites
  3. b) Asians
  4. c) Blacks
  5. d) Latinos

Answer: c

Section Reference: Cancer

  1. Which cosmetic procedure is shown to be associated with a higher rate of skin cancer?
  2. a) Liposuction
  3. b) Tattooing
  4. c) Tanning beds
  5. d) Body piercing

Answer: d

Section Reference: Cancer

  1. People living in India who engage in the dietary practice of chewing or eating ___________ put themselves at higher risk of developing cancer.
  2. a) betel quid
  3. b) dried fish
  4. c) fried naan
  5. d) fresh rogan

Answer: a

Section Reference: Cancer

  1. Exposure to the asbestos increases an individual’s risk of developing _______ cancer.
  2. a) skin
  3. b) stomach
  4. c) lung
  5. d) colon

Answer: c

Section Reference: Cancer

  1. The disease that involves an abnormal thinning of the bones is:
  2. a) osteoarthritis
  3. b) tendonitis
  4. c) osteoporosis
  5. d) sarcopenia

Answer: c

Section Reference: Disorders of the Musculoskeletal System

  1. A 72-year-old woman has been told by her physician that, because she is obese, she is putting increased weight on her joints, thus increasing her risk of developing the musculoskeletal disease known as:
  2. a) hypertension.
  3. b) osteoarthritis.
  4. c) emphysema.
  5. d) hypolipidemia.

Answer: b

Section Reference: Disorders of the Musculoskeletal System

  1. Which of the following is a side effect involved in taking NSAID’s for osteoporosis?
  2. a) Chemical dependence
  3. b) Kidney disease and ulcers
  4. c) Destruction of cartilage
  5. d) Weight gain

Answer: b

Section Reference: Disorders of the Musculoskeletal System

  1. One of the risks of osteoporosis medication (bisphosphonates) is the potential for the individual to develop:
  2. a) loss of bone in the jaw.
  3. b) higher rates of brain tumors.
  4. c) increases in blood glucose.
  5. d) loss of synovial fluid.

Answer: a

Section Reference: Disorders of the Musculoskeletal System

  1. A middle-aged man is worried that his 83-year-old mother may develop osteoporosis, a reasonable concern because she:
  2. a) is relatively overweight.
  3. b) takes in very little vitamin D.
  4. c) consumes high amounts of protein.
  5. d) exercises at least 3 times a week.

Answer: b

Section Reference: Disorders of the Musculoskeletal System

  1. Health professionals treating older adults with osteoarthritis are most likely to recommend which of the following approaches as a long-term strategy, particularly for individuals with mild symptoms?
  2. a) Weight gain
  3. b) Bed rest
  4. c) Corticosteroids
  5. d) Mild exercise

Answer: d

Section Reference: Disorders of the Musculoskeletal System

  1. Diabetes can be traced to the abnormal functioning of which bodily organ?
  2. a) Hypothalamus
  3. b) Liver
  4. c) Pancreas
  5. d) Kidney

Answer: c

Section Reference: Diabetes

  1. Diabetes can be prevented and even treated by which behavior?
  2. a) Increasing the intake of sugars.
  3. b) Monitoring weight and diet.
  4. c) Reducing involvement in exercise.
  5. d) Increasing intake of red wine.

Answer: b

Section Reference: Diabetes

  1. The World Health Organization estimates that, in 2013 , approximately _______ million people over the globe had diabetes.
  2. a) 25
  3. b) 622
  4. c) 171
  5. d) 347

Answer: c

Section Reference: Diabetes

  1. Chronic Obstructive Pulmonary Disease (COPD) is almost always caused by:
  2. a) sun exposure.
  3. b) overeating.
  4. c) smoking.
  5. d) genetics.

Answer: c

Section Reference: Respiratory Diseases

  1. A 65-year-old man smoked all his life and now has ____________, a combination of chronic bronchitis and emphysema.
  2. a) Elastase resistance dysfunction.
  3. b) Chronic obstructive pulmonary disease.
  4. c) Acute pulmonary inflammation.
  5. d) Chronic respiratory syndrome.

Answer: b

Section Reference: Respiratory Diseases

  1. The increased release of elastase stimulated by cigarette smoking is thought to be a cause of which disease?
  2. a) Emphysema.
  3. b) Diabetes.
  4. c) Hypertension.
  5. d) Atherosclerosis.

Answer: a

Section Reference: Respiratory Diseases

  1. Destruction of the _______________ is a consequence of emphysema.
  2. a) trachea
  3. b) nephrons
  4. c) alveoli
  5. d) pancreas

Answer: c

Section Reference: Respiratory Diseases

  1. Unlike memory loss caused by Alzheimer’s disease, the symptoms of vascular dementia may be:
  2. a) progressive.
  3. b) fatal.
  4. c) biologically based.
  5. d) treatable.

Answer: d

Section Reference: Neurocognitive Disorders

  1. According to your text, _____ is a major factor associated with increased vulnerability to illness that is often not considered and may account for inflated prevalence statistics.
  2. a) the better nutritional status of older adults
  3. b) generally lower socio-economic status of some samples
  4. c) prevalence of larger numbers of males
  5. d) genetic influences on the nervous system

Answer: b

Section Reference: Neurocognitive Disorders

  1. The plaques found in the brains of people with Alzheimer’s disease are made up of which substance?
  2. a) tau proteins
  3. b) dead dendrites
  4. c) acetylcholine
  5. d) beta amyloid

Answer: d

Section Reference: Neurocognitive Disorders

  1. Researchers believe that the APP gene contributes to Alzheimer’s disease by causing faulty:
  2. a) synapses between neurons
  3. b) electrical discharges
  4. c) snipping of amyloid proteins
  5. d) memory formation

Answer: c

Section Reference: Neurocognitive Disorders

  1. In Alzheimer’s disease, neurofibrillary tangles cause what changes to occur within the brain?
  2. a) Accumulation of harmful waste products.
  3. b) Targeted death of motor neurons.
  4. c) Loss of blood supply to the hippocampus.
  5. d) Twisting of microtubules in the neurons.

Answer: d

Section Reference: Neurocognitive Disorders

  1. Which neurotransmitter is thought to be involved in the memory loss of Alzheimer’s disease?
  2. a) acetylcholine
  3. b) estrogen
  4. c) apoptosis
  5. d) caspase

Section Reference: Neurocognitive Disorders

Correct choice: A

  1. Which theory of Alzheimer’s disease proposed that beta amyloid releases an enzyme that causes neuronal death?
  2. a) caspase
  3. b) neurofibrillary
  4. c) cortisol
  5. d) multi-infarct

Answer: a

Section Reference: Neurocognitive Disorders

  1. The enzymes that normally trim the amyloid precursor protein (APP) to make it flush with the neuron’s outer membrane are the:
  2. a) elastases.
  3. b) caspases.
  4. c) secretases.
  5. d) apoptoses.

Answer: c

Section Reference: Neurocognitive Disorders

  1. Researchers investigating the role of lifestyle factors as modifying an individual’s risk of developing Alzheimer’s disease believe that __________ can play a protective role.
  2. a) exercise
  3. b) nicotine
  4. c) caffeine
  5. d) mood

Answer: a

Section Reference: Neurocognitive Disorders

  1. The condition known as multi-infarct dementia causes cognitive changes as a result of:
  2. a) traumatic brain injury.
  3. b) chronic substance abuse.
  4. c) sensory deprivation.
  5. d) a series of small strokes.

Answer: d

Section Reference: Neurocognitive Disorders

  1. The condition known as Mild Cognitive Impairment (MCI) is used in cases involving:
  2. a) memory loss that may progress to Alzheimer’s disease.
  3. b) documented loss of memory, language, and judgment.
  4. c) loss of blood supply to the subcortical brain regions.
  5. d) poor judgment due to acute alcohol intoxication.

Answer: a

Section Reference: Neurocognitive Disorders

  1. Psychologists diagnosing Alzheimer’s disease look for which key symptom in its early stage?
  2. a) occasionally misplacing objects at home
  3. b) being absent-minded from time to time
  4. c) forgetting names of good friends or family
  5. d) being unable to name the star of a popular movie

Answer: c

Section Reference: Neurocognitive Disorders

  1. Which medication that treats some of the symptoms of Alzheimer’s disease falls into the category of anticholinesterases?
  2. a) memantine
  3. b) lithium bicarbonate
  4. d) beta amyloid
  5. c) donepezil hydrochloride

Answer: d

Section Reference: Neurocognitive Disorders

  1. Memantine is a medication for Alzheimer’s disease that is intended to produce which changes in the individual’s brain?
  2. a) stimulates new neurons to replace those that have died.
  3. b) provides more beta amyloid to replace old plaques.
  4. c) Reduces the death of neurons by blocking glutamate receptors .
  5. d) Allows more acetylcholine to remain in the brain .

Answer: c

Section Reference: Neurocognitive Disorders

  1. A woman is caring for her husband who suffers from advanced dementia. The Alzheimer’s Society of Canada would suggest that caregivers she should engage in which activity to help herself cope with caregiver burden?
  2. a) Join a caregiver’s support group.
  3. b) Discontinue ties with friends.
  4. c) Move her husband to a nursing home.
  5. d) Find a psychiatrist to prescribe antidepressants.

Answer: a

Section Reference: Neurocognitive Disorders

  1. The condition known as _________ may increase the risk of cognitive disorders developing in older adults by overdiagnosis of prescription drugs.
  2. a) peptide poisoning
  3. b) polypharmacy
  4. c) pseudodementia
  5. d) protein overloading

Answer: b

Section Reference: Neurocognitive Disorders

  1. Though very similar in many ways to Alzheimer’s disease, multi-infarct dementia (MID) differs importantly in that it is caused by:
  2. a) excessive intake of alcohol.
  3. b) abnormalities in metabolism.
  4. c) traumatic brain injury.
  5. d) loss of blood supply to the brain.

Answer: d

Section Reference: Neurocognitive Disorders

  1. An 82-year-old man constantly feels sad, demoralized, and worthless. He also is experiencing significant memory problems. Based on this pattern of symptoms, physician examining Mr. Grah should take care to rule out which possible cause of his memory loss?
  2. a) polypharmacy
  3. b) pseudodementia
  4. c) Pick’s disease
  5. d) Lewy body dementia

Answer: b

Section Reference: Neurocognitive Disorders

  1. In ________________ disease, the individual primarily suffers from disturbances in motor functioning, including having tremors, shuffling gait, and difficulties maintaining balance.
  2. a) Lewy Body
  3. b) Pick’s
  4. c) Wernicke’s
  5. d) Parkinson’s

Answer: d

Section Reference: Neurocognitive Disorders

  1. According to your text an important but often neglected focus on health of older adults in Canada involves:
  2. a) Distinguishing Alzheimer’s disease from other neurological disorders.
  3. b) Studying mild cognitive impairment as a risk for Alzheimer’s Disease
  4. c) An emphasis on prevention and health promotion
  5. d) Drug treatments of neurological disorders.

Answer: c

Section Reference: Neurocognitive Disorders

Short Answer

  1. Describe five diseases of the cardiovascular system along with their causes.

Section Reference: Diseases of the Cardiovascular System

  1. What are two forms of cerebrovascular disease?

Section Reference: Diseases of the Cardiovascular System

  1. How do incidence rates of cardiovascular and cerebrovascular disease vary by sex and race in adulthood?

Section Reference: Diseases of the Cardiovascular System

  1. What are the four major risk factors for diseases of the cardiovascular system?

Section Reference: Diseases of the Cardiovascular System

  1. What three measures can people take to lower their risk of cardiovascular disease?

Section Reference: Diseases of the Cardiovascular System

  1. Describe five major forms of cancer according to their site in the body and the nature of the specific form of cancer.

Section Reference: Cancer

  1. What are the three greatest risk factors for the development of cancer?

Section Reference: Cancer

  1. What four forms of treatment are available for cancer? What are their side effects?

Section Reference: Cancer

  1. List four forms of treatment for osteoarthritis.

Section Reference: Disorders of the Musculoskeletal System

  1. What are five risk factors for the development of osteoporosis?

Section Reference: Disorders of the Musculoskeletal System

  1. List five forms of treatment and prevention of osteoporosis.

Section Reference: Disorders of the Musculoskeletal System

  1. Describe the disease process in Type 2 diabetes.

Section Reference: Diabetes

  1. What are four interventions that can be implemented for people with Type 2 diabetes?

Section Reference: Diabetes

  1. List the two forms of respiratory disease that make up COPD.

Section Reference: Chronic Respiratory Disease

  1. What two forms of treatment are available for people with COPD?

Section Reference: Chronic Respiratory Disease

  1. Describe the issues involved in determining the prevalence of Alzheimer’s disease.

Section Reference: Neurocognitive Disorders

  1. What are three major psychological symptoms of Alzheimer’s disease?

Section Reference: Neurocognitive Disorders

  1. What are the two major microscopic changes in the brain associated with Alzheimer’s disease? What processes are thought to be responsible for the development of these changes?

Section Reference: Neurocognitive Disorders

  1. What are the three genes thought to be the major causes of Alzheimer’s disease?

Section Reference: Neurocognitive Disorders

  1. Describe three lifestyle or environmental factors thought to be causes of or contributors to Alzheimer’s disease.

Section Reference: Neurocognitive Disorders

  1. List the five diagnostic criteria of the American Psychiatric Association for the diagnosis of Alzheimer’s disease.

Section Reference: Neurocognitive Disorders

  1. What four types of medical treatment are currently being tested for people with Alzheimer’s disease?

Section Reference: Neurocognitive Disorders

  1. Psychosocial treatments for Alzheimer’s disease attempt to change which two major categories of problems dealt with by caregivers?

Section Reference: Neurocognitive Disorders

  1. List and describe six forms of dementia that may appear to be Alzheimer’s disease. Indicate how each form of dementia is different from Alzheimer’s disease.

Section Reference: Neurocognitive Disorders

  1. What are six forms of reversible dementia that may be confused with Alzheimer’s disease? Why is it important to identify these forms of dementia?

Section Reference: Neurocognitive Disorders

Essay

  1. Take the role of a public health expert working on behalf of the American Heart Association. Design a media campaign that would help lower the risk for cardiovascular and cerebrovascular disease among the groups with the highest rates of these diseases. Justify the steps you would take and the information you would provide.
  2. Diseases of later life are becoming increasingly important for physicians to understand, diagnose, and treat. What would you regard as the main lessons that physicians should learn about these diseases? How can efforts to educate physicians about gerontology and geriatrics be improved?
  3. Why are First Nation and Aboriginal people at such high risk for diabetes? How would you address these risks in terms of intervention?
  4. If you were designing a program to help family caregivers of people with Alzheimer’s disease, what types of features would you emphasize to make your program as effective as possible? Why would you include those features?
  5. Is your community “age-friendly”? Review the characteristic of “age-friendly communities” as they apply to your city/town/neighbourhood? What improvement would you recommend to support the health and well-being of local seniors?

Adult Development and Aging: Biopsychosocial Perspectives Canadian Edition Test Bank Whitbourne