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NR601 Midterm Exam (Version-1, New-2023) / NR 601 Midterm Exam: Chamberlain College of Nursing |100% Correct Q & A| NR601 Midterm Exam / NR 601 Midterm ... [Show More] Exam (Latest): Chamberlain College Of Nursing 1. The percentage of the FVC expired in one second is: 2. The aging process causes what normal physiological changes in the heart? 3. A 55yo Caucasian male follows up after referral to cardiologist. He thinks his med is causing a cough and sometimes he has difficulty breathing. Which med was most likely prescribed? 4. JM is a 68yo man who presents for a physical. He has T2DM x5yrs, smokes 1/2 PPD, BMI is 30. No other previous medical dx, no current complaints. According to the AHA/ACC guidelines, JM is stage A HF. Treatment goals for him include: 5. MJ presents with h/o structural damage with current s/s of HF. Treatment will be based on his stage of HF, which is: 6. 65yo Caucasian female presents with mitral valve stenosis, physical exam unremarkable. You know her stage of HF is: 7. DG, 65yo man, presents for eval of CP and L-sided shoulder pain, beginning after strenuous activity, including walking. Pain is dull, aching, 8/10 during activity, otherwise 0/10. Began few mo ago, intermittent, aggravated by exercise, relieved by rest. Occasional nausea. Pain is retrosternal, radiating to L shoulder, affects QOL by limiting activity. Pain is worse today, did not go away after stopped walking. BP 120/80, HR 72 and regular. Normal heart sounds, no murmur, S1, S2. Which differential dx would be most likely? 8. The best way to dx structural heart dz/dysfunction non-invasively is: 9. Chronic pain can have major impact on pt's ability to function and have profound impact on overall QOL. Ongoing pain may be linked to: 10. The Beers criteria are appropriate for use in evaluating use of certain meds in pts: 11. Pt presents with c/o increasing SOB, cough w/occasional white sputum, fatigue. As part of the plan you order labs. You know the likelihood of HF is low if the BNP is: 12. All of the following statements are true about lab values in older adults except: a. Normal ranges may not be applicable to older adults b. Abnormal findings are often due to physiological aging c. Reference ranges are preferable d. References values are not necessarily acceptable values 13. According to the 2017 ACC HTN guidelines, the recommended BP goal for a 65yo African American woman w/a h/o HTN and DM and no h/o CKD is: 14. The pathophysiology of HF is due to: 15. A 60yo woman w/30 pack yr hx, presents for eval of persistent, daily cough w/increased sputum, worse in the AM, occurring over past 3 months. She tells you, "I have the same thing year after year." Which of the following choices would you consider strongly in your critical thinking process? 16. JM is a 68yo man who presents for a physical. He has T2DM x5yrs, diet controlled. His BMI is 32. He has HTN, smoker (10 cigs/day x20yrs). He denies other medical problems. Fam hx includes CAD, CABG x4 for dad, now deceased; CHF, T2DM, HTN for mom. He is asymptomatic today, exam is normal, EKG NSR. According to AHA/ACC guidelines, JM is at risk for what stage of HF? 17. The volume of air a pt is able to exhale for total duration of the test during maximal effort is: 18. According to the 2017 ACC HTN guidelines, normal BP is: 19. Functional abilities are best assessed by: 20. LB is a 77yo pt w/chronic poorly controlled HTN. You know that goals include prevention of target organ damage. During your eval you will assess for evidence of: 21. Aortic regurgitation requires medical treatment for early signs of HF with: a. ACEi 22. The volume of air in the lungs at max inflation is: a. TLC (total lung capacity) 23. Preferred amount of exercise for older adults is: a. 30min/day of aerobic activity 5 days/wk 24. The total volume of air a pt is able to exhale in the first second during max effort is: a. FEV1 25. You know the following statements regarding the pain of acute coronary syndrome are true except: a. Present atypically more often in men than women b. May be retrosternal or poorly localized c. May last longer than 20min d. May radiate to arms, back, neck, jaw a. A 26. Elderly pt presents w/new onset of feeling heart race, fatigue. EKG reveals afib w/rate >100. Pt also has a new tremor in both hands. Which of the following would you suspect? a. Hyperthyroidism 27. 62yo female c/o fatigue, lack of energy. Constipation increased, pt gained 10lbs in past 3mo. Depression is denied although pt reports lack of interest in usual hobbies. VS are WNL, skin is dry/cool. Which of the following must be included in the DD? a. Hypothyroidism 28. Mrs. Black, 87yo, has been taking 100mcg Synthroid x10yrs. She comes for routine follow-up, feeling well. HR is 90. Your first response is to: a. Order TSH 29. Which pt is most likely to have osteoporosis? 30. 80yo underweight male who smokes and has been on steroids for psoriasis 31. When evaluating the expected outcome for hypothyroid elderly pt on levothyroxine, you will: a. Assess TSH in 4-6wks 32. Postmenopausal woman w/osteoporosis is taking bisphosphonate daily PO. What action info statement would indicate she understood your instructions regarding this med? a. Take med w/full glass of water when up in the AM 30min before other food and meds 33. Primary reason levothyroxine sodium is initiated at low dose in elderly pt w/hypothyroidism is to prevent which of the following untoward effects? a. Angina and arrhythmia 34. 6mo ago an elderly pt was dx'd w/subclinical hypothyroidism. Today the pt returns and has TSH of 11 and c/o fatigue. He has taken Synthroid 25mcg daily as prescribed. What is the best course of action? a. Double the dose 35. A fluoroquinolone (Cipro) is prescribed for a male pt w/a UTI. What should you teach him regarding this med? a. Its effectiveness is decreased by antacids, iron, or caffeine 36. Pt has been rx'd metformin (Glucophage). One wk later, he returns w/lowered BGL but c/o loose stools during the week. How should you respond? a. Reassure him that this is an anticipated SE 37. Which of the following s/s of hyperthyroidism commonly manifest in younger populations, but is notably lacking in elderly? a. Exopthalmos 38. 60yo obese male has T2DM and lipid panel of TC = 250, HDL = 32, LDL = 165. You teach him about his modifiable cardiac risk factors, which include: a. DM, obesity, hyperlipidemia 39. Diabetic pt presents w/R foot pain but denies any recent known injury. He states it has gotten progressively worse over past few months. On exam, vibratory sense, as well as sensation tested w/monofilament, was abnormal. Pt's foot is warm, edematous, misshapen. You suspect Charcot foot. What intervention is indicated? a. Referral to orthopedist 40. What is a s/s of insulin resistance that can present in African Americans? a. Acanthosis Nigricans 41. During routine exam of 62yo female, you ID xanthelasma around both eyes. What is the significance of this? a. Abnormal lipid metabolism requiring medical management 42. Mr. White is 62yo, had CKD that has been relatively stable. He also has h/o hyperlipidemia, OA, HTN. He is compliant w/meds, BP has been well controlled on CCB. Last lipids showed: TC = 201, HDL = 40, TG = 180, LDL = 98. He currently takes Crestor 20mg daily. Today his BP is 188/90 and urine dip shows significant proteinuria. He denies changes in dietary habits or med regimen. What would be the best med change at this point? a. Change CCB to ACEi 43. You are working as NP in Fast Track of ER. 76yo male presents w/LUQ pain. There can be many conditions that present as LUQ pain, but which of the following is least likely to cause pain here? a. Acute pancreatitis 44. Which is cardinal feature of failure to thrive? a. Poor nutritional status 45. Feeding gastrostomy tubes at end-of-life Alzheimer's pt's have been associated with: a. Aspiration pna 46. Which of the following nutritional indicators is not an indication of poor nutritional status in elderly? a. BMI 25 47. OA of cervical and lumbar spine causes pain related to all of the following except: a. Crystal deposition 48. In differentiating OA from chronic gout, pseudogout, or septic arthritis, the most valuable diagnostic study would be: a. Synovial fluid analysis 49. Pt's w/OA of hip and knee often have distinguishable gait described as: a. Antalgic 50. Which of the following best describes pain associated w/OA? a. Begins upon arising and after prolonged wt bearing and/or use of the joint 51. Joint effusions typically occur later in the course of OA, especially in the: 52. Knee 53. You ordered CBC for your pt you suspect has polymyalgia rheumatica (PMR). Which 2 clinical findings are common in pt's w/PMR? a. Normochromic, normocytic anemia and thrombocytosis 54. You suspect your pt has PMR and now are concerned that they may have Giant Cell Arteritis (GCA) too. Which of the following 2 symptoms are most indicative of GCA and PMR? a. Scalp tenderness and aching in shoulder and pelvic girdle 55. 63yo Caucasian pt w/PMR will begin Tx w/corticosteroids until the condition has resolved. You look over her records and it has been 2yrs since her last physical exam and any labs or diagnostic tests as she relocated and had not yet ID'd a provider. In prioritizing your management plan, your first orders should include: a. Duel-energy x-ray (DEXA) scan and updating immunizations 56. Which of the following DD for pt's presenting w/PMR can be ruled out w/a muscle biopsy? a. Polymyositis 57. In reviewing lab results for pt's w/suspected PMR, you realize there is no definitive test to dx PMR, rather clinical response to Tx. Results you would expect to see include: a. Elevated erythrocyte sed rate (ESR) >50 58. Which of the following is the most appropriate lab test for monitoring gout therapy over the long-term? a. Serum urate level 59. In providing health teaching related to dietary restrictions, you should advise a pt w/gout to avoid which of the following dietary items: a. Beer, sausage, fried seafood 60. The best method of verifying gout dx in a joint is which of the following: 61. Joint aspiration and polarized-light microscopy 62. The most appropriate first-line Tx for acute gout flare is (assuming no kidney dz or elevated bleeding risk): a. Indomethacin 50mg TID x2 days, then 25mg TID x3 days 63. You order bilat wrist XR on 69yo man c/o pain both wrists x6 wks no related to any known trauma. You suspect early onset RA. The initial XR finding in a pt w/elderly onset RA would be: a. Soft tissue swelling 64. You examine the hands of a 55yo woman w/RA and note bilat spindle shaped deformities on middle interphalangeal joints. These are known as: a. Haygarth's nodes 65. A 72yo female has been dx'd w/gout. She also has h/o chronic HF. The most likely contributing factor to development of gout in this older female is: a. Thiazide diuretics 66. Which of the following statements about OA is true? 67. It affects primarily wt-bearing joints 68. In considering the specificity of lab data, the most reliable diagnostic test listed below would be: a. Synovial fluid analysis to differentiate between infectious versus inflammatory infusion 69. When examining the spine of an older adult you notice a curvature w/a sharp angle. This is referred to as a: a. Gibbus 70. The prevalence of depression in nursing home residents is ___________ greater than adults living in the community. a. 3-4 times 71. The majority of depressed older adults remain untreated because of: a. Misdiagnosis, social stigma, environmental barriers 72. Symptoms of depression distinct to the elderly include: a. Lack of emotions 73. The justification for ordering CBC, TSH, serum B12 for a pt you may suspect have clinical depression is: a. Because of overlapping symptoms w/anemia, thyroid dysfunction, and nutritional deficiencies 74. One major difference that is useful in the DD of dementia versus delirium is that: a. Dementia develops slowly and delirium develops quickly 75. Which of the following is the most appropriate screening tool for delirium? a. Confusion Assessment Method 76. The proposed mechanism by which diphenhydramine causes delirium is: a. Anticholinergic effects 77. The elderly are at high risk for delirium because of: a. Multisensory declines, polypharmacy, multiple medical problems 78. A consistent finding in delirium, regardless of cause, is: a. Reduction in regional cerebral perfusion 79. Older adults w/dementia sometimes suffer from agnosia, which is defined as the inability to: a. Recognize objects 80. In late stages of dementia, a phenomenon called sun downing occurs, in which cognitive disturbances tend to: a. Become worse in the evening 81. Of the following, which one is the most useful clinical eval tool to assist in the dx of dementia? a. St. Louis University Mental Status Exam (SLUMS) 82. The cornerstone of pharmacotherapy in treating Alzheimer's is: a. Cholinesterase inhibitors 83. The comorbid psych problem w/the highest frequency in dementia is: a. Anxiety 84. When treating depression associated w/dementia, which of the following would be a poor choice and should not be prescribed? a. Amitriptyline 85. The leading COD in elderly travelers worldwide is: a. Accidents 86. Which of the following should be avoided in countries where food and water precautions are to be observed? a. Salad buffet 87. What insect precautions are not necessary to prevent insect-borne dz's in the tropics? a. Using 100% DEET on skin to prevent bites 88. An example of secondary prevention you could recommend/order for older adults would be to: a. Check for fecal occult blood 89. Ali is a 72yo man who recently came to US from Nigeria. He reports having BCG (bacille Calmette-Guerin) vax as a child. Which of the following is correct regarding a TB skin test? a. Vax hx is irrelevant; read as usual 90. Ivan is 65yo man who is new to your practice. He has h/o COPD, CAD, HTN, T2DM. He has had no immunizations since his d/c from military at 25yo. Childhood dz's include chickenpox, measles, mumps, and German measles. He presents for a dz management visit. Which of the following immunizations would you recommend for Ivan? a. Tdap, pneumococcal, influenza, Zostavax 91. Leo is a 62yo African American male who comes in for an initial visit. Personal health hx includes smoking 1 PPD since 11yo, consuming a case of beer (24 bottles) every weekend, and working as an assembler (sedentary job) for the past 10yrs. Fam Hx in first-degree relatives includes HTN, high cholesterol, MI, T2DM. Leo's BMI is 32. BP is 130/86. You order fasting glucose, lipid profile, and return visit for BP check. This is an example of: a. Secondary prevention 92. A local chapter of NP organization has begun planning a community-based screening for HTN at a local congregate living facility. This population was selected on the basis of: a. A recognized element of high risk within this group. 93. Performing ROM exercises on a pt who has had a CVA is an example of which level of prevention? a. Tertiary 94. You demonstrate an understanding of primary prevention of falling among the elderly through which management plan? a. Provide info about meds, SE, interactions 95. An example of an active strategy of health promotion for an individual to accomplish would be: a. Beginning stress management program 96. You are working w/an older adult male w/a long h/o ETOH abuse and a 30yr h/o smoking. In recommending an intervention, your responsibility is to: a. Promote positive change in lifestyle choices 97. The 4 main domains of clinical preventive services that you will provide are: a. Counseling interventions, screening tests, immunizations, chemoprophylaxis 98. Which organism that can be prevented by immunization is most often responsible for an infectious "outbreak" in the nursing home setting? a. Influenza A 99. What is the appropriate method for TB screening of an older adult entering a nursing home? a. 5 TBU intradermal PPD injection and if negative, repeat w/same dose one week later 100. Meds known to contribute to constipation include all of the following except: a. Broad-spectrum abx 101. All of the following are considered contributors to dysphagia except: a. Smooth muscle relaxants 102. The term "geriatric syndrome" is best described as: a. Condition that has multiple underlying factors and involves multiple systems 103. The anal wink reflex is used to test: a. Sensation and pudental nerve function 104. Atypical presentation of acute coronary syndrome is: a. More common in females 105. What dz can mimic and often co-exists w/MI in elderly w/CAD? a. Esophageal dz 106. Thoracic aortic dissection presents typically as: a. Severe retrosternal CP that radiates to the back and both arms 107. Bordetella pertussis is best characterized by: a. Sub-acute cough lasting >2wks 108. Routine testing of TB should occur in all of the following vulnerable populations except: a. Hospitalized elderly 109. Which of the following statements about fluid balance in elderly is false? a. Assessment of skin turgor at the sternum is a reliable indicator of dehydration in elderly. 110. Distinguishing delirium from dementia can be problematic since they may co-exist. The primary consideration in the DD is: a. Rapid change and fluctuating course of cognitive function 111. Presbystasis is best described as: a. Age-related disequilibrium of unknown pathology characterized by gradual onset of difficulty walking 112. If dizziness has a predictable pattern associated w/it, you should first consider: a. Hypoglycemia 113. Evidence shows that the most important predictor of a fall is: a. Prior h/o a fall 114. The most cost-effective interventions used to prevent falls are: 115. Home modifications and vit D supplements 116. Chronic fatigue syndrome is best described as: 117. Fatigue lasting longer than 6mo and not relieved by rest 118. Which form of HA is bilat? 119. Tension 120. Microscopic hematuria is defined as: 121. 3 or more RBCs on 3 or mor samples of urine 122. Risk factors associated with the finding of a malignancy in a pt w/hemoptysis include all of the following except: a. Childhood asthma 123. Recent wt loss is defined as: a. Loss of >10lbs over the past 3-6mo 124. The most common cause of disability in elderly is due to: a. Arthritis 125. Lipedema is best described as: a. Bilat distribution of fat in lower extremities 126. Drug-induced pruritis is distinguished because it: a. May occur right after drug is taken or months later 127. A form of syncope that is more common in elderly than in younger adults is: a. Orthostatic hypotension 128. All of the following statements about tremor are true except: a. The most common tremor is the Parkinson tremor 129. Overflow incontinence is usually associated with: a. Bladder outlet obstruction 130. Wandering is best described as: a. Purposeful excessive ambulatory behavior 131. A key symptom of ischemic heart dz is CP. However, angina equivalents may include exertional dyspnea. Angina equivalents are important because: a. Women w/ischemic heart dz many times don't present w/CP. Some pt's may have no symptoms or atypical symptoms so dx may only be made at the time of the actual MI. 132. Which test is clinical standard for assessment of aortic stenosis? a. Echocardiogram 133. Ischemic heart dz is: a. Defined as an imbalance between O2 supply and demand. Frequently manifested as angina. Leading COD in elderly. 134. Preceding a stress test, the following lab work might include: a. CBC w/diff to differentiate ischemic heart dz from anemia. Thyroid studies to rule out hyperthyroidism. 135. On exam, what type of murmur can be auscultated w/aortic regurg? a. Austin flint 136. Which of the following statements is true regarding anti-arrhythmic drugs? a. Most anti-arrhythmics have low toxic/therapeutic ratio and some are exceedingly toxic. 137. In mitral stenosis, p waves may suggest: a. L atrial enlargement 138. Aortic regurg requires medical tx for early signs of CHF with: a. ACEi 139. The best evidence rating drugs in a post-MI pt include: a. ASA, ACEi/ARB, BB, aldosterone blockade 140. 55yo post-menopausal woman with h/o HTN c/o jaw pain on heavy exertion. No c/o CP. EKG is NSR w/out ST segment abnormalities. Your plan may include: a. Exercise stress test 141. What is the most common valvular heart dz in elderly? a. Aortic stenosis 142. Elderly may present with atypical clinical signs of pna. You need to be aware that clustering of all of the following s/s may indicate pna in the elderly except for: a. Bradycardia 143. A common auscultatory finding in CHF is: a. S3 144. The most common organism responsible for CAP in the elderly is: a. Strep pneumoniae 145. 72yo woman and her husband are driving cross-country. After a long day of driving, they stop to eat. Midway through the meal, the woman becomes very SOB w/CP and a sense of panic. Which problem is most likely? a. Pulmonary embolism 146. Exercise recommended for elderly should include activities that: a. Strengthen muscles 147. Preferred amount of exercise for elderly is: a. 30min of aerobic activity a day 5 days a week 148. Which of the following medical conditions is not considered restrictive for engaging in physical activity? a. Depression 149. The best recommendation for a pt who says they have no equipment to exercise is: a. Improvise w/recommended objects at home that can be used 150. When you recommend exercise for elderly, which of the following pieces of advice should be considered for all types of exercise? a. Start low and go slow 151. All of the following statements are true about lab values in the elderly except: a. Abnormal findings are often due to physiological aging 152. Biochemical individuality is best described as: a. Each individual's variation is often much smaller than that of a larger group 153. All the following statements about drug absorption are false except: a. Underlying chronic dz has little impact on drug absorption 154. The cytochrome p system involves enzymes that are generally: a. Inhibited or induced by drugs 155. A statement not shown to be true about pharmacodynamic changes with aging is: a. Decreased sensitivity to oral anticoagulants 156. The major impact of the physiological changes that occur w/aging is: a. Reduced physiological reserve Reduced homeostatic mechanisms Impaired immunolgoical response 157. The strongest evidence regarding normal physiological aging is available through: a. Longitudinal studies 158. Pharmacokinetic changes w/aging is reflective of: a. What the body does to the drug 159. All of the following statements are true about drug distribution in the elderly except: a. Drugs distributed in water have lower concentration 160. Men have faster and more efficient biotransformation of drugs and this is thought to be due to: a. Testosterone 161. Atypical presentation of dz in elderly is reflected by all the following except: a. MI w/CP and diaphoresis 162. Polypharmacy is best described as taking: a. Even a single med if there is not a clear indication for its use [Show Less]
NR 601 Midterm Exam (Version-2, New-2023) / NR601 Midterm Exam: Chamberlain College of Nursing |100% Correct Q & A| NR601 Midterm Exam / NR 601 Midterm ... [Show More] Exam (Latest): Chamberlain College Of Nursing 1. A 60-year-old woman presents with a chief complaint of uncomfortable breathing on exertion. She has had a minimally productive cough for several years that does not bother her. On further questioning, she states that her breathing gets much worse when she lies down. The most likely cause of her dyspnea is: Cardiac 2. A 68-year-old male presents with a chief complaint of episodes of lightheadedness or dizziness. He states that sweating, tachycardia, and some hand trembling are often associated with these episodes. Which one of the following questions should you ask to help confirm the diagnosis? Are these symptoms related to eating? 3. A 68-year-old male presents with a chief complaint of episodic dizziness. Although not dizzy at present, he states that he has noted onset of dizzy episodes when he rolls over in bed and occasionally when he turns his head rapidly. Episodes last about 3 minutes. The most likely diagnosis is: Benign positional vertigo 4. A 75-year old resident in the nursing home has end stage dementia and experiences a 10-pound weight loss over the course of 2 months. The resident has become increasingly difficult to feed and often spits out food, pockets food, and frequently drools. The family is concerned about the resident's nutritional status. What is the initial action of the nurse practitioner? order a swallow evaluation 5. A 77-year-old client being treated for glaucoma asks the nurse practitioner what causes glaucoma. The nurse bases the response on the knowledge that the increase in intraocular pressure is a result of: a breakdown in the absorption process 6. . A 78-year-old man is being evaluated in the geriatric clinic. His daughter reports that he has been very forgetful lately, and she is concerned that he might be "senile." The advanced practice nurse administers the clock drawing test and the patient draws a distorted circular shape and places the numbers all on one side of the shape. Based on his performance, the nurse concludes that the patient: needs further evaluation 7. The abrupt onset of symptoms of stress or urge incontinence is most often due to a urinary tract infection True 8. After first managing the pain being experienced by the client with gout, the treatment focuses on: Preventing systemic involvement by altering the client's diet 9. Based on current demographic data, which statement identifies a predictive trend regarding the health care needs of society? More nursing services will be required to serve the needs of the population 85 years of age and older. 10. The caregiver for an older adult with cognitive impairment is concerned about the individual's seeming disinterest in eating. Which suggestion does the nurse practitioner offer based upon a known effect of dementia on a client's nutrition? Establish a routine of when and where the individual will have their meals. 11. A client is newly diagnosed with type 2 diabetes mellitus. Which diagnostic test will best evaluate the management plan prescribed for this client? Quarterly hemoglobin A1C 12. Compared with acute pain, persistent chronic pain requires the nurse practitioner to: Educate the patient to the benefit of specific lifestyle changes 13. Ethnocentrism is defined as: a belief that one's ethnic group is superior to that of another true 14. The FANCAPES assessment tool focuses on the older adult's: ability to meet personal needs to identify the amount of assistance needed 15. The following are true statements about bipolar disorders in older adults except "Bipolar disorder is the most commonly diagnosed psychiatric disorder in older adults." 16. The greatest risk for injury for a client with progressed Parkinson's disease is: Falls 17. In the elderly population, the fastest growing group is the age range: 85 years or older 18. It has been projected that the cultural group presenting the greatest growth rate among the older adult population will be the: Hispanic Americans 19. The nurse is teaching a health promotion class at a senior center. Which of the following statements demonstrate that the participant does not understand the topic: "We need to use caustic soaps and scrub aggressively with a wash cloth bathing to minimize bacteria on the skin." 20. The nurse practitioner educates that client that Healthy People 2010: offers direction for the achievement of improved quality of life across the life span 21. The nurse practitioner is caring for a client with a newly diagnosed chronic illness. In answering the client's questions, the nurse practitioner most accurately responds when basing the response on the fact that: chronic illness is lifelong, and coping can be influenced by perceived uncertainty. true 22. The nurse practitioner is developing a class on stroke prevention for a local senior citizens center. What would be an important focus when teaching stroke prevention directed at modifiable risk factors? Smoking cessation 23. The nurse practitioner provides a client with education regarding the use of My Pyramid. What is the primary advantage of the United States Department of Agriculture's (USDA) My Pyramid to the older adult client? It's an easy method for identifying and correcting nutritional deficiencies in one's diet. 24. The nurse practitioner shows an understanding of appropriate influenza vaccination guidelines for a client over the age of 65 when stating: "Regardless of your physical health you really should get a yearly flu shot." 25. The nurse shows understanding of the need to promote healthy skin in the older adult when encouraging the client to all of the following except : clean the skin with a moisturizing soap 26. Of the following clients, all of whom are 65 years of age or older, the nurse practitioner anticipates that the one who will rate himself or herself as has having excellent health will be: a white female who lives independently in a senior citizen community 27. An older adult client has been voluntarily admitted for treatment of alcohol dependency. In implementing care, the nurse plans which intervention based upon knowledge about alcohol and aging? Assessing the client for both depression and anxiety 28. An older adult client shares with the nurse that, "I don't know what it is but it seems that I need more light for reading or even watching television as I get older." The nurse explains that aging may cause this change due to the: Slower ability of the pupil to adjust to changes in lighting. 29. An older adult is admitted to the hospital during the night after a serious fall. When you round on the patient, you note that the patient has been prescribed meperidine (Demerol) for muscle pain. The nurse practitioner: Changes this medication order as Demerol is contraindicated in older adults 30. An older adult is currently prescribed both aspirin (81 mg) and ibuprofen daily. What instructions are most important for the nurse practitioner to provide to assure the expected outcomes for this client? Take ibuprofen 30 minutes after the aspirin so as to not interfere with its effectiveness 31. An older adult recently diagnosed with depression asks, "How long will it take for the antidepressant medication to make me feel better?" The nurse practitioner correctly responds: "It can take up to 3 months for the full effects of the medication to be felt." 32. An older man has a history of medication therapy for hypertension. Which intervention does the nurse practitioner implement when the client reports that, "I've fallen twice in 5 weeks"? Orthostatic blood pressures 33. Tinnitus is defined as: a buzzing, clicking, or ringing in the ear 34. Weight loss is frequently caused by ingestion of one or more of the following drugs. Antibiotics Digoxin Nonsteroidal anti-inflammatory drugs (NSAIDs) Theophylline A, B, and C All of the above Answer: All of the above 35. What information will be included in client education for an older adult who needs to manage their calcium levels? Take your 1200-1500 mgs of daily calcium spread out between your meals and snacks 36. When best promoting a sense of well-being, the role of the nurse practitioner caring for a terminally ill client is to: help empower the client to achieve his/her potential for wellness 37. When considering Erikson's developmental stages, the task for later life is referred to as: ego integrity 38. When diagnosed with diverticulosis, a client asks how this problem occurred. Which assessment data identifies a risk factor for diverticulosis? Maintains a diet low in fiber. 39. When educating the older adult population about the risks to physical health that chronic alcohol abuse presents, the nurse practitioner is especially careful to include the: Identification of the signs and symptoms of gastrointestinal bleeding 40. Which assessment data does not support the medical diagnosis of coronary heart disease? Client reported an unexplained gain of 10 pounds in last 6 months. 41. Which assessment data would not be of particular concern when attempting to manage an older adult's risk for dehydration? Chronic constipation 42. Which diagnostic laboratory test would the nurse practitioner typically not order for the purpose of evaluating an individual's acute, unexplained weight loss? Serum Potassium 43. Which intervention is not therapeutic when facilitating communication with a cognitively impaired older client? Use non-verbal as well as verbal cues to help get your message across to the client 44. Which of the following causes of chest pain are often relieved by sublingual nitroglycerin? Esophagitis 45. Which of the following culturally diverse male clients will most benefit from educational material related to "Staying Healthy into your 80s" Japanese 46. Which of the following drugs does not typically cause constipation? Magnesium-containing antacid 47. Which of the following drugs do not trigger or aggravate a cough? Hydrochlorothiazide 48. Which of the following is not a common cause of constipation? hypercalcemia 49. Which statement correctly describes normal changes of aging? Individual variations are enormous at every age and in every part of the body. 50. Which statement made by a client recently diagnosed with diverticular disease would indicate that she needs additional teaching regarding dietary considerations? "I'll have to give up eating right before I go to bed." [Show Less]
NR601 Final Exam (Version-1, New-2023) / NR 601 Final Exam: Chamberlain College of Nursing |100% Correct Q & A| NR601 Final Exam / NR601 Final Exam (L... [Show More] atest): Chamberlain College Of Nursing 1. Which of the following statements is NOT true about palliative care teams? 2. A 55-year-old women has type 2 DM she had three UTIs in the last 9 months and she is concerned about her kidneys. She has no report of dysuria, frequency or urgency at this time. Which of the following is the best action to follow? 3. According to the sexuality presentation, atrophic vaginitis (AV) 4. Ms. L 55-year-old women with BMI of 28, has 20-yearhx of primary HTN and has been on hydrochlorothiazide 25 mg daily for years with excellent response. During follow up visit Mrs L reports that for the last 6 months she has felt thirsty all of the time even though she drinks at least 10 glasses of water a day. Upon chart review the N notes that the last two fasting blood glucose levels have been 136 mg/dl and 165 mg/dl. The NP checks a random blood glucose, which is 210 mg/dl. What is the next appropriate test? 5. A patient has been prescribed Metformin (Glucophage). One week later he returns with lowered blood sugars but complaints of some loose stools during the week. How should the NP respond? 6. A 60-year-old obese male client has type 2 DM and a lipid panel of TC= 250, HDL = 32, LDL= 165. The NP teaches the patient about his modifiable cardiac risk factors which include: 7. Lifestyle approaches to postmenopausal symptom management include 8. When treating depression associated with dementia, which of the following would be a poor choice and should not be prescribed? 9. How does women’s anatomy make them more susceptible to UTIs? 10. A 48-year-old male patient screened for diabetes has a fasting plasma glucose level of 120 mg/dl. The NP plan includes 11. Which of the following assessments are commonly noted in a client with Parkinson’s disease? 12. A 76-year-old man is seen in the office for c/o urinary incontinence. The clinician should explore which of these causes of incontinence in men? 13. Which of the following maneuvers is contraindicated in acute prostatis? • A: Massaging the infected prostate 14. Mrs. N a 65-year-old women with BMI of 29 on Medicare , has a 20-yearhx of primary HTN and has been on HCTZ 25 mg daily for years , reports that for the past 6 months she has felt thirsty all of the time even though she drinks at least 10 glasses of water a day. Upon charting NP notes that the last two fasting blood glucose levels have been 136 mg/dl and 165 mg/dl. What actions should the NP perform next? • A: order a fasting blood glucose??? PRESCRIBE METFORMIN XR 500MG PO 15. According to the WHO analgesic ladder, which drug combination would be most appropriate in an opiate-naïve patient who presents with moderate pain? • A: Indomethacin/ hydrocodone 16. The cornerstone of pharmacotherapy in treating Alzheimer’s disease is : • A: Cholinesterase inhibitors 17. The highest level of evidence to support interventions at the end of life is with: • A: opioids for dyspnea 18. The comorbid psychiatric problem with the highest frequency in dementia is: • A: Anxiety 19. All of the following are true statements regarding elder abuse EXCEPT: • A : common signs of abuse include decreased anxiety and depression 20. Which of the following is a role of the advanced nurse in ????? • A: All of the above 21. The proposed mechanism by which diphenhydramine causes delirium is: • A: Anticholinergic effect 22. A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea) is : • A : Morphine 23. According to the Palliative Care presentation, hospice care may be provided to: • A: those with a life expectancy < 6 months 24. A 68-year-old women is being worked up for stress incontinence. UA reveals positive leukocyte esterase, positive nitrites, 15 WBCs, no RBS, no protein, no casts. She denies frequency, urgency, suprapubic pressure or urgency. What is the first treatment for her US results? • A: no treatment is necessary 25. The elderly are at higher risk for delirium because of: • A: All of the above 26. A 63-year-old man is seen in the clinic with a c/o nocturia. Which of the following should be included in the differential diagnosis? • A: Benign prostatic hypertrophy (BPH) 27. A 75-year-old man is being treated as an outpatient for metastatic prostate cancer. Which of the following statements is true regarding the management of pain with opioids in the elderly? • A: none of the above 28. The highest level of evidence with the use of adjuvant analgesics is with: • A: neuropathic pain patients are candidates for adjuvant analgesia 29. The 56-year-old man with chronic prostatis should initially be treated with antibiotics for how long? • A: 14 days 30. A 50-year-old female patient screened for diabetes has a fasting plasma glucose level of 124 mg/dl. The NP plan includes: • A: repeat fasting plasma glucose in one year 31. When assessing a patient who complains of a tremor, the NP must differentiate essential tremor from the tremor of Parkinson’s disease. Which of the following findings are consistent with essential tremor? • A: The tremor occurs with purposeful movement 32. Which characteristic of delirium helps to distinguish it from dementia? • A: abrupt or Acute onset 33. According to the sexuality presentation, the biggest barrier to appropriate sexual evaluation in the older patient: • A: Ageist attitudes 34. Mrs. Smith a 65-year-old women presents to the clinic for the first time and c/o UI and dyspareunia, she went through menopause 10 years ago without any hormone replacement therapy and had a hysterectomy for fibroid. Her mother had a hip fracture at 82, pt had mammogram 5 years ago and no known fam hx of breast cancer……you decide to begin topical hormone replacement therapy. Which of the following evaluations would be necessary prior initiating hormone replacement therapy? • A: Mammogram 35. Mr. A experienced a brief onset of right-sided weakness, slurred speech and confusion yesterday. The symptom has resolved. What should the NP do? • A: identify modifiable cardiovascular risk factors 36. Any women with a complicated cystitis or symptoms of upper tract disease needs a urine culture and • A: sensitivity test 37. All of the following patients have a risk of adverse reaction from Metformin except: • A: patients with BMI >30 38. A middle-aged patient has been diagnosed with Parkinson’s disease. What influences the NP’s decision to begin pharmacological treatment for this patient? • A: symptom interfering with functional ability 39. Which of the following medications can blunt the signs of hypoglycemia in diabetes? • A: beta blockers 40. The Mini-cog is a short screening tool used to assess cognition. Which of the following statements pertaining to the test is a true statement? • A: A score of 0-2 is a positive screen for dementia 41. What is a sign of insulin resistance that can present in African American patients? • A: Acanthosis Nigricans 42. Age related changes in bladder, urethra and ureters include all of the following in older womenexcept: • A: increased estrogen production’s influence on the bladder and ureter 43. The majority of patients enrolled in hospice care die: • A: at home 44. Diabetes is the leading cause of: • A: kidney failure 45. A male pt with a BMI of 30 presents to the office for an annual exam. You ordered a CMP as part of routine labs. The fasting glucose was 130. Your next action is: • A: repeat the fasting glucose 46. A pelvic mass in a postmenopausal woman: • A: highly suspicious of ovarian cancer 47. A 65-year-old Hispanic woman presents to the office for routine follow up for her DM2. Her routine UA results are as follows: few epithelial cells, negative leukocytes, negative nitrates, negative protein, no ketones. Which test would you order next? • A: 24-hour urine for albumin 48. Hospice services and palliative services are underutilized due to: • A: All of the above (Services not well understood, confusion remains over when it is appropriate to consult palliative care, denial of impending death) 49. Which of the following would be an appropriate treatment for a patient with mild BPH? • A: reevaluate symptoms in 1-3 months 50. The most common neurological cause of seizures in an older adult is: • A: stroke 51. A 68-year-old women presents with a c/o urine leakage whenever she sneezes, laughs, or strains for the past 4 months. She denies dysuria, frequency and nocturia. US dipsticks is negative for RBCs, leukocytes esterase, nitrites, ketones and urobilinogen. What is the diagnosis? • A: stress incontinence 52. The tasks of grieving include all of the following EXCEPT: • A: begin to disengage 53. Acanthosis nigrans is associated with all of the following conditions except: • A: tinea versicolor 54. Which of the following statements is trueregarding pain? • A: pain is subjective experience related to actual or potential tissue damage 55. A 51-year-old male pt screened for diabetes has a fasting plasma glucose level of 98 mg/dl. The NP plan includes: • A: repeat fasting plasma glucose in 3 years 56. Increased risk factors for erectile dysfunction include all EXCEPT: • A: dominant personality 57. When assessing an elderly client who reports a tremor, which assessment findings would be most reliable in identifying Parkinson’s disease? • A: Resting tremor, slow unsteady gait, and cogwheel resistance 58. Which of the following is the most appropriate screening tool for delirium? • A: Confusion Assessment Method 59. An 82-year-old man is seen in the primary care office with complaints of dribbling urine, difficulty starting his stream. Which of the following should be included in the list of differential diagnosis? • A: all of the above (BPH, Parkinson’s disease, prostate cancer) 60. The patient with BPH is seen for follow up. He has been taking finasteride(Proscar) for 6 months. The clinician should assess this patient for which of the side effects? • A: Erectile dysfunction 61. Hospice care differs from palliative care in that: • A: supports patients and families through both the dying and the bereavement process 62. According to the genitourinary presentation, the number 1 risk factor for urinary incontinence is: • A: AGING 63. The firs step in treating delirium is to: • A: identify the cause 64. Which of the listed conditions is most likely to cause delirium? • A: Acute infection 65. You are working up a 52-year-old patient for microscopic hematuria. Your differential diagnosis list includes all of the following EXCEPT: • A: renal stenosis 66. Don’t have 67. A 55-year-old Caucasian man with type 2 DM presents to the clinic a as new pt. he takes metformin 500 mg twice a day. His last Hgb A1C was 7%. He is up to date on eye and foot examinations. His BP is 142/96. According to JNC8, what is the most appropriate medication? • A: lisinopril 68. Delirium is typically characterized by all of the following except: • A: Hyperactive level of psychomotor activity 69. An 80-year-old female widow asks her NP about hospice enrolment. Her diagnosis includes congestive HF, HTN and DM2. She has noticed that in the last month she has lower extremity edema and she is finding it difficult to walk to the grocery store and church, she does not use oxygen. She is able to maintain her home but requires more frequent rest after vacuuming. She does not wish to be admitted to the hospital again in the future but if admitted wants to remain full code status. Why is this patient NOT appropriate for hospice? • A: her prognosis is > 6 months 70. Jean a 42-year-old, presents to the clinic with c/o dysuria, frequency and strong odor of her urine for 5 days. This is the second occurrence this year. What is the appropriate next step to this patient? • A: order UA and urine culture and sensitivity and treat the patient with antibiotics today 71. All of the following patients should be screened for diabetes EXCEPT: • A: 44-year-old Caucasian with HTN 72. A male patient with a BMI of 33 presents to the office with c/o fatique, excessive hunger and excessive thirst. You suspect type 2 DM . initial testing to confirm diagnosis can include: • A: all of the above 73. An 87-year-old tells the NP that his grandson locks him in his bedroom when he goes out. The grandson withholds food if the patient does not give him money every week. The patient appears frail, ungroomed, and his clothes are visibly dirty and smell of urine. Which of the following is the best action for NP? • A: report the grandson to your state’s protective services 74. The leading cause of death in elderly travelers worldwide is: • A: accidents 75. The majority of depressed older adults remain untreated because of : • A: All of the above (misdiagnosis, social stigma, environmental…) 76. When examining the spine of an older adult you notice a curvature with a sharp angle. This is referred to as a: • A: scoliosis 77. Which of the following patients has the highest risk for the development of osteoporosis? • A: A 5’4” Asian female weighing 95 lbs 78. When assessing a patient’s mental health, the NP knows: • A: both A & B ( cognition affects mental status and affect reflects mood) 79. You are working with an older male adult with a long hx of alcohol abuse and a 30-yearhx of smoking. In recommending an intervention for this client, your responsibility is to: • A: Promote positive change in lifestyle choices 80. The pathophysiology of heart failure is due to: • A: inadequate cardiac output to meet the metabolic and oxygen demands of the body 81. The leading cause of disability worldwide is: • A: depression 82. Which of the following patients has the highest risk for the development of osteoporosis? • A: A 5’4” Asian female weighing 95 lbs 83. Mrs. G is a 65-year-old Caucasian female who presents for her yearly physical. A review of her chart reveals she smokes 1 pack of cigarettes a day, and drinks 2 beers every evening since she retired. She does not exercise, she likes to sit and knit. The NP know the NONMODIFIABLE risk factor for osteoporosis for Mrs. G is : • A: Age 84. The NP orders bilateral wrist X-rays on a 69-year-old gentleman c/o of pain in both wrists for the past 6 weeks not related to any known trauma. The NP suspects elderly onset RA. The initial radiographic finding in a patient with elderly onset RA would be: • A: soft tissue swelling 85. The NP is reviewing a patient chart prior to the start of the encounter. The NP notes that the patient is using topical CAPSAICIN. The NP knows that topical capsaicin id often used for treatment of: • A: Diabetic neuropathy 86. Which of the following statements about OA is true? • A: It affects primarily weight bearing joints 87. MJ presents to the clinic with the following hx and presentation: hx of structural damage with current s/s of HF. Treatment will be based on MJs stage of HF which is: • A: Stage C 88. Dietary supplements such as Omega 3 (fish oils) are often taken for cardioprotective benefit. The NP knows regarding Omega 3 consumption: • A: randomized control trials have found no reduction in morbidity or mortality 89. A 55-year-old Caucasian male pt follows up with you after referral to a cardiologist. The pt reports he thinks the medication is causing cough and sometimes he has difficulty breathing, which of the following medication was most likely prescribed? • A: Lisinopril 90. The prevalence of depression in nursing home residents is _____greater than adults living in the community: • A: 3-4 times 91. The NP orders bilateral wrist Xrays on a 69-year-old gentleman c/o of pain in both wrists for the past 6 weeks not related to any known trauma. The NP suspects elderly onset RA. The initial radiographic finding in a patient with elderly onset RA would be: 92. The NP knows that the goal of treatment for anxiety should: 93. All of the following statements are true regarding anxiety EXCEPT: 94. Which of the following best describes the pain associated with OA? 95. Which organism that can be prevented by immunization is most often responsible for infectious outbreak in the nursing home setting? 96. JK 60 year old women comes to the office today for evaluation of mgmt. plan of her c/o insomnia…..she wakes up after about 4 hrs and cannot return to sleep. The next step in treatment of insomnia is: 97. You have ordered a CBC for your patient you suspect has PMR. Which two clinical findings are common in pt with PMR? 98. PG is a 58-year-old Caucasian man with stable mental health diagnosis of schizophrenia who presents for a yearly physical. PG is prescribed aripiprazole for treatment of his schizophrenia. The NP knows the following labs should be ordered to assess for cardiometabolic changes related to his medication EXCEPT: [Show Less]
NR 601 Final Exam (Version-2, New-2023) / NR601 Final Exam: Chamberlain College of Nursing |100% Correct Q & A| NR601 Final Exam / NR601 Final Exam (Lat... [Show More] est): Chamberlain College Of Nursing 1. A 77-year-old Hispanic Catholic Nun (retired) who immigrated to the United States 15 years ago lives alone but in an apartment complex where her sister lives as well. She is being discharged home after a hospitalization for congestive heart failure with prescriptions for 8 different medications. She is considered at risk for noncompliance due to the following contributing factors except: 2. A 78-year-old patient who is dying of colon cancer with metastases to the liver is refusing to eat or drink. He is alert and oriented, and states that he has no desire to eat, which is causing the family great distress. In order to best address the client and family, you should: 3. A 79-year-old female client resides independently in the community. The client’s daughter is concerned because her mother insists on wearing a sweater and keeps all of the windows closed even though it is 90 degrees Fahrenheit outside. The nurse practitioner initially recognizes that this behavior may be related to: 4. An 88-year-old, being admitted to rule out lung cancer, is assessed using the short form of the Geriatric Depression Scale tool. When it is determines that the earned score is 9, the nurse practitioner initially: 5. The area in which nurse practitioners have the greatest effect on the safe, effective medication therapy of an older client is: 6. The Beers list is an effective tool for healthcare professionals prescribing and/or managing the medication therapy of older adults since it identifies medications that for this population: • have a higher than usual risk for injury 7. A client who reported, “a problem sleeping” shows an understanding of good sleep hygiene when: • limiting the afternoon nap to just 30 minutes 8. Common causes of dyspnea in the older adult may include which of the following? • Heart failure Asthma Chronic obstructive lung disease Pneumonia 9. Common ethical issues in the nursing home may include which of the following? • Quality of life Decision-making capacity Preservation of autonomy Surrogate decision making 10. The cost of nursing home care is significant. The primary payer for nursing home care is: • Medicaid and private pay. 11. Each of the following assessment finding is a contributor to an older client’s risk for falls except: • client has a history of contact dermatitis and psoriasis 12. Each of the following data supports the diagnosis of sleep apnea in the older adult except: • followed a vegetarian diet for last 28 years 13. Factors that affect the pharmacokinetics of lipophilic medications in older include: • greater adipose tissue ratio to body mass 14. The following precautions are beneficial in minimizing an older adult’s risk of being a victim of fraud except: • Rely on the advice of people who only friends have recommended. 15. In order to focus on the older population with the greatest risk for suicide the nurse practitioner would conduct a depression that targets: • White men 16. In planning teaching for a client with diabetes, which precaution related to fall prevention is particularly important for the nurse practitioner to include? • Rising slowly from the table after meals 17. It is imperative that nursing take a leadership role in providing effective health care across the lifespan and in various health care settings. Which intervention will have the greatest impact on achieving positive outcomes concerning that issue? • A baccalaureate degree nursing program including a geriatric care course into the curriculum 18. The nurse is most concerned by observing which of the following during an older client’s physical assessment: • a slightly raised irregular patch that is bluish black in color 19. The nurse is providing care to a client diagnosed with dementia. What option is an example of the appropriate use of implied consent by the nurse? • Changing the client's dressing when the client asks, "Will you change this bandage now?" 20. The nurse practitioner demonstrates an understanding of the older client’s preventable risk factors for early death when: • providing clients with information regarding the effectiveness of a nicotine patch monitoring the blood pressure of those living at a homeless shelter each month weighing the clients who visit a walk-in clinic that is located in an economically depressed neighborhood educating the diabetic residents of a low rent apartment complex on how to monitor their blood glucose levels 21. The nurse practitioner documents that an older adult client is living independently in a safe environment. Which assessment data supports this evaluation? • The client demonstrates the home's security alarm system. Various safety features were installed when the bathroom was remodeled. The nurse observes the client wearing a safety alarm bracelet. The client's home is within walking distance of a grocery store. 22. The nurse practitioner educates the older client that the greatest risk related to poor foot care results is: • loss of independent mobility. 23. The nurse practitioner has the obligation to ask questions and obtain specific information about the use of herbs and supplements. Which of the following statements is most accurate regarding herbal therapy? • may interact with prescription medications 24. A nurse practitioner in an area of the country that is prone to tornadoes routinely discusses disaster preparedness with older adult clients. What is the primary rationale for this intervention? • Older adults are less likely to seek formal and informal help when affected by natural disasters. 25. A nurse practitioner is preparing an educational program focused on herbal supplements. Which of the following is a likely interested target group? • White females who own their own successful businesses 26. The nurse practitioner is preparing educational material concerning fire safety in the home. What research data will be included in the material? • fire mortality is highest in adults older than 65 years of age 27. The nurse practitioner is providing care for an older client who is experiencing mild cognitive impairment. Which communication technique is most likely to bring about a negative outcome? • Asking the family to answer interview questions 28. The nurse practitioner makes the greatest impact on the safe management of an 81-year-old client’s medication administration when included in education is: • a pillbox with compartments for each day and each of the doses 29. The nurse practitioner’s first response when told by a client during an assessment interview that they “can’t take furosemide (Lasix)” is to ask: • "Can you describe what happened when you took Lasix?" 30. The nurse practitioner suspects that a client is experiencing tardive dyskinesia when observing: • the client's facial muscles are twisting involuntarily 31. The nurse suspects that an older adult client is experiencing symptomology seen in herpes zoster when the client • rates the pain as an 8 out of a possible 10 develops clusters of fluid-filled vesicles reports symptoms focused on one side of the body 32. A nurse suspects that her next-door neighbor, an older woman, is a victim of elder abuse by her daughter. What is the appropriate action for the nurse to do in this situation? • Complete a confidential report with the adult protective services in the area. 33. Of the following agents, which is least likely to cause a chronic or recurrent cough? • Gabapentin 34. Of the following risk factors, which is not 35. An older adult client will require extensive rehabilitative therapy after a fall that resulted in several fractures and reconstructive surgeries. Which intervention will have the greatest impact on the individual’s relocation to a rehabilitation facility? • Actively seeking the individual's input regarding the decisions relating to the move 36. An older adult has recently experienced a number of stressful life events. The client comes to the ambulatory clinic and tells the nurse practitioner that, “On top of all I’ve had to endure; now I’ve got this flu!” In rendering care for this client, the nurse practitioner recognizes that: • crisis and stressful situations may produce emotions that erode the health of the older people. 37. An older adult is concerned that if her spouse, who recently suffered a stroke, is placed in a nursing home, “they will take everything in order to pay for his care.” What response will the nurse practitioner make? • "A spouse is allowed to keep a percentage of the family income and cash as well as the family home, car, and personal property." 38. An older adult patient with a history of osteoporosis is hospitalized for wrist surgery. Which medication that is currently being prescribed would be most likely to interfere with bone integrity? • heparin 39. An older client diagnosed with dementia resides with his daughter. When the home care nurse visits, the daughter tearfully tells the nurse that her father scratched her hand and cursed at her when she was attempting to feed him. She states, “I don’t know why he hates me and wants to hurt me. I try so hard to take good care of him. I love him.” How will the nurse respond to the client’s daughter? • "Let's try to figure out what your father was trying to say with his behavior." 40. An older client prescribed a transdermal morphine patch for severe chronic pain is being educated on the appropriate administration of the medication. The nurse shows an understanding of essential information regarding this route of drug administration when stating: • “Since you have problems with digestion, this is a good way to take your medication." 41. The original intent of Social Security was to: • minimize the dependency of older members on younger members of society. 42. The primary risk for injury experienced by a client diagnosed with asthma is: • infections of the lower respiratory tract 43. Research has shown that long-term care (LTC) facility nursing • is comparable to the complexity and demand of intensive care nursing is a nursing intensive environment crosses the continuum of care 44. Snoring is a symptom of which of the following disorders: • Sleep apnea 45. State Death with Dignity Laws require that the terminally ill client be • educated regarding treatment alternatives. 46. Weight loss is frequently caused by ingestion of the following drugs. • Antibiotics Digoxin Nonsteroidal anti-inflammatory drugs (NSAIDs) Theophylline 47. What factor is an important contribution to polypharmacy in older adults? • Inadequate communication among medical care providers 48. What research finding is the basis for care planning of the client receiving palliative care? • Pain management is inadequately addressed among the terminally ill population. 49. When a chronically ill 80-year-old client is admitted to your acute care facility in an unconscious state, the nurse practitioner’s priority is to determine: • who is the client's durable power of attorney for health care (DPAHC). 50. When acting as a fictive kin, in which activity will a paid caregiver engage? • organizing the client's birthday celebration 51. When an older adult client is diagnosed with restless leg syndrome (RLS), the nurse practitioner is confident that client education on the condition’s contributing factors has been effective when the client states: • "I've cut way back on my caffeinated coffee, teas and sodas." 52. When answering an older client’s questions about diet, exercise, and bone integrity, which exercise would the nurse practitioner identify as ineffective at meeting the need for moderately intense aerobic activity? • Yoga for 45 minutes twice a week 53. When assessing an older client for indications of depression, the nurse practitioner bases the intervention on the knowledge that: • The older client's symptoms may be atypical for the disorder 54. When assessing the intellectual abilities of an older adult, the nurse practitioner demonstrates an understanding of a major barrier to reliable testing of this population when: • stating, "Just take your time and try to relax; there are no wrong answers to this test." 55. When caring for an ill adult client, the nurse is particularly concerned that the client communicates well since: • Assessment, planning of care and even the therapeutic relationship is based on effective communication? 56. When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse practitioner best ensures an understanding of oral hypoglycemic medications when providing: • oral explanations and sending the client home with a written copy 57. When discussing pharmacological considerations, a 68-year-old client asks, “Why do medications seem to act differently than they did when I was younger?” The nurse practitioner bases the response on the concept that: • Age-related changes affect the way drugs are metabolized by older adults 58. When educating an older adult about Medicare Part D which information will be included? • It is an elective prescription drug plan with associated out-of-pocket premiums All persons with either Medicare Part A or B can voluntarily purchase a Medicare Part D prescription drug plan. The plan is not voluntary for individuals who are receiving both Medicaid and Medicare. This prescription drug plan requires client co-payments. 59. When performing the initial assessment on a new client in the geriatric outpatient’s practice, the most effective method the nurse practitioner can implement to elicit an accurate medication assessment is to ask that the client: • bring in all of the medications that they are currently taking 60. When preparing an educational program on the minimizing the effects of aging to a “seniors’ group,” the nurse practitioner’s discussion on exercise is based upon the fact that: • Losses experienced with age related mobility are associated with physical inactivity 61. When providing information regarding age-related visual problems, the nurse practitioner recognizes that the target population is: • African-American 62. When using the Fulmer SPICES assessment tool, the nurse practitioner expects to ask: • "Who helps you when you can't do something by yourself?" 63. When working with a bereaved individual, the goal of nursing interventions is to: • assist the individual to attain a healthy adjustment to the loss experience. 64. Which activity would a couple in the reorientation phase of their retirement engage in? • Establishing a new budget that will allow them to travel to see the grandchildren 65. Which behavior suggests that an older adult who has lost their life partner is successfully managing the exploration stage of the adjustment process? • Smiles when reminiscing about the trips they took over the years 66. Which characteristic is seen in a family’s ‘kin-keeper’? • Organizes the yearly family reunion 67. Which client statement indicates an understanding of a primary benefit to be derived from moderately intense aerobic exercise? • "Exercise will help keep my heart strong." 68. Which diagnosis is associatedwith the symptom of early morning awakening and poor quality of sleep: • Sleep apnea 69. Which factor is the greatest barrier to an older adult living independently? • Deficits in vision and/or hearing resulting in safety issues 70. Which form of urinary incontinence is most common in older adults? • Urge 71. Which housing arrangement would best address the family who wants to provide housing for an older family member who has a large degree of physical and cognitive independence and a desire to be closely involved with the family? • A "granny" apartment in a separate part of the house 72. Which intervention addresses a guiding principle for creating an elder-friendly acute care facility? • A client is asked when they would prefer to bathe; morning, afternoon or evening 73. Which intervention addresses a right guaranteed a long-term care facility resident? • Family members are welcome at anytime 74. Which intervention best addresses the principle that is the basis for communicating with a client experiencing post-surgical delirium? • Assuming that the client's statements are an attempt to express needs 75. Which intervention best demonstrates the nurse practitioner understands safe medication administration of rivastigmine (Exelon) to the older client experiencing symptoms of Alzheimer’s disease? • The client is carefully monitored for side effects before the medication dose is increased 76. Which intervention demonstrates effective care for an individual who has expressed a wish to “retire sometime soon”? • Asking about when they plan to retire Assessing their ability to handle the stresses of retirement Engaging them in a conversation about their interests Inquiring about the existence of any chronic illnesses 77. Which intervention to manage wandering in clients in a long-term care facility should not be implemented? • Using physical restraints to prevent wandering to maintain safety 78. Which is the most likely reason that Type 2 diabetes mellitus is often difficult to diagnose in older adults? • The classic symptoms may not be present in older adults. 79. Which nursing intervention will have the greatest impact on minimizing an older adult’s risk for re-hospitalization within 30 days of discharge? • Evaluation of a cardiac client's comprehension of their prescribed medication therapy 80. Which of the following commonly causes insomnia: • Alcohol consumption Caffeine ingestion Sleep apnea Depression 81. Which of the following does not demonstrate an understanding of the factors affecting physical wellness of the older adult client when: • Asking each client if "they come from a healthy family" 82. Which of the following is the best advice a nurse practitioner can give an older client who is about to move to a new apartment and needs to feel safe about living alone for the first time? . 83. Which older adult client has the greatest risk for readmission into the acute care health system and so is the focus of extensive nursing follow-up post discharge? 84. Which older adult meets the criteria for foster care housing? 85. Which option is an example of which type of elder exploitation? 86. Which pharmacokinetic/pharmacodynamic parameter is least affected by the aging process? 87. Which question will best assess the ability of the LGBT older couple to successfully adjust to the challenges of aging ? 88. Which reaction to the loss of a spouse or long-term partner is a unique example of older adult male bereavement? 89. Which statement correctly describes normal changes of aging? 90. Which statement made by a nurse regarding a resident of a long-term care facility requires follow up by the nurse manager? 91. Which statement made by the resident of a long-term care facility is evidence that the facility is providing care in accordance with the Long-Term Care Residents’ Bill of Rights? 92. Which statement reflects a need for further education on elder abuse? 93. Which statements made by a couple who have recently retired support the nurse’s evaluation that the transition to retirement has been a successful one? 94. Which truism will the nurse practitioner base spousal grief counseling upon? 95. While the older African-American is at the highest risk for developing Alzheimer’s disease, the nurse practitioner demonstrates an understanding of this disease process’s risk factors when assessing this population’s: 96. A widowed grandmother is about to assume the role of custodial parent for her 6-year-old grandchild. Which intervention has priority 97. Your client is cared for at home by his son and daughter-in-law, who are also responsible for the care of their four preschool-aged children. What is true of this “sandwich” generation? 98. You suspect that the spouse of a terminally ill client is experiencing anticipatory grief when they: 99. Of the following risk factors, which is not associated with Alzheimer's disease (AD)? 100 Which diagnosis is associated with the symptom of early morning awakening and poor quality of sleep: [Show Less]
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