NR 601 Final Exam 2 – Question with Answers
Chamberlain College of Nursing NR 601 Final Exam 2 – Question with Answers (Latest, Graded A)
1. A
... [Show More] 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:
• Ethnic background
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:
• Educate the family that this is normal behavior in this situation
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:
• age-related neurosensory changes that diminish awareness of temperature changes
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:
• asks if they have any thoughts of committing suicide
5. The area in which nurse practitioners have the greatest effect on the safe, effective medication therapy of an older client is:
• educating the client to all aspects of the medication.
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 associated with 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?
• Arrange with the local police to have a home security assessment done and then follow through with their suggestions.
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?
• The client recovering from an exacerbation of congestive heart failure
84. Which older adult meets the criteria for foster care housing?
• A cognitively impaired homeless individual diagnosed with congestive heart failure
85. Which option is an example of which type of elder exploitation?
• A home bound client can only get groceries by agreeing to pay for her neighbor's groceries, too.
86. Which pharmacokinetic/pharmacodynamic parameter is least affected by the aging process?
• Absorption
87. Which question will best assess the ability of the LGBT older couple to successfully adjust to the challenges of aging ?
• "Have you experienced prejudice and discrimination in your life?"
88. Which reaction to the loss of a spouse or long-term partner is a unique example of older adult male bereavement?
• Remarrying within months of the loss
89. Which statement correctly describes normal changes of aging?
• Individual variations are enormous at every age and in every part of the body.
90. Which statement made by a nurse regarding a resident of a long-term care facility requires follow up by the nurse manager?
• "If he doesn't take his medication, he'll get no dessert tonight."
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?
• "I was told that if I didn't want to change rooms, I didn't have to."
92. Which statement reflects a need for further education on elder abuse?
• "Abuse does not happen in people of financial means."
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?
• "I'm afraid we can't make it that weekend; we'll be visiting the grandchildren."
94. Which truism will the nurse practitioner base spousal grief counseling upon?
• Women are generally more likely to outlive their spouses.
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:
• Blood pressure and glucose serum ln
96. A widowed grandmother is about to assume the role of custodial parent for her 6-year-old grandchild. Which intervention has priority
• Teaching stress management and relaxation techniques
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?
• The conflicts that arise from caring for both older adults and children can be very stressful.
98. You suspect that the spouse of a terminally ill client is experiencing anticipatory grief when they:
• Dramatically reduce the time they spend attending to the client
99. Of the following risk factors, which is not associated with Alzheimer's disease (AD)?
• history of respiratory infections
100 Which diagnosis is associated with the symptom of early morning awakening and poor quality of sleep:
• Depression [Show Less]