NR 601 midterm study guide
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
After first mana
...
NR 601 midterm study guide
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
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
The abrupt onset of symptoms of stress or urge incontinence is most often due to a
urinary tract infection
True
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
Which of the following drugs do not trigger or aggravate a cough?
Hydrochlorothiazide
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.
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
It has been projected that the cultural group presenting the greatest growth rate among
the older adult population will be the:
Hispanic Americans
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."
Ethnocentrism is defined as:
a belief that one's ethnic group is superior to that of another true
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.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
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
Which of the following culturally diverse male clients will most benefit from educational
material related to "Staying Healthy into your 80s"
Japanese
The following are true statements about bipolar disorders in older adults except
"Bipolar disorder is the most commonly diagnosed psychiatric disorder in older adults."
Which assessment data would not be of particular concern when attempting to manage
an older adult's risk for dehydration?
Chronic constipation
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
Which of the following drugs does not typically cause constipation?
Magnesium-containing antacid
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
The greatest risk for injury for a client with progressed Parkinson's disease is:
Falls
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.The nurse practitioner educates that client that Healthy People 2010:
offers direction for the achievement of improved quality of life across the life span
Which of the following is not a common cause of constipation?
hypercalcemia
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."
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."
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
. 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
Tinnitus is defined as:
a buzzing, clicking, or ringing in the ear
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
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
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?
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.
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
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
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
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.
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."
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
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
In the elderly population, the fastest growing group is the age range:
85 years or older
Which statement correctly describes normal changes of aging?
Individual variations are enormous at every age and in every part of the body.
Compared with acute pain, persistent chronic pain requires the nurse practitioner to:
Educate the patient to the benefit of specific lifestyle changesAn 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
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
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
The FANCAPES assessment tool focuses on the older adult's:
ability to meet personal needs to identify the amount of assistance needed
Which of the following causes of chest pain are often relieved by sublingual
nitroglycerin?
Esophagitis
When considering Erikson's developmental stages, the task for later life is referred to
as:
ego integrity
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
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.
What are the 3 primary physiological changes of aging?
1. Reduced physiological reserve of most body systems, esp. cardiac, resp, renal.
2. Reduced homeostatic mechanisms that fail to adjust regulatory systems (i.e. temp
control, fluid/lyte balance, etc.).3. Impaired immunological function (infection risk is greater, autoimmune dz's more
prevalent)
What is the preferred amount of exercise for elderly?
30min/day 5 days/wk of moderate exercise.
If trying to lose wt: 60min/day.
What are PFTs?
Group of tests that provide quantifiable measurement of lung function, used to dx resp
abnormalities or assess progression/resolution of lung dz.
What is FEV1?
Forced Expiratory Volume in 1 second (80-120%)
What is FVC?
Forced Vital Capacity (80-120%)
What is normal FEV1/FVC ratio?
<0.7 (70%)
What is GOLD 1 criteria?
Mild
FEV1 >/= 80% predicted
What is GOLD 2 criteria?
Moderate
FEV1 50-79% predicted
What is GOLD 3 criteria?
Severe
FEV1 30-49% predicted
What is GOLD 4 criteria?
Very severe
FEV1 <30% predicted
What are the signal symptoms of COPD?
Dyspnea
Chronic cough w/sputum
Decreased activity tolerance
Wheezing
What are characteristics of COPD?
Common, preventable, treatable
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