care extra shiz

a, b, d a.) Organizing an influenza vaccination clinic b.) Promoting a smoking cessation program in the community d.) Visiting a congressman representative to advocate for legislation on clean air Primary prevention includes activities such as promoting or conducting smoking cessation programs and community intervention, including organizational efforts to promote and administer preventive vaccinations such as that for influenza and pneumonia. Primary prevention includes political activism with industry leaders and environmental agencies to push for clean air and water. Referrals to specialists or teaching individuals who already have respiratory illness are not part of primary prevention.

A nurse is involved in primary prevention activities related to the promotion of respiratory health. The nurse is involved in which of the following activities? (Select all that apply.) a.) Organizing an influenza vaccination clinic b.) Promoting a smoking cessation program in the community c.) Referring individuals with respiratory disease to the pulmonology clinic at the hospital d.) Visiting a congressman representative to advocate for legislation on clean air e.) Teaching individuals with COPD measures to maximize lung function

a.) Following a diet with adequate amounts of calcium and vitamin D A diet with adequate amounts of calcium and vitamin D is important in preventing osteoporosis. Phosphorous is not recommended for osteoporosis prevention. The recommendation for DXA/DEXA scan is every 2 years. Exercise recommendations are for weight-bearing exercise.

A nurse is planning an educational session on osteoporosis to be given at a senior center. Which of the following should be discussed as preventive measures for osteoporosis? a.) Following a diet with adequate amounts of calcium and vitamin D b.) Increasing the intake of beverages containing phosphorus c.) Having a yearly dual-energy X-ray absorptiometry DXA (or DEXA) scan d.) Including isometric exercise for at least 30 minutes three times per week

a, b, c a.) Annual influenza immunization b.) Pneumococcal pneumonia immunization c.) Smoking cessation Guidelines for good respiratory health include pneumonia immunization, annual influenza immunization, avoiding exposure to smoke and pollutants, smoking cessation, avoiding individuals with respiratory illness, promptly treating respiratory infections, and hand hygiene. Although weight reduction and a low-sodium, low-fat diet are important, neither is directly related to respiratory health.

A nurse is planning education for a group of older adults at a senior center on promoting respiratory health. Which of the following should the nurse include in the education? (Select all that apply.) a.) Annual influenza immunization b.) Pneumococcal pneumonia immunization c.) Smoking cessation d.) Weight reduction e.) Benefits of low-sodium low-fat diets

a, c, d, e a.) Rest the joint during the acute gout attack. c.) Increase fluid intake to 2 L/day. d.) Avoid foods high in purine. e.) Avoid alcoholic beverages. Individuals who are having an acute attack of gout should not take salicylates for pain. ASA is a salicylate.

A nurse is teaching an older adult who is experiencing an acute attack of gout. Which of the following should the nurse include in the teaching? (Select all that apply.) a.) Rest the joint during the acute gout attack. b.) Take acetylsalicylic acid (aspirin, or ASA) to relieve pain. c.) Increase fluid intake to 2 L/day. d.) Avoid foods high in purine. e.) Avoid alcoholic beverages.

c.) Remove clutter from the floors of the home. Individuals with osteoporosis are very high risk for falls. The most serious health complication of osteoporosis is the morbidity and mortality associated with a fall. There is no evidence that stress impacts osteoporosis. The recommendation for a DXA/DEXA scan is every 2 years. There is no evidence that a high-protein diet is important for an individual with osteoporosis.

A nurse plans for the discharge of a 75-year-old patient who has the diagnosis of osteoporosis. Which of these actions would the nurse consider first? a.) Avoid stressful situations. b.) Schedule an annual DXA/DEXA scan. c.) Remove clutter from the floors of the home. d.) Encourage consumption of a high-protein diet.

b.) The patient's manual dexterity d.) The patient's cognitive status Inhaled medications may be taken a number of ways. When choosing which method to order, the prescriber needs to consider the manual dexterity of the patient as well as the cognitive ability to follow directions. The patient's age, ability to swallow, and mobility do not directly impact the ordering of inhaled medications.

A nurse practitioner is caring for a 90-year-old adult with asthma who has comorbid dementia and severe osteoarthritis in the hands. The nurse practitioner considers inhaled medications to manage the asthma. Which of the following factors should the nurse take into consideration when developing the medication plan for this patient? (Select all that apply.) a.) The patient's ability to swallow safely b.) The patient's manual dexterity c.) The patient's age d.) The patient's cognitive status e.) The patient's mobility status

b.) OA is a localized process, whereas RA may be systemic. c.) OA usually impacts distal interphalangeal joints; RA impacts proximal interphalangeal joints. OA has an insidious presentation, and RA has an acute presentation. OA presents with joint stiffness, which resolves in less than 20 minutes, and RA presents with joint stiffness that lasts more than 20-30 minutes. OA is initially treated with nonpharmacological treatments such as heat or exercise, and RA is treated with medications disease-modifying antirheumatic drugs (DMARDs) immediately after diagnosis.

A nursing student is preparing a presentation on arthritis. The nursing student knows that differences between osteoarthritis (OA) and rheumatoid arthritis (RA) include that: (Select all that apply.) a.) both OA and RA have an acute onset in older adults. b.) OA is a localized process, whereas RA may be systemic. c.) OA usually impacts distal interphalangeal joints; RA impacts proximal interphalangeal joints. d.) both OA and RA present with joint stiffness lasting 20-30 minutes after rest. e.) initial treatment of both OA and RA is usually nonpharmacological using heat or exercise.

a, b, d a.) Osteoporosis is common in females after menopause. b.) Osteoporosis is a degenerative disease characterized by a decrease in bone density. d.) Osteoporosis can cause pain and injury. Osteoporosis is not a congenital disease. While a low intake of calcium is a factor, there are dietary sources of calcium other than dairy products. Passive range of motion cannot prevent osteoporosis

A patient is diagnosed with osteoporosis. Which statements should the nurse include when teaching the client about the disease? (Select all that apply.) a.) Osteoporosis is common in females after menopause. b.) Osteoporosis is a degenerative disease characterized by a decrease in bone density. c.) The disease is congenital, caused by poor dietary intake of dairy products. d.) Osteoporosis can cause pain and injury. Passive range of motion can prevent osteoporosis.

c.) preventing systemic involvement by altering the client's diet. After the acute attack, the goal is to prevent systemic spread of the disease. This may be done by avoiding drugs or foods that are high in purine and alcohol, both of which increase uric acid levels. Exercise and splinting are not effective in achieving the goal and salicylates should be avoided since they will affect the effectiveness of the prescribed medications for gout.

After first managing the pain being experienced by the client with gout, the treatment focuses on: a.) strengthening the affected joints through a controlled exercise plan. b.) minimizing joint disfigurement by using therapeutic splinting. c.) preventing systemic involvement by altering the client's diet. d.) managing chronic pain by taking regular doses of salicylates.

(E) Obesity. Risk factors for osteoporosis may be inherited or acquired. 1,2 Inherited factors include female sex and white or Asian ancestry. Women with Turner's syndrome or any condition leading to low estrogen levels are at increased risk of osteoporosis. Women with a personal history of fracture as an adult or history of osteoporosis in a first-degree rela- tive also are at increased risk. Acquired risk factors include current smoking ( ≥ 1 pack per day), alco- hol use ( ≥ 2 drinks per day), low calcium intake (< 1200 mg per day), and sedentary lifestyle. Finally, women with low body weight (< 127 lb) are at in- creased risk for osteoporosis. Guidelines for osteo- porosis screening and prevention are available only for women at this time.

All of the following are risk factors for osteoporo-sis EXCEPT: (A) Low calcium intake (B) Smoking (C) Alcohol use (D) Turner's syndrome (E) Obesity

b.) symptoms of asthma are often attributed to normal age-related changes. Asthma is both underdiagnosed and undertreated in older adults. Instead, the symptoms are attributed to normal changes with aging, cardiovascular disease, or are simply labeled "COPD." Older adults do present with the usual signs and symptoms; however, they are often overlooked. Asthma is not uncommon in older adults. Adults over 65 make up a small percentage of those with asthma, and they have the highest associated death rate than any other group. Asthma symptoms in older adults range from mild to very severe.

Asthma is often underdiagnosed in older adults because: a.) older adults frequently do not have any of the classic signs and symptoms. b.) symptoms of asthma are often attributed to normal age-related changes. c.) asthma is very uncommon in older adults. d.) asthma symptoms are usually very mild in older adults

c.) The routine use of antibiotics is controversial because the causal role of bacterial infection is often not clear. In chronic bronchitis, the routine use of antibiotics is controversial because the causal role of bacterial infection is often difficult to document. Antibiotics are generally indicated in frail elders when the possibility of pneumonia or an acute exacerbation of bronchitis is suspected. There is no evidence that antibiotics are less effective in older adults or that chronic bronchitis is usually caused by a nonbacterial cause. While it is correct that a normal age-related decreased immune response may delay the presentation of classic symptoms, this does not explain why antibiotics are often not prescribed.

The daughter of an older patient with chronic bronchitis says to the nurse, "I don't understand why my father has not been prescribed antibiotics for his bronchitis. The last time I had bronchitis I got antibiotics." The nurse considers the following when formulating a response: a.) Antibiotics tend to be less effective in older adults than in younger adults. b.) Antibiotics are not prescribed in chronic bronchitis since the cause is usually not bacterial. c.) The routine use of antibiotics is controversial because the causal role of bacterial infection is often not clear. d.) Normal age-related decreases in immune response delay the presentation of classic symptoms.

a, b, d, e a.) "Are you familiar with pursed-lip breathing?" b.) "It will be necessary to demonstrate postural drainage techniques with a caregiver." d.) "Can you explain the purpose of the medications you have been prescribed?" e.) "There are some things I'd like to discuss about adaptive sexual practices." Topics that will be included in this client's discharge teaching include pursed lip breathing, postural drainage techniques, medication education, and safe sexual activity. Diet is not generally a factor in this disease process.

The nurse is preparing discharge teaching for a client diagnosed with chronic obstructive pulmonary disease (COPD). Which nursing statement would be included in this intervention? (Select all that apply.) a.) "Are you familiar with pursed-lip breathing?" b.) "It will be necessary to demonstrate postural drainage techniques with a caregiver." c.) "We will need to discuss alterations in your diet." d.) "Can you explain the purpose of the medications you have been prescribed?" e.) "There are some things I'd like to discuss about adaptive sexual practices."

c.) Heberden's nodes on the distal phalanges Herbeden's nodes are common in osteoarthritis. As the disease progresses, osteophytes develop in the joints of the fingers. Swan neck deformity and subluxation of the fingers are common in RA. An enlarged great toe is characteristic of gout.

Which of the following manifestations would a nurse expect in a 70-year-old patient who has the diagnosis of osteoarthritis? a.) Swan neck deformity of the hand b.) Subluxation of the fingers c.) Heberden's nodes on the distal phalanges d.) Enlarged great toe

b

The nurse knows that a 60-year-old female client's susceptibility to osteoporosis is most likely related to: a-Lack of exercise. b-Hormonal disturbances. c-Lack of calcium. d-Genetic predisposition

a.) tobacco use. Tobacco use or exposure is the most significant etiology for COPD and accounts for 80% to 90% of all cases of COPD. Exposure to certain chemicals in the work environment may be a causative factor of COPD but is not as significant as tobacco. COPD includes emphysema and chronic bronchitis.

1. The most significant etiology for chronic obstructive pulmonary disease (COPD) is: a.) tobacco use. b.) chronic bronchitis. c.) exposure to carcinogens in the workplace. d.) emphysema.

b.) 79. The maximal PO2 possible at sea level can be estimated by multiplying the person's age by 0.3 and subtracting the product from 100.

A nurse assesses an older patient's blood gases. The patient is 70 years old. The nurse knows that this patient's maximum PO2 is: a.) 69. b.) 79. c.) 89. d.) 99.

a, b, c, e a.) Diminished cough reflex b.) Stiffening of the chest wall c.) Increased resistance to airflow e.) Loss of elastic recoil Age-related changes include loss of elastic recoil, stiffening of the chest wall, and increased resistance to airflow leading to more effort required for movement of the diaphragm. A diminished cough reflex is a normal age-related change. A decreased respiratory rate is not a normal age-related change.

A nurse is assessing an older adult's respiratory status. Which of the following are normal age-related changes in the respiratory system? (Select all that apply.) a.) Diminished cough reflex b.) Stiffening of the chest wall c.) Increased resistance to airflow d.) Decreased respiratory rate e.) Loss of elastic recoil

d.) The woman has been taking corticosteroids for 10 years because of chronic Bone loss is rapid in individuals who take steroids for extended periods of time.

A nurse is interviewing an older woman who is a new patient in an outpatient medical clinic. Which of the following findings by the nurse is considered a risk factor for osteoporosis? a.) The woman is obese and has hip pain with ambulation. b.) The woman drinks three glasses of skim milk daily. c.) The woman eats three to five servings of shrimp and liver per week. d.) The woman has been taking corticosteroids for 10 years because of chronic pulmonary disease.

b.) History of joint injuries e.) Obesity Gender and advancing age are nonmodifiable risk factors for osteoarthritis. There is no evidence that coffee or caffeine has any relationship to the development of osteoarthritis.

A nurse is teaching a group of 65-year-old patients about reducing the risk of osteoarthritis. Which of the following would the nurse discuss as a modifiable risk factor for osteoarthritis? (Select all that apply.) a.) Female sex b.) History of joint injuries c.) Advancing age d.) Drinking one cup of regular coffee a day e.) Obesity

b.) A 72-year-old non-Hispanic white female who never worked outside of the home and is a former smoker The profile of individuals most likely to have COPD include: persons 65-75 years of age, non- Hispanic whites, women, those who are unemployed, retired or do not work, have less than a high school education, have lower incomes, are current or former smokers, and have a history of asthma. Option B meets all of the criteria listed above.

A nurse is organizing a support group for older individuals with COPD in the community. The nurse knows that which of the following individuals is most likely to have COPD? a.) A 75-year-old Hispanic male who is a retired truck driver and never smoked b.) A 72-year-old non-Hispanic white female who never worked outside of the home and is a former smoker c.) A 67-year-old African American male who is a retired physician d.) A 70-year-old Asian woman who is a retired college professor

c.) Osteoporosis Kyphosis is a common presentation in osteoporosis. Individuals can lose as much as 3 cm or more in height and develop a "c" shape to the vertebral column.

Kyphosis in the older adult can be a result of which of the following? a.) Osteoarthritis b.) Rheumatoid arthritis c.) Osteoporosis d.) Gout

C

Which patient would be at greatest risk for developing osteoporosis? a )A 73-year-old man who has five alcoholic drinks per week and limits sun exposure to prevent recurrence of skin cancer. b )An 84-year-old man who has recently been diagnosed with hypothyroidism and is prescribed levothyroxine (Synthroid). c )A 69-year-old woman who had a renal transplant 5 years ago and has been taking prednisone to prevent organ rejection. d )A 55-year-old woman who recently had a hysterectomy with bilateral salpingo-oophorectomy and refuses estrogen therapy.