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Mental Health 4

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The registered nurse is teaching a novice nurse about the rights of delegation. Which statement by the novice nurse indicates a need for further teaching? "I will refer to the guidelines before delegating the task." "I will check for the competence of the delegatee for the assigned task." "I will instruct the delegatee to monitor and evaluate the client appropriately." "I will check whether the environment is conducive to completing the task safely."

"I will instruct the delegatee to monitor and evaluate the client appropriately."

A registered nurse is educating a licensed practical nurse (LPN) about involving assistive personnel in providing palliative care to a dying client. Which statements made by the LPN indicate effective understanding of the role of assistive personnel? Select all that apply. "I'll ask assistive personnel to inform me when the client's family members arrive." "I'll ask assistive personnel to administer antidepressants, if prescribed, to the client." "I'll ask assistive personnel to inform me when the client expresses anger or loss of appetite." "I'll ask assistive personnel to inform me about change in the nature of the client's symptoms." "I'll ask assistive personnel to determine which of the client's symptoms can be independently managed."

"I'll ask assistive personnel to inform me when the client's family members arrive." "I'll ask assistive personnel to inform me when the client expresses anger or loss of appetite." "I'll ask assistive personnel to inform me about change in the nature of the client's symptoms."

A patient has been taking donepezil (Aricept) for 2 weeks as part of the treatment for early stages of Alzheimer's disease. Her daughter calls the prescriber's office and is upset because "Mother has not improved one bit!" Which response by the nurse is appropriate? A. "Increase the dosage to twice daily." B. "It takes time for the cure to take effect." C. "It may take up to 6 weeks to see an improvement." D. "Take the medication on an empty stomach for improved absoption."

"It may take up to 6 weeks to see an improvement."

While assessing an older adult with decreased perception of touch, the nurse provides instructions to the client to reduce the risk associated with falling. Which statements made by the nurse are beneficial to the client? Select all that apply. "Move slowly when changing positions." "Hold on to handrails while ambulating." "Look where your feet are placed while walking." "Wear shoes that give good support while walking." "If you are unable to change your position frequently request assistance."

"Look where your feet are placed while walking." "Wear shoes that give good support while walking." "If you are unable to change your position frequently request assistance."

A patient who is dehydrated has been experiencing confusion. The daughter is concerned about taking the patient home in a confused state. What statement by the nurse is correct? A. "Don't worry; the patient should be fine once they are in a familiar. environment." B. "I can make a referral for a home health aide to assist with the patient." C. "Once the dehydration is corrected, the patient's confusion should improve." D. "I can show you how to care for the patient once you return home."

"Once the dehydration is corrected, the patient's confusion should improve."

A nurse is learning about palliative care and curative care. Which statement by the nurse indicates effective understanding of the difference between the two types of care? "Palliative care aims at hastening death, whereas curative care aims at providing comfort to postpone death." "Palliative care can be started earlier in the dying process, whereas curative care is usually available only in the last 6 months of life." "Palliative care emphasizes the control of pain and relief of symptoms, whereas curative care is intended to cure the disease and prolong life at all costs." "Palliative care is providing psychological, social, and spiritual assistance, whereas curative care is providing adequate nutrition and maintaining the elimination pattern."

"Palliative care emphasizes the control of pain and relief of symptoms, whereas curative care is intended to cure the disease and prolong life at all costs."

A licensed practical nurse discusses hospice care with a nursing student. Which statements made by the nursing student indicates a need for further discussion? select all that apply. "A client's spouse is considered a primary caregiver." "The hospice Medicare benefit covers all expenses for palliative treatments." "A hospice provides dying older adults with a higher level of control and dignity in death." "The hospice Medicare benefit for bereavement care is not provided after the death of the client." "Hospice care can be provided to all older adults requiring hospitalization for the treatment of an illness."

"The hospice Medicare benefit for bereavement care is not provided after the death of the client." "Hospice care can be provided to all older adults requiring hospitalization for the treatment of an illness."

The nurse is sitting with the family of a patient who has just received the diagnosis of dementia. The family asks for information on what treatment will be needed to cure the condition. What is the nurse's best response? A. "Hormone therapy will reverse the condition." B. "Vitamin C and Zinc will reverse the condition." C. "There is no treatment that reverses dementia." D. "Dementia can be reversed with diet, exercise, and medications."

"There is no treatment that reverses dementia."

The family of a patient who has recently been diagnosed with Alzheimer's disease is asking about the new drug prescribed to treat this disease. The patient's wife says, "I'm so excited that there are drugs that can cure this disease! I can't wait for him to start treatment." Which reply from the nurse is appropriate? A. "The sooner he starts the medicine, the sooner it can have this effect." B. "These effects won't be seen for a few months." C. "These drugs do not cure Alzheimer's disease. Let's talk about what the physician said to expect with this drug therapy." D. "His response to this drug therapy will depend on how far along he is in the disease process."

"These drugs do not cure Alzheimer's disease. Let's talk about what the physician said to expect with this drug therapy."

A registered nurse is educating a licensed practical nurse (LPN) about the importance of palliative care in clients with HIV disease. Which statement made by the LPN indicates a need for further teaching? "While palliative care is being provided to a client with HIV disease, intravenous therapy, blood transfusions, and radiation therapy should be considered." "While providing palliative care to a client with HIV disease, I'll advocate for any client who becomes unable to communicate his or her treatment desires." "While providing palliative care to a client with HIV disease, we should be sure to address any potential chronic, debilitating conditions associated with the disease." "While providing palliative care to a client with HIV disease, we should address any superimposed acute exacerbations of opportunistic infections and related symptoms that occur.

"While palliative care is being provided to a client with HIV disease, intravenous therapy, blood transfusions, and radiation therapy should be considered."

An older client with a diagnosis of dementia is living in a long-term care facility. The client's daughter, who lives 300 miles away, calls the unit to speak to the nurse about her upcoming visit. What should the nurse say in response to her question about the best time of day to visit? "Around 2:30 in the afternoon is the best time to visit." "Whenever is most convenient for you. She'll be glad to see you." "Come at noon. You'll be able to go to the dining room and visit while she eats." "The longest uninterrupted time begins after supper and extends until bedtime, at 8:30 pm."

"around 2:30 in the afternoon is the best time to visit."

A client says to the nurse, "The federal guards were sent to kill me." Which is the best response by the nurse to the client's concern? "I don't believe this is true." "The guards are not out to kill you. "Do you feel afraid that people are trying to hurt you?" What makes you think the guards were sent to hurt you?"

"do you feel afraid that people are trying to hurt you?"

A diet that contains restricted amounts of protein, sodium, and potassium has been prescribed for a client with end-stage renal disease who is receiving dialysis. The nurse is providing dietary instructions. Which statement by the client indicates teaching is effective? "I should avoid using salt substitutes." "I should exclude meat from my diet." "I may not add seasoning to my food." "I may eat low-sodium canned vegetables."

"i should avoid using salt substitutes."

A hospice-care facility is providing care to a client in the terminal stage of renal disease. The primary health-care provider is explaining to a client how a hospice facility works. Which statement made by the client's caregiver indicates the need for correction? "A hospice facility provides care to terminally ill clients." "With admission to hospice facility, we should realize that death is a natural part of life." "The objective of hospice facility is to provide care to clients with terminal illness and a poor prognosis." "The goal of hospice-care facility is to maximize the quality of life and keep the client as comfortable as possible."

"ja hospice facility provided care to terminall ill clients."

The registered nurse is evaluating the statements of the student nurse after teaching about delegation. Which statement made by the student nurse indicates a need for teaching? "Delegation is merely sharing a set of functions." "Delegation ensures quality client care outcomes." "Professional aspects of care can also be delegated." "The final accountability of a task remains with the delegator."

"professional aspects of care can also be delegated."

A client in thyroid storm tells the nurse, "I know I'm going to die. I'm very sick." What is the nurse's best response? "You must feel very sick and frightened." "Tell me why you feel you are going to die." "I can understand how you feel, although people do not die from this problem." "If you would like, I will call your family and tell them to come to the hospital."

"you must feel very sick and frightened."

A client diagnosed with terminal cancer says to the nurse, "I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." Which response by the nurse is therapeutic? "Have you shared your feelings with your family?" "I think we should talk more about your anger with your family." "You're feeling angry that your family continues to hope for you to be cured?" "You are probably very depressed, which is understandable with such a diagnosis."

"you're feeling angry that your family continues to hope for you to be cured?"

The nurse visits a client at home. The client states, "I haven't slept at all the last couple of nights." Which response by the nurse demonstrates therapeutic communication? "I see." "Really?" "You're having difficulty sleeping?" "Sometimes I have trouble sleeping too."

"you're having difficulty sleeping?"

Which statements made by a terminally-ill client address primary goals regarding end-of-life [EOL] nursing care? Select all that apply. I want my children to carry my casket ive prepaid all my funeral expenses so I wont be a burden. ;My living will states that I want no heroic measures to prolong my life Pain is a concern of mine, so Ive discussed that thoroughly with my doctor Ive made arrangements that will allow me to spend my final days in my own home

;My living will states that I want no heroic measures to prolong my life Pain is a concern of mine, so Ive discussed that thoroughly with my doctor Ive made arrangements that will allow me to spend my final days in my own home

An older adult is diagnosed with Alzheimer's disease. The nurse knows that this diagnosis is made on the presence of which of the following? (Select all that apply.) A. A decline from a previous level of functioning B. Fluctuation of symptoms over the course of a 24-hour period C. An insidious onset D. A gradual decline in cognitive abilities E. The cognitive changes worsen in the evening hours

A decline from a previous level of functioning An insidious onset A gradual decline in cognitive abilities

Post posterior surgical approach what should you place between the legs

A regular or abduction pillow

A systemic inflammatory autoimmune disorder affecting primarily the joints, where it causes pain, swelling, stiffness, and loss of function

Classic symptoms of parkinson's

Akinesia Bradykinesia Rigidity Tremor Postural instability Staggering gait Drooling

A pt has been diagnosed with PD. Medication therapy is started for this patient. The nurse should teach the patient and care giver that pharmacological therapy? a. The medication should be stopped when the pt symptoms improve b. Alcohol , OTC drugs, and herbals are to be avoided unless approved by the prescriber c. A common side effect of anticholinergics is drooling d. Improvements in symptoms are expected within 5 days of medication therapy

Alcohol, OTC drugs, and herbals are to be avoided unless approved by the prescriber

A patient has been diagnosed with PD. Medication therapy is started for this patient. The nurse should teaching the patient and caregiver that pharmacologic therapy of PD? A. The medication should be stopped when the patient's symptoms improve. B. Alcohol, over-the-counter drugs, and herbals are to be avoided unless approved by the prescriber. C. A common side effect of anticholinergics is drooling. D. Improvements in symptoms are expected within 5 days of medication therapy.

Alcohol, over-the-counter drugs, and herbals are to be avoided unless approved by the prescriber.

A high degree of helping behaviors describes what? a.Self-renewal b.Courage c.Continuous moral development d.Altruism

Altruism

Which drug is used for the management of the patient with PD is most likely to cause postural hypotension a. amantadine (symmetrel) b. selegiline (eldepryl) c. tolcapone (tasmar) d. entacapone (comtan)

Amantadine (Symmetrel)

Arthroscopy

An examination of the interior of a joint, by inserting a specially designed endoscope through a small incision

Gout

An inflammatory RA characterized by the deposition of uric acid crystals in the tissues and fluid in the body

An inflammatory process affecting the entire joint, involving the cartilage, joint lining, ligaments, and underlying bones.

Benztropine

Anticholinergic drug used for PD and extrapyramidal symptoms from antipsychotic drugs

Pharmacological Agent Examples

Antiinflammatory agents Analgesics Nutrition supplement

Amantadine

Antiviral drug used to treat influenze, blocks reuptake of dopamine in the never fibers

Common worldwide musculoskeletal disorder with a dramatic prevalence anticipated due to the aging population

Arthritis

What is the leading cause for disability for people in the US

Arthritis

What musculoskeletal disorder is more common in women

Arthritis

What is a procedure that is used primarily in knee problems to allow biopsy of cartilage or synovium and to diagnose a torn meniscus and for removal of loose bodies in the joint

Arthroscopy

A 14-month-old child is admitted to the pediatric hospital with a fractured right femur. The child is placed in Bryant traction. When the parents see the child for the first time in traction, they are surprised to see both legs in traction and ask why. What information should the nurse share about Bryant traction? Putting both legs in traction keeps one leg from becoming longer than the other. Putting both legs in traction keeps the baby from turning over in bed and breaking his leg again. As a means of ensuring counter-traction, both legs are placed in traction and the buttocks are suspended off the bed. When the leg was x-rayed, the health care practitioner apparently discovered that the other leg was broken as well.

As a means of ensuring counter-traction, both legs are placed in traction and the buttocks are suspended off the bed.

What should you always do after a hip surgery

Assess the pts risk factors for clotting problems, previous clotting problems, limited postoperative mobility, obesity, smoking and advanced age

A patient took an accidental overdose of a cholinergic drug while at home. He comes to the emergency department with severe abdominal cramping and bloody diarrhea. The nurse expects that which drug will be used to treat this patient? A. atropine (generic) B. pilocarpine (Salagen) C. bethanechol (Urecholine) D. phentolamine (Regitine)

Atropine (generic)

1. A client who recently underwent total hip arthroplasty and is on anticoagulants is preparing for discharge from the hospital. Which information is most important for the nurse to provide to the client and caregiver? A. Use an abduction pillow between the legs. B. Keep heels off the bed. C. Avoid using a straight razor. D. Re-orient frequently.

Avoid using a straight razor

Most common deformity in RA

Boutonniere deformity or flexion of the distal interphalangeal (DIP) joint with flexion of the proximal interphalangeal (PIP) joint followed by swan neck or flexion of DIP and extension of PIP

Which drug is derived from a natural source and may be prescribed for the treatment of osteoporosis? Calcitonin Raloxifene Clomiphene Bisphosphonates

Calcitonin

The surgeon may ask pt with RA to have a what done if planning for general anesthesia

Cervical spine x-ray

Many people with arthritis also have what

Chronic conditions and are at high risk for development of other chronic conditions

What is OA also known as

Degenerative joint disease (DJD)

Which beliefs may be associated with a registered nurse's failure to delegate tasks? Select all that apply. Delegation is too time consuming. More energy is required to delegate others. The registered nurse will not receive credit for total client care. Delegation minimizes the contribution of the delegator for client care. Delegation requires complete transfer of accountability for final client care.

Delegation is too time consuming. More energy is required to delegate others. The registered nurse will not receive credit for total client care.

Which of the following is a medical emergency? a.Delirium b.Dementia c.Depression d.Wandering

Delirium

Which information will the nurse manager include when discussing the major differentiation between delirium and dementia with novice nurses? (Select all that apply.) A. The delirious client learns to make up answers to hide his or her confusion. B. Delirium requires increased monitoring at night. C. The client diagnosed with dementia generally looks frightened. D. Dementia results in a steady decline in cognitive abilities. E. Delirium is characterized by fluctuations in alertness.

Delirium requires increased monitoring at night. Dementia results in a steady decline in cognitive abilities. Delirium is characterized by fluctuations in alertness.

Categories of cognitive impairment

Delirium, Neurocognitive disorders, cognitive impairment not dementia, focal cognitive disorders, intellectual disabilities, learning disabilities

Which cognitive disorder occurs over several months and is characterized by a progressive deterioration of all cognitive functions with little or no disturbance of consciousness or perception? A. Dementia B. Delirium C. Focal cognitive disorder D. Abstract reasoning disorder

Dementia

Three Ds of cognitive impairment

Depression Delirium Dementia

Secondary OP can be caused by what

Dietary deficiencies of calcium, vitamin D, corticosteroids, thyroid replacement and autoimmune disorders

When providing teaching to the patient receiving an anticholinergic for the treatment of PD, the nurse will include which information a. Take the medication first thing in the morning b. Limit fluid intake when taking this drug c. The tremors you experience will be reduced within 24 hours of taking this drug d. Do not take this medication at the same time as other medications

Do not take this medication at the same time as other medications

When providing teaching to a patient receiving an anticholinergic for the treatment of PD, the nurse will include which information A. Take the medication first thing in the morning. B.Limit fluid intake when taking this drug. C.The tremors you experience will be reduced within 24 hours of taking this drug. D.Do not take this medication at the same time as other medications.

Do not take this medication at the same time as other medications.

Alzheimers drugs

Donepezil (aricept) Galantanmine (Razadyne) Rivastigmine (exelon) Memantine HCL (Namenda)

Levodopa is the precursor of what

Dopamine

Parkinson's worsens when too little what is present

Dopamine

Parkinson's is caused by an imbalance of these two neurotransmitters

Dopamine and Acetylcholine

Levodopa is taken up by what and converted into dopamine and then released

Dopaminergic

Osteopenia

Excessive loss of BMD leads to this

Signs and symptoms of gout

Exquisite pain that often starts in middle of night waking them from sleep Joint is bright red, hot, too painful to touch

A computerized calculator for determining 10-year probability of fracture

FRAX Tool

Remind pt that had posterior approach to avoid what

Flexing the hips more than 90 degrees at all times

General care for an immobilized patient

Frequent turning, posistioning Skin assessment Skin care ROM Deep breathing Weight bearing (if allow) Optimize elimination Nurtriton Exercise therapy Pharmacological agents Surgical intervention Immobilizations Assisted devices

The nurse is teaching a patient about the possible adverse effects of donepezil (Aricept) for Alzheimer's disease. Which of these are possible adverse effects? (Select all that apply.) A. Constipation B. GI upset C. Drowsiness D. Dizziness E. Blurred vision

GI upset Drowsiness Dizziness

This disorder can either be a one time acute illness or can become chronic with intermittent and unpredictable acute attacks

Gout

People with RA are most likely to die from what

Heart disease

What scans are done to assess the operative joint and surrounding soft tissues, especially if the pt is undergoing a robotic-assisted THA

Hip x-rays, CT scan, MRI

Clinical subtypes of delirum

Hyperactive Hypoactive Mixed

Remind pt with anterior approach to avoid what

Hyperextension of the operative hip and external rotation of the leg

Each of the following conditions may cause cognitive impairment. Which is most likely to cause delirium, which is reversible? A. A stroke B. Hypoglycemia C. A brain tumor D. A brain hemorrhage

Hypoglycemia

Progressive

Increase in severity and present all the time

Sinement CR

Increases "on" time and decreases "off" time

As a nurse prepares an older adult client for sleep, actions are taken to help reduce the likelihood of a fall during the night. What nursing action is most appropriate when targeting older adults' most frequent cause of falls? Moving the client's bedside table closer to the bed Encouraging the client to take an available sedative Instructing the client to call the nurse before going to the bathroom Assisting the client to telephone home to say goodnight to the spouse

Instructing the client to call the nurse before going to the bathroom

The registered nurse (RN) is caring for a client with epilepsy. Which tasks delegated by the registered nurse (RN) to the assistive personnel indicates active delegation? Select all that apply. Instructing the licensed practical nurse (LPN) to administer diazepam Instructing the licensed practical nurse (LPN) to monitor the vital signs Instructing the licensed vocational nurse (LVN) to administer sedatives Instructing the unlicensed assistive personnel (UAP) to reposition the client Instructing the unlicensed assistive personnel (UAP) to place the oxygen mask

Instructing the licensed practical nurse (LPN) to monitor the vital signs Instructing the unlicensed assistive personnel (UAP) to reposition the client Instructing the unlicensed assistive personnel (UAP) to place the oxygen mask

What is polycyclic

Intensity of symptoms varies over time

RA is the result of what

Interaction between environmental exposures, genetic factors, and age-related increased auto-immunity

What devices are used to help assist in maintaining acceptable hemoglobin and hematocrit levels

Intra-operative cell savers and postoperative re-infusion blood collection systems

The nursing staff complains about confusion at the work place due to the nurse leader's habit of avoiding responsibility and asking the staff to self-schedule client care assignments. Which type of leadership does the leader exhibit? Autocratic leadership Democratic leadership Situational leadership Laissez-faire leadership

Laissez-faire leadership

The home care nurse is visiting an older client whose spouse died 6 months ago. Which behaviors by the client indicate effective coping? Select all that apply. Neglecting personal grooming Looking at old snapshots of family Participating in a senior citizens program Visiting the spouse's grave once a month Decorating a wall with the spouse's pictures and awards received

Looking at old snapshots of family Participating in a senior citizens program Visiting the spouse's grave once a month Decorating a wall with the spouse's pictures and awards received

The home care nurse is visiting an older client whose spouse died 6 months ago. Which behaviors by the client indicates effective coping? Select all that apply. Neglecting personal grooming Looking at old snapshots of family Participating in a senior citizens program Visiting the spouse's grave once a month Decorating a wall with the spouse's pictures and awards received

Looking at old snapshots of family Participating in a senior citizens program Visiting the spouse's grave once a month Decorating a wall with the spouse's pictures and awards received

An older patient is concerned that her neighbor was recently diagnosed with Alzheimer's disease and asks a nurse what can be done to decrease the risk of Alzheimer's disease. The nurse includes which of the following in the response to the patient? (Select all that apply.) A. Maintain blood pressure within normal limits B. Smoking cessation C. Maintain control of blood sugar (hemoglobin A1C<) D. Eliminate fats from the diet E. Maintain ideal body weight

Maintain blood pressure within normal limits Smoking cessation Maintain control of blood sugar (hemoglobin A1C<)

The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer's disease. She was diagnosed 3 months ago, has mild memory loss, and will be receiving donepezil (Aricept). What is the drug's expected action? A. Prevents memory loss in later stages. B. Reverses the course of Alzheimer's disease. C. Provides sedation to prevent agitation and restlessness D. May help to improve the mood and decrease confusion

May help to improve the mood and decrease confusion

Goals to minimize disability by preventing further damage and assuring adequate pain relief

Minimize or prevent pain Balance rest and activity of joint Maintain self-esteem Minimize swelling and inflammation Maintain function of affected joints

patient will be taking selegiline (Eldepryl), 10 mg daily, in addition to dopamine replacement therapy for Parkinson's disease. The nurse will implement which precautions regarding selegiline? A. Teach the patient to avoid foods containing tyramine. B. Monitor for dizziness. C. Inform the patient that this drug may cause urine discoloration. D. Monitor for weight gain.

Monitor for dizziness.

What are the three variations of RA

Monocyclic Polycyclic Progressive

Treatment of gout

NSAIDS, or a short course of steroids or colchicine

What drugs should be discontinued 5-10 days before surgery

NSAIDs and vitamins C because they can increase risk for clotting and bleeding

Pharmacological approach for OA and RA

NSAIDs, COX-2 Inhibitors, Joint injections with steroids or intraarticular hyaluronans and disease modifying anti rheumatic drugs (DMARDs)

Primary OP is caused by what

Normal change aging, particularly in postmenopausal women who do not take hormone replacement

Preventative strategies for OP

Nutrition Calcium Vitamin D Exercise Education Pharmacological Approaches

Onset of this is gradual and usually begins to be noticed after the age of 40

nursing student is preparing to teach about the difference between OA and RA, what should they teach?

OA is local and RA impacts distal joints

What is monocyclic

One episode lasting 3-5 years

As OA advances what develops in the joints of the fingers

Osteophytes

Common symptoms associated with Altered Mobility

Pain Reduced joint movement Reduced sensation or loss of sensation Falls Fatigue Altered gait or imbalance Reduced functional ability

MIS procedure is ONLY done for what

Primary THA not for revision surgeries

2. Which of the following behaviors are associated with higher-order cognitive functioning? (Select all that apply.) A. Pattern recognition B. Attention C. Problems solving D. Insight E. Creativity

Problem solving Insight Creativity

Complications of gout

Prolonged elevation of uric acid, crystallizes forming insoluble precipitates that gather in subcutaneous tissue, small white tophi, can collect in kidneys and for urate renal stones and cause renal failure.

When caring for a patient with cognitive impairment, which of the following nursing interventions are appropriate? (Select all that apply). A. Vary the caregivers assigned to the patient so the caregivers do not burn out. B. Provide simple instructions so the patient is able to understand the instructions more easily. C. Avoid eye contact so the patient does not feel insecure. D. Vary the routines so the patient does not become bored. E. Have the patient use his glasses and hearing aids consistently to maximize accurate sensory input.

Provide simple instructions so the patient is able to understand the instructions more easily. Have the patient use his glasses and hearing aids consistently to maximize accurate sensory input.

What two musculoskeletal disorders are less likely to occur

Pseudogout and Polymyalgia

This musculoskeletal disorder is characterized by symmetrical polyarticular limitations affecting five or more joints

What disease is considered a systemic inflammatory autoimmune disorder?

What disorder affects the joints and system as a whole: pain, fatigue, malaise, weakness and fever

Which musculoskeletal disorder is illustrated in the image? Osteoporosis Osteoarthritis Rheumatoid arthritis Ankylosing spondylitis

What diagnosis is necessary for RA so that you can preserve the joints

Rapid

Primary prevention for immobility

Regular physical activity Protection against injury Optimal nutrition Fall prevention measures

A nurse is caring for an older adult with the diagnosis of dementia. Which manifestations are expected in this client? Select all that apply. Resistance to change Inability to recognize familiar objects Preoccupation with personal appearance Inability to concentrate on new activities or interests Tendency to dwell on the past and ignore the present

Resistance to change Inability to recognize familiar objects Inability to concentrate on new activities or interests Tendency to dwell on the past and ignore the present

Cholinergic crisis--SLUDGE

Salivation Lacrimation Urinary Incontinence Diarrhea GI cramps Emesis

MAO-B inhibitors

Selegiline (Eldepryl) Rasagiline (Azilect)

Five characteristics of High-Reliability Organizations (HRO) mindset

Sensitivity to operations, focused on predicting and preventing rather than reacting to errors, reluctance to simplify, deference to expertise, exhibit commitment to reliance

What kinds of joints does RA usually affect

Small joints of the wrist, ankle and hand although can also affect large joints like the knee

Risk factors associated with the development of RA in older adults

Smoking Periodontitis Viral infections

As OA advances what develops in the lumbar region

Spinal stenosis

Bone loss declines rapidly in anyone who takes what for an extended period of time

Steroids

Signs and symptoms of OA

Stiffness with inactivity and pain with activity relieved at rest.

The first goal of treatment during an acute attack of gout is to what

Stop it as promptly as possible

If you have RA there is a possibility of having a cervical spine disease and this could lead to what during intubation of general anesthesia

Subluxation

Once pt is PACU from a THA what position should you place them in

Supine with head slightly elevated

Surgical approach to OA and RA

Surgical replacement of joint (arthroplasty)

Worldwide 9.6% of men and 18% of women have what

Symptomatic OA

Inflammation of what causes destruction of the surrounding cartilage and bone

Synovium

During a patient teaching session about antiparkinson drugs, the nurse will include which statement? A. "The drug will be stopped when tremors and weakness are relieved." B. "If a dose is missed, take two doses to avoid significant decreases in blood levels." C. "Be sure to notify your physician if your urine turns brownish-orange in color." D. "Take care to change positions slowly to prevent falling due to a drop in blood pressure."

Take care to change positions slowly to prevent falling due to a drop in blood pressure."

Remind a patient that has had a TJA to do what

Tell any future health care provider that they have had a TJA

Signs and symptoms of RA

Tender warm swollen joints Symmetrical pattern of affected joint Joint inflammation often affecting the wrist and finger joints closest to the hand Joint inflammation affecting other joints including the neck, shoulders, elbows, hips, knees, ankles and feet Fatigue, occasional fevers, loss of energy Pain and stiffness lasting more than 30 min in the morning or after a long rest Symptoms that last for many years Variability of symptoms among people with the disease

The practitioner prescribes no weight bearing on a leg that has been casted because of a fracture of the femur. How should the nurse determine the appropriate length of the crutches for this child? Select all that apply. The crutches should reach 2 inches below the axillae. The crutches' tips should rest 6 inches outside the feet. There should be a snug fit under the axillae when the child walks. There should be a slight stoop of the shoulders when the child walks. The elbows should be extended when the crutches are held at the crossbar.

The crutches should reach 2 inches below the axillae. The crutches' tips should rest 6 inches outside the feet.

Primary Arthroplasty is what

The first time a person has a total joint arthroplasty

A patient who has been taking carbidopa-levodopa for Parkinson's disease for over 1 year wants to start a low-carbohydrate/high-protein weight-loss diet. The nurse tells the patient that this type of diet may have what effect on his drug therapy? There will be no problems with this diet while on this medication. B. The high-protein diet can slow or prevent absorption of this mediation. C. The high-protein diet may cause increased blood levels of this medication. D. The high-protein diet will cause no problems as long as the patient also takes pyridoxine (vitamin B6).

The high-protein diet can slow or prevent absorption of this mediation.

Which of the following best describes perception? A. A focus on a particular area of conscious thought B. The ability to recall past learning C. The interpretation of the environment D. Higher thinking processes allowing for adaptability

The interpretation of the environment

Current blood banks do not recommend storage of donor or autologous blood before surgery unless what

The patients blood type or antibody profile is difficult to crossmatch

Preoperative care begins with assessing what

The patients level of understanding about the surgery and ability to participate in postoperative plan of care

Osteotomy

The sawing or cutting of the bone

Vertebral disks

These become thinner as a result of gravity, dehydration, spotaneous and unknown spinal fractures may occur as the result of OP causing shortening of trunk

Revision arthroplasty

This is done if the first implant loosens or fails for any reason this is done.

Postural and structural changes

This occurs primarily because of age-related bone calcium loss and atrophic cartilage and muscle.

Total hip arthroplasty is also called what

Total hip replacement

Chronic pain: Surgical management

Total joint arthroplasty (TJA) Total joint replacement (TJR) Arthroscopy Osteotomy

Risk Factors for Mobility

Traumatic Injury to brain or spinal cord, bones, joints, muscles, neurological changes, chronic conditions

What is thought to account for about 80-90% of hyperuricemia

Underexcretion

Non pharmacological approaches for OA and RA

Use of heat and cold, joint support and protection, exercise, and diet

Amantadine (Symmetre)

Used early in PD, effective for 6-12 months, used to treat dyskinesia associated with carbidopa-levodopa

The nurse supports cognitive ability in clients with Alzheimer dementia, by doing what? Select all that apply. Using calendars, clocks, and pictures to support memory Encouraging caregivers to support protected independence Providing a limited number of choices to support decision making Quizzing the client regularly to assess orientation to person, place, and time Administering prescribed rivastigmine to the client with severe Alzheimer's dementia

Using calendars, clocks, and pictures to support memory Encouraging caregivers to support protected independence Providing a limited number of choices to support decision making

The "off-on phenomenon" that some patients with PD experience is best explained as the a. need to take drug holiday to improve response to medications, b. Variable response to levodopa, resulting in periods of good control and periods of poor control of PD symptoms c. alternating schedule of medications needed to control PD d. fluctuation of emotions that often occurs with PD

Variable response to levodopa, resulting in periods of good control and periods of poor control of PD symptoms

What is the most serious postoperative complication

Venous Thromboembolism (VTE)

Kinds of fractures that are not often recognized by clinicians

Vertebral fractures

What equipment may be needed following a THA to prevent hip dislocation and promote recovery

Walker, commode chair

A client in the early dementia stage of Alzheimer's disease is admitted to a long-term care facility. Which activities must the nurse initiate? Select all that apply. Weighing the client once a week Having specialized rehabilitation equipment available Keeping the client in pajamas and robe most of the day Establishing a schedule with periods of rest after activities Reviewing the client's weekly budget and use of community resources Setting up a plan for weekly entertainment through a senior citizens group

Weighing the client once a week Having specialized rehabilitation equipment available Establishing a schedule with periods of rest after activities

Diagnostic Tests for Immobility

X-Ray MRI CT Scan Bone Scan Bone mineral density Myelogram Arthrography Arthroscopy Electromyography General labs

A client is admitted to the mental health unit with a diagnosis of depression. The nurse should develop a plan of care for the client that includes which intervention? Encouraging quiet reading and writing for the first few days Identification of physical activities that will provide exercise No socializing activities, until the client asks for participate in milieu A structured program of activities in which the client can participate

a structured program of activities in which the client can participate

A client is admitted to the mental health unit with a diagnosis of depression. The nurse should develop a plan of care for the client that includes which intervention? Encouraging quiet reading and writing for the first few days Identification of physical activities that will provide exercise No socializing activities, until the client asks to participate in milieu A structured program of activities in which the client can participate

a structured program of activities in which the client can participate.

A nurse is working in a daycare center with clients who have cognitive impairments. What does the nurse expect of a client in the middle stages of dementia? Able to recall events from the past Able to cope effectively with anxiety Able to follow a simple schedule without help Can remember what was eaten on the previous day

able to recall events from the past

A patient with Alzheimer's disease accidentally took 2 weeks' worth of a cholinergic medication. He is brought to the emergency department, is going into shock, and experiencing severe hypotension and vomiting. The nurse will expect which initial treatment? A.Administration of physostigmine B.Administration of atropine C.Administration of epinephrine D.Cardiovascular support with dopamine

administration of atropine

A client is preparing to attend a Gamblers Anonymous meeting for the first time. The nurse should tell the client that which is the first step in this 12-step program? Admitting to having a problem Substituting other activities for gambling Stating that the gambling will be stopped Discontinuing relationships with people who gamble

admitting to having a problem

The use of restraints can lead to which of the following a. death b. depression c. exacerbation of agitation d. asphyxiation e. all of the above

all of the above

Risk factors for falls include: a.OH. b.cognitive impairment. c.vision and hearing problems. d.foot deformities. e.all of the above.

all of the above.

The use of restraints can lead to which of the following? a.Death b.Depression c.Exacerbation of agitation d.Asphyxiation e.All of the above

all of the above.

An older adult resident of a nursing home who has the diagnosis of dementia of the Alzheimer type, frequently talks about the good old days at the ranch. What is the most appropriate action by the nurse? Allowing the resident to reminisce about the past and listening with interest Involving the resident in interesting diversional activities with a small group Reminding the resident that those "good old days" are past and that he or she should focus on the present Introducing the resident to other residents with the same diagnosis so that they can share their past experiences

allowing the resident to reminisce about the past and listening with interest.

Which drug used for the management of the patient with PD is most likely to cause postural hypotension? A.amantadine (Symmetrel) B.selegiline (Eldepryl) C.tolcapone (Tasmar) D.entacapone (Comtan)

amantadine (Symmetrel)

The patient diagnosed with PD has been started on dopaminergic replacement drug therapy with carbidopa-levodopa, it is most important for the nurse to A.assess the patient for dizziness and syncope when the patient is walking. B.administer the medication first thing in the morning. C.administer the medication on an empty stomach. D.omit protein from the patient's diet.

assess the patient for dizziness and syncope when the patient is walking.

The pt diagnosed with PD has been started on dopaminergic replacement drug therapy with carbidopa-levodopa, it is most important for the nurse to a. assess the patient for dizziness and syncope when the patient is walking b. administer the medication first thing in the morning c. administer the medication on an empty stomach d. omit protein from the patients diet

assess the patient for dizziness and syncope with the patient is walking

Which task is most appropriate for a nurse to delegate to unlicensed assistive personnel? Emptying a portable wound drainage device. Instructing a client to use an incentive spirometer. Monitoring the rate of infusion of intravenous fluids. Assessing the blood pressure of a client before physical therapy.

assessing the blood pressure of a client before physical therapy.

What should be the priority action of the nurse who is caring for a client with a leg in traction? Assessing the mobility Assessing the injured bone Assessing the skin integrity Assessing the muscle spasm

assessing the skin integrity

patient has a new order for COMT- for parkison's disease, what is one bonus to this type of medication for these type of patients?

associated with fewer wearing off effects

A patient has had an over dose of a cholinergic drug. The nurse expects to administer which drug as an antidote? A. Atenolol (Tenormin) B. Bethanechol (Urecholine) C. Dobutamine D. Atropine

atropine

a patient OD on Cholinergenic drugs, what is the antidote?

atropine

Which cognitive impairment occurs due to delirium? Attentiveness Concentration Thought process Abstract thinking

attentiveness

A client newly diagnosed with rheumatoid arthritis is admitted to the hospital with bilateral painful knee and wrist joints. The nurse identifies impaired physical mobility related to painful, swollen joints. What should the nurse teach the client to do during the acute phase of the disease? Avoid exercises to the involved joints Engage in passive exercises to the involved joints Increase isometric exercises to the involved joints slowly Participate in progressive, resistive exercises to the involved joints

avoid exercises to the involved joints

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? a. avoid foods in high purine b. encourage the pt to take in 1L of fluid daily c. consume one glass of red wine daily d. recommend that the pt eat 12-16 oz of food high in protein such as red meat

avoid foods high in purine

nurse is teaching about gout, what should she teach?

avoid purine, 2L of water

a patients recently underwent a total hip replacement and is on anticoagulants, what information is important to teach the patient?

avoid using a straight razor.

A 60-year-old woman asks the nurse about taking ginkgo biloba to help with her memory. The patient has a history of arthritis, type 2 diabetes, thyroid disease, and hypertension. She is currently taking NSAIDs for arthritis, oral antidiabetic medications, thyroid replacement hormone, and a beta blocker for blood pressure. What potential adverse effect from the ginkgo biloba would be of most concern for this patient? A. Stomach upset B. Diarrhea C. Bleeding D. Drowsiness

bleeding

A 60-year-old woman asks the nurse about taking ginkgo biloba to help with her memory. The patient has a history of arthritis, type 2 diabetes, thyroid disease, and hypertension. She is currently taking NSAIDs for arthritis, oral antidiabetic medications, thyroid replacement hormone, and a beta blocker for blood pressure. What potential adverse effect from the ginkgo biloba would be of most concern for this patient? a. Stomach upset b. diarrhea c. bleeding d. drowsiness

bleeding

A client with a diagnosis of dementia of the Alzheimer type has been taking donepezil (Aricept) 10 mg/day for 3 months. The client's partner calls the clinic and reports, "He's gotten more restless and agitated, and now he's nauseated." What should the nurse advise the partner to do? Give the medication with food Administer the medication to the partner at bedtime Omit one dose today and start with a lower dose tomorrow Bring the partner to the clinic for testing and a physical examination

bring the partner to the clinic for testing and a physical examination

An older client with the diagnosis of dementia, Alzheimer type, is admitted to a nursing home. The client is confused and forgetful, wanders, and has intermittent episodes of urinary incontinence. How should the nurse plan to meet this client's elimination needs? By pointing out the behavior to the client By obtaining incontinence pads for the client By taking the client to the bathroom at regular intervals By encouraging the client to call for help when there is an urge to urinate

by taking the client to the bathroom at regular intervals

The nurse is discussing care coordination with the patient, the patient asked the nurse to explain care coordination what is the nurses best response: Care coordination is cost effective Forces health care facilities to work together Exists for children and unishered in the community Care coordination allows health care services to work together in the community.

care coordination allows health care services to work together in the community.

Which of the following roles describes "having a wide variety of tools and selecting the right tools for the job, in order to build individualized plans of care"? a. Jester role b. Magician role c. Detective role d. Carpenter role

carpenter role

What is the priority nursing care in the immediate postoperative period for a toddler with a newly applied hip spica cast? Offering oral fluids Checking the toddler's peripheral circulation Encouraging independent incentive spirometer use Teaching how to use the overhead trapeze

checking the toddlers peripheral circulation

A 7-year-old child sustains a fractured femur in a bicycle accident. The admission x-ray films reveal evidence of fractures of other long bones in various stages of healing. What does the nurse suspect as the cause of the fracture? Child abuse Vitamin D deficiency Osteogenesis imperfecta Inadequate calcium intake

child abuse

Which risk factors are associated with the future development of osteoporosis in women? Select all that apply. Cigarette smoking Moderate exercise Use of street drugs Familial predisposition Inadequate intake of dietary calcium

cigarette smoking familial predisposition inadequate intake of dietary calcium

home health nurse conducts safety of environment, what two things should the nurse particularly look for?

clutter, carpet

A nurse is caring for a newly admitted client in a long-term care facility. The nurse notes that the client has a decreased attention span and cannot concentrate. The nurse suspects which effects of sensory deprivation? Cognitive response Emotional response Perceptual response Physical response

cognitive response

Nursing instructors are talking to students about care coordination the nursing instructor stresses the following to the students concerning care coordination? Pt must ask for what they need The nurse does most of the work Medical diagnosis is an integral part of care coordination Collaboration is a significant part of care coordination.

collaboration is a significant part of care coordination.

S&S of a pt who is diagnosed with OP

common in females post menopause, decrease in bone density, passive ROM can prevent loss of range of motion.

aspect of safety culture include what component:

communication

A client is to receive donepezil for treatment of dementia of the Alzheimer type. The nurse sits down with the primary caregiver and the client and reviews the purpose of the drug, its dosage, and the usual side effects. What side effect identified by the caregiver leads the nurse to conclude that further teaching is needed? Nausea Dizziness Headache Constipation

constipation

Carvadopa/Levodopa is an antiparkison medication. the nurse needs to warn about what side effect?

constipation, hypotension, unrinary retention

The nurse is preparing discharge instructions for a client who has begun to demonstrate signs of early Alzheimer's dementia. The client lives alone. The client's adult children live nearby. According to the prescribed medication regimen the client is to take medications six times throughout the day. What is the priority nursing intervention to assist the client with compliance of the medication regimen? Contact the client's children and ask them to hire a private duty aide who will provide round-the-clock care. Develop a chart for the client, listing the times the medication should be taken. Contact the primary healthcare provider and discuss the possibility of simplifying the medication regimen. Instruct the client and client's children to put medications in a weekly pill organizer.

contact the primary healthcare provider and discuss the possibility of simplifying the medication regmin.

The six C's approach to the need of dying include all of the following expect? Continuity Composure Confidence Control

control

An older widow with lung cancer is now in the terminal stage of her illness. Her family is puzzled by her mood changes and apparent anger at them. The nurse explains to the family that the client is doing what? Trying to avoid her situation Coping with her impending death Attempting to reduce family dependence on her Hurting because the family will not take her home to die

coping with her impending death

nurse interviews in a patients in outpt clinical ID's risk for OP:

corticosteroids

What is the priority nursing care for a client with delirium? Providing a body massage Arranging for music therapy Teaching relaxation techniques Creating a calm and safe environment

creating a calm and safe environment

The nurse is caring for a client with dementia whose expression of emotions is altered. Which behavior is unexpected with this client? Lability Passivity Curiosity Withdrawal

curiosity

a patient is taking Entacope, and complains of dark urine. what should the nurse inform the patient about this complaint.

dark urine is a side effect (cotamen)

The lack of weight bearing leads to what effects on skeletal system a. Demineralization, calcium loss b. Thickened bones c. Increased range of motion d. Increased calcium deposition in the bones

demineralization, calcium loss

A client who recently was told by her practitioner that she has extensive terminal metastatic carcinoma of the breast tells the nurse that she believes an error has been made. She states that she does not have breast cancer, and she is not going to die. The nurse determines that the client is experiencing which stage of death and dying? Anger Denial Bargaining Acceptance

denial

Medical models coordinate medical services and were traditionally designed to fulfill what function? Be patient-specific Nursing oriented Diagnostic specific Communitive oriented

diagnostic specific

A client says to the nurse, "The federal guards were sent to kill me." Which is the best response by the nurse to the client's concern? I don't believe this is true The guards are not out to kill you Do you feel afraid that people are trying to hurt you What makes you think the guards were sent to hurt you

do you feel afraid that people are trying to hurt you

which precaution will minimize fraud?

don't allows sales in home, never provide info on phone, contact local medicare/medicaid as needed

A client returns from surgery after a total hip arthroplasty. A pillow to maintain abduction is in place. Under what conditions should the nurse remove this pillow? During the client's bed bath When the client is sitting in a chair When the client needs a change of position Once the client's operative pain has ceased

during a clients bed bath

The nurse is assessing a patient who has been taking a cholinergic drug for 3 days. The patient has flushed skin and orthostatic blood pressure changes and is complaining of abdominal cramps and nausea. The nurse recognizes that the patient is most likely experiencing a. early signs of a cholinergic crisis. b. late signs of a cholinergic crisis. c. an allergic reaction to the drug. d. expected adverse effects.

early signs of a cholinergic crisis

A nurse involves a dying client's family members in the provision of palliative care to the client. Which action by the nurse in the provision of care needs correction? Listening to family members' complaints about the client's care Supporting the act of shared grieving by the client and the family Allowing family members to help with as much or as little client care as they desire Encouraging family members to avoid conducting conversations about family activities or problems

encouraging family members to avoid conducting conversations about family activities or problems.

A client with advanced bone cancer is experiencing cachexia. The nurse discusses the nutritional aspect of palliative care with the family. What is the importance of the nurse explaining these nutritional interventions to the family? Enhances the quality of the client's life Reduces the likelihood of a respiratory infection Prevents the malabsorption syndrome from occurring Cures the cachexia that results from bone cancer and chemotherapy

enhances the quality of the clients life

A nurse is caring for a patient with diagnosis of delirium. Which of the following is an expected assessment finding for this patient? A. Normal attention span B. Fluctuation in symptoms C. Normal sleep cycle D. Increased appetite

fluctuation in symptoms

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

following a diet with adequate amounts of calcium and vitamin d

A cholinergic drug is prescribed for a patient. The nurse checks the patient's medical history, knowing that this drug is contraindicated in which disorders? (Select all that apply). A. Bladder atony B. Gastrointestinal obstruction C. Bradycardia D. Alzheimer's disease E. Hypotension F. Chronic obstructive pulmonary disease

gastrointestinal obstruction bradycardia alzheimers disease hypotension

what causes changes in mobility?

growth and development

A school-age child with a fracture of the femur near the epiphyseal plate is admitted to the hospital. The parents ask if there will be any aftereffects when the bone heals. Before responding, what should the nurse consider? Growth of that leg may be affected. Risk for infection at this location is increased. Fracture repair will necessitate prolonged traction. Long bones contain marrow, which increases the risk for anemia.

growth of that leg may be affected

why might a patient receive an antiparkison medication?

have a difficulty preforming voluntary movements

The student nurses are being questioned by the nursing instructor about the health care coordination system, the instructor known the students understand health care delivery when making which statement: Health care is available for everyone every time Health care need is best met with a collaborative effort Health care is meeting the need of the homeless population Health needs are mostly in 3rd world

health care need is best met with a collaborative effort.

A mildly elevated core temperature, being cool and clammy, altered mental status, and thirst are signs of: a.heat fatigue. b.heat stroke. c.heat exhaustion. d.heat sensitivity.

heat exhaustion

When a client is admitted to an inpatient mental health unit with the diagnosis of anorexia nervosa, a cognitive behavioral approach is used as part of the treatment plan. The nurse plans care based on which purpose of this approach? Providing a supportive environment Examining intrapsychic conflicts and past issues Emphasizing social interaction with clients who withdraw Helping the client to examine dysfunctional thoughts and beliefs

helping the client to examine dysfunctional thoughts and beliefs

A group of older women in an assisted living facility are talking about one of the residents who fell and fractured her hip. The women ask a nurse the following: "It seems like so many of us fall and break our hips, and then it is downhill from there. Is this really true?" In formulating a response, the nurse considers which of the following? (Select all that apply.) a. hip fractures are a leading cause of hospitalization for older people b. the major cause of hip fractures is falls c. women have a significantly higher mortality rate from hip fractures than men d. nearly all older pt who sustain a hip fracture will regain prefracture mobility within 1 year e. hip fractures are associated with very high morbidity and mortality

hip fractures are a leading cause of hospitalization for older people the major cause of hip fractures is falls hip fractures are associated with very high morbidity and mortality

A nurse is completing the health history of a client admitted to the hospital with osteoarthritis. The nurse expects the client to report that which joints were involved initially? Select all that apply. Hips Knees Ankles Shoulders Metacarpals

hips knees

Where do most people die? Nursing home Hospital Skilled care facility Home

home

When planning the discharge of a client with chronic anxiety, the nurse directs the goals at promoting a safe environment at home. Which is the most appropriate maintenance goal? Suppressing feelings of anxiety Identifying anxiety-producing situations Continuing contact with a crisis counselor Eliminating all anxiety from daily situations

identifying anxiety-producing situations

nurse is teaching drug therapy for treatment of alzheimers, donezpril/aricept. what should the nurse that the medication will do what?

improve mood and confusion

nurse is planning education at a senior center out patient to prevent osteoporosis, what should they implement?

increase vitamin D and calcium

An older adult who is cognitively impaired is admitted to the hospital with pneumonia. Which sign or symptom would the nurse expect to be exhibited by the patient? A. Severe headache B. Flank pain C. Increased confusion D. Decreased blood glucose

increased confusion

cognitive impairment related to PNA. what is likely to be a key indicator?

increased confusion

A client is admitted to the hospital for an acute episode of rheumatoid arthritis. During the initial assessment, the nurse observes that the client's finger joints are swollen. To what does the nurse most likely attribute this swelling? Urate crystals in the synovial tissue Inflammation in the joint's synovial lining Formation of bony spurs on the joint surfaces Erosion of cartilage that lines the inside of joints

inflammation in the joints synovial lining

The nurse is working with a client who despite making a heroic effort was unable to rescue a neighbor trapped in a house fire. Which client-focused action should the nurse engage in during the working phase of the nurse-client relationship? Exploring the client's ability to function Exploring the client's potential for self-harm Inquiring about the client's perception or appraisal of why the rescue was unsuccessful Inquiring about and examining the client's feelings for any that may block adaptive coping

inquiring about and examining the clients feelings for any that may block adaptive coping

inquiring about and examining the clients feelings for any that may block coping

A thin older adult client is found to have osteoporosis. What should the nurse include in the discharge plan for this client? Encouragement of gradual weight gain Monitoring for decreased urine calcium Instructions relative to diet and exercise Safety factors in the use of opioids and nonsteroidal anti-inflammatory drugs

instructions relative to diet and exercise

What is the most prominent goal of palliative care? integrate into chronic disease management sooner rather than later Enroll the pt into Medicare hospice benefit Ensure pt has a 6-month prognosis. (HOSPICE) Reserve this type of care until pt is actually dying

integrate into chronic disease management sooner rather than later.

When having a conversation with a nurse, an older client states, "I've lived a good life. I don't want to die, but I accept it as a part of life." What developmental stage, according to Erikson, has the client completed? Integrity Identity Acceptance Generativity

integrity

which of the following best describes perception?

interruption of environment

Chorea

irregular, spasmodic, involuntary movements of the limbs or facial muscles

A pt diagnosed with osteoporosis. Which statement should the nurse include when teaching the client about the disease (select all that apply) a. is common in females after menopause b. is a degenerative disease characterized by a decrease in bone density c. is congenital, caused by poor dietary intake of dairy products d. can cause pain and injury e. passive ROM can prevent osteoporosis

is common in females after menopauses is a degenerative disease characterized by a decrease in bone density can cause pain and injury

A nurse is writing a teaching plan about osteoporosis. How should the nurse explain what osteoporosis is? It is avascular necrosis. It is caused by pathologic fractures. It is hyperplasia of osteoblasts. It involves a decrease in bone substance.

it involved a decrease in bone substance.

When answering questions from the family of a client with Alzheimer disease the nurse explains what about the disease? It emerges in the fourth decade of life It is a slow, relentless deterioration of the mind It is functional in origin and occurs in the later years It is diagnosed through laboratory and psychological tests

it is a slow, relentless deterioration of the mind

An older client with the diagnosis of dementia of the Alzheimer type is admitted to a long-term care facility. When planning care for this client, the nurse recalls what about confusion? It occurs with a transfer to new surroundings It will be unchanged despite reality orientation It is a common finding and is expected with aging It results from brain changes that make interventions futile

it occurs with a transfer to new surroundings

A nurse is planning to teach the four-point alternate crutch gait to a 9-year-old child with cerebral palsy. The nurse teaches the parents that this gait was chosen because of what? The child has minimal step ability in the lower extremities It provides for two points of support on the floor at all times It provides for equal but partial weight bearing on each limb The child has more power in the upper extremities than in the lower extremities

it provides for equal but partial weight bearing on each limb.

what intervention should you implement for a cognitive impairment for a patient with sun downers?

leave a night light on

A cognitively impaired patient newly admitted to the hospital is experiencing signs of sundown syndrome. Which intervention is best for the nurse to implement? A. Leave a night light on in the room at all times. B. Leave the television on at night with the volume up. C. Restrain the patient to maintain safety during the confusion. D. Administer a sleeping medication to help the patient sleep.

leave a night light on in the room at all times

A client is admitted to the hospital with the diagnosis of Parkinson disease. What medication should the nurse expect the health care provider to prescribe to relieve the client's physiological responses to this disease? Levodopa Isocarboxazid Dopamine Pyridoxine

levodopa

The nurse is teaching breathing exercises to a client who underwent surgery. Which member of the healthcare team is most suitable for reinforcement of teaching in the client? Certified technician Case manager Cross-trained technician Licensed vocational nurse (LVN)

licensed vocational nurse (LVN)

A 65-year-old client is depressed and has dementia. Which health-care facility would be most beneficial for the client? Respite-care facility Hospice-care facility Palliative-care facility Long-term care facility

long-term care facility

A client with dementia has been cared for by the spouse for 5 years. During the last month, the client has become agitated and aggressive and is incontinent of urine and feces. Which is the priority while this client is in an inpatient mental health facility? Managing the behavior Preventing further deterioration Focusing on the needs of the spouse Establishing an elimination retraining program

managing the behavior

What is the priority nursing intervention for a forgetful, disoriented client with the diagnosis of dementia of the Alzheimer type? Restricting gross motor activity Preventing further deterioration Keeping the client oriented to time Managing the client's unsafe behaviors

managing the clients unsafe behaviors

a patient is on an Antiparkison, overtime the s&s are returning. what is the possible reason for this occurrence?

medication begins to lose effect

A client is participating in a therapy group and focuses on viewing all team members as equally important in helping the clients to meet their goals. The nurse is implementing which therapeutic approach? Milieu therapy Interpersonal therapy Behavior modification Support group therapy

milieu therapy

The plan of care for a client with osteoporosis includes active and passive exercises, calcium supplements, and daily vitamins. How does the nurse determine whether the desired effect of therapy has been achieved? Mobility increases Fewer muscle spasms occur The heartbeat is more regular There are fewer bruises than before therapy

mobility increases

What is the priority of nursing care for an infant with a newly applied spica cast? Giving the child oral fluids Monitoring the child's peripheral circulation Encouraging the child to take deep breaths Teaching the child how to use the overhead trapeze

monitor the childs peripheral circulation

Nurses work to serve the population, and they know that which priority population needs to be served by care coordination? most vulnerable and the frail Uninsured and young Uninsured and old Whole population

most vulnerable and the frail

A nurse has provided discharge instructions to a client who received a prescription for a walker to use for assistance with ambulation. The nurse determines that the teaching has been effective when the client does what? Picks up the walker and carries it for short distances. Uses the walker only when someone else is present. Moves the walker no more than 12 inches ahead during use. States that a walker will be purchased on the way home from the hospital.

moves the walker no more than 12 inches ahead during use.

A nurse notes the weights attached to a 7-year-old child in traction are touching the floor. What action should the nurse take? Raising the foot of the bed Lengthening the traction rope Notifying the health care provider Moving the child toward the head of the bed

moving the child toward the head of the bed

A client is admitted to the hospital with a diagnosis of Parkinson disease. Which common signs of Parkinson disease does the nurse expect to identify when completing a nursing admission history and physical? Select all that apply. Muscle rigidity Blank facial expression Leaning toward the affected side Intention tremors with movement Hyperextension of the affected extremity

muscle rigidity blank facial expression

A client is diagnosed with terminal pancreatic cancer and is not expected to live much longer. Which of the following health-care organizations is most concerned with the type of facility this client might seek? World Health Organization American Hospital Association Health maintenance organization National Hospice and Palliative Care Organization

national hospice and palliative care orangization

Which is a clinical manifestation of osteoarthritis? Inflammation of the joints Pain and stiffness of the joints Tophi around the rim of the ear Generalized achiness in the lower back

pain and stiffness of the joints

82 year old patient has taken pain medications before bed. patient wakes up from sleep, the nurse reorients. what is the possible cause of the disorientation?

pain medications

An 82-year old patient who is in the hospital awakens from sleep and is disoriented to where she is at the present time. The nurse reorients the patient to her surroundings and helps the patient return to sleep. What data does the nurse consider as a probable cause of the patient's confusion? A. Pain medication received earlier in the night. B. The death of the patient's spouse 2 years ago. C. The patient's history of diabetes. D. The age of the patient.

pain medications recieved earlier in the night

Today most patients are living for several years before dying with multiple chronic conditions such as; COPD, CHF, Diabetes, Obesity. These diseases contribute to multiple symptoms that interfere with patients quality of life, what type of care would you consider for this patient? Palliative Care Supportive Comfort

palliative care

A client with chronic lung disease visited the clinic for a regular check-up. On assessment, the primary health-care provider determined that the client was in the terminal stage of the disease. Which type of health-care facility would provide the most appropriate care or services to the client at this time? Respite-care facility Hospice-care facility Curative-care facility Palliative-care facility

palliative-care facility

9. An 88-year-old woman is admitted to the hospital with a diagnosis of pneumonia. She has a history of hypertension and congestive heart failure and is on a total of five different medications for these chronic conditions. The nurse caring for the woman develops a care plan that includes the diagnosis "Risk for falls." A priority nursing intervention for this client is to: a. perform a fall assessment b. keep all of side rails up on pt bed at night time c. place client on bed rest so do not fall d. assess client for dietary intake for calcium adequacy

perform a fall assessment

When considering the trajectory a of specific disease what is the most important concept? Hospital admission Physical functioning Quality of life Symptom management.

physical functioning

The nurse is developing a care plan for a patient newly admitted to a unit that cares for patients with cognitive impairment. What is an important component of care for the patients on this unit? Allow food selections from a menu with several choices Schedule frequent field trips off the unit for cognitive stimulation. Plan for attendance at activities with several other patients on the unit. Plan for a structured daily routine of events and caregivers.

plan for a structures daily routine of events and caregivers

An older depressed person at an independent living facility constantly complains about her health problems to anyone who will listen. One day the client says, "I'm not going to any more activities. All these old crabby people do is talk about their problems." What defense mechanism does the nurse conclude that the client is using? Projection Introjection Somatization Rationalization

projection

A nurse is assessing a client for the potential for osteoporosis. Which factor in the client's history increases the risk for this disorder? Estrogen therapy Hypoparathyroidism Prolonged immobility Excessive calcium intake

prolonged immobility

what action by pre-op nursing staff is the most important in preventing infection?

prophylactic antibiotic

What is the most appropriate nursing intervention for clients who exhibit mild cognitive impairment? Reality orientation Behavioral confrontation Reflective communication Reminiscence group therapy

reality orientation

A 54-year-old client has demonstrated increasing forgetfulness, irritability, and antisocial behavior. After being found walking down a street, disoriented and seminaked, the client is admitted to the hospital, and a diagnosis of dementia of the Alzheimer type is made. The client expresses fear and anxiety. What is the best approach for the nurse to take? Exploring the reasons for the client's concerns Reassuring the client with the frequent presence of staff Initiating the program of planned interaction and activity Explaining the purpose of the unit and why admission was necessary

reassuring the client with the frequent presence of staff

Which information from the client's history does the nurse identify as a risk factor for developing osteoporosis? Receives long-term steroid therapy Has a history of hypoparathyroidism Engages in strenuous physical activity Consumes high doses of the hormone estrogen

receives long-term steroid therapy

A client with rheumatoid arthritis asks the nurse why it is necessary to inject hydrocortisone into the knee joint. What reason should the nurse include in a response to this question? Lubricates the joint Reduces inflammation Provides physiotherapy Prevents ankylosis of the joint

reduces inflammation

The health care provider prescribes donepezil (Aricept) 5 mg by mouth once a day for a client exhibiting initial signs of dementia of the Alzheimer type. The client is already taking digoxin (Lanoxin) 0.125 mg in the morning and alprazolam (Xanax) 0.5 mg twice a day. What should the nurse teach the client's spouse to do? Hang a list of medications with the times at which the spouse should take them Prefill a weekly drug box with the medications for the spouse to self-administer Remind the spouse in the morning which medications must be taken during the day Provide the spouse with the medications at the appropriate times they should be taken

refill a weekly drug box with the medications for the spouse to self-administer

The rehabilitation team is caring for an older adult client, who is completely immobile, with a history of knee replacement. Which member of the team reinforces education about the processes of rehabilitation provided to the client and family members? Physical therapist Rehabilitation registered nurse Vocational rehabilitation counselor Rehabilitation licensed practical nurse/licensed registered nurse

rehabilitation licensed practical nurse/licensed registered nurse

A client is diagnosed with Parkinson disease and receives a prescription for levodopa therapy. The nurse concludes that the medication is appropriate for this client because it does what? Blocks the effects of acetylcholine Increases the production of dopamine Restores the dopamine levels in the brain Promotes the production of acetylcholine

restores the dopamine levels in the brain

What should a nurse who is caring for a hospitalized older client with dementia consider before planning care? Physical contact will increase dependency needs. Routines provide stability for clients with dementia. Regressive behavior should be interrupted immediately. Procedures do not have to be explained to clients with dementia.

routine provide stability for clients with dementia

An older client with dementia of the Alzheimer's type is residing in a nursing home. When in bed, the client consistently is found sleeping in the semi-Fowler position. What area of the client's body does the nurse determine is at the greatest risk for developing a pressure ulcer? Sacrum Scapulae Ischial spine Greater trochanter

sacrum

Six critical components of safety

situational awareness, problem identification, decision making by generating alternative acceptable solutions, appropriate workload distribution, time management, conflict resolution.

For children and adolescents which model included school-based services: Integrated Nurse oriented Social Medically oriented

social

During the first month in a nursing home, an older client with dementia demonstrates numerous disruptive behaviors related to disorientation and cognitive impairment. What should the nurse take into consideration when planning care? Client's orientation to time, place, and person Ability to perform daily activities without assistance from others Stressors that appear to precipitate the client's disruptive behavior Cognitive impairments will increase until adjustment to the home is accomplished

stressors that appear to precipitate the client's disruptive behavior

A client who was involved in a car accident was admitted to the hospital. After the client received immediate care, the primary health-care provider suggested the client receive intensive dietary and rehabilitative care. Which facility is most appropriate for this client? Hospice care Palliative care Subacute care Long-term care

subacute care

A 13-year-old adolescent is diagnosed with idiopathic scoliosis. Because exercise and avoidance of fatigue are essential components of care, which sport should the nurse suggest as the most therapeutic for this preadolescent? Golf Bowling Swimming Badminton

swimming

The nurse considers that a 70-year-old female can best limit further progression of osteoporosis by doing what? Taking supplemental calcium and vitamin D Increasing the consumption of eggs and cheese Taking supplemental magnesium and vitamin E Increasing the consumption of milk and milk products

taking supplemental calcium and vitamin D

After several weeks of caring for clients who are in the terminal stage of illness, the nurse becomes aware of feeling depressed when coming to work. What should the nurse do? Talk with other nurses on the unit. Take several personal days off from work. Limit emotional involvement with the clients. Request a transfer to another area of the hospital.

talk with other nurses on the unit.

The nurse is caring for an elderly client who has kyphotic posture with a widened gait. Which nursing interventions help reduce the severity of the client's condition? Select all that apply. Teaching isometric exercises Teaching safety tips to prevent falls Teaching proper body mechanics Preventing pressure on bony prominences Instructing the client to sit in supportive chairs with arms

teaching proper body mechanics instructing the client to sit in supportive chairs with arms

The patient has now been ordered an orally disintegrating form of the MAO-B inhibitor drug selegiline. When administering the drug, the nurse should A. tell the patient to take the medication with liquids. B. tell the patient to take the medication with a meal. C. assess the patient for hypertension, a common side effect of this medication. D. tell the patient to place oral disintegrating dosage forms on the tongue and do not swallow dosage form until it is completely melted.

tell the patient to place oral disintegrating dosage forms on the tongue and do not swallow dosage form until it is completely melted

The patient has now been ordered an oral disintegrating form of the MAO-B inhibitor drug selegiline. When adminstering the drug, the nurse should a. tell the patient to take the medication with liquids b. tell the patient to take the medication with a meal. c. assess the patient for hypertension, a common side effect of this medication d. tell the patient to place oral disintegrating dosage

tell the patient to place oral disintegrating dosage forms on the tongue, and do not swallow dosage form until it is completely melted.

What is the most appropriate nursing action to help manage a manic client who is monopolizing a group therapy session? Ask the client to leave the group for this session only. Refer the client to another group that includes other manic clients Tell the client to stop monopolizing in a firm but compassionate manner. Thank the client for the input, but inform the client that others now need a chance to contribute.

thank the client for the input, but inform the client that others now need a chance to contribute

What is the most appropriate nursing action to help manage a manic client who is monopolizing a group therapy session? Ask the client to leave the group for this session only Refer the client to another group that includes other manic clients Tell the client to stop monopolizing in a firm but compassionate manner Thank the client for the input, but inform the client that others now need a chance to contribute.

thank the client for the input, but inform the client that others now need a change to contribute.

A client with dementia is admitted with a fractured hip following a fall at home. The client's family member witnessed the fall. Four hours after admission, the client's blood pressure increases to a moderately severe hypertensive level. The client pulls on the bedclothes continuously. The client's family member asks for pain medication for the client. What does the nurse conclude? The client has the need to go to the bathroom The client may be in pain and unable to respond appropriately The family member may be trying to keep the client overmedicated The family member feels guilty about the fall and wants to keep the client pain free

the client mat be in pain and unable to respond appropriately

An emaciated older adult with dementia develops a large pressure ulcer after refusing to change position for extended periods of time. The family blames the nurses for the client's condition. What is considered when determining the source of blame for the pressure ulcer? The client should have been turned regularly. Older clients frequently develop pressure ulcers. The nurse is not responsible to the client's family. Nurses should respect a client's right not to be moved.

the client should be turned regularly

An 89-year-old client with osteoporosis is admitted to the hospital with a compression fracture of the spine. What factor of special concern will the nurse identify when caring for this client? The client's irritability in response to deprivation The client's inecreased ability to recall recent facts The client's inability to maintain an optimal level of functioning The client's gradual memory loss resulting from change in environment

the clients inability to maintain an optimal level of functioning

Which of the following best describes perception? A focus on a par\icular area of conscious thought The ability to recall past learning The interpretation of the environment Higher thinking processes allowing for adaptability

the interpretation of the environment

What is one of the biggest challenges facing current nursing practice? The number of aging Americans living with chronic diseases. The number of patients entering into hospice care The number of cancer patients receiving supportive care. Reduced length of stay in hospitals.

the number of aging Americans living with chronic diseases.

family of patient with Alzheimer's asks about a new drug called Donezpril/Aricept, what should the nurse tell the family about these drugs?

these drugs do not cure Alzheimer's

A nurse reminds a client that it is time for group therapy. The client responds by shouting, "You're always telling me what to do, just like my father!" What defense mechanism is the client using? Regression Transference Reaction formation Cognitive distortion

transference

A client diagnosed with delirium becomes disoriented and confused at night. Which intervention should the nurse implement initially? Move the client next to the nurses' station Use an indirect light source and turn off the television Keep the television and a soft light on during the night Play soft music during the night, and maintain a well-lit room

use an indirect light source and turn off the television

The "off-on the phenomenon" that some patients with PD experience is best explained as the: A.need to take a drug holiday to improve response to medications. B.variable response to levodopa, resulting in periods of good control and periods of poor control of PD symptoms. C.alternating schedule of medications needed to control PD. D.fluctuation of emotions that often occurs with PD.

variable response to levodopa, resulting in periods of good control and periods of poor control of PD symptoms.

A child with recently diagnosed idiopathic scoliosis has a mild structural curve. The child's mother asks whether the problem can be corrected with exercise. What should the nurse tell the mother concerning an exercise program? Exercise is used in conjunction with a brace. Exercise can be used if the child appears highly motivated. Exercise might exaggerate the curvature if the curve is severe. Exercise is needed to correct the curvature without the need for a brace.

exercise is used in conjunction with a brace

Gout affects approximately how many people in the US

6.1 million

Hypothermia is defined as having a core body temperature (° F) of less than: a.97.5 b.95.0 c.93.2 d.90.5

95.0

Mobility

A state or quality of being mobile or movable.

Carbidopa

Adjunct to treat nausea associated with sinement

Which group is at greatest risk for developing AD? a.African American b.Hispanic c.White (Caucasian) d.Asian American/Native Hawaiian

African American

What are the most common comorbidities of RA

Cardiovascular disease, TB (1/4 of RA patients), depression, anxiety, and lymphoproliferative malignancies

Immobilization examples

Casts Splints Braces Traction Slings Shoulder immobilizers Pillows

MAOIs break down what in the CNS mainly in the brain

Catecholamines

Etiology of OA

Caused by a combination of mechanical forces and molecular events in the affected joints

Cartilage, Ligaments and tendons

Cellular cross-linkage affected what

Two common types of dyskinesia

Chorea and dystonia

Which precaution would be beneficial in minimizing an older adult's risk of being a victim of fraud? (Select all that apply.) A. Do not allow uninvited salespersons into your home. B. Never provide personal information to telephone sales solicitors C. Rely on the advice of people who only friends have recommended. D. Contact the local Medicare or Medicaid service office for information when needed.

Do not allow uninvited salespersons into your home. Never provide personal information to telephone sales solicitors.Contact the local Medicare or Medicaid service office for information when needed.

An older adult is referred to geriatric nurse practitioner because of changes in memory and reports by family members that "there is something different about her." The nurse practitioner evaluates the older adult for potentially reversible causes for the changes, which include: (Select all that apply.) A. depression B. delirium C. osteoporosis D. rheumatoid arthritis E. medication side effects

Depression Delirium Medication side effects

Subluxation, joint instability and crepitus are all indicators of what

Deterioration of the synovial covering of the joints

What other autoimmune disease had PTPN22 been associated with

Diabetes

The interprofessional core team includes members from which disciplines? A. Nursing, medicine, volunteers, nutrition B. Medicine, nursing, social work, clergy. C. Medicine, nursing, physical therapy, volunteer. D. Nursing home health volunteer clergy.

Medicine, nursing, social work, clergy.

Who is usually affected by gout

Men between the ages of 40 and 50

Bone loss declines rapidly in women after what

Menopause

What can younger patients be taught to use for gait assistance

Crutches

Assistive devices

Crutches Canes Walkers Wheelchairs Prosthesis

Surgical interventions examples

Curative Palliative

Other factors that can cause gout

Excessive alcohol consumption, lead toxicity, high purine diet

Most common sites for fractures are

Hips, vertebra, wrist and pevlis

Anticholinergics

do not take at the same time as other meds

Kyphosis in the older adult can be a result of which of the following a. osteoarthritis b. RA c. Osteoporosis d. Gout

osteoporosis

Which musculoskeletal condition occurs in part as a result of deficiencies in vitamin D and calcium? Osteoporosis Osteoarthritis Ankylosing spondylitis Fibromyalgia syndrome

osteoporosis

kyphosis is related to:

osteoporosis

What disease is considered a systemic inflammatory autoimmune disorder? a.OP b.Gout c.RA d.OA

rheumatoid arthritis

nurse develops a care plan for cognitive impairment. what would this care plan include?

structure daily routine, regular care givers

A client experiencing disturbed thought processes believes that his food is being poisoned. Which communication technique should the nurse use to encourage the client to eat? Using open-ended questions and silence Sharing personal preference regarding food choices Documenting reasons why the client does not want to eat again Offering opinions about the necessity of adequate nutrition

use open-ended questions and silence

A client diagnosed with terminal cancer says to the nurse, "I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." Which response by the nurse is therapeutic? Have you shared your feelings with your family? I think we should talk more about your anger with your family You're feeling angry that your family continues to hope for you to be cured? You are probably very depressed, which is understandable with such a diagnosis

you're feeling angry that your family continues to hope for you to be cured?

The nurse visits a client at home. The client states, "I haven't slept at all the last couple of nights." Which response by the nurse demonstrates therapeutic communication? I see Really? You're having difficulty sleeping? Sometimes I have trouble sleeping too

you're having difficulty sleeping?

A client with a diagnosis of depression who has attempted suicide says to the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me." Which response by the nurse demonstrates therapeutic communication? You have everything to live for Why do you see yourself as a failure Feeling like this is all part of being depressed You've been feeling like a failure for a while

you've been feeling like a failure for a while

A client with a diagnosis of depression who has attempted suicide says to the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me." Which response by the nurse demonstrates therapeutic communication? "You have everything to live for." Why do you see yourself as a failure?" "Feeling like this is all part of being depressed." "You've been feeling like a failure for a while?"

" you've been feeling like a failure for a while."

While assessing an elderly client, a nurse infers cognitive impairment. Which statements made by the client confirm the nurse's conclusion? Select all that apply. "I have difficulty judging things." "I forget to take medicines." "I am unable to do financial calculations." "I get confused about the proper date and time." "I am unable to recall words during conversations with my family."

"I have difficulty judging things." "I am unable to do financial calculations." "I am unable to recall words during conversations with my family."

When does debilitation of PD usually occur

5-10 years after the start of levodopa therapy

What percentage of the bulk and strength of skeletal muscle declines each year after the age of 50

A nurse teaches a client about wearing thigh-high anti-embolism elastic stockings. What would be appropriate to include in the instructions? "You do not need to wear them while you are awake but it is important to wear them at night." "You will need to apply them in the morning before you lower your legs from the bed to the floor." "If they bother you, you can roll them down to your knees while you are resting or sitting down." "You can apply them either in the morning or at bedtime but only after the legs are lowered to the floor."

"You will need to apply them in the morning before you lower your legs from the bed to the floor."

sentinel event refers to what:

an event that results in death or serious injury

During hospitalization what percent of older adults develop delirium

11-42%

A patient is scheduled to have lunch at 1200. The nurse will administer the pyridostigmine (Mestinon) at what time for optimal therapeutic effect? A.1100 B.1130 C.1200 D.1230

1130

A patient is scheduled to have lunch at 1200. The nurse will administer the pyridostigmine (Mestinon) at what time for optimal therapeutic effect? a. 1100 b. 1130 c. 1200 d. 1230

1130

How far in advance must patients have necessary dental work done before surgery

2 weeks

what nursing care is used for TJA (total joint arthroplasty) to prevent VTE?

apply compression stockings or continuous compression device, use anticoagulants

a patients daughter is concerned with dad's driving, the nurse recommends what?

arrange for alternative transportation, hold a family meeting about the patients status.

nurse cares for joint replacement bandage, what technique is used?

aseptic technique

Treatment of early phase cholinergic crisis

Atropine, or cholinergic antagonist

How much percent of all people with gout have what

A genetic component

Hip fractures lead to a what

A high degree of morbidity and premature mortality

Epoetin alfa

A recombinant human erythropoietin, essential for developing RBCs. Especially useful in older adults who have mild anemia before surgery

Two components of THA

Acetabular and femoral

A nurse is taking the health history of a client who is to have surgery in one week. The nurse identifies that the client is taking ibuprofen for discomfort associated with osteoarthritis and notifies the healthcare provider. Which drug does the nurse expect will most likely be prescribed instead of the ibuprofen? Naproxen Aspirin Ketorolac Acetaminophen

Acetaminophen

Bromocriptine

Activates presynaptic dopamine receptors to stimulate the production of more dopamine Caution when using with pt who have PVD

Contraindications for total joint arthroplasty

Active infection anywhere in the body Advanced osteoporosis Rapidly progressive inflammation

What action by the perioperative nursing staff is most important to prevent surgical wound infection in a client having a total joint replacement? A. Administer preoperative antibiotic as ordered. B. Assess the client's white blood cell count. C. Instruct the client to shower the night before. D. Monitor the client's temperature postoperatively.

Administer preoperative antibiotic as ordered.

A patient with Alzheimer's disease accidentally took 2 weeks' worth of a cholinergic medication. He is brought to the emergency department, is going into shock, and experiencing severe hypotension and vomiting. The nurse will expect which initial treatment? a. Administration of physostigmine b. Administration of atropine c. Administration of epinephrine d. Cardiovascular support with dopamine

Administration of atropine

Which of the following factors places an individual at the greatest risk for cognitive impairment? A. Having a lower socioeconomic status B. Advancing age C. Lacking postsecondary education D. Belonging to a minority population

Advancing age

What group is at greatest risk for developing AD a. African American b. Hispanic C. White D. Asian American/ Native Hawaiian

African american

Biochemical changes

Age related deterioration in articular cartilage results from this

Risk factors for falls include a. OH b. Cognitive impairment c. Vision and hearing problems d. Foot deformities e. All of the above

All of the above

Spirituality is best described as: a.indescribable need that drives individuals throughout life to seek meaning and purpose in their existence. B. the spiritual aspect of people's lives transcends the physical and psychosocial to reach the deepest individual capacity for love, hope, and meaning. c.spirituality must be considered a significant factor to understanding healthy aging. d.all of the above.

All of the above.

A reinfusion system

Allows for collection of red blood cells from a joint drain over a specific time frame, which then can be reinfused directly back into the

A cell saver system

Allows for collection of the persons own red blood cells during surgery

Hip Resurfacing

Alternative to total hip replacement--instead of removing the femoral head and inserting the stem into the femoral canal the surgeon will remove the cartilage from the surface and metal cap is placed over the natural femoral head

Exercise therapy examples

Ambulation Joint mobility Stretching Balance

Growth and development

Best words that describe how mobility changes throughout the lifespan.

Tasmar and Comtan

Block COMT, prolong duraction of levodopa and reduce wearing off phenomenon

Aspects of safety culture that contribute to a culture of safety in a health care organization include which component? A. Communication B. Fear of punishment C. Malpractice implications D. Team nursing

Communication

Entacapone may do what to urine and sweat

Darken

When should the surgeon explain the procedure and postoperative care

During the office visit

The nurse is assessing a patient who has been taking a cholinergic drug for 3 days. The patient has flushed skin and orthostatic blood pressure changes and is complaining of abdominal cramps and nausea. The nurse recognizes that the patient is most likely experiencing A.early signs of a cholinergic crisis. B.late signs of a cholinergic crisis. C.an allergic reaction to the drug. D.expected adverse effects.

Early signs of a cholinergic crisis.

What would the doctor prescribe with or without iron to prevent anemia after hip or knee replacement

Epoetin alfa (Epogen, Procrit, Eprex)

What do joints feel like in RA

Erythematous, painful, and swollen morning stiffness lasts longer than 30 min compared with the few minutes seen in OA

The nurse is reviewing the use of bethanechol (Urecholine) in a patient who is experiencing postoperative urinary retention. Which statement best describes the mechanism of action bethanechol? A. It causes decreased bladder tone and motility. B. It causes increased bladder tone and motility. C. It increases the sensation of full bladder. D. It causes the sphincters in the bladder to become tighter.

It causes increased bladder tone and motility

Most typical spot for gout

Joint of the great toe, but can occur in ankle, knee, wrist, or elbow

Joints commonly affected in OA

Knees, hips, hands and spine

A nursing student is preparing a presentation on arthritis. The student knows that differences between OA and RA include that (Select all that apply) a. Both OA and RA have an acute onset in older adults b. OA is localized process, whereas RA may be systemic c. OA usually impacts distal interphalangeal joints; RA impacts proximal joints d. Initial treatment of both OA and RA is usually non pharmacological using heat or exercise

OA is localized process, whereas RA may be systemic OA usually impacts distal interphalangeal joints; RA impacts proximal joints

The most serious consequence is the morbidity and mortality from what kind of related fall

What affects 75 million people in the US, Europe, and Japan combined

What disease affects 75 million people in the United States, Europe, and Japan and may be associated with a fragility fracture? a.OP b.OA c.RA d.Gout

OP - osteoporosis

The most common musculoskeletal disorders are:

OP, OA, RA and Gout

Which nursing intervention is most helpful in meeting the needs of an older adult with the diagnosis of dementia of the Alzheimer type? Providing nutritious foods that are high in carbohydrates and protein Offering opportunities for choices in the daily schedule to stimulate interest Developing a consistent plan with a fixed time schedule to fulfill emotional needs Simplifying the environment as much as possible and eliminating the need for decisions and choices

Simplifying the environment as much as possible and eliminating the need for decisions and choices

What genetic factor plays a role in RA

Single nucleotide polymorphism (found with enzyme PTPN22)

Bone loss occurs what

Slowly

On review of the client's record, the nurse notes that the admission was voluntary. Based on this information, the nurse plans care anticipating which client behavior? Fearfulness regarding treatment measures Anger and aggressiveness directed toward others An understanding of the pathology and symptoms of the diagnosis A willingness to participate in the planning of the care and treatment plan

a willingness to participate in the planning of the care and treatment plan

On review of the client's record, the nurse notes that the admission was voluntary. Based on this information, the nurse plans care to anticipate which client behavior? Fearfulness regarding treatment measures Anger and aggressiveness directed toward others An understanding of the pathology and symptoms of the diagnosis A willingness to participate in the planning of the care and treatment plan

a willingness to participate in the planning of the care and treatment plan

A client, admitted to the hospital with a fractured hip, is scheduled for surgery for a total hip replacement. In which position should the nurse place the client's affected limb after surgery? Adduction and flexion Abduction and extension Adduction and internal rotation Abduction and external rotation

abduction and extension

Dystonia

abnormal muscle tone leading to impaired or abnormal movements

A client diagnosed with delirium becomes disoriented and confused at night. Which intervention should the nurse implement initially? Move the client next to the nurses' station Use an indirect light source and turn off the television. Keep the television and a soft light on during the night Play soft music during the night, and maintain a well-lit room.

use an indirect light source and turn off the television.

A client experiencing disturbed thought processes believes that his food is being poisoned. Which communication technique should the nurse use to encourage the client to eat? Using open-ended questions and silence Sharing personal preference regarding food choices Documenting reasons why the client does not want to eat Offering opinions about the necessity of adequate nutrition

Mental Health 4

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