NUR 424 final ch 9, 11, 16 prep u questions

Which is a true statement regarding pharmacologic aspects of aging?

Absorption may be affected by changes in gastric pH.

Which is also known as a proxy directive?

Durable power of attorney for health care

A nurse is conducting a spiritual assessment of a terminally ill client using the four step FICA process and asks the question, "What gives your life meaning?" The nurse is assessing which of the following?

Faith and belief

Which statement provides accurate information related to chronic illness?

Most people with chronic conditions do not consider themselves sick or ill.

As the moment of death approaches, which of the following does the nurse encourage the family to do?

Speak to the client in a calm and soothing voice.

An older adult female client tells the nurse, "I have lost an inch [2.5 cm] of height and have a hump on my back. What can I do about this?" What is the best response by the nurse?

"In order to prevent further bone loss, eat a diet high in calcium and low in phosphorus."

A patient's family member asks the nurse what the purpose of hospice is. What is the best response by the nurse?

"It will enable the patient to remain home if that is what is desired."

A mother of three young children has been diagnosed with stage III breast cancer and is distraught. Which statement best communicates a spirit of hopefulness to this client?

"Let's take this one day at a time; remember you have your daughter's dance recital next month."

An older adult develops sudden onset of confusion and is hospitalized. The family expresses concern that their loved one is developing Alzheimer disease. What response by the nurse is most appropriate?

"Several possible underlying factors could be causing the confusion. Alzheimer's usually does not present with sudden confusion."

While providing care to a terminally ill client, the client asks, "Am I dying?" Which response by the nurse would be most appropriate?

"Tell me some more about what is on your mind."

The family of a terminally ill client tells the nurse that the client has been breathing irregularly and, at times, it appears that he is not breathing at all. The client's daughter states, "He moans when he breathes. Is he in pain?" Which response by the nurse would be most appropriate?

"The moaning you hear is from air moving over very relaxed vocal cords."

A client reports to the nurse that her grandmother with Alzheimer's disease recently moved in with her and her two school-aged children. The client states the grandmother becomes agitated and starts yelling and crying frequently. The woman asks, "What can I do?" The nurse first responds:

"What precipitates the outbursts?"

A client who is obese and the nurse have established a goal for the client to achieve a weight loss of 1 pound each week. One month later, the nurse evaluates that the client has lost 2 pounds. The nurse first states

"You have succeeded in making positive progress."

According to federal guidelines, hospices may provide no more than what percentage of the aggregate annual patient-days at the inpatient level?

20

The nurse is planning community education on the prevalence and incidence of disabilities in the United States. The nurse includes that, according to the U.S. Census (2010), what percentage of people are diagnosed with a disability?

20%

An elderly female client who has dizziness and osteoporosis fell at home and fractured her hip. She underwent surgical intervention for repair of the fractured hip and is now being discharged to a subacute care facility. In the comeback phase of the Trajectory Model of Chronic Illness, the nurse

Acknowledges the client's achievement when she walks to the bedside commode with her walker

The client who has the chronic condition of diabetes, reports blurry vision, and admits to nonadherence to the diet and medications. The home health nurse checks the client's fasting blood glucose level, which is 412 mg/dL. What phase of the Trajectory Model of Chronic Illness does the nurse assess this client is in?

Acute

The nurse identifies a nursing diagnosis of Imbalanced nutrition: less than body requirements for a terminally ill client who is near the end of life. Which of the following would the nurse expect to include in the client's plan of care?

Advice for the family to have fruit juices readily available at the client's bedside.

A client with multiple sclerosis is being discharged. The nurse understands that living with chronic conditions imposes many challenges, including the need for which accomplishments? Select all that apply.

Alleviate and manage symptoms Validate individual self-worth Validate family functioning

The nurse is preparing an elderly hospitalized client for discharge to home within the hour. What should be the priority for the nurse?

Assess the need for pneumococcal and influenza vaccinations.

The nurse is teaching about preventing pneumonia and influenza to a group of clients in a senior citizens' wellness class. The nurse includes which of the following topics in the class? Select all options that apply.

Avoiding environmental smoke Participating in regular exercise Ensuring appropriate fluid intake

Which term refers to the period of time during which mourning of a loss takes place?

Bereavement

The nurse is working in a long-term care facility. When assessing her patients, what body system dysfunction should the nurse look for as the leading cause of morbidity and mortality in the older adult population?

Cardiovascular

Which statement is a misconception about chronic disease?

Chronic illnesses cannot be prevented.

A nurse is providing care to a client experiencing symptoms associated with terminal illness. Which of the following would be most appropriate to use as a means for managing the client's symptoms?

Client's goals

Which is a true statement regarding hospice care?

Clients have a life expectancy of 6 months or less.

Which phase of the Trajectory Model does the nurse recognize is present when the patient is in remission, after an exacerbation of illness?

Comeback

An elderly client reports fatigue without shortness of breath with walking 30 minutes five times each week. The nurse assesses the resting heart rate as 72 beats per minute; 10 minutes after walking, the client's heart rate is 92 beats per minute. What should the nurse instruct the client to do next?

Continue to walk at his current level.

A nurse is providing hospice care in Portland, Oregon to a client with terminal liver cancer. The client confides to the nurse, "I'm in agony all the time. I want this to be over now—please help me." Which interventions should the nurse implement? Select all that apply.

Control the client's pain with prescribed medication. Advise the client's health care provider of the client's condition. Encourage the client to explain his or her wishes.

A nurse is assessing an elderly client with senile dementia. Which neurotransmitter condition is most likely to contribute to this client's cognitive changes?

Decreased acetylcholine level

A client with Alzheimer disease becomes agitated while the nurse is attempting to take vital signs. What action by the nurse is most appropriate?

Distract the client with a familiar object or music.

A client has had multiple admissions for heart failure. The client is now on continuous oxygen, bedridden, and provided care by his family. The nurse discusses end-of-life preferences with the client. The nurse assesses the client is in the phase of the Trajectory Model of Chronic Illness known as

Downward

Which phase of the Trajectory Model of Chronic Illness is characterized by the gradual or rapid decline in the condition despite efforts to halt the disorder?

Downward

A nursing instructor is discussing the causes of the increasing number of people with chronic conditions. Which of the following would the nurse correctly identify as a cause?

Early detection and treatment of diseases

The family members of a dying patient are finding it difficult to verbalize feelings and show tenderness for the dying person. Which of the following nursing interventions should a nurse perform in such situations?

Encourage the family members to express their feelings and listen to them in their frank communication.

A nurse is teaching nursing assistants in an extended-care facility measures to protect the skin of elderly clients. Which of the following measures is the nurse likely to recommend?

Encouraging clients to avoid cigarette smoking

Which aspect of a healthy lifestyle can the nurse encourage a patient to improve that can significantly enhance quality of life with a chronic condition?

Exercise

The nurse is caring for a pediatric client who is dying. The best way to provide care and comfort to dying clients and their families is to first do which of the following?

Explore own feelings on mortality and death and dying.

Which term is used to describe the personal feelings that accompany an anticipated or actual loss?

Grief

A client who is legally blind had orthopedic surgery 3 days ago and wants to urinate. She is using a walker for ambulation. It would be best for the nurse to

Guide the client's hand to the armrest on the bedside commode prior to the client sitting on the commode.

A nurse is presenting a safety program to a group of older adults at a continuing care retirement community. The nurse emphasizes measures to reduce the risk of falls based on the understanding that which type of fracture is the most common?

Hip

A nurse is educating a group of middle-aged adults on aging. What information should the nurse include in the teaching?

How old you feel will be determined by your physical and cognitive abilities.

The client with blindness is hospitalized following a myocardial infarction. Which care measures would the nurse take with this client? Select all that apply.

Identify self when walking into the client's room. State when the nurse is leaving the room. Orient the client to the room using a clock reference.

Which is a cause related to the increasing number of people with chronic conditions?

Improved screening and diagnostic procedures

An elderly client exhibits blood pressure of 110/76 while prone, 100/72 sitting, and 92/64 standing. The nurse instructs the client to

Ingest five or six small meals each day.

An elderly female client has been taking prednisone for breathing problems for many years. The nurse notes that the client's current height is 64 inches. Two years ago, her height was 66 inches. The nurse assesses this loss in height is most likely the result of

Loss of bone density

Which of the following is a term that refers to individual, family, group, and cultural expressions of grief and associated behaviors?

Mourning

A nurse prepares a diabetes prevention health seminar for community residents. Her teaching points should emphasize the most important factor influencing metabolic syndrome (pre-diabetes). What is that factor?

Obesity

Why are IV solutions usually given at a slower rate to older adults?

Older adults may have cardiac or renal disorders.

A nurse is providing care to a terminally ill client who follows Islamic traditions and is experiencing pain. When developing a plan of care for this client, an understanding of which of the following would the nurse need to integrate into the plan?

Pain is viewed as a means of cleansing by God.

A 50-year-old client is an alcoholic. The client has been diagnosed with pancreatic cancer and underwent surgery to remove the tumor. Despite the tumor being removed, the physician informs the client that chemotherapy needs to be started immediately. Using evidence-based practice, which intervention might the nurse expect the physician to include, with the goal of improving quality of life, mood, and median survival.

Palliative care

The family of a client in hospice decides to place their loved one in a long-term care facility to establish an effective pain control regimen. Which aspects of hospice care is the family using?

Palliative care

An elderly client recovering from a hip repair becomes disoriented and tries to get out of bed frequently. The client states, "I forget I am in the hospital." The best nursing intervention is to

Post a sign stating "You are in the hospital" at the client's eye level.

Which is an age-related change associated with the nervous system?

Postural hypotension

Which action is included in a nurse's role when providing home care for a client with Alzheimer disease?

Provide emotional and physical support

Chronic conditions are most acutely experienced by clients and their immediate families. Nurses provide direct care especially during acute episodes. Which of the following is an example of what the nurse can do for a client with a chronic illness?

Provide teaching and secure resources and other support systems needed.

A client has been declared to have a terminal illness. What intervention will a nurse perform regarding the final decision of a dying client?

Respect the client's and family members' choices

A client is declared to have a terminal illness. What intervention will a nurse perform related to the final decision of a dying client?

Respect the client's and family members' choices.

A terminally ill client is receiving morphine around-the-clock for pain control. As part of the client's plan of care focusing on pain management, which nursing diagnosis would the nurse most likely identify?

Risk for constipation related to the effects of an opioid

Which of the following would be a characteristic of a chronic illness?

Slow, progressive decline

The nurse is with a client who has a chronic illness and is reinforcing positive behaviors and teaching about health promotion. For which phase of the trajectory model of chronic illness are these nursing actions appropriate?

Stable

Which of the following does not coincide with Kübler-Ross's stages related to a dying client?

The dying client usually exhibits anger first.

A nurse cares for a client with a chronic illness who has a diagnostic workup for the illness and announces the diagnosis to friends and family. According to the Trajectory Model of Chronic Illness, what phase is the client displaying?

Trajectory onset

In spite of administering the prescribed pain medication, a dying client is still experiencing dyspnea due to fear and anxiety. Which nursing intervention should the nurse use to potentiate the effects of pain medication and help reduce the dyspnea?

Use imagery, humor, and progressive relaxation

A client reports to the nurse that her mother had macular degeneration and is concerned that she, too, may be at risk. What should the nurse tell the client?

Wear sunglasses with ultraviolet (UV) protection when outside.

The spouse of a terminally ill client is confused by the new terminology being used during discussions regarding the client's treatment. The nurse should explain that palliative care is:

care that will reduce the client's physical discomfort and manage clinical symptoms.

A nurse is preparing a presentation for a local senior center about the health status of older adults. What trends in health promotion and disease prevention activities would the nurse explain as contributing to declining death rates in the older adult population? Select all that apply.

decreased smoking improved nutrition screening for hypertension early detection of elevated cholesterol levels

As a client approaches death, respirations become noisy. This is the result of which type physical event?

musculoskeletal change