Care Test 3 Quizzes
A nurse measures an older adult's blood pressure on the right arm and notes a reading of 150/100. The nurse waits 5 minutes and measures the blood pressure again in the right arm and obtains a reading of 152/100. What is the next action by the nurse? Measure the blood pressure in the left arm. Measure the blood pressure in sitting and standing positions. Immediately contact the medical provider. Document the findings in the medical record; elevated blood pressures are normal in older adults.
A
An older man who is a smoker is hospitalized for orthopedic surgery. A nurse takes the opportunity to provide smoking cessation education. The patient asks the nurse. "I have been smoking for most of my life, and I an an old man. Why are you wasting your time telling me to stop smoking? Isn't it too late?". The nurse bases the response on the knowledge that: Smoking cessation as late as age 75 can reduce premature death by up to 50%. Smoking cessation education is only effective in individuals under age 75. Smoking cessation as late as age 75 can completely eliminate death. Smoking cessation at a late age will not impact the smoker but can reduce exposure of family members to second-hand smoke.
A
While the older African American is at the highest risk for developing Alzheimer's disease, the nurse demonstrates an understanding of this disease process's risk factors when assessing this population's: Blood pressure and serum lipid levels. Heart rate and capillary refill status. Muscle strength and reflex time. Weight and elimination pattern.
A
A major difference in the diagnosis of chronic disease between younger adults and older adults is that: Chronic disease is usually not identified in older adults because of the many age-related changes. Chronic disease if often diagnosed earlier in younger adults and measures can be implemented to prevent later complications. Chronic disease if often diagnosed earlier in older adults since they are more likely to seek medical care. Chronic illness is uncommon in younger adults.
B
A nurse is ascultating an older patient's heart and notes a systolic murmur heard between the S1 and S2 heart sounds. The first action by the nurse is to: Note it in the chart as this is always a normal finding for the older adult. Question the patient about the presence of the murmur. Immediately implement emergency interventions Contact the medical provider as this is an abnormal finding.
B
An older adult who was diagnosed with atrial fibrillation asks a nurse. "I feel fine. I have no symptoms at all with this heart problem, yet I am now on blood thinner medication, which I understand can be very dangerous. Is this really necessary?" The nurse formulates a response based on the understanding that: Untreated atrial fibrillation will likely cause a heart attack. The risk of stroke is very high for a person with atrial fibrillation. Atrial fibrillation can cause coronary heart disease. Atrial fibrillation, while initially asymptomatic, will progress and become symptomatic.
B
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 the following in the response to the patient? Smoking cessation All of the above. Maintain control of blood sugar ( hemoglobin A1c less than 7). Maintain blood pressure within normal limits.
B
What is the most important risk factor for development of a stroke? Conjestive heart failue Inceasing age CVI MI
B
Which is the most likely reason that type 2 diabetes mellitus is often difficult to diagnose in older adults? The disease rarely occurs in older adults. The classic symptoms may not be present in older adults. Ther are no recognizable symptoms; it is a "silent killer". Presenting symptoms occur very quickly.
B
A nurse is teaching a group of older adults about healthy aging. The nurse discusses global lifestyle risk factors for chronic disease. The nurse includes which of the following in the education? ( Select all that apply). Development of advance directives. Smoking cessation and avoidance of tobacco. Maintenance of blood pressure readings at a level of 102/70 or lower. Maintenance of high levels of physical activity.
B, D
A nurse is caring for an older adult who is in the pre-trajectory phase of the Chronic Illness Trajectory. The nurse knows that his phase is characterized by which of the following: A period of temporary remission from the crisis. A progressive decline in physical and or mental status. The absence of signs or symptoms of the illness. Diagnostic testing being conducted.
C
Signs and symptoms related to the diagnosis of Parkinson's Disease includes all of the following except: dramatic improvement with administration of levodopa resting tremor symmetry of motor symptoms Muscular rigidity
C
What disease is considered a systemic inflammatory autoimmune disorder? OP OA RA Gout
C
One of the most common chronic condiions noted in the United States is: kidney failue heart failure peripheral vascular disease hypertension
D
The greatest risk for injury for a client with progressed Parkinson's disease is: Bleeding ulcers Suicide Respiratory arrest Falls
D
A client is newly diagnosed with type 2 diabetes mellitus. Which diagnostic test will best evaluate the management plan prescribed for this client? Quarterly hemoglobin A1c. A yearly funduscopic examination by an ophthalmologist. Biannual cholesterol testing. Regular foot examination by a podiatrist.
a
A nurse assess the lower extremities of an older adult and notes a small ulcer between the person's great toe. The ulcer has well-defined edges and there is no bleeding; however, there is a small amount of necrotic tissue present. This wound is most likely a(n): arterial ulcer surgical ulcer venous ulcer pressure ulcer
a
A nurse is organizing a support group for older individuals with COPD in the community. The nurse knows that which of the following individuals is most likely to have COPD? A 72-year-old non-Hispanic female who never worked outside of the home and is a former smoker, A 75-year-old Hispanic male who is a retiredtruck driver and never smoked. A 67-year-old African American male who is a retired physician. A 70-year-old Asian woman who is a retired college professor.
a
A nurse is organizing a support group for older individuals with COPD in the community. The nurse knows that which of the following individuals is most likely to have COPD? A 72-year-old non-Hispanic female who never worked outside of the home and is a former smoker. A 70-year-old Asian woman who is a retired college professor. A 75-year-old Hispanic male who is a retired truck driver and never smoked. A 67-year-old African American male who is a retired physician.
a
A nurse is planning an educational session on osteoporosis to be given at a senior center. Which of the following should be discussed as preventive measures for osteoporosis? Following a diet with adequate amounts of calcium and vitamin D Increasing the intake of beverages containing phosphorus. Including isometric exercise for at least 30 minutes three times per week. Having a early dual-energy X-ray absorptiometry DXA ( or DEXA) scan.
a
A nurse is teaching a group of 65-year-old patients about reducing the risk of osteoarthritis. Which of the following would the nurse discuss as a modifiable risk factor for osteoarthritis? Obesity Female sex. Drinking one cup of regular coffee a day. Advancing age.
a
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? Avoid foods high in purine. Encourage the patient to take 1 L of fluid daily. Consume one glass of red wine daily. Recommend that the patient eat 12-16 ounces of foods high in protein such as red meat.
a
All of the following factors affect the degree of bone loss while aging except: skin diseases physical inactivity immune disorders Genetics
a
An older adult with suspected Parkinson's Disease has a "challenge test" performed in order to confirm the diagnosis. The nurse understands that a "challenge test" will demonstrate which of the following? Dramatic improvement of symptoms of Parkinson's Disease after administration of levodopa. Dramatic improvement in tremor only after administration of levodopa. Dramatic improvement of gait only after administration of levodopa. Immediate reversal of all symptoms of Parkinson's Disease after administration of levodopa
a
An older adult with type 2 Diabetes is being treated with insulin wants to increase his activity level and begin a walking program. What recommendations should the nurse provide for this patient? The walking regimen needs to be done on a regularly scheduled basis. Regular exercise should not exceed 30 minutes three times a week. A walking program is not recommended for an older adult with diabetes. Insulin can most probably be discontinued if the individual adheres to the walking program.
a
Kyposis in the older adult can be a results of which of the following? Osteoporosis Rheumatoid Arthritis Osteoarthritis Gout
a
The most significant etiology for chronic obstructive pulmonary disease (COPD) is: tobacco use chronic bronchitis exposure to carcinogens in the workplace emphysema
a
Which of the following manifestations would a nurse expect in a 70-year-old patient who has a diagnosis of osteoarthritis? Heberden's nodes on the distal phalanges. Subluxation of the fingers. Enlarged great toe. Swan neck deformity of the hand.
a
Why would an older person not necessarily present with the classic signs and symptoms ( polyuria, polyphagia, and polydipsia ) of DM? All of the above Reduced thirst reflex Increased renal threshold for glucose Age- related decrease in appeitie
a
A nurse is planning education for a group of older adults at a senior center on promoting respiratory health. Which of the following should the nurse include in the education? (Select all that apply). Pneumococcal pneumonia immunization. Annual influenza immunization Benefits of low-sodium low- fat diets. Smoking cessation.
a,b,d
A patient is diagnosed with osteoporosis. Which statement should the nurse include when teaching the client about the disease? ( Select all that apply) Osteoporosis is common in females after menopause. The disease is congenital, caused by poor dietary intake of protein. Osteoporosis is a degenerative disease characterized by a decrease in bone density. Passive range of motion can prevent Osteoporosis.
a,c
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 decline from a previous level of functioning. The cognitive changes worsen in the evening hour. A gradual decline in cognitive abilities. Fluctuation of symptoms over the course of a 24-hour period.
a,c
A diagnosis of Parkinson's disease is made on the presence of which of the following symptoms? ( Select all that apply) Resting tremor Orthostatic hypotension Rigidity Bradykinsesia
a,c,d
An older adult patient with atrial fibrillation is prescribed warfarin for anticoagulation. Which of the following should the nurse include in the teaching plan? (Select all that apply) Seek medical attention immediately if an injury is sustained. Increase dietary intake of vitamin D and calcium. Frequent blood testing is required to assure that the level of anticoagulation is in the correct range. Limit dietary intake of vitamin K.
a,c,d
A nurse is caring for an older adult who has metabolic syndrome. The nurse knows that all of the following conditions are common in persons with metabolic syndrome except: Glucose levels that are higher than normal. Blood pressure that is lower than normal. Increased waist circumference. Increased blood cholesterol levels.
b
A nurse is interviewing an older woman who is a new patient in an outpatient medical clinic. Which of the following findings by the nurse is considered a risk factor for osteoporosis? The woman drinks three glasses of skim milk daily. The woman has been taking corticosteroids for 10 years because of chronic pulmonary disease. The woman is obese and has hip pain with ambulation. The woman eats three to five servings of shrimp and liver per week.
b
A nurse plans for the discharge of a 75-year-old patient who has the diagnosis of osteoporosis. Which of these actions would the nurse consider first? Encourage consumption of a high-protein diet. Remove clutter from the floors of the home. Schedule an annual DXA/DEXA scan. Avoid stressful situations.
b
Asthma is often underdiagnosed in older adults because: symptoms of asthma are often attributed to normal age-related changes. asthma is very uncommon in older adults. older adults frequently do not have any of the classic signs and symptoms. asthma symptoms are usually very mild in older adults.
b
The daughter of an older patient with chronic bronchitis says to the nurse,"I don't understand why my father has not been prescribed antibiotics for his bronchitis. The last time I had bronchitis I got antibiotics." The nurse considers the following when formulating a response: Antibiotics are not prescribed in chronic bronchitis since the cause is usually not bacterial. The routine use of antibiotics is controversial because the causal role of bacterial infection is often not clear. Antibiotics tend to be less effective in older adults than younger adults. Normal age-related decreases in immune response delay the presentation of classic symptoms.
b
A nurse understands that the pathophysiology of Parkinson's Disease includes which of the following? ( Select all that apply) The presence of neurofibrillary tangles and amyloid plagues in the brain. A deficiency of the neurotransmitter dopamine. An accumulation of Lewy Bodies, especially in the basal ganglia. Elevated lipid panel.
b, c
An older adult patient asks a nurse. "I went to my diabetes doctor and everything was stable. The nurse practitioner spent the entire time teaching me about decreasing my risks of heart disease. It seemed odd that she did not focus on teaching me how to better control my diabetes. "Do you know why?" The nurse formulates a response based on the understanding that: ( Select all that apply) Diabetes is not a common chronic condition in older adults. Promoting cardiovascular health has the potential to minimize complications of DM. There is little evidence that demonstrates the course of DM can be altered in an older adult. The benefit of better control of blood and lipid levels are seen much quicker than the benefits of better glycemic control
b,d
A nurse is assessing an older adult's respiratory status. All of the following are normal age related changes in the respiratory system except:? Stiffening of the chest wall. Diminished cough reflex. Decreased respiratory rate. Increased resistance to airflow.
c
After first managing the pain being experienced by the client with gout, the treatment focuses on: strengthening the affected joints through a controlled exercise plan. minimizing joint disfigurement by using therapeutic splinting. preventing systemic involvement by altering the client's diet managing chronic pain by taking regular doses of salicylates.
c
Hyperglycemia is harder to detect in older adults due to which of the following? Fingerstick glucose monitoring is inaccurate in older adults. Older adults tend to metabolize glucose at a faster rate than younger adults. There is a higher tolerance for elevated levels of circulating glucose in older adults. The classic signs of elevated glucose levels, polyuria, polyphagia, and polydipsia are rarely present in older adults.
c
A nursing student is preparing a presentation on arthritis. The nursing student knows the difference between osteoarthritis (OA) and rheumatoid arthritis(RA) include that: (Select all that apply) Both OA and RA present with joint stiffness lasting 20-30 minutes after rest. both OA and RA have an acute onset in older adults. OA is a localized process, where RA my be systemic. OA usually impacts distal interphalangeal joints; RA impacts proximal interphalangeal joints
c,d
A nurse assess an older patient's blood gases. The patient is 70 years old. The nurse knows that this patient's maximum P02 is: 89 99 69 79
d
A nurse is caring for an older adult with Parkinson's Disease. The patient is receiving the medication levodopa-carbidopa. The nurse understands that in order to maximize effectiveness, the administration schedule for this medication should adhere to which of the following: Administer with a full 8 ounces of water and have the patient sit upright for thirty minutes after. Administer first thing in the morning. Administer with meals only. Administer on an empty stomach, 30-60 minutes before or 40-60 minutes after a meal.
d
In the pharmacological treatment of pain, which drug is contraindicated in older adults? Tramadol Oxycodone Acetaminophen Demerol
d
Persons presenting with anxiety, dementia or depression should be screened for : autoimmune disorder infection DM thyroid disorder
d
A nurse is planning health education on chronic illness for a group of seniors in the community. When deciding upon which illnesses to focus upon, the nurse knows that which of the following are the most common diseases in the United States
heart disease and hypertension
A nurse is caring for an older adult who is diagnosed with type 2 Diabetes. The patient is prescribed oral medication for diabetes. The nurse can expect that which of the following medications is prescribed as a first-line therapy?
metmorfin
