Geri Final

On a visit to the clinic, a client reports the onset of early symptoms of rheumatoid arthritis. The nurse should conduct a focused assessment for: 1. Limited motion of joints. 2. Deformed joints of the hands. 3. Early morning stiffness. 4. Rheumatoid nodules.

3

Donezepil- Compliance

5 mg once daily, in evening before bed Skip missed doses and resume normal schedule next day. May take week before improvements seen. May cause dizziness. Cognitive enhancing med for Alzheimer's

What are the main symptoms of ALS A. Weakness in legs and feet B. Blindness C. Slurred speech D. Hearing loss

a,c

Exacerbations of MG are caused by which of the following? (select all that apply) A. Stress B. Trauma C. Pregnancy D. Physical activity

abc

Symptoms of andropause include: (Select all that apply) A. Reduced energy B. Reduced sexual function C. Enlargement of testes D. Enlarged prostate E. Increased stamina

abd

Treatments for MG include which of the following? (Select all that apply) A. Thymectomy B. Corticosteroids C. NSAIDS D. Cholinesterase inhibitors

abd

Which of the following are risk factors of delirium? A. Infection B. Metabolic Disorders C. Depression D. Dementia E. Blindness

abd

Mr. P presents to the clinic reporting various symptoms that have been interfering with his activities of daily life. Which of the following symptoms would alert the nurse to the possibility of Parkinson's disease? (Select all that apply.) A) Shuffling gait B) Tremors at rest C) Polyuria D) Frequent diarrhea E) Muscle rigidity

abe

A healthcare professional is caring for a patient who is to begin taking calcitonin-salmon (Miacalcin) intranasal spray to treat PGB. Which of the following information should the healthcare professional include? (Select all that apply) a. Report rash or itching b. Deliver two sprays to each nostril c. Prime the pump d. Report nasal irritation e. Hold the pump horizontally

acd

What are ways to decrease a glaucoma patient's potential for injury? (SATA) a) Keep clutter off floor b) Keep hallways and bathroom dimly lit, to avoid eye strain c) Avoid driving d) Avoid straining during bowel movement

acd

Actions that enhance sexual function include: (Select all that apply) A. good nutrition B. moderate alcohol consumption C. ample rest D. good hygiene E. regular exercise

acde

A patient with mild, non-disabling spinal stenosis is being evaluated for treatment. Which option would most likely be suggested for this patient? [Select all that apply] A) Percutaneous image-guided lumbar decompression B) Massage therapy C) Chiropractic therapy D) Acupuncture E) Laminoplasty

BCD

A 56 year old female patient comes in for her annual check up and asks the nurse about an osteoporosis screening and when she should begin getting that checked. The patient has no family history of osteoporosis and does not have an risk of fractures at this point. The nurse speaks with her and tells her... A. Osteoporosis screenings should begin by age 65 B. Osteoporosis screenings should begin by age 60 C. Osteoporosis screenings start when the patient has an increase of fractures or other risk factors present D. Osteoporosis screenings are voluntary and only if the patient wishes to get it done

A

A healthcare professional is caring for a patient who is taking alendronate (Fosamax) to treat PGB. The healthcare professional should explain to the patient that alendronate increases bone mass by which of the following actions? a. Decreases activity of osteoclasts b. Increases calcium excretion c. Promotes intestinal absorption of calcium and phosphorus d. Reduces action of osteoblasts

A

What are nonmodifiable risk factors for hip fractures? (Select all that Apply) Age Gender Fall Risk Smoking and alcohol use

A, B

tPa- nursing actions

Bleeding precaution, don't give if concurrent blood thinner use and recent surgery or traumas, platelets below 100,000 Monitor vitals at least q4h, contact doc if BP is 180/111 or higher During first hour, monitor bleeding every 15 min. Every 15-30 min during next 8 hours. And at least every 4 for remainder. Look for black tarry stools, coffee ground emesis. Check neuro status. Monitor CBC, pTT, stool/urine FDP titer Most effective if given within first 3 hours after stroke happens Don't give to people with suspected hemorrhagic stroke - do CT first!

metoprolol- action

Blocks stimulation of B1-adrenergic (Myocardial) receptors. Makes each heart beat more effective in pumping.

What is a secondary name for a Colles Fracture? A. Spoon deformity B. Broken wrist C. Silver fork deformity D. Compound Fracture

C

A 70-year-old patient is admitted to the recovery unit after undergoing surgery for retinal detachment. The patient tells the nurse that she is worried that she will never regain her sight. Which of the following is the best response by the nurse? A. "Why would you say that?" B. "You'll be fine. There's no reason for you to be worried." C. "My mother underwent this surgery and she healed just fine." D. "Could you tell me more about your concerns?"

D

Naproxen- adverse reaction

Dizzy, drowsy, HA, constipation, dyspepsia, nausea, dark tarry stools

Sildenafil- purpose of the drug (original)

Erectile dysfunction as side purpose (Viagra). But main purpose was pulmonary hypertension (Revatio).

57. True or false: Penile penetration can be harmful to a woman after a hysterectomy.

F

True or False: Bioidentical, custom-compounded hormones is recommended for treatment of menopause symptoms.

F

Warfarin- foods to avoid

Foods high in Vitamin K (dark leafies), cranberry juice, alcohol

Memantine- purpose for the drug

Moderate to severe dementia associated with Alzheimer's Disease Decreases the symptoms but does NOT slow progression

Erythrocyte sedimentation rate (ESR) is one of the laboratory tests used to diagnose rheumatoid arthritis? True or False

T

True or False: Repositioning the individual is key when it comes to ALS

T

Enalapril (Vasotec)- patient teaching

Take at same time everyday, avoid high amounts of sodium and potassium, change positions slowly, dizziness, dry cough, if possibly pregnant d/c immediately, continue other methods of HTN control like diet and exercise

Oxybutynin- purpose for the drug

Urinary tract antispasmodic - for frequent urination, urgency, nocturia, incontinence

A nurse is caring for an 80 year-old ICU patient who is at risk for delirium. Which of the following is a strategy to prevent delirium? A. Address issues with polypharmacy B. Allow patient to eat whatever they want C. Avoid administering pain medications as to avoid side effects that alter cognition D. Create a stimulating environment E. Make sure the patient is in a room that is close to the nurse's station

a

A 77 year-old ICU patient has been diagnosed with delirium. Which of the following should the nurse do in order to care for the patient? A. Allow a wide variety of visitors to come talk to the patient. B. Make sure the T.V. is on and music is playing in the background. C. Ensure the patient's safety D. Avoid communicating with the patient as to not confuse them more. E. Make sure that a variety of nurses take care of the patient.

c

A long-term care patient with moderate dementia develops increased restlessness and agitation. The nurse's initial action should be to a. Administer the PRN dose of lorazepam (Ativan). b. Reorient the patient to time and place c. Assess the patient for anything that might be causing discomfort. d. Have a nursing assistant stay with the patient to ensure safety

c

A patient with Alzheimer's disease (AD) is hospitalized with a urinary tract infection. The spouse tells the nurse, "I am just exhausted from the constant care and worry. We don't have any children and we can't afford a nursing home. I don't know what to do." The most appropriate nursing diagnosis for the spouse is a. Anxiety related to limited financial resources. b. Ineffective health maintenance related to stress. c. Caregiver role strain related to limited resources for caregiving. d. Social isolation related to unrelieved caregiving responsibilities.

c

Dementia is defined as a: a. Syndrome that results only in memory loss b. Disease associated with abrupt changes in behavior c. Disease that is always due to reduced blood flow to the brain d. Syndrome characterized by cognitive dysfunction and loss of memory

d

Which drug class is contraindicated when given high-dose aspirin concurrently? a) B-Adrenergic blockers b) A-Adrenergic agonists c) Cholinergic Agents d) Carbonic Anhydrase inhibitors

d

Which is a risk factor for ALS? A. Advanced age B. Male gender C. Genetics D. All of the above

d

Which is not an appropriate goal to implement for a client with glaucoma? a) Understand disease process and rationale for therapy b) Comply with all aspects of therapy regiment c) Have no postoperative complications d) Restore vision loss

d

Signs and symptoms for MS include which of the following? A) Muscle weakness B) Vision problems C) Fatigue D) Cognitive Decline E) All the above

e

A client with rheumatoid arthritis states, "I can't do my household chores without becoming tired. My knees hurt whenever I walk." Which nursing diagnosis would be most appropriate? 1. Activity intolerance related to fatigue and pain. 2. Self-care deficit related to increasing joint pain. 3. Ineffective coping related to chronic pain. 4. Disturbed body image related to fatigue and joint pain.

1

Which of the following medications may be used in the management of manifestations of Huntington's Disease? (select all that apply) 1. Risperidone (Risperdal) 2. Sertraline (Zoloft) 3. Allopurinol (Zyloprim) 4. Tetrabenazine (Xenazine) 5. Diazepam (Valium)

1,2,4,5

A 68 year old woman has just been given the diagnosis of Osteoporosis and is speaking with her doctor on recommendations and treatments. Her doctor states that she can take supplements to increase her calcium or naturally get calcium from foods. Which of these foods will the doctor be telling her what she can have? Select all that apply 1. Eggs 2. Fish 3. Ice cream 4. Cream cheese 5. Milk 6. spinach

2, 3, 5, 6

Which of the following statements are true regarding Huntington's Disease? (select all that apply) 1. Huntington's Disease prevalence is similar across all races. 2. People at risk for Huntington's Disease will sometimes forgo genetic testing to preserve quality of life. 3. The care of the family caregiver is an important component of the nursing care plan. 4. Treatment of Huntington's Disease is aimed to cure and to manage.

2,3

A nurse is teaching students about Huntington's Disease. Which statement by the student indicates a need for further teaching? 1. The typical onset of Huntington's Disease occurs between the ages of 30 and 50, but can also occur in juveniles and older adults. 2. Pneumonia and suicide are top causes of death for persons with Huntington's Disease. 3. Genetic testing can determine if a patient has the defective gene and also at what age symptoms will begin to manifest themselves. 4. A difficult aspect of Huntington's Disease is that persons often do not know they carry the gene until after they have had children.

3

The occupational health nurse is teaching a class on the risk factors for developing OA. Which is a modifiable risk for developing OA? a. Being overweight b. Increasing age c. Previous joint damage d. Genetic susceptibility

A

Which of the following care settings would be suggested for a patient who recently underwent surgery for a hip fracture. The patient is able to perform ADLs and has potential for a full recovery. a. Rehabilitative services b. Long-term care (nursing home) c. Restorative care d. Acute care

A

When assessing a patient for a fracture either Colles or Hip it is KEY for the nurse to directly assess (select all that apply): A. Neurological Function B. Vascular Insufficiency C. Home Risk D. None of the Above

A, B

Which are appropriate therapies for patients with diabetic retinopathy? (Select all that apply). A. Anti-VEGF Injection Therapy B. Focal/grid Macular Laser Surgery C. Corticosteroids D. Use of diuretics E. Vitrectomy

A, B, C, E

A 65-year-old patient who has been diagnosed with myopia, diabetes with retinopathy,, and lung cancer is admitted to the hospital for retinal detachment. Which of the following are known risk factors that the patient has for this condition? (Select All That Apply) A. Age B. Gender C. Myopia D. Cancer E. Retinopathy

A, C, E

A 42-year-old woman with Ménière's disease is admitted with vertigo, nausea, and vomiting. Which nursing intervention will be included in the care plan? A. Dim the lights in the patient's room B. Encourage increased oral fluid intake C. Change the patient's position every 30 minutes D. Keep the head of the bed elevated 30 degrees

A. Dim the lights

What factors contribute to the placement of an older adult in a long-term facility? Select all that apply. A. Caregiver burnout or stress B. Loss of family support system C. Older adults prefer living in nursing homes to living with their family D. Deterioration in the health of the patient E. It's cheaper to live in a long-term facility

ABD

A nurse is explaining to an older adult patient how aging impacts spinal stenosis. He tells the patient the following factors: [Select all that apply] A) Musculoskeletal disorders B) Swollen bones C) Thickened ligaments D) Increased fall risk

ACD

What are ways that nurses can violate the respect towards older adults' sexual identities? (Select all that apply) A. Joking about senior citizens' flirtation/relationship B. Making sure the elderly client has proper privacy while receiving care and treatments C. Denying an elderly patient's request for a same-sex aide to perform bathing/hygiene D. Belittling the elderly client's interest in makeup, clothing and hairstyles E. Ensuring the elderly client has had the opportunity to obtain proper clothing and personal hygiene before their visitor arrives

ACD

Which of the following are elderly adults at an increased risk for due to physiological age-related effects (select all that apply)? a. Impaired communication b. Urinary incontinence c. Limited mobility d. Risk for falls e. Tooth loss

ACD

What is true relating to the unavailability of a partner: (Select all that apply) A. Men tend to marry women younger than themselves B. Women tend to marry men younger than themselves C. Most men are widowed D. Most women are widowed

AD

A nurse manager is reviewing the types of glaucoma with a newly hired nurse. What would the newly hired nurse respond to the nurse manager's question, "What type of glaucoma is a result of the iris being too close to the drainage angle of the eye"? A. Primary Open-Angle Glaucoma B. Angle-closure Glaucoma C. Tension-Angle Glaucoma D. Stress-induced Glaucoma

B

A patient has been recently diagnosed with spinal stenosis. She asks, "What exactly is spinal stenosis?" The nurse answers with which of the following? A) "It's the curvature of the spine." B) "It's the narrowing of the spaces within your spine." C) "It's swelling of the cranial nerves." D) "It's a condition in which there are missing vertebrae"

B

After the nurse has finished teaching a patient with osteoarthritis (OA) of the right hip about how to manage the OA, which patient statement indicates a need for more teaching? a. "I can exercise every day to help maintain joint motion." b. "I will take 1 g of acetaminophen (Tylenol) every 4 hours." c. "I will take a shower in the morning to help relieve stiffness." d. "I can use a cane to decrease the pressure and pain in my hip."

B

All of the following are true regarding surgical care of the elderly patient except... A. The elderly patient may take longer to wake up from anesthesia B. Hyperthermia is a major concern for older adults C. There is a greater risk for postsurgical infection D. Immobility can increase the risk for respiratory complications

B

All of the following individuals are at a higher risk for developing depression except: A.The 66-year old female who has been taking spironolactone for the past six weeks for a newly diagnosed heart condition. B.The 67-year old female who stopped attending church luncheons because they interfere with her time with her grandchildren. C.The 84-year old female who lost her husband two years ago. D.The 65-year old male who retired 2 months ago from his career as an Airline pilot.

B

The healthcare provider is assessing the glucose level of a patient with a diagnosis of diabetes. Which of these is most helpful in evaluating this patient's long-term glucose management? A. Urine Specific Gravity B. Hemoglobin A1c C. Patient's food diary D. Fasting blood glucose level

B

What nursing action is most important for the patient with age-related macular degeneration (AMD)? A. Teach the patient how to use topical eye drops for treatment of AMD. B. Emphasize the use of vision enhancement techniques to improve what vision is present. C. Encourage the patient to undergo laser treatment to slow the deposit of extracellular debris. D. Explain that nothing can be done to save the patient's vision because there is no treatment for AMD.

B

Which of the following is NOT a primary goal of restorative care? a. Maintaining current level of function b. Providing basic care and management of acute conditions c. Preventing decline and complications d. Assisting to achieve highest possible quality of life e. Improving functional ability to promote independence

B

A patient is admitted to the hospital with the diagnosis of retinal detachment. Which of the following symptoms might the patient be experiencing? (Select All That Apply) A. Pain B. Blurred vision C. Flashes of light D. Bleeding from the eyes E. Decreased peripheral vision

B, C, E

A nurse performs an assessment of a client with a diagnosis of macular degeneration of the eye. The nurse would expect the client to report which of the following symptoms? (Select all that apply.) A. Loss of peripheral vision B. Blurred central vision C. Increased clarity when looking at objects D. Scotomas E. Metamorphopsia

B, D, E

The clinic nurse is preparing to test the visual acuity of a client using a Snellen chart. Which of the following identifies the accurate procedure for this visual acuity test? A. Both eyes are assessed together, followed by the assessment of the right and then the left eye. B. The right eye is tested followed by the left eye, and then both eyes are tested. C. The client is asked to stand at a distance of 40ft. from the chart and is asked to read the largest line on the chart. D. The client is asked to stand at a distance of 40ft from the chart and to read the line then can be read 200 ft away by an individual with unimpaired vision.

B.

A nurse is providing teaching to a client who has a new diagnosis of Ménière's disease. Which of the following instructions should the nurse include in the teaching? A. Increase caffeine intake B. Avoid sudden movements C. Increase sodium intake D. Avoid bearing down

B. Avoid sudden movements

The nurse is reviewing the physician's orders for a client with Meniere's disease. Which diet will most likely be prescribed? A. Low-cholesterol diet B. Low-sodium diet C. Low-carbohydrate diet D. Low-fat diet

B. low-sodium diet

A 65-year-old client is diagnosed with macular degeneration. Which statement by the client indicates a need for further discharge teaching? A. "I should use magnification devices as much as possible." B. "I will look at my Amsler grid at least twice a week." C. "I am going to use low-watt light bulbs in my house." D. "I am going to contact a low-vision center to evaluate my home."

C

A 74-year old female client who lost her husband 5 months ago and lives alone in her home is brought to the emergency department by her 52-year old son who states that his mother fell in her living room 2 hours ago. The admitting nurse asks the client if she can describe the events surrounding her fall. The nurse suspects the client may need further assessment for depression when the client states: A. I fell asleep in my chair watching T.V. When I got up I suddenly felt dizzy and fell. B. I don't really remember what happened. I think I may have tripped. C. Who cares what happened. I don't need your help or anyone else's. D. I was reaching for the remote and lost my balance. I'm so embarrassed.

C

A client is expressing concern to a registered nurse at a local eye clinic about recently finding out that the results of her tonometry test were 22mmHg. She states, "I'm so worried that I now have glaucoma." What should be the best response by the registered nurse? A. I understand that you are concerned. Let me get you some information on Glaucoma. B. I would be worried too. I suggest you start treatment right away. C. An elevated intraocular pressure reading does not necessarily mean that you have glaucoma. Glaucoma is best diagnosed with a complete eye exam. D. This is a low test result. You have nothing to worry about.

C

By looking at these patients, which one is most at risk of osteoporosis? A. A 73 year old female who has recently fallen B. A 69 year old female who is active and likes to run, but eats only eggs C. A 68 year old female who has had 3 children and smokes cigarettes D. A 68 year old female who smokes cigarettes and has a BMI of 29.5

C

The client diagnosed with OA is a resident in a long term care facility. The resident is refusing to bathe because she is hurting. Which instruction should the nurse give the unlicensed nursing assistant? a. Allow the client to stay in bed until the pain becomes bearable b. Tell the assistant to give the client a bed bath this morning c. Try to encourage the client to get up and go to the shower d. Notify the family that the client is refusing to be bathed

C

The nurse is developing a plan of care for the client scheduled for cataract surgery. The nurse documents which more appropriate nursing diagnosis in the plan of care? A. Self-care deficit B. Imbalanced nutrition C. Disturbed sensory perception D. Anxiety

C

What is the most common infection in the older population? A. Methicillin resistant Staphylococcus aureus (MRSA) B. Bacterial pneumonia C. Urinary tract infections D. Influenza

C

Which of the following most accurately describes diabetic retinopathy? A. High blood glucose causes the retina to detach and bleed. B. The retina loses its circulation. C. Chronic high blood glucose damages retinal capillaries, leading to fluid leakage, swelling, and growth of abnormal, new blood vessels. D. High internal eye pressure damages the retina and optic nerve.

C. Chronic high blood glucose damages...

Oxycodone- side effect

Confusion, sedation, constipation, ortho hypo

A nurse educator is reviewing the effects of Glaucoma with a newly diagnosed patient. How should the nurse educator respond to the patient's question, "What exactly is putting me at risk for vision loss related to my Glaucoma?" A. Vision loss does not occur with Glaucoma. You will only have headaches. B. The increased glucose in your eyes put you at risk for vision loss. C. The lens in your eye is becoming increasingly cloudy. D. Vitreous humor in your eye is not draining properly. This can cause damage to the optic nerve resulting in vision loss. E. I don't know!

D

Signs and symptoms of depression in the older adult population may include all of the following except: A.Insomnia, fatigue, anorexia and constipation B.Expression of guilt, remorse, hopelessness and being a burden to others C.Sleep and psychomotor activity changes D.Racing thoughts, diaphoresis and paranoia

D

The client's vision is tested with a Snellen's chart. The results of the tests are documented as 20/60. The nurse interprets this as: A. The client can read at a distance of 60 feet what a client with normal vision can read at 20 feet. B. The client is legally blind. C. The client's vision is normal D. The client can read only at a distance of 20 feet what a client with normal vision can read at 60 feet.

D

MS is diagnosed through which of the following? A) MRI B) CSF analysis C) Clinical manifestations D) Ruling out all other options E) All the above

E

Carbidopa/levodopa- adverse reactions

GI issues (constipation & bleeding), psychosis (anxiety, hallucinations, depression, suicidal), orthostatic hypotension

Atorvastatin (lipitor)- adverse reaction

GI upset, confusion, ↑ BG, joint/muscle pain/breakdown

Allopurinol- action of drug

Gout; Inhibits production of uric acid by inhibiting the action of xanthine oxidase

Simvastatin- what to limit

Grapefruit juice (less than 20 oz/day), fat, cholesterol, carbs, smoking

Digoxin- drugs that make levels higher (higher risk for toxicity)... know toxicity

Loop diuretics, calcium, thyroid, corticosteroids, excessive laxatives cause hypokalemia which ↑ toxicity. Licorice & aloe (stimulant natural product) may ↓ potassium levels Withhold if pulse below 60 Toxicity Serum levels should be between 0.5 - 2 ng/mL First signs are: abdominal pain, anorexia, N/V, visual disturbance, bradycardia Maintain potassium levels between 4 - 5.5 Digibind is antidote for toxicity or overdose

Diltiazem (Cardizem)- teaching, actions, side effect

Teaching: avoid large amts of grapefruit juice, monitor pulse, good oral hygiene, change positions slowly, dizziness, HR below 50 call Doc, exercise/diet, can take w/o food, bleeding precautions Actions: inhibits calcium into smooth muscle cells of heart, which inhibits excitation and contraction. It dilates. Calcium channel blocker. Side effect: peripheral edema is most common, hypotension, cough, urinary probs, sexual dysfunction, thrombocytopenia/leukopenia,

What is true of S/S of MG? A. Muscles that control eyes and facial movements are usually affected first B. Muscles controlling breathing usually affected first C. Resting rarely helps weakness D. Loss of sensation is common

a

MS is more common in which of the following groups? (Select all that apply) A) People from temperate climates B) Women C) Men D) Those with a family history of it E) Native Alaskans

a,b,d

A health care professional should tell a patient who is taking alendronate (Fosamax) to monitor for which of the following adverse effects? (Select all that apply) a. Jaw and joint pain b. Drowsiness c. Blurred vision d. Tinnitus e. Muscle pain

ace

A patient who has been diagnosed with Parkinson's disease demonstrates difficulty with performing fine motor skills. The nurse is aware that the patient's problem is due to a deficiency in which neurotransmitter? A) Seratonin B) Dopamine C) Epinephrine D) Norepinephrine

b

Which of the following patient goals should the nurse prioritize in the patient's plan of care? A) Working on his favorite hobby B) Taking a walk around the block every day C) Developing a taste for different foods D) Maintaining independence with bathing and toileting

d