Geri Test 2
A 78 y/o client has recently been diagnosed with dehydration. Which of their following is most likely not attributing to their dehydration? A. Diabetes, with glucose of 103 B. Controlling incontinence by restricting fluid C. Diuretics q12hrs D. Fever for 2 weeks
A
A patient who has just started taking sustained-release morphine sulfate (MS Contin) for chronic pain complains of nausea and abdominal fullness. The best initial action by the nurse is to A. administer the ordered antiemetic medication. B. tell the patient that the nausea will subside in about a week. C. order the patient a clear liquid diet until the nausea decreases. D. consult with the health care provider about using a different opioid
A
A patient with chronic abdominal pain has learned to control the pain with the use of imagery and hypnosis. A family member asks the nurse how these techniques work. The nurse's reply is based on the information that these strategies A. impact the cognitive and affective components of pain. B. increase the modulating effect of the efferent pathways. C. prevent transmission of nociceptive stimuli to the cortex. D. slow the release of transmitter chemicals in the dorsal horn.
A
For a cognitively impaired client who cannot accurately report pain, what is the first action that you should take? A. Closely assess for nonverbal signs such as grimacing or rocking. B. Obtain baseline behavioral indicators from family members. C. Look at the MAR and chart, to note the time of the last dose and response. D. Give the maximum PRS dose within the minimum time frame for relief.
A
In the elderly, alcohol abuse is a huge risk factor for ______. A. Vitamin deficiency B. Muscle weakness C. Dysphagia D. Chronic Pain
A
The nurse knows the concentration of many drugs is decreased by the "first pass effect" of the liver and understands that older adults are likely to require which dosage change of these drugs? A) Decreased dose B) Increased dose C) Increased dose over more frequent intervals D) Same dose divided over more frequent intervals
A
To promote sleep in a patient, a nurse suggests what intervention? A. Follow the usual bedtime routine if possible. B. Drink two or three glasses of water at bedtime. C. Have a large snack at bedtime. D. Take a sedative-hypnotic every night at bedtime.
A
Your 73 year old patient is suffering from unintentional weight loss. Which of the following is the least likely cause of their weight loss? A. Cushing's disease B. Recently diagnosed with dementia C. Social isolation D. Polypharmacy
A
Community dwelling seniors experience which of the following barriers to obtaining adequate nutritional intake? (Select all that apply) A). Lack of transportation B). Low income C). High socialization D). Poor social support resources E). Vegetarianism
A, B, D
19. A nurse is assessing patients in a skilled nursing facility for sleep deficits. Which patients would be considered at a higher risk for having sleep disturbances? Select all that apply. A. A patient who is incontinent B. A patient who has gastroesophageal reflux (GERD) C. A patient who is HIV positive D. A patient who is taking corticosteroids for arthritis E. A patient with urinary frequency from a urinary tract infection
A, B, D, E
A nurse formulates the following diagnosis for an elderly patient who is having trouble getting to sleep at night: Disturbed Sleep Pattern: Initiation of Sleep. Which of the following nursing interventions would the nurse perform related to this diagnosis? Select all that apply. A. Arrange for assessment for depression and treatment. B. Discourage napping during the day. C. Decrease fluids during the evening. D. Administer diuretics in the morning. E. Encourage patient to engage in some type of physical activity. F. Assess medication for side effects of sleep pattern disturbances
A, B, E, F
A nurse is talking with an older adult client about improving her nutritional status. Which of the following interventions should the nurse recommend? (Select all that apply.) A. Increase protein intake to increase muscle mass B. Decrease fluid intake to prevent urinary incontinence C. Increase calcium intake to prevent osteoporosis D. Limit sodium intake to prevent edema E. Increase fiber intake to prevent constipation
A, C, D, E
One of the most common distinctions of pain is whether it is acute or chronic. Which examples describe chronic pain? Select all that apply. A. A patient is receiving chemotherapy for bladder cancer. B. An adolescent is admitted to the hospital for an appendectomy. C. A patient is experiencing a ruptured aneurysm. D. A patient who has fibromyalgia requests pain medication. E. A patient has back pain related to an accident that occurred last year. F. A patient is experiencing pain from second-degree burns.
A, D, E
Which action will help the nurse determine whether a patient's confusion is caused by delirium? A. Ask about family history of Dementia B. The Confusion Assessment Method tool C. Ask the patient their birthday, name and the current president D. Ask the patient when they last took medications
B
Which goal is a priority for a client with a DSM-IV TR diagnosis of delirium and the nursing diagnosis Acute confusion related to recent surgery secondary to traumatic hip fracture? A. The client will complete ADLs B. The client will maintain safety C. The client will remain oriented D. The client will understand communication
B
A nurse caring for patients in a busy hospital environment should implement which recommendation to promote sleep? A. Keep the room light dimmed during the day. B. Keep the room cool. C. Keep the door of the room open. D. Offer a sleep aid medication to patients on a regular basis.
B
One reason for medication problems in the elderly is that A. Regular use of laxatives increases absorption of medications B. Decreased renal function slows excretion of drugs C. Enhanced sense of taste of medications D. Increased perception of pain from injections
B
The client is to begin taking atorvastatin and the nurse is providing education about the drug. Which symptoms related to this drug should be reported to the health care provider? A. Constipation B. Increasing muscle or joint pain C. Hemorrhoids D. Flushing or "hot flash"
B
The nurse has received a shift report and entered the room to assess an older adult client. Upon entering the room, the nurse notes that the client will not make eye contact and is unwilling to engage in a discussion. The client states, "I never sleep well, but I'm tired now, so will you let me sleep tonight?" The nurse recognizes this as which common problem experienced by a client of this age? A. Sleep deprivation B. Depression C. Dementia D. Stroke
B
To validate the suspicion that a married male client has sleep apnea the nurse first: A. Asks the client if he experiences apnea in the middle of the night B. Questions the spouse if she is awakened by her husband's snoring C. Places the client on a continuous positive airway pressure (CPAP) device D. Schedules the client for a sleep test
B
When doing a pain assessment for a patient who has been admitted with metastatic breast cancer, which question asked by the nurse will give the most information about the patient's pain? A. "How long have you had this pain?" B. "How would you describe your pain?" C. "How much medication do you take for the pain?" D.."How many times a day do you medicate for pain?"
B
Which ability should Nurse Rebecca expect from a client in the mild stage of dementia of the Alzheimer's type? A. Remembering the daily schedule B. Recalling past events C. Coping with anxiety D. Solving problems of daily living
B
Which of the following nursing interventions is inappropriate for clients with swallowing difficulties? A. Sitting the patient upright B. Encouraging talking while eating C. Small portions D. Keeping the suction machine near the bedside
B
Which of the following patients is at the greatest risk for aspiration? A. 55 male with hemorrhagic retinopathy B. 67 male with GERD C. 75 female with CHF D. 66 male with COPD
B
Your 72 year old patient asks how his diet needs to change as he ages. You instruct the patient that which nutrient recommendations change with age? (Select All that apply) A. Vitamin C B. Calcium C. Vitamin D D. Vitamin K E. Vitamin B12 F. Vitamin B6
B, C, E, F
A 91-year-old female comes into the emergency room with symptoms of delirium. Which of the following would NOT be a possible cause of her condition? A. Urinary tract infection B. Dehydration C. Alzheimer's disease D. Recent anesthesia
C
A nurse is discussing with an older female patient the factors that affect sleep. What fact does the nurse teach her? A. Drinking a cup of regular tea at night induces sleep. B. Using alcohol moderately promotes a deep sleep. C. Aging decreases the amount of REM sleep a person experiences. D. Exercising decreases REM and NREM sleep.
C
A prescriber has ordered rosuvastatin (Crestor) for an older adult with cirrhosis. Which intervention would be most appropriate for the nurse before administration of this drug? A. Question the order, because rosuvastatin is contraindicated in patients with liver disease. B. No intervention is necessary; just administer the drug as ordered. C. Review the baseline liver function test results. D. Assess the patient for liver disease.
C
An 84-year-old female patient is displaying signs of a delirium episode. To prevent the patient from injury, the most appropriate action by the nurse is to: A. Ask the provider about ordering an antipsychotic medication. B. Have the patient's guardian stay with the patient and give reassurance. C. Assign a staff member to remain with patient and provide frequent reorientation. D. Use a soft chest restraint to secure the patient in bed.
C
An older patient states that they have trouble eating due to diminished appetite. Which of the following is the most likely reason for this? A. Their cataracts and macular degeneration B. They've been diagnosed with diabetes for 15 years C. They have lost 60% of their smell D. Their complete loss of conductive hearing
C
Mrs. Jordan is an elderly client diagnosed with Alzheimer's disease. She becomes agitated and combative when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation would be to: A. Tell the client firmly that it is time to get dressed. B. Obtain assistance to restrain the client for safety C. Remain calm and talk quietly to the client D. Call the doctor and request an order for sedation
C
The nurse administered a presurgical anticholinergic drug about 30 mins ago. Which of the following responses would be of concern and should be reported immediately? A. "Nurse, my throat is dry" B. "I'm feeling a bit anxious. When will the surgeon be here?" C. "I need to leave. I have business to do!" D. "My nose is suddenly stuffy. I wonder if I have a cold"
C
Which of the following is not a clinical sign of malnutrition in a 75 y/o male who weighs 155 lbs? A. Serum albumin level lower than 3.5 g/100 mL B. Hemoglobin level below 12 g/dL 12-15.5 C. Weights 150 pounds a month later D. Hematocrit value below 35%
C
he nurse assesses a patient who takes ibuprofen [Advil] on a regular basis. Which finding in the patient would prompt the nurse to contact the healthcare provider immediately? A. jaundice B. drowsiness C. hematemesis D. dysmenorrhea
C
A nurse is providing teaching for an older adult client who has lost 4.5 kg (9.9 lbs) since his last admission 6 months ago. Which of the following instructions should the nurse include in teaching? (select all that apply) A. "Eat three large meals a day" B. "Eat your meals in front of the television" C. "Eat foods that are easy to ear, such as finger foods" D. "Invite family members to eat meals with you" E. "Exercise every day to increase your appetite"
C, D, E
A nurse suspects her patient may be suffering from delirium. What signs does the nurse observe to support this diagnosis? A) Slurred speech and one sided weakness B) Mask-like face and tremors C) Gradual onset of forgetfulness reported by family members D) Confusion and visual hallucinations
D
A patient with chronic cancer pain is receiving imipramine (Tofranil) in addition to long-acting morphine for pain control. Which information is the best indicator that the imipramine is effective? A. The patient sleeps 8 hours every night. B. The patient has no symptoms of anxiety. C. The patient states, "I feel much less depressed since I've been taking the imipramine." D. The patient states, "The pain is manageable, and I can accomplish my desired activities.
D
These medications are ordered for an 86-year-old patient with arthritis in both hips who is complaining of level 3 (0 to 10 scale) hip pain while ambulating. Which medication should the nurse use as initial therapy? A. aspirin (Bayer) 650 mg orally B. naproxen (Aleve) 200 mg orally C. oxycodone (Roxicodone) 5 mg orally D. acetaminophen (Tylenol) 650 mg orally
D