NUR130 Exam 1

A nurse is providing care to a patient with delirium. Which interventions would be most appropriate to implement? Select all that apply.

-Providing a calm, quiet environment -Supervising nutritional intake -Using familiar cues about the environment

A nurse is caring for a patient diagnosed with empyema. Which of the following interventions does a nurse implement for patients with empyema?

Encourage breathing exercises.

The nurse is providing discharge instructions to a client with pulmonary sarcoidosis. The nurse concludes that the client understands the information if the client correctly mentions which early sign of exacerbation?

Shortness of breath

After teaching an older adult about measures to relieve constipation, which statement by the client indicates a need for additional teaching?

"I should use a laxative every other day."

A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy. What should the nurse tell the patient?

"You should switch to wearing your glasses while taking this medication."

On auscultation, which finding suggests a right pneumothorax?

Absence of breath sounds in the right thorax

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 auscultating the patient's lung sounds to determine the presence of pulmonary edema. What adventitious lung sounds are significant for pulmonary edema?

Crackles in the lung bases

Which condition is characterized by a decline in intellectual functioning?

Dementia

The occupational nurse is completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases?

Fibrotic changes in lungs

The nurse is caring for a client with tuberculosis. Why should the nurse always encourage a client with tuberculosis to perform active range-of-motion (ROM) exercises three times a day?

For maintaining muscle strength

Which are leading causes of death among the elderly? Select all that apply.

Heart disease

The plan of care for a patient with advanced Alzheimer's disease includes the nursing diagnosis of risk for injury. The nurse has identified this nursing diagnosis most likely as related to which of the following?

Impaired memory

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 client is hospitalized for treatment related to leukemia. Family members want to visit with a toddler who has a cold. It would be best for the nurse to

Instruct the family to remove the toddler from the room for the protection of the client.

Older adults, who are more subject to falls, may fracture one or more ribs and be more susceptible to which condition after a rib fracture?

Pneumonia

Which refers to the decrease in lens flexibility that occurs with age, resulting in the near point of focus getting farther away?

Presbyopia

The nurse is assessing sleep habits of an elderly client who reports difficulty falling asleep and staying asleep. The nurse intervenes when the client reports he

Reads in bed before going to sleep

Which is a factor that contributes to urinary incontinence in older female adults?

Relaxed perineal muscle

A client reports to the nurse that her mother had macular degeneration and is concerned that she, too, may be at risk. The nurse tells the client to

Wear sunglasses with ultraviolet (UV) protection when outside.

An age-related change associated with the cardiovascular system is

decreased cardiac output.

A physician stated to the nurse that the client has fluid in the pleural space and will need a thoracentesis. The nurse expects the physician to document this fluid as

pleural effusion.

Resistance to a first-line antituberculotic agent in a client who has not received previous treatment is referred to as

primary drug resistance.

A nurse is reviewing the medications of a client who lives alone and reports having difficulty remembering when to take them. To aid in medication compliance, which of the following measures would the nurse employ? Select all answers that apply.

-Write down the medication schedule for the client. -Suggest that the client use a multiple-dose medication dispenser. -Recommend to the client to use one pharmacy for all prescriptions.

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

Provide emotional and physical support

A nurse is caring for a client with dementia. A family member of the client asks what the most common cause of dementia is. Which response by the nurse is most appropriate?

The most common cause of dementia in the elderly is Alzheimer's disease.

During discharge teaching, a nurse is instructing a client about pneumonia. The client demonstrates his understanding of relapse when he states that he must:

continue to take antibiotics for the entire 10 days.

Which action by the nurse demonstrates ageism?

Directing all health decisions to the older adult's child

A client has recently brought her elderly mother home to live with her family. The client states that her mother has moderate Alzheimer's disease and asks about appropriate activities for her mother. The nurse tells the client to

Ensure that the mother does not have access to car keys or drive an automobile.