Unit 1, 4, 5 IGGY exam
A nurse working with older adults in the community plans programming to improve morale and emotional health in this population. What activity would best meet this goal?
Exercise program to improve physical function
A nurse working with older adults in the community plans programming to improve moral and emotional health in this population. What activity would be best to meet the goal
Exercise programs to improve physical function
What are the legal requirements under the Patient Self Determination Act? Select all that apply.
Patients who do not have an Advanced Directive should be receive education, Representatives in a health care agency should ask all patients if they have an Advanced Directive,
decitabine, an oral chemotherapeutic agent belongs to which drug category
Antimetabolite
A terminally ill client who has just died in a hospital setting with family members at the bedside. Which action will the nurse take first?
Ask family members if they would like to spend time alone with the client.
A client has extreme postoperative pain that is worsened when participating in physical therapy sessions. Which intervention for pain management would the nurse include in this client's care plan for the 48 hours post-surgery?
Round-the-clock analgesia with PRN analgesics
The nurse is caring for a client in a rehabilitation setting who has a urinary tract infection with burning and urgency. Which drug does the nurse anticipate will be prescribed?
trimethoprim
Elderly adults are at risk for dehydration due to voluntary limiting fluid intake during the evening hours. Elderly adults do this because (select all that apply):
urinary incontinence, prescribed diuretic use, poor mobility
A nurse working in an Acute Care of the Elderly unit learns that frailty in the older population includes which components? (Select all that apply.)
weakness, slowed physical activity, exhaustion
A novice nurse reports to the nurse preceptor that a client requested pain medication, and when the nurse brought it, the client was sound asleep. The nurse states the client cannot possibly sleep with the severe pain the client described. Which response by the experienced nurse is best?
"Being able to sleep doesn't mean pain doesn't exist."
A nurse planning hospice care for a client who is nearing end of life can best assure client-centered care by asking which question?
"Do you want to be at home or in a care facility at the end of your life?"
The nurse is caring for a terminally ill client who is has entered the end-of-life stage of illness. How does the nurse respond when the spouse expresses concern about the client's lack of appetite?
"Let him know that food is available if he wants it, but do not insist that he eat."
A nurse cares for a client who recently completed genetic testing and received a negative result. The client states, "I feel guilty because so many of my family members are carriers of this disease and I am not." How would the nurse respond?
"We usually encourage clients to participate in counseling after receiving test results. Can I arrange this for you?"
The nurse is talking with a family member of a dying client who states, "I am afraid to say goodbye to my mother." Which nursing response is appropriate?
"Why do you think it is hard for you to say goodbye?"
A patient in the medical surgical unit is in active process of dying. The patient's significant other asks the nurse what to expect when the patient's heart stops. The nurse responds correctly by saying:
"your loved one will stop breathing shortly after"
What is the mean arterial pressure necessary to maintain perfusion of major body organs
60 to 70
Which nursing intervention would help prevent extravasation in a patient receiving combined chemotherapy
Access the site of drug ministration for pain, infection or tissue loss, closely monitor the IV site before, during, and after administration of vesicants
What action does the nurse anticipate for patients with bandemia
Administration of antibiotics
The nurse cares for a client who has a specific mutation in the A-1 a T or alpha one antitrypsin gene. What action will the nurse take
Advise the client to limit exposure to secondhand smoke and other respiratory irritant
A nurse cares for a client who has a specific mutation in the a1AT (alpha1-antitrypsin) gene. What action would the nurse take?
Advise the client to limit exposure to secondhand smoke and other respiratory irritants
Abdominal tumors may obstruct or compressed structures in the G.I. tract which cause
Altered absorption of nutrients
Which area will a lung cancer tumor likely metastasize
Bone, liver, brain
A home health care nurse is planning an exercise program with an older adult who lives at home independently but whose mobility issues prevent much activity outside the home. Which exercise regimen would be most beneficial to this adult?
Building strength and flexibility
How is the TNM classification of TisN0Mx for a patient with lung cancer interpreted
Carcinoma in situ, presence of metastasis cannot be assessed
The nurse understands that a patient with the CD4 plus T-cell count of less than 200 has which class level of HIV
Class three
A nurse on the MedSurg unit receives handoff report. Which client with the nurse assess first
Client reported new onset abdominal pain rated as an eight on 0 to 10 scale
A nurse on the medical-surgical unit has received a hand-off report. Which client would the nurse assess first?
Client reporting new-onset abdominal pain, rated as an 8 on a 0-10 scale
Which of the following client problems would the nurse recognize as general consequences of a cancer diagnosis
Clotting abnormalities from thrombocythemia, nutritional deficits such as early satiety and catch Exiä, increased risk of infection from white blood cell deficit
The nurse is learning about cancer development and remembers characteristics of normal cells. Which of the following characteristics with the nurse recognize resulting from normal cell development
Differentiated function, nonmigratory
A nurse cares for an adult client who has received genetic testing. The patient's mother asks to receive the results of the genetic tests. Which action would the nurse take?
Direct the mother to speak with the client and support the client's decision to share or not share the results.
A nurse caring for an older client in the hospital is concerned the client is not competent to give consent for upcoming surgery. What action by the nurse is best?
Discuss concerns with the health care team
A nurse caring for an older client in the hospital is concerned that the client is not competent to give consent for upcoming surgery. Which action by the nurse is best
Discuss concerns with the healthcare team
A nurse is assessing pain on a confused older client who has difficulty with verbal expression. Which pain assessment tool would the nurse choose for this assessment?
FACES Pain Scale-Revised
A nurse is assessing pain on a confused older client who has difficulty with verbal expression. Which pain assessment tool would the nurse choose for the assessment
Faces pain scale revised
A pathology report of a patient with prostate cancer who underwent prostate surgery shows moderately differentiated cancer cells, indicating that some cells have retained some of the characteristics of normal cells, and many others have more malignant characteristics. Based on these findings, the nurse expects documentation of which malignancy grade
G2
The histopathology report of a patient with breast cancer reveals poorly differentiated cells with no normal characteristics. It also is difficult to determine the tissue of origin. Which grade of cancer will the nurse anticipate being assigned to this patient
G4
The allele test used to determine hypersensitivity reactions to abacavir is called
HLA B5701
One of the direct causes of death include:
Heart Failure
When the nurse is reviewing the laboratory reports for a group of patients receiving chemotherapy, which laboratory result indicates the patient is displaying signs of bone marrow suppression
Hemoglobin of 7.4
The result of inadequate tissue perfusion and anaerobic metabolism includes
Hyperkalemia
Which statement by an older adult indicates the need for additional teaching on health-enhancing behaviors?
I will sit in the sun for 30 minutes every day
The part of the immune system that provides non-specific initial response to infection is called
Innate immunity
An older adult client is in the hospital. The client is ambulatory and independent. What intervention by the nurse would be most helpful in preventing falls in this client?
Keep the light on in the bathroom at night
An older client is in the hospital. The client is ambulatory and independent. Which intervention by the nurse would be most helpful in preventing Falls in this client
Keep the light on in the bathroom at night
The rationale for patient staying at home during periods of neutropenia is to
Keep the patient's flora under control
It is the coronary artery that maintains perfusion to the anterior wall and Apex of the left ventricle
LAD
What are the social determinants of health that lead more adults of color to increase hospitalizations and mortality
Limited income and multiple health conditions
A client receiving chemotherapy has a white blood cell count of 1000. Which of the following actions with the nurse take to most appropriately address risks to the client
Listen to lung sounds and monitor for cough, monitor the venous access device appearance frequently, take and record vital signs every 4 to 8 hours, assess all mucous membranes every 4 to 8 hours
It is a repetitive procedure of choice for most patients with acquired mitral insufficiency consisting of leaflet repair and making the Anullus smaller
Mitral valve annuloplasty
A nurse caring for a client who is in the terminal stage of lung cancer would question which prescription?
Morphine 10 mg sublingual every 6 hours PRN for pain level greater than 5
The leukocyte that provides nonspecific ingestion of invading microbes
Neutrophil
Which assessment would the nurse complete to assist in the prevention of pressure injury formation for a bed bound client?
Nutritional intake and serum albumin levels
Which assessment would the nurse complete to assist in the prevention of pressure injury formation for a bedbound client
Nutritional intake and serum albumin levels
Superior vena cava syndrome is an oncological emergency caused by
Partial obstruction of blood of the superior vena cava
A nurse admits an older patient to the hospital who lives at home with family. The nurse assesses that the client is malnourished. What actions by the nurse are best
Perform and document results of a Braden scale assessment, assess the clients own teeth and the dentures for a proper fit, request a dietary consultation from the healthcare provider, suggest a high-protein oral supplement between meals
The defense mechanism where in neutrophils and golf and ingest invading microorganisms is called
Phagocytosis
The nurse has assessed a client who is dying. Which action will the nurse take when cool extremities that are mottled and cyanotic are noted?
Place a warm blanket over the client.
To cope with the stress of relocation, which suggestion would the nurse make to an older adult who recently became widowed and moved into an assisted living apartment?
Place valued knickknacks in the new setting
Elderly adults are at risk for dehydration due to voluntary limiting fluid intake during the evening hours. Elderly adults do this because what
Prescribed diuretic use, poor mobility, urinary incontinence
Origin group of cancer cells or tumors caused by carcinogenesis is
Primary tumor (the school has it wrong and puts primary disease though)
Which type of surgery is scheduled for a patient with colon polyps who has a strong family history of cancer
Prophylactic
When a client develops mucositis which of the following actions would the nurse take to help manage the discomfort and avoid additional risks
Provide local anesthetic medication's to swish and spit, encourage the client to eat room temperature food, assist with frequent rinsing of the mouth of the saline solution, remind the client to brush their teeth gently after each meal
The following activities with the nurse promote when developing primary efforts directed against preventing cancer
Providing vaccinations against certain cancers, instructing people on the use of chemo prevention
Which is a compensatory mechanism that works to increase cardiac output
Release of catecholamines
Which assessment finding noted by the nurse is this older adult client's greatest risk for health inequality?
Reliance on public transportation
Which assessment finding noted by the nurse is this older adult clients greatest risk for health inequality
Reliance on public transportation
A nurse admits an older patient from a home environment. The client lives with adult son and daughter-in-law. The patient has urine burns on the skin, no dentures, and several pressure injuries, which action by the nurse is most appropriate
Report the findings as per agency policy
A nurse admits an older adult from a home environment. The client lives with an adult son and daughter-in-law. The client has urine burns on the skin, no dentures, and several pressure injuries. What action by the nurse is most appropriate?
Report the findings as per agency policy.
A nurse admits an older adult to the hospital who lives at home with family. The nurse assesses that the client is malnourished. What actions by the nurse are best? (Select all that apply.)
Request a dietary consultation from the health care provider., Suggest a high-protein oral supplement between meals, Perform and document results of a Braden Scale assessment., Assess the client's own teeth or the dentures for proper fit.
An older adult recently retired and reports "being depressed and lonely." What information would the nurse assess as a priority?
Role of work in the adult's life Correct
A client has extreme postoperative pain that is worse than when participating in physical therapy sessions. Which intervention for pain management with the nurse include in the clients care plan for the 48 hours post surgery
Round the clock analgesia with PRN analgesics
In response to the increasing fall rates among elderly clients, the center for disease control and prevention launched a STEADI initiative which includes
Screening elderly adults for fall risk, assess the modifiable risk factors, intervenes suing community and clinical strategies
Intact skin is important to cancer patients because____ can occur when microbes enter the bloodstream at any site of skin breakdown
Sepsis
Which laboratory value is invaluable in supporting the diagnosis of bone cancer
Serum calcium
Which instruction will the nurse give to the patient who has mild abdominal pain and is prescribed ibuprofen?
Stop taking the medication if you notice any blood in your stool
It's the amount of blood ejected by the left ventricle during each contraction
Stroke volume
An older adult recently retires and reports being depressed and lonely. What information would the nurse assess as a priority
The role of work in the adults life
A client asks for the nurse why did my colorectal cancer spread to my liver what does the nurse say
There are numerous lymph nodes in the abdomen which allow for spread to the liver
Which of the following factors with the nurse include when educating a group of older adults about their increased risk for infection
There's a higher risk for respiratory tract and genital urinary infection, they should receive influenza pneumococcal, and shingles vaccination, they may not have a fever with a severe infection
Which of the following infections with the nurse recognize as being associated with increased risk to client diagnosed with COVID-19
VAE, CAUTI, CLABSI, MRSA
Which assessment with the nurse complete to evaluate the clients activity tolerance three days post coronary bypass graft surgery
Vital signs before, during, and after activity
Which assessment would the nurse complete to evaluate the client's activity tolerance 3 days post coronary bypass graft surgery?
Vital signs before, during, and after activity
A nurse cares for a client who recently completed genetic testing and received a negative result. The client states I feel guilty because so many of my family members are carriers of the disease and I am not. How would the nurse respond
We usually encourage clients to participate in counseling after receiving test results. Can I arrange this for you
In response to the increasing fall rates among elderly adults, the Center for Disease Control and Prevention launched the STEADI initiative which includes (select all that apply):
assess for modifiable risk factors, intervene suing community and clinical strategies, and screening adults for fall risks
Which action would the nurse perform first after entering the room of a patient whose pain was reported to the nurse by assistive personnel?
assess location and intensity with a pain scale
The nurse is planning care for a client in a rehabilitation setting. To avoid patient constipation, which dietary choices will the nurse include in the plan of care? Select all that apply.
whole grain bread, bran muffins, apples, green peas, baked beans
The nurse is assessing an older adult using the Confusion Assessment Method (CAM) and finds that the client meets the required criteria. Which condition would the client most likely have?
delirium
The overuse of table salt and sugar places the elderly at risk for hypertension and diabetes. The developmental change attributed to this is:
diminished taste and smell
The nurse's role in advanced care planning is to:
facilitate informed decisions and communication
Advance Directive is similar to the Durable Power of Attorney document.
false
It is the model of care for patients who have life limiting injury or illness.
hospice
The result of inadequate tissue perfusion and anaerobic metabolism includes:
hyperkalemia
Which clinical sign would the nurse expect in a patient approaching death? Select all that apply
increased sleeping; decreased temperature of the extremities ; increased restlessness
What are the social determinants of health that lead more older adults of color to increased hospitalizations and mortality?
limited income and multiple health conditions
The nurse is assessing medications being taken by an older adult who lives in the community. For which medication would the nurse contact the client's primary health care provider?
lorazepam
Which term would the nurse use to document the pain experienced by a patient who underwent a below-the-knee amputation 2 weeks ago and is reporting continued pain where the leg used to be located?
neuropathic
Which term reflects the concept that listening and acknowledging the legitimacy of a patient's or family's impending loss is often more therapeutic than speaking?
presence
The condition which leads to inadequate tissue perfusion and potentially death is:
shock
The health risks for unhoused and imprisoned elderly populations increase due to:
substance abuse
Which statement made by the nurse indicates effective communication with grieving family members?
this must be very difficult for you
