Nursing NR 601 Final Exam 2 - Questions with Answers, Exams of Nursing

Download Nursing NR 601 Final Exam 2 - Questions with Answers and more Exams Nursing in PDF only on Docsity! 1 NURSING NR 601 FINAL EXAM 2 – QUESTION WITH ANSWERS (LATEST, GRADED A) 1. A 77-year-old Hispanic Catholic Nun (retired) who immigrated to the United States 15 years ago lives alone but in an apartment complex where her sister lives as well. She is being discharged home after a hospitalization for congestive heart failure with prescriptions for 8 different medications. She is considered at risk for noncompliance due to the following contributing factors except: • Ethnic background 2. A 78-year-old patient who is dying of colon cancer with metastases to the liver is refusing to eat or drink. He is alert and oriented, and states that he has no desire to eat, which is causing the family great distress. In order to best address the client and family, you should: • Educate the family that this is normal behavior in this situation 3. A 79-year-old female client resides independently in the community. The client’s daughter is concerned because her mother insists on wearing a sweater and keeps all of the windows closed even though it is 90 degrees Fahrenheit outside. The nurse practitioner initially recognizes that this behavior may be related to: • age-related neurosensory changes that diminish awareness of temperature changes 4. An 88-year-old, being admitted to rule out lung cancer, is assessed using the short form of the Geriatric Depression Scale tool. When it is determines that the earned score is 9, the nurse practitioner initially: • asks if they have any thoughts of committing suicide 5. The area in which nurse practitioners have the greatest effect on the safe, effective medication therapy of an older client is: • educating the client to all aspects of the medication. 6. The Beers list is an effective tool for healthcare professionals prescribing and/or managing the medication therapy of older adults since it identifies medications that for this population: • have a higher than usual risk for injury 7. A client who reported, “a problem sleeping” shows an understanding of good sleep hygiene when: • limiting the afternoon nap to just 30 minutes 2 8. Common causes of dyspnea in the older adult may include which of the following? 5 • a slightly raised irregular patch that is bluish black in color 19. The nurse is providing care to a client diagnosed with dementia. What option is an example of the appropriate use of implied consent by the nurse? • Changing the client's dressing when the client asks, "Will you change this bandage now?" 20. The nurse practitioner demonstrates an understanding of the older client’s preventable risk factors for early death when: • providing clients with information regarding the effectiveness of a nicotine patch monitoring the blood pressure of those living at a homeless shelter each month weighing the clients who visit a walk-in clinic that is located in an economically depressed neighborhood educating the diabetic residents of a low rent apartment complex on how to monitor their blood glucose levels 21. The nurse practitioner documents that an older adult client is living independently in a safe environment. Which assessment data supports this evaluation? • The client demonstrates the home's security alarm system. Various safety features were installed when the bathroom was remodeled. The nurse observes the client wearing a safety alarm bracelet. The client's home is within walking distance of a grocery store. 22. The nurse practitioner educates the older client that the greatest risk related to poor foot care results is: • loss of independent mobility. 23. The nurse practitioner has the obligation to ask questions and obtain specific information about the use of herbs and supplements. Which of the following statements is most accurate regarding herbal therapy? • may interact with prescription medications 24. A nurse practitioner in an area of the country that is prone to tornadoes routinely discusses disaster preparedness with older adult clients. What is the primary rationale for this intervention? • Older adults are less likely to seek formal and informal help when affected by natural disasters. 6 25. A nurse practitioner is preparing an educational program focused on herbal supplements. Which of the following is a likely interested target group? • White females who own their own successful businesses 26. The nurse practitioner is preparing educational material concerning fire safety in the home. What research data will be included in the material? 7 • fire mortality is highest in adults older than 65 years of age 27. The nurse practitioner is providing care for an older client who is experiencing mild cognitive impairment. Which communication technique is most likely to bring about a negative outcome? • Asking the family to answer interview questions 28. The nurse practitioner makes the greatest impact on the safe management of an 81- year-old client’s medication administration when included in education is: • a pillbox with compartments for each day and each of the doses 29. The nurse practitioner’s first response when told by a client during an assessment interview that they “can’t take furosemide (Lasix)” is to ask: • "Can you describe what happened when you took Lasix?" 30. The nurse practitioner suspects that a client is experiencing tardive dyskinesia when observing: • the client's facial muscles are twisting involuntarily 31. The nurse suspects that an older adult client is experiencing symptomology seen in herpes zoster when the client • rates the pain as an 8 out of a possible 10 develops clusters of fluid-filled vesicles reports symptoms focused on one side of the body 32. A nurse suspects that her next-door neighbor, an older woman, is a victim of elder abuse by her daughter. What is the appropriate action for the nurse to do in this situation? • Complete a confidential report with the adult protective services in the area. 33. Of the following agents, which is least likely to cause a chronic or recurrent cough? • Gabapentin 34. Of the following risk factors, which is not 35. An older adult client will require extensive rehabilitative therapy after a fall that resulted in several fractures and reconstructive surgeries. Which intervention will have the greatest impact on the individual’s relocation to a rehabilitation facility? • Actively seeking the individual's input regarding the decisions relating to the move 10 • Sleep apnea 45. State Death with Dignity Laws require that the terminally ill client be • educated regarding treatment alternatives. 46. Weight loss is frequently caused by ingestion of the following drugs. 11 • Antibioti cs Digoxin Nonsteroidal anti-inflammatory drugs (NSAIDs) Theophylline 47. What factor is an important contribution to polypharmacy in older adults? • Inadequate communication among medical care providers 48. What research finding is the basis for care planning of the client receiving palliative care? • Pain management is inadequately addressed among the terminally ill population. 49. When a chronically ill 80-year-old client is admitted to your acute care facility in an unconscious state, the nurse practitioner’s priority is to determine: • who is the client's durable power of attorney for health care (DPAHC). 50. When acting as a fictive kin, in which activity will a paid caregiver engage? • organizing the client's birthday celebration 51. When an older adult client is diagnosed with restless leg syndrome (RLS), the nurse practitioner is confident that client education on the condition’s contributing factors has been effective when the client states: • "I've cut way back on my caffeinated coffee, teas and sodas." 52. When answering an older client’s questions about diet, exercise, and bone integrity, which exercise would the nurse practitioner identify as ineffective at meeting the need for moderately intense aerobic activity? • Yoga for 45 minutes twice a week 53. When assessing an older client for indications of depression, the nurse practitioner bases the intervention on the knowledge that: • The older client's symptoms may be atypical for the disorder 54. When assessing the intellectual abilities of an older adult, the nurse practitioner demonstrates an understanding of a major barrier to reliable testing of this population when: • stating, "Just take your time and try to relax; there are no wrong answers to this test." 12 55. When caring for an ill adult client, the nurse is particularly concerned that the client communicates well since: • Assessment, planning of care and even the therapeutic relationship is based on effective communication? 15 65. Which behavior suggests that an older adult who has lost their life partner is successfully managing the exploration stage of the adjustment process? • Smiles when reminiscing about the trips they took over the years 66. Which characteristic is seen in a family’s ‘kin-keeper’? • Organizes the yearly family reunion 67. Which client statement indicates an understanding of a primary benefit to be derived from moderately intense aerobic exercise? • "Exercise will help keep my heart strong." 68. Which diagnosis is associated with the symptom of early morning awakening and poor quality of sleep: • Sleep apnea 69. Which factor is the greatest barrier to an older adult living independently? • Deficits in vision and/or hearing resulting in safety issues 70. Which form of urinary incontinence is most common in older adults? • Urge 71. Which housing arrangement would best address the family who wants to provide housing for an older family member who has a large degree of physical and cognitive independence and a desire to be closely involved with the family? • A "granny" apartment in a separate part of the house 72. Which intervention addresses a guiding principle for creating an elder-friendly acute care facility? • A client is asked when they would prefer to bathe; morning, afternoon or evening 73. Which intervention addresses a right guaranteed a long-term care facility resident? • Family members are welcome at anytime 74. Which intervention best addresses the principle that is the basis for communicating with a client experiencing post-surgical delirium? • Assuming that the client's statements are an attempt to express needs 75. Which intervention best demonstrates the nurse practitioner understands safe medication administration of rivastigmine (Exelon) 16 to the older client experiencing symptoms of Alzheimer’s disease? • The client is carefully monitored for side effects before the medication dose is increased 17 76. Which intervention demonstrates effective care for an individual who has expressed a wish to “retire sometime soon”? • Asking about when they plan to retire Assessing their ability to handle the stresses of retirement Engaging them in a conversation about their interests Inquiring about the existence of any chronic illnesses 77. Which intervention to manage wandering in clients in a long-term care facility should not be implemented? • Using physical restraints to prevent wandering to maintain safety 78. Which is the most likely reason that Type 2 diabetes mellitus is often difficult to diagnose in older adults? • The classic symptoms may not be present in older adults. 79. Which nursing intervention will have the greatest impact on minimizing an older adult’s risk for re-hospitalization within 30 days of discharge? • Evaluation of a cardiac client's comprehension of their prescribed medication therapy 80. Which of the following commonly causes insomnia: • Alcohol consumption Caffeine ingestion Sleep apnea Depression 81. Which of the following does not demonstrate an understanding of the factors affecting physical wellness of the older adult client when: • Asking each client if "they come from a healthy family" 82. Which of the following is the best advice a nurse practitioner can give an older client who is about to move to a new apartment and needs to feel safe about living alone for the first time? • Arrange with the local police to have a home security assessment done and then follow through with their suggestions. 83. Which older adult client has the greatest risk for readmission into the acute care health system and so is the focus of extensive nursing follow-up post discharge? • The client recovering from an exacerbation of congestive heart 20 96. A widowed grandmother is about to assume the role of custodial parent for her 6- year-old grandchild. Which intervention has priority • Teaching stress management and relaxation techniques 21 97. Your client is cared for at home by his son and daughter-in-law, who are also responsible for the care of their four preschool-aged children. What is true of this “sandwich” generation? • The conflicts that arise from caring for both older adults and children can be very stressful. 98. You suspect that the spouse of a terminally ill client is experiencing anticipatory grief when they: • Dramatically reduce the time they spend attending to the client 99. Of the following risk factors, which is not associated with Alzheimer's disease (AD)? • history of respiratory infections 100 Which diagnosis is associated with the symptom of early morning awakening and poor quality of sleep: • Depression