NursGuru

    Exam Review

    1. Which patient is likely to present with an incorrect pulse oximetry reading?
      A)
      A middle-aged patient admitted with depression
      B)
      A teenager with brightly painted fingernails
      C)
      An older adult diagnosed with dementia
      D)
      A toddler with a fever of 100.2° F
    2. Which nursing statement shows a true appreciation for an older client's willingness to tell his personal stories about "the war?
      A)
      “I learn so much about clients when they share their life story with me."
      B)
      "They are so proud of the things they have accomplished in their life."
      C)
      "It helps their memory so much to retell their stories."
      D)
      "It's so nice to see them excited and engaged as they tell the stories."
    3. Which patient receiving skilled nursing care at home is presenting with a risk for hospitalization identified on an OASIS Assessment? (Select all that apply.)
      (SATA)
      A)
      A 17-year-old who with a history of depression
      B)
      A 20-year-old who has been treated in the emergency department 2 times in the last 6 months for gastrointestinal issues.
      C)
      A 78-year-old who has fallen three times in the last 13 months
      D)
      A 69-year-old with a documented, unintentional weight loss of 12 pounds in the past year
      E)
      An 11-year-old with a history of attention deficient hyperactive disorder (ADHD)
    4. A nurse discusses the "age in place" concept with an older adult client. The nurse would provide information related to which facility? (Select all that apply.)
      (SATA)
      A)
      Retirement communities.
      B)
      A long-term care facility that is affiliated with the hospital.
      C)
      Independent senior housing complexes.
      D)
      Assisted living facilities.
      E)
      Adult day health centers.

    Exam Review

    1. What documented assessment finding is suggestive of compromised respiratory function? (Select all that apply.)
      (SATA)
      A)
      Dyspnea
      B)
      Bluish tinge to fingers
      C)
      Restlessness
      D)
      Cyanosis of the trunk
      E)
      Tachypnea
    2. What are the symptoms of gastroesophageal reflux disease (GERD) in older adults? (Select all that apply.)
      (SATA)
      A)
      Heartburn.
      B)
      Vomiting.
      C)
      Abdominal pain within 1 hour of eating.
      D)
      Fever and elevated white blood cell count.
      E)
      Regurgitation.
    3. A hospitalized older adult who recently had surgery and a wound infection postoperatively is noted to be losing weight despite consuming provided meal trays and snacks. What is one reason that this might be occurring?
      A)
      An injury may cause malabsorption of nutrients.
      B)
      An injury may trigger inflammatory mediators that increase metabolic rate and impair nutrient utilization.
      C)
      Most hospitalized patients do not have accurate weights recorded upon admission.
      D)
      Most hospitalized older patients do not consume adequate amounts of micro- and macronutrients.
    4. An older resident of a long-term care facility diagnosed with dementia has in the last 48 hours become more confused than usual and while usually requiring help with toileting has been incontinent of urine. The client's health care provider orders a complete blood count and serum electrolytes. When the laboratory tests are all within normal limits, what action will the nurse initially take?
      A)
      Speaking with the health care provider regarding the possibility of obtaining a urine culture.
      B)
      Assuring the family that the changes in the resident's functioning is a result of advancing dementia.
      C)
      Changing the plan of care to include bladder training and implement a 24-hour calorie count.
      D)
      Suggesting that the resident be placed on broad-spectrum antibiotics to prevent infections.

    Exam Review

    1. A nurse implements a nursing care plan for a patient experiencing constipation. Which intervention should the nurse include in the plan?
      A)
      Bed rest
      B)
      Administering aluminum hydroxide antacids
      C)
      Increasing fiber in the diet
      D)
      Restricting fluids
    2. Which nursing interventions should be implemented to prevent dehydration in hospitalized older adults? (Select all that apply.)
      (SATA)
      A)
      Implementing intake and output recording for any patients with fever, diarrhea, vomiting, or an infection
      B)
      Limiting duration of NPO requirements for diagnostic tests and procedures
      C)
      Limiting the use of diuretic medications in hospitalized older adults
      D)
      Making sure that hospitalized patients have easy access to fluids
      E)
      Administering IV fluids to all hospitalized older adults
    3. Which factor contributes to poor outcomes for older adults during transitions of care? (Select all that apply.)
      A)
      Lack of desire to comply with discharge instructions
      B)
      Inadequate financial resources to purchase medications
      C)
      High levels of nurse-patient engagement
      D)
      Improved medication reconciliation during hospitalization
      E)
      Inability to read and understand discharge instructions
    4. A 78-year-old female patient is admitted to the hospital with complaints of abdominal discomfort, constipation, and difficulty passing stools. The patient has also been experiencing urinary incontinence. She has a history of chronic constipation and is on long-term opioid therapy for pain management due to osteoarthritis. The patient is oriented, but appears fatigued and anxious. Upon assessment, the nurse finds the patient is unable to pass stool, and a digital rectal exam reveals fecal impaction. Exhibits Which nursing intervention is the priority at this time?
      A)
      Insert a Foley catheter
      B)
      Administer a prescribed opioid analgesic
      C)
      Perform manual removal of the fecal impaction as per protocol
      D)
      Encourage fluid intake and ambulation

    Exam Review

    1. An elderly patient presents with weight loss, muscle weakness, and poor wound healing. Upon examination, they also exhibit dry, scaly skin and hair loss. Which of the following conditions is most likely affecting this patient?
      A)
      Hypertension
      B)
      Malnutrition
      C)
      Dementia
      D)
      Osteoporosis
    2. Many older adults have a vitamin B12 deficiency. Reasons for this include which of the following? (Select all that apply.)
      A)
      Proton pump inhibitors, a frequently prescribed medication in older adults, impair absorption of vitamin B12 from food.
      B)
      The major source of vitamin B12 is sunlight, and older adults are less likely to be outdoors and absorb vitamin B12 in this manner.
      C)
      Vegetarian diets increase the risk of vitamin B12 deficiency.
      D)
      Most older adults do not consume five servings of fruits and vegetables daily, which is the main dietary source of vitamin B12.
      E)
      Normal age-related changes in the stomach include a lower production of gastric acid making vitamin B12 absorption less efficient.
    3. Mrs. Johnson continued: Mrs. Johnson is an 82-year-old widow living alone in her two-story home. She has a history of hypertension, osteoarthritis, and mild cognitive impairment. Mrs. Johnson prefers to age in place and maintain her independence. She receives weekly visits from a home health aide and occasional help from her daughter, who lives nearby. During a routine visit, the home health aide notes that Mrs. Johnson has had a few minor falls recently and has been forgetting to take her medications on time. She also appears to have lost some weight and seems more withdrawn than usual. What is the most effective strategy to enhance Mrs. Johnson's socialization and reduce her withdrawal?
      A)
      Encourage her to adopt a pet for companionship.
      B)
      Increase the frequency of her daughter's visits.
      C)
      Arrange for her to participate in a local senior center's activities.
      D)
      Hire a full-time live-in caregiver.
    4. A patient tells the nurse, "Every time I laugh or cough, I wet myself." Which type of urinary incontinence is this patient describing?
      A)
      Functional
      B)
      Stress
      C)
      Mixed
      D)
      Urge

    Exam Review

    1. Which age-related change affects absorption?
      A)
      Reduced body water
      B)
      Increased adipose tissue
      C)
      Reduced enzyme activity
      D)
      Reduced saliva
    2. The Beers Criteria is an effective tool for health care professionals prescribing and/or managing the medication therapy of older adults since it identifies medications that have what possible outcome?
      A)
      Likely to be abused
      B)
      High risk of allergic reactions
      C)
      Not typically covered by drug benefit plans
      D)
      Higher than usual risk for injury
    3. Which of the following are examples of elderspeak? (Select all that apply.)
      A)
      A nurse attempts to medicate a patient and states, "Now come on and be a good girl."
      B)
      A nurse explains a procedure to a patient using simple nonmedical terms.
      C)
      A nursing assistant tells a patient, "It is time for our bath now."
      D)
      A nursing assistant refers to one of her patients as "grandma.”
      E)
      A nurse makes sure that she is directly facing a patient who has hearing loss when she is speaking.
    4. Elderspeak is often used in communication with older adults. Which of the following statements about elderspeak is true?
      A)
      Elderspeak can be patronizing and may contribute to negative outcomes such as reduced self-esteem and increased dependency in older adults.
      B)
      Elderspeak is beneficial because it simplifies communication, making it easier for older adults to understand.
      C)
      Elderspeak involves the use of technical jargon to ensure clear and precise communication with older adults.
      D)
      Elderspeak is a form of respectful communication that acknowledges the unique needs of older adults.

    Exam Review

    1. You are developing a care plan for an older adult in a long-term care facility that has a nutritional problem. Which interventions are appropriate to ensure adequate nutrition? (Select all that apply.)
      A)
      Provide a pleasant eating environment.
      B)
      Assign a nursing aide to feed the resident to ensure adequate consumption of meals.
      C)
      Provide nutritional supplements for the resident.
      D)
      Assess the resident for ability to feed himself or herself.
      E)
      Supervise the resident during meals.
    2. A 78-year-old female presents to the clinic for a routine check-up. Using the FANCAPES method, which of the following questions is most appropriate to ask when assessing her Nutrition status?
      A)
      Do you experience any pain while moving or at rest?
      B)
      Do you have any difficulty breathing during activities?
      C)
      How much water do you drink daily?
      D)
      What does a typical day's diet look like for you?
    3. The major goal of the NICHE (Nurses Improving Care for Healthsystem Elders) program includes which of the following?
      A)
      Increase the number of iatrogenic complications that occur in hospitalized older adults.
      B)
      Improve outcomes for hospitalized older adults.
      C)
      Increase the number of older adults cared for in hospitals.
      D)
      Decrease 30-day readmission rates for hospitalized older adults.
    4. The nurse suspects that a client is experiencing tardive dyskinesia when observing what behavior?
      A)
      Involuntary twisting of facial muscles
      B)
      Inability to voluntarily get up out of a chair.
      C)
      Involuntary moving
      D)
      Bilateral hand tremors