NursGuru

    Exam Review

    1. After 1 week of continuous mental confusion, an elderly client is admitted with a preliminary diagnosis of major neurocognitive disorder (NCD) due to Alzheimer's disease. Based on the nurse's knowledge of NCD, what should cause the nurse to question this diagnosis? (select all that apply)
      (SATA)
      A)
      Alzheimer's disease does not develop suddenly.
      B)
      Dementia and cognitive dullness are expected in those of advanced age.
      C)
      The symptoms presented could be due to an underlying medical condition.
      D)
      Symptom severity of Alzheimer's disease usually gets better as the day progresses.
    2. Which clinical features are most characteristic of Lewy Body dementia?
      A)
      Loss of expressive language and comprehension
      B)
      Stepwise irregular cognitive decline
      C)
      Gradual memory decline without motor symptoms
      D)
      Visual hallucinations and parkinsonian features
    3. An elderly client is experiencing progressive changes in memory that have interfered with personal, social, and occupational functioning. The client exhibits poor judgment and has a short attention span. A nurse should recognize these as classic signs of which condition?
      A)
      Neurocognitive disorder
      B)
      Pseudodementia
      C)
      Delirium
      D)
      Mania
    4. Mr. Feisty has mild Alzheimer's disease (AD) diagnosed 2 years ago after progressive short-term memory decline. His wife reports that over the last three weeks he has shown irritable mood, anhedonia, early-morning awakening, low energy, reduced appetite with ~5 lb (2.3 kg) loss, and difficulty concentrating beyond his baseline cognitive impairment. He has skipped two community senior-center activities he previously enjoyed. No hallucinations or delusions. He denies active suicidal intent but says, "Sometimes I wonder if it would be easier if I didn't wake up." No recent illness, fever, or falls. No alcohol or illicit drug use. Which symptoms should a nurse identify that would support a diagnosis of depression? (Select all that apply)
      (SATA)
      A)
      Passive death wish
      B)
      Anhedonia
      C)
      Progressive short-term memory decline
      D)
      Sudden onset of confusion
      E)
      Sleep disturbances

    Exam Review

    1. Mr. Feisty has mild Alzheimer's disease (AD) diagnosed 2 years ago after progressive short-term memory decline. His wife reports that over the last three weeks he has shown irritable mood, anhedonia, early-morning awakening, low energy, reduced appetite with ~5 lb (2.3 kg) loss, and difficulty concentrating beyond his baseline cognitive impairment. He has skipped two community senior-center activities he previously enjoyed. No hallucinations or delusions. He denies active suicidal intent but says. "Sometimes I wonder if it would be easier if I didn't wake up." No recent illness, fever, or falls. No alcohol or illicit drug use. Which is a first-line medication option for treating depression in an elderly patient
      A)
      Olanzapine (Zyprexa)
      B)
      Memantine (Namenda)
      C)
      Haloperidol (Haldol)
      D)
      Fluoxetine (Prozac)
    2. Mr. Feisty has mild Alzheimer's disease (AD) diagnosed 2 years ago after progressive short-term memory decline. His wife reports that over the last three weeks he has shown irritable mood, anhedonia, early-morning awakening, low energy, reduced appetite with ~5 lb (2.3 kg) loss, and difficulty concentrating beyond his baseline cognitive impairment. He has skipped two community senior-center activities he previously enjoyed. No hallucinations or delusions. He denies active suicidal intent but says. "Sometimes I wonder if it would be easier if I didn't wake up." No recent illness, fever, or falls. No alcohol or illicit drug use. Which of the following nursing interventions would NOT be appropriate for this patient?
      A)
      Provide education on medication adherence
      B)
      Monitor for suicidal ideation
      C)
      Encourage participation in groups and cognitive stimulation activities
      D)
      Provide low-stimulation environment at all times
    3. A family asks why their father is attending activity groups at the long-term care facility. The son states, "My father worked hard all of his life. He just needs some rest at this point." Which is the appropriate nursing reply?
      A)
      "The groups are optional. Only clients at high functioning levels would benefit."
      B)
      "If your father doesn't go to these activity groups, he will be at high risk for developing dementia."
      C)
      "The groups benefit your father by providing social interaction, sensory stimulation, and reality orientation."
      D)
      "I'm glad we discussed this. We'll excuse him from the activity groups."
    4. At what time during a 24-hour period should a nurse expect clients with Alzheimer's disease to exhibit more pronounced symptoms?
      A)
      At twilight/evening
      B)
      After taking medications
      C)
      In the middle of the night
      D)
      When they first awaken

    Exam Review

    1. A client diagnosed with bulimia nervosa has a nursing diagnosis of ineffective coping related to (R/T) feelings of loneliness as evidence by (AEB) bingeing then purging when alone. Which is an appropriate outcome related to this nursing diagnosis?
      A)
      The client will verbalize two positive self attributes by day 3 in treatment.
      B)
      The client will list five ways that the body reacts to bingeing and purging.
      C)
      The client will appropriately express angry feelings about lack of control by week 2 in treatment.
      D)
      The client will identify two alternative methods of dealing with loneliness by day 3 in treatment.
    2. Which of the following signs and symptoms supports a diagnosis of depression in an adolescent? Select all that apply.
      (SATA)
      A)
      New onset inappropriate anger
      B)
      Exaggerated somatic complaints
      C)
      Insomnia onset
      D)
      Inflated self esteem
    3. Depression in the elderly is often characterized by:
      A)
      Lack of distress
      B)
      Improvement in symptoms as the day progresses
      C)
      Disorientation
      D)
      Slow progression
    4. Maya's parents state she becomes irritable and aggressive in response to sensory challenges and changes in routine. They are interested in learning about all of the available options to support her safety and well-being. The nurse anticipates providing education on which medications that are FDA-approved for irritability in Autism Spectrum Disorders (ASD)?
      A)
      haloperidol (Haldol) and diphenhydramine (Benadryl)
      B)
      methylphenidate (Ritalin) and atomoxetine (Strattera)
      C)
      sertraline (Zoloft) and fluoxetine (Prozac)
      D)
      risperidone (Risperdal) and aripiprazole (Abilify)

    Exam Review

    1. A physician orders mixed amphetamine salts (Adderall) for a child diagnosed with attention deficit-hyperactivity disorder (ADHD). Which information about this medication should the nurse provide to the parents?
      A)
      Administer Adderall to the child just prior to bedtime to reduce nausea.
      B)
      Adderall must be titrated to a therapeutic dose for it to work properly.
      C)
      Administer Adderall to the child after breakfast.
      D)
      If one dose of Adderall is missed, double the next dose.
    2. Which psychiatric disorder would a nurse most likely to expect to see newly diagnosed in a geriatric client?
      A)
      Phobic disorder
      B)
      Paranoid personality disorder
      C)
      Major depressive disorder
      D)
      Schizophrenia
    3. The nurse suspects a client is experiencing delirium. Which specific assessment information would support this suspicion?
      A)
      Onset is insidious (gradual) and relentless
      B)
      Symptoms last for 1 month or longer
      C)
      Slow onset of confusion and agitation
      D)
      A decreased level of consciousness with intermittent hypervigilance
    4. A parent describes a 3-year-old child in constant motion and is unable to sit still during story time. The parent is concerned about this behavior. Which nursing response indicates an appropriate evaluation of the situation?
      A)
      "This child has symptoms of the early stages of autistic disorder."
      B)
      "This child's behavior indicates possible symptoms of oppositional defiant disorder."
      C)
      "This child has symptoms of attention deficit hyperactivity disorder."
      D)
      "This child's behavior must be evaluated according to developmental norms."

    Exam Review

    1. The family members of a patient with vascular dementia note that the patient is acting like herself and that she has returned to baseline. As the nurse, you want to be sure that the family understands that:
      A)
      Vascular dementia symptoms can vary and may clear up, but there is an irregular pattern of decline.
      B)
      Vascular dementia involves the development of Lewy Bodies.
      C)
      Vascular dementia is not treatable with medication.
      D)
      Vascular dementia has a slow, insidious (gradual) onset
    2. A nursing instructor is teaching about pharmacological treatments for attention deficit-hyperactivity disorder (ADHD). Which information about atomoxetine (Strattera) should be included in the lesson plan?
      A)
      Strattera will be a life-long intervention for clients diagnosed with this disorder.
      B)
      Strattera, unlike methylphenidate (Ritalin), is a selective norepinephrine reuptake inhibitor.
      C)
      When taking Strattera, a client should not be taking Ritalin or any other stimulant.
      D)
      Strattera, unlike methylphenidate (Ritalin), is a central nervous system depressant.
    3. A 23-year old male presents to the outpatient clinic for his annual physical exam. He endorses periods of bingeing on certain foods, and then feeling guilty and attempting to purge the calories by inducing vomiting, drinking excessive amounts of coffee and taking laxatives. A nurse observes dental deterioration when assessing the patient. What explains this assessment finding?
      A)
      Food is rapidly ingested without proper mastication.
      B)
      Poor dental and oral hygiene leads to dental caries.
      C)
      Purging causes the depletion of dietary calcium.
      D)
      The emesis produced during purging is acidic and corrodes the tooth enamel.
    4. A 23-year old male presents to the outpatient clinic for his annual physical exam. He endorses periods of bingeing on certain foods, and then feeling guilty and attempting to purge the calories by inducing vomiting, drinking excessive amounts of coffee and taking laxatives. A nurse observes dental deterioration when assessing the patient. The nurse is preparing educational materials for the patient. Which FDA approved medication should the nurse anticipate discussing with the patient?
      A)
      fluoxetine (Prozac)
      B)
      clonidine
      C)
      lisdexamphetamine (Vyvanse)
      D)
      olanzapine (Zyprexa)

    Exam Review

    1. A 19-year old female is being hospitalized with a BMI of 16. For over a year, she has been dieting and has become more withdrawn from friends and family. She continues to perform well in college classes. An ECG showed bradycardia and her temperature is 36C. Physical findings in the patient with Anorexia Nervosa is likely include:
      A)
      Tachycardia, increased BP
      B)
      Amenorrhea
      C)
      Esophageal tears
      D)
      Increase in bone density
    2. A 19-year old female is being hospitalized with a BMI of 16. For over a year, she has been dieting and has become more withdrawn from friends and family. She continues to perform well in college classes. A ECG showed bradycardia and her temperature is 36C. When obtaining a daily weight for the patient in the acute-care unit who has Anorexia Nervosa, the nurse checks:
      A)
      That the patient can see the weight to minimize anxiety
      B)
      To make sure that the patient knows their exact weight so that they participate in care.
      C)
      For "tricks" that could cause the measured weight to be more than actual weight of the patient.
      D)
      That the patient is always wearing layered gowns to ensure privacy during weight checks.
    3. The client has a nursing diagnosis of "altered body image as evidence by client claims of "feeling fat" despite emaciated appearance (extremely thin)". Which is the most appropriate outcome goal for this nursing diagnosis
      A)
      The client will verbalize positive statements about healthy weight and body image.
      B)
      The client will not express a preoccupation with food.
      C)
      The client will cease strenuous exercise programs.
      D)
      The client will consume adequate calories to sustain normal weight.
    4. A child with a diagnosis of ODD begins yelling at staff members when asked to leave group therapy because of inappropriate language. Which nursing intervention would be the most therapeutic approach?
      A)
      Institute seclusion following agency protocol.
      B)
      Allow the child to stay in group therapy to monitor the situation further.
      C)
      Accompany the child to a quiet area to decrease external stimuli.
      D)
      Administer PRN medication to decrease inappropriate behaviors.