NR 601 Midterm (Questions and Answers) 1.            A 60-year-old woman presents with a chief complaint of uncomfortable breathing on exertion. She has had a minimally productive cough for several years that does not bother her. On further questioning, she states that her breathing gets much worse when she lies down. The most likely cause of her dyspnea is: 2.            A 68-year-old male presents with a chief complaint of episodes of lightheadedness or dizziness. He states that sweating, tachycardia, and some hand trembling are often associated with these episodes. Which one of the following questions should you ask to help confirm the diagnosis? 3.            A 68-year-old male presents with a chief complaint of episodic dizziness. Although not dizzy at present, he states that he has noted onset of dizzy episodes when he rolls over in bed and occasionally when he turns his head rapidly. Episodes last about 3 minutes. The most likely diagnosis is: 4.            A 75-year old resident in the nursing home has end stage dementia and experiences a 10-pound weight loss over the course of 2 months. The resident has become increasingly difficult to feed and often spits out food, pockets food, and frequently drools. The family is concerned about the resident’s nutritional status. What is the initial action of the nurse practitioner? 5.            A 77-year-old client being treated for glaucoma asks the nurse practitioner what causes glaucoma. The nurse bases the response on the knowledge that the increase in intraocular pressure is a result of: 6.            . A 78-year-old man is being evaluated in the geriatric clinic. His daughter reports that he has been very forgetful lately, and she is concerned that he might be “senile.” The advanced practice nurse administers the clock drawing test and the patient draws a distorted circular shape and places the numbers all on one side of the shape. Based on his performance, the nurse concludes that the patient: 7.            The abrupt onset of symptoms of stress or urge incontinence is most often due to a urinary tract infection 8.            After first managing the pain being experienced by the client with gout, the treatment focuses on: 9.            Based on current demographic data, which statement identifies a predictive trend regarding the health care needs of society? 10.          The caregiver for an older adult with cognitive impairment is concerned about the individual’s seeming disinterest in eating. Which suggestion does the nurse practitioner offer based upon a known effect of dementia on a client’s nutrition? 11.          A client is newly diagnosed with type 2 diabetes mellitus. Which diagnostic test will best evaluate the management plan prescribed for this client? 12.          Compared with acute pain, persistent chronic pain requires the nurse practitioner to: 13.          Ethnocentrism is defined as: 14.          The FANCAPES assessment tool focuses on the older adult’s: 15.          The following are true statements about bipolar disorders in older adults except 16.          The greatest risk for injury for a client with progressed Parkinson’s disease is: 17.          In the elderly population, the fastest growing group is the age range: 18.          It has been projected that the cultural group presenting the greatest growth rate among the older adult population will be the: 19.          The nurse is teaching a health promotion class at a senior center. Which of the following statements demonstrate that the participant does not understand the topic: 20.          The nurse practitioner educates that client that Healthy People 2010: 21.          The nurse practitioner is caring for a client with a newly diagnosed chronic illness. In answering the client’s questions, the nurse practitioner most accurately responds when basing the response on the fact that: 22.          The nurse practitioner is developing a class on stroke prevention for a local senior citizens center. What would be an important focus when teaching stroke prevention directed at modifiable risk factors? 23.          The nurse practitioner provides a client with education regarding the use of My Pyramid. What is the primary advantage of the United States Department of Agriculture’s (USDA) My Pyramid to the older adult client? 24.          The nurse practitioner shows an understanding of appropriate influenza vaccination guidelines for a client over the age of 65 when stating: 25.          The nurse shows understanding of the need to promote healthy skin in the older adult when encouraging the client to all of the following except : 26.          Of the following clients, all of whom are 65 years of age or older, the nurse practitioner anticipates that the one who will rate himself or herself as has having excellent health will be: 27.          An older adult client has been voluntarily admitted for treatment of alcohol dependency. In implementing care, the nurse plans which intervention based upon knowledge about alcohol and aging? 28.          An older adult client shares with the nurse that, “I don’t know what it is but it seems that I need more light for reading or even watching television as I get older.” The nurse explains that aging may cause this change due to the: 29.          An older adult is admitted to the hospital during the night after a serious fall. When you round on the patient, you note that the patient has been prescribed meperidine (Demerol) for muscle pain. The nurse practitioner: 30.          An older adult is currently prescribed both aspirin (81 mg) and ibuprofen daily. What instructions are most important for the nurse practitioner to provide to assure the expected outcomes for this client? 31.          An older adult recently diagnosed with depression asks, “How long will it take for the antidepressant medication to make me feel better?” The nurse practitioner correctly responds: 32.          An older man has a history of medication therapy for hypertension. Which intervention does the nurse practitioner implement when the client reports that, “I’ve fallen twice in 5 weeks”? 33.          Tinnitus is defined as: 34.          Weight loss is frequently caused by ingestion of one or more of the following drugs. Antibiotics Digoxin Nonsteroidal anti-inflammatory drugs (NSAIDs) Theophylline A, B, and C 35.          What information will be included in client education for an older adult who needs to manage their calcium levels? 36.          When best promoting a sense of well-being, the role of the nurse practitioner caring for a terminally ill client is to: 37.          When considering Erikson’s developmental stages, the task for later life is referred to as: 38.          When diagnosed with diverticulosis, a client asks how this problem occurred. Which assessment data identifies a risk factor for diverticulosis? 39.          When educating the older adult population about the risks to physical health that chronic alcohol abuse presents, the nurse practitioner is especially careful to include the: 40.          Which assessment data does not support the medical diagnosis of coronary heart disease? 41.          Which assessment data would not be of particular concern when attempting to manage an older adult’s risk for dehydration? 42.          Which diagnostic laboratory test would the nurse practitioner typically not order for the purpose of evaluating an individual’s acute, unexplained weight loss? 43.          Which intervention is not therapeutic when facilitating communication with a cognitively impaired older client? 44.          Which of the following causes of chest pain are often relieved by sublingual nitroglycerin? 45.          Which of the following culturally diverse male clients will most benefit from educational material related to “Staying Healthy into your 80s” 46.          Which of the following drugs does not typically cause constipation? 47.          Which of the following drugs do not trigger or aggravate a cough? 48.          Which of the following is not a common cause of constipation? 49.          Which statement correctly describes normal changes of aging? 50.          Which statement made by a client recently diagnosed with diverticular disease would indicate that she needs additional teaching regarding dietary considerations?                            

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