Nur 163 Final Exam Review Questions With Answers Latest Update 2023/2024 Graded A+

NUR 163 FINAL EXAM REVIEW QUESTIONS WITH ANSWERS LATEST UPDATE 2023/2024 GRADED A+. Benefit of reminiscing with elderly patients? Diversion, brings back happy memories, it reienforces that their life made a difference What do elderly fear the least? Dying If spouse passed 18 months ago what stage would they be in? renewed energy, acceptance stage Middle eastern pt that doesn’t drink milk or eat cheese, what can you use to give them calcium instead? Yogurt Chronic fatigue syndrome have lack of energy, we want them to still be able to function? Frequent breaks, balance, work and rest. What might help elderly patient sleep? Warm milk, bathroom before bed, expose them to sunlight daily, bath (may not be warm) Elderly should not nap throughout the day, but early in the afternoon for about 30 minutes When doing ROM assess pain first Vaginal dryness and pain during intercourse- water soluble, over the counter, no prescription Why do we keep religious items by our patients if they don’t recognize them? comfort Can family bring food to patients? Yes Low bp, increased heart rate, sunken eyes, what interventions we do? Monitor fluid balance, daily weights, labs, increased fluids Plan of care for pt swallowing problems? Thickened liquids, feed them slowly, small bites, sips of their drink, rest periods, position upright Why are good coping skills when you are younger important when you get older? Use what works and they may change due to situation Electrolye imbalance causes muscle weakness, lethargyhypercalcemia Vitamin D what does it do? Helps absorb calcium What level of prevention are vaccines? Primary How to care for a hearing aid? Wipe with wet cloth, open batter case Positive effect of mild stress? Mental alertness What can reduce stress if pt is hospitalized or in a nursing home? Continuity of care, keeping the same caregivers Which normal complication of aging will lead to a decreased appetite? Decreased parastalysis Low bone density, what do we teach them? weight bearing exercises Does physical therapy assess for bone density? No If you have a pt who is bed bound what would be a teritiary prevention? (teaching) ROM- when pt doesn’t participate it is called passive Glaucoma- stand in front of the patient, down on their level If you are working in a nursing home that refuses to leave their room what can you say to help them? validating them and encourage them to come out of their room. Ask how can I help you? Osteoporosis do you want them to do strength training? No, they can swim, walk, yoga, ti-chee If pt is on hospice care can they seek life saving treatment? No What are s/s of BPH? Nocturia, uti, urinary retention, igniting urine and maintaining a urine stream Lipid proten which is good? HCL s/s of dvt- swelling of affected leg, redness, warm to touch low fat foods to help you raise your HDL? Lentils, beans, fish, chicken, whole grains if pt is high fall risk are you going to turn off all of the lights in the room? No multiple physicians,what are they at risk for? Polypharmacy what causes delirium? uti Expressive ephasia? Uti in elderly patients? Disorientation, dark urine, strong odor Malordoris-bad odor What foods are higher in sodium? Canned and processed Do normal changes in again sometimes mimic alcohol? Yes, shaking, stumbling, unsteady, if you notice pt has these signs what do you do? Don’t assume they are using alcohol and assess the patient What are s/s of ineffective coping? Alterations in sleep, lack of self care, changes in bowel and bladder, anxiety s/s of depression- isolation, poor appetite, irritable, loss of interest, alterations in sleep, heart failure what do we want to teach them to do throughout the day? Elevate their legs rationalization= explaining or justifying your behavior using logical reasons, actions if they are right or wrong dysphagia- frequent breaks, take your time, don’t eat alone, positioning, oral care, speech therapy helps with swallowing problems osteoporosis elderly patients will loose height pt stays up when nurse makes round and they stay up all night- what is an intervention- minimize interruptions crutches- bear weight on good leg prioritizing- ABC’s, vital signs, Level of consciousness Goal of using assistive devicesprevent injury Vision screening- once a year Nation patient safety goals are set by joint commission Do older adults need to use fluoride toothpaste? Yes Have a family who brings pt in for routine visit and they want a mental status exam? You ask them what are other changes If pt has insomnia what are the positive outcomes we want for treatment? Better sleep, able to function throughout the day Last resort for sleeping issues- medication Nocturnal movement disorder- contributes to sleep disturbances (RLS) Should you drink caffeine or alcohol before bedtime? No Do we want them to eat a big meal before bedtime? No Watch tv or read a book? No Bed for sleep only What is one of the good routines we want the elderly to have to sleep? A schedule for bedtime What older adults are at higher risk of suicide? Alcohol abuse Low selfesteem- sadness and anger, lack of motivation, don’t make eye contact Chronic fatigue- 8 things- nutrition, disturbed sleep, no exercise, depression, pain How do we diagnose chronic fatigue? Rule out other diagnoses, assessment and labs Best nursing interventions for chronic fatiguesupport, validate the patient How do you get people to trust you? Establish a therapeutic relationship NUR 163 FINAL EXAM REVIEW WITH ANSWERS Exercise with chronic fatigue? Start out slow, avoid over exertion or strenuous activities Estrogen and progesterone decrease with menopause What interventions can maintain the sexual health of an older adult? Educate them on STD’s Teach them interventions related to comfort If we have pts from other cultures, values and beliefs, what is a positive outcome of them receiving good care? better outcomes, increases willingness to use the healthcare system, participate in healthcare planning Energy, joints and muscles, improve strength and balance, cardiac, weight control- benefits of exercise in elderly Normal physiological changes in aging? Decreased bone density, decreased peristalsis, decreased metabolism, decreased cardiac output What are symptoms of poor stress coping? Fatigue, tachycardia, tension in muscles (neck), disorientation or inability to concentrate, anxiety Genetic test a preventative meause for elderly patients? No Risk factors related to poor nutrition? Low income, loss of independence, proximity, geographical location, loss of mobility What can you do for a patient who is incontinent? Incontinence pads or briefs Which one of these would be a priority? Chronic pain, indigestion, restless leg syndrome, headache, or obstructive sleep apena? OSA If pt tells you he has trouble getting an erection, what do you say? Medication may cause ED If your patient is of a different culture who can we refer them to? Dietitian Intervention of orthostatic hypotension? Dangle feet or sit at edge of bed before getting up What food group helps heal wound- proteins- chicken, beans, eggs, dairy Besides dangling feet over the side of the bed, what else do we want them to do? No quick movement, get up slowly What disease process can put pt at risk for hypothermia- dementia How frequently are we screening health- yearly, eyes-yearly NUR 163 FINAL EXAM REVIEW WITH ANSWERS Compliance and willingness to learn, what is one of the big factors that impact our patients compliance and willingness to learn? Motivation and where it is SPICES- used to identify or monitor health status over time, sleep disturbance, problems with eating/feeding, C continence, e, s is skin breakdown Unpaid care givers who are family members- caregiver breakdown- make sure they are not overwhelmed and make sure they are recognized as part of the healthcare team, appreciate and noticed Who established national patient safety goals? Joint commission Things that effect drug metabolism in geriatric patients? Liver, decrease blood flow to liver, decrease activity, GI, As LPN who can you delegate to STNA? Feeding, bath, walking, any nonskilled task How much exercise do we recommend for our elderly a day? 3o minutes walking or swimming Secondary measures for screenings: yearly exams, mammograms, vaccinations KATZ- measures ADLs Communication with a patients loved one, what do we want to remember when communicating with them? Be simple, direct, sensitive, don’t use medical jargon, verify what is really going on If we are communication with a patient who is hard of hearing? Face patient, low tone, speak clearly If we are doing an interview with a patient when we go into a room? Introduce yourself, tell them what you are going to do, make sure you have the right person Risk factors for hip fracture: history of falls, female, osteroporisis, non skids, reduce clutter, assistive devices, exercise, rugs, reduce fall risks, frequent checks, help toileting If stna reports a list of things to you, which one of these would be wrong? That you would want to follow up on? Turned off all of the lights when the patient went to bed. Moved the beside table and belongings to the end NUR 163 FINAL EXAM REVIEW WITH ANSWERS of the bed Barrier cream in a deep open wound What is a treatment we can do to treat hypothermia? Increase temp slowly, blankets, increase room temp, hat, warm bath/shower, clothing, cover head and toes MORSE Scale? Fall scale-strength, gait, transfer, orientation, NUR 163 FINAL EXAM REVIEW WITH ANSWERS Administering medication to geriatric patients what do we want to keep in mind? Don’t give as much due to slow metabolism, will affect dosage ranges that we use What contributes to a culture of safety for staff? positive attitude If you go into a patient’s room and they are usually nice and now the attitude has changed, what might you want to test? UA Is Alzheimer’s disease a normal part of aging? No When we are trying to care for our patients with Alzheimer’s disease what do we want to do to not overwhelm them? Reduce choices, one or two options, enter their world. If were interviewing a patient with expressive dysphagia what is one of the techniques, we can use while interviewing? Picture board, just yes or no questions What do vital signs do if we have dehydration- bp goes down and pulse goes up Pernicious anemia- vitamin b-12 deficiency