Adult nursing I - midterm
The nurse utilizing evidence-base practice (EBP) considers which factors when planning care?
(select all that apply)
a. Cost-saving measures
b. Values of the client
c. Nurse's expertise
d. Client preferences
e. Research findings - ANS b. Values of the client
c. Nurse's expertise
d. Client preferences
e. Research findings
A nursing student working in an Adult Care for Elders unit learns that frailty in the older
population includes which components? (Select all that apply)
A: Exhaustion
B: Slowed physical activity
C: Dementia
D: Weight gain
E: Weakness - ANS A: Exhaustion
B: Slowed physical activity
E: Weakness
A health care provider prescribes genetic testing for a client who has a family history of
colorectal cancer. Which action should the nurse take before scheduling the client for the
procedure?
a. Assess if the client is prepared for the risk of psychological side effects.
b. Respect the client's right not to share the results of the genetic test.
c. Confirm that informed consent was obtained and placed on the client's chart.
d. Provide genetic counseling to the client and the client's family members. - ANS c. Confirm
that informed consent was obtained and placed on the client's chart.
An older client had hip replacement surgery and the surgeon prescribed morphine sulfate for
pain. The client is allergic to morphine and reports pain and muscle spasms. When the nurse
calls the surgeon, which medication should he or she suggest in place of the morphine?
a. Meperidine (Demerol)
b. Cyclobenzaprine (Flexeril)
c. Hydromorphone hydrochloride (Dilaudid)
d. Ketorolac (Toradol) - ANS c. Hydromorphone hydrochloride (Dilaudid)
, Cyclobenzaprine (used for muscle spasms), ketorolac, and meperidine (both used for pain) are
all on the Beers list of potentially inappropriate medications for use in older adults and should
not be suggested. The nurse should suggest hydromorphone hydrochloride.
A nurse cares for a client of Asian descent who is prescribed warfarin (Coumadin). What action
should the nurse perform first?
a. Schedule an international normalized ratio (INR) test to be completed each day.
b. Teach the client about bleeding precautions, including frequent checks for any bruising.
c. Initiate fall precautions and strict activity limitations.
d. Confirm the prescription starts warfarin at a lower-than-normal dose. - ANS d. Confirm the
prescription starts warfarin at a lower-than-normal dose.
Most individuals of Asian heritage have a single nucleotide polymorphism in the CYP2C19 gene
that results in low activity of the enzyme produced. This mutation greatly reduces the
metabolism of warfarin, leading to increased bleeding risks and other serious side effects. Any
person of Asian heritage who needs anticoagulation therapy should be started on very low
dosages of warfarin and should have his or her INR monitored more frequently. The nurse can
always teach about the risk of bleeding and can monitor for any bruising. The priority action is
for the nurse to check the prescription and confirm the dose prior to administering the
medication. It is not necessary to initiate fall precautions and to limit activity based on the
administration of warfarin.
An older adult is brought to the emergency department because of sudden onset of confusion.
After the client is stabilized and comfortable, what assessment by the nurse is most important?
a. Evaluate the client for gait abnormalities.
b. Perform a delirium screening test.
c. Assess for orthostatic hypotension.
d. Determine if there are new medications. - ANS d. Determine if there are new medications.
A hospice nurse is caring for a variety of clients who are dying. Which end-of-life and death
ritual is paired with the correct religion?
a. Islam - An ill or dying person should receive the Sacrament of the Sick.
b. Judaism - A person who is extremely ill and dying should not be left alone.
c. Christian - Upon death, a religious leader should perform rituals of bathing and wrapping the
body in cloth.
d. Roman Catholic - Autopsies are not allowed except under special circumstances. - ANS b.
Judaism - A person who is extremely ill and dying should not be left alone.
According to Jewish law, a person who is extremely ill or dying should not be left alone.
Orthodox Jews do not allow autopsies except under special circumstances. The Islamic faith
requires a religious leader to perform rituals of bathing and wrapping the body in cloth upon
death. A Catholic priest performs the Sacrament of the Sick for ill or dying people.
The nurse utilizing evidence-base practice (EBP) considers which factors when planning care?
(select all that apply)
a. Cost-saving measures
b. Values of the client
c. Nurse's expertise
d. Client preferences
e. Research findings - ANS b. Values of the client
c. Nurse's expertise
d. Client preferences
e. Research findings
A nursing student working in an Adult Care for Elders unit learns that frailty in the older
population includes which components? (Select all that apply)
A: Exhaustion
B: Slowed physical activity
C: Dementia
D: Weight gain
E: Weakness - ANS A: Exhaustion
B: Slowed physical activity
E: Weakness
A health care provider prescribes genetic testing for a client who has a family history of
colorectal cancer. Which action should the nurse take before scheduling the client for the
procedure?
a. Assess if the client is prepared for the risk of psychological side effects.
b. Respect the client's right not to share the results of the genetic test.
c. Confirm that informed consent was obtained and placed on the client's chart.
d. Provide genetic counseling to the client and the client's family members. - ANS c. Confirm
that informed consent was obtained and placed on the client's chart.
An older client had hip replacement surgery and the surgeon prescribed morphine sulfate for
pain. The client is allergic to morphine and reports pain and muscle spasms. When the nurse
calls the surgeon, which medication should he or she suggest in place of the morphine?
a. Meperidine (Demerol)
b. Cyclobenzaprine (Flexeril)
c. Hydromorphone hydrochloride (Dilaudid)
d. Ketorolac (Toradol) - ANS c. Hydromorphone hydrochloride (Dilaudid)
, Cyclobenzaprine (used for muscle spasms), ketorolac, and meperidine (both used for pain) are
all on the Beers list of potentially inappropriate medications for use in older adults and should
not be suggested. The nurse should suggest hydromorphone hydrochloride.
A nurse cares for a client of Asian descent who is prescribed warfarin (Coumadin). What action
should the nurse perform first?
a. Schedule an international normalized ratio (INR) test to be completed each day.
b. Teach the client about bleeding precautions, including frequent checks for any bruising.
c. Initiate fall precautions and strict activity limitations.
d. Confirm the prescription starts warfarin at a lower-than-normal dose. - ANS d. Confirm the
prescription starts warfarin at a lower-than-normal dose.
Most individuals of Asian heritage have a single nucleotide polymorphism in the CYP2C19 gene
that results in low activity of the enzyme produced. This mutation greatly reduces the
metabolism of warfarin, leading to increased bleeding risks and other serious side effects. Any
person of Asian heritage who needs anticoagulation therapy should be started on very low
dosages of warfarin and should have his or her INR monitored more frequently. The nurse can
always teach about the risk of bleeding and can monitor for any bruising. The priority action is
for the nurse to check the prescription and confirm the dose prior to administering the
medication. It is not necessary to initiate fall precautions and to limit activity based on the
administration of warfarin.
An older adult is brought to the emergency department because of sudden onset of confusion.
After the client is stabilized and comfortable, what assessment by the nurse is most important?
a. Evaluate the client for gait abnormalities.
b. Perform a delirium screening test.
c. Assess for orthostatic hypotension.
d. Determine if there are new medications. - ANS d. Determine if there are new medications.
A hospice nurse is caring for a variety of clients who are dying. Which end-of-life and death
ritual is paired with the correct religion?
a. Islam - An ill or dying person should receive the Sacrament of the Sick.
b. Judaism - A person who is extremely ill and dying should not be left alone.
c. Christian - Upon death, a religious leader should perform rituals of bathing and wrapping the
body in cloth.
d. Roman Catholic - Autopsies are not allowed except under special circumstances. - ANS b.
Judaism - A person who is extremely ill and dying should not be left alone.
According to Jewish law, a person who is extremely ill or dying should not be left alone.
Orthodox Jews do not allow autopsies except under special circumstances. The Islamic faith
requires a religious leader to perform rituals of bathing and wrapping the body in cloth upon
death. A Catholic priest performs the Sacrament of the Sick for ill or dying people.
