Walden NRNP 6540 Final Exam Latest
Update Questions with Correct Answers
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1. In the assessment for peripheral vascular disorders, the clinician should begin with which of
the following after the general history and physical examination?
1. Auscultation of the carotid arteries bilaterally.
2. Palpation of the carotid arteries bilaterally.
3. Inspection of the carotid arteries bilaterally.
4. Order diagnostic testing. - Answer -1. Answer: 1
Page: 215
Feedback
1.
The clinician should begin with auscultation of the carotid arteries bilaterally because cardiac murmurs
will usually radiate into the carotid arteries.
2.
After auscultation of the carotid and subclavian arteries, the clinician should proceed to palpation of the
brachial, radial, and ulnar arteries.
3.
After auscultation and palpation, careful inspection should be performed of the distal fingers and the nail
beds.
4.
Diagnostic testing is usually ordered when areas of concern are found.
1. Mrs. Borden is 67 years old and her primary care physician wants her to be seen by a nurse
practitioner who specializes in geriatric issues. On completing the interview and examination, the nurse
practitioner tells Mrs. Borden that she will order a blood laboratory specimen for thyroid function and
pancreatic function. Mrs. Borden asks what the reason is. Which of the following is the nurse
practitioner's best response?
,1. Diabetes is more common in older patients.
2. Thyroid issues are less common in older patients.
3. These are common tests to be done on any new patient.
4. These tests are necessary to obtain baseline information. - Answer -1. Answer: 1
Page: 361
Feedback
1.
The nurse practitioner recognizes that normal aging changes of the endocrine system primarily are
related to a decrease in pancreatic function (inability to sufficiently secrete insulin), resulting in diabetes
mellitus.
2.
The nurse practitioner needs to screen older adults periodically for diabetes mellitus and thyroid disease
because the incidence of these conditions increases with age.
3.
The nurse practitioner managing the care of older adults needs to differentiate among four clinical
states. One of those is an endocrine function that is altered relative to that of younger patients, but is an
expected consequence of normal aging.
4.
Overall, the nurse practitioner managing the care of older adults needs to differentiate among four
clinical states:
1. An endocrine function that is altered relative to that of younger patients, but is an expected
consequence of normal aging.
2. Altered endocrine function secondary to coincident nonendocrine disease, but is not of known
pathological significance.
3. Iatrogenic changes in endocrine function that largely reflect the polypharmacy seen in the older adult
population.
4. Authentic endocrinopathy.
1. Mrs. James is 78 years old and comes to the clinic for an annual checkup. The nurse practitioner
addresses the psychosocial needs of older adults and specifically the need for which of the following?
,1. Dependence.
2. Dignity, credibility, and respect.
3. Being alone.
4. Not being touched. - Answer -1. Answer: 2
Page: 428
Feedback
1.
The psychosocial assessment of the older adult entails an evaluation of the following basic needs:
autonomy and independence.
2.
The psychosocial assessment of the older adult entails an evaluation of the following basic needs:
dignity, credibility, and respect.
3.
The psychosocial assessment of the older adult entails an evaluation of the following basic needs:
communication and belonging.
4.
The psychosocial assessment of the older adult entails an evaluation of the following basic needs: touch.
1. Mrs. M. W. comes into the primary care office for her regular yearly checkup. The nurse practitioner
begins the assessment by asking if there are concerns Mrs. M. W. has that need to be addressed. The
patient says that she has been experiencing periodic episodes of abdominal cramps and diarrhea that
just comes and goes. The nurse practitioner continues the assessment with which of the following?
1. Asking about the sequence of events and events that triggered each episode.
2. Conducting a complete neurological examination.
3. Collecting a urine specimen.
4. Evaluating abdominal pain. - Answer -1. Answer: 1
Page: 225
, Feedback
1.
Determining the sequence of events that triggered each symptom and inquiring about precipitating
factors such as a meal, position of the body, use of caffeine, or alcohol and smoking will lead to a
differential diagnosis.
2.
Information regarding episodes of anorexia, dyspepsia, dysphagia, heartburn, nausea, regurgitation,
vomiting, painful or difficult defecation, diarrhea, tenesmus, or constipation can be clustered to form a
differential diagnosis.
3.
The physical examination is often unremarkable, and laboratory findings may not provide diagnostic
information because the presentation of illness in an older adult is usually subdued.
4.
Ask about the severity of pain by having the patient rate her pain on a scale of 1 to 10. Realize, however,
that in older adults, pain may be blunted despite the underlying pathology.
1. Mrs. Williams is 76 years old and comes in to have a wound checked on her right leg. She fell a month
ago and the wound has not healed. She is concerned that something is wrong. The nurse practitioner
examines the wound and sees that it has been cleaned properly and has no signs of infection. The edges
are approximated, but the skin around the wound is red and tender to touch. The best response
regarding Mrs. Williams' concern is:
1. Wound healing for older people may take up to four times longer than it does for younger people.
2. Let us talk about what you are eating.
3. Had you come in earlier, I would have ordered medicine that would have healed that right up.
4. I will order an antibiotic to prevent infection. - Answer -1. Answer: 1
Page: 96
Feedback
1.
Skin renewal turnover time increases to approximately 87 days in older adults, compared with 20 days
during youth.
Update Questions with Correct Answers
Guaranteed Pass
1. In the assessment for peripheral vascular disorders, the clinician should begin with which of
the following after the general history and physical examination?
1. Auscultation of the carotid arteries bilaterally.
2. Palpation of the carotid arteries bilaterally.
3. Inspection of the carotid arteries bilaterally.
4. Order diagnostic testing. - Answer -1. Answer: 1
Page: 215
Feedback
1.
The clinician should begin with auscultation of the carotid arteries bilaterally because cardiac murmurs
will usually radiate into the carotid arteries.
2.
After auscultation of the carotid and subclavian arteries, the clinician should proceed to palpation of the
brachial, radial, and ulnar arteries.
3.
After auscultation and palpation, careful inspection should be performed of the distal fingers and the nail
beds.
4.
Diagnostic testing is usually ordered when areas of concern are found.
1. Mrs. Borden is 67 years old and her primary care physician wants her to be seen by a nurse
practitioner who specializes in geriatric issues. On completing the interview and examination, the nurse
practitioner tells Mrs. Borden that she will order a blood laboratory specimen for thyroid function and
pancreatic function. Mrs. Borden asks what the reason is. Which of the following is the nurse
practitioner's best response?
,1. Diabetes is more common in older patients.
2. Thyroid issues are less common in older patients.
3. These are common tests to be done on any new patient.
4. These tests are necessary to obtain baseline information. - Answer -1. Answer: 1
Page: 361
Feedback
1.
The nurse practitioner recognizes that normal aging changes of the endocrine system primarily are
related to a decrease in pancreatic function (inability to sufficiently secrete insulin), resulting in diabetes
mellitus.
2.
The nurse practitioner needs to screen older adults periodically for diabetes mellitus and thyroid disease
because the incidence of these conditions increases with age.
3.
The nurse practitioner managing the care of older adults needs to differentiate among four clinical
states. One of those is an endocrine function that is altered relative to that of younger patients, but is an
expected consequence of normal aging.
4.
Overall, the nurse practitioner managing the care of older adults needs to differentiate among four
clinical states:
1. An endocrine function that is altered relative to that of younger patients, but is an expected
consequence of normal aging.
2. Altered endocrine function secondary to coincident nonendocrine disease, but is not of known
pathological significance.
3. Iatrogenic changes in endocrine function that largely reflect the polypharmacy seen in the older adult
population.
4. Authentic endocrinopathy.
1. Mrs. James is 78 years old and comes to the clinic for an annual checkup. The nurse practitioner
addresses the psychosocial needs of older adults and specifically the need for which of the following?
,1. Dependence.
2. Dignity, credibility, and respect.
3. Being alone.
4. Not being touched. - Answer -1. Answer: 2
Page: 428
Feedback
1.
The psychosocial assessment of the older adult entails an evaluation of the following basic needs:
autonomy and independence.
2.
The psychosocial assessment of the older adult entails an evaluation of the following basic needs:
dignity, credibility, and respect.
3.
The psychosocial assessment of the older adult entails an evaluation of the following basic needs:
communication and belonging.
4.
The psychosocial assessment of the older adult entails an evaluation of the following basic needs: touch.
1. Mrs. M. W. comes into the primary care office for her regular yearly checkup. The nurse practitioner
begins the assessment by asking if there are concerns Mrs. M. W. has that need to be addressed. The
patient says that she has been experiencing periodic episodes of abdominal cramps and diarrhea that
just comes and goes. The nurse practitioner continues the assessment with which of the following?
1. Asking about the sequence of events and events that triggered each episode.
2. Conducting a complete neurological examination.
3. Collecting a urine specimen.
4. Evaluating abdominal pain. - Answer -1. Answer: 1
Page: 225
, Feedback
1.
Determining the sequence of events that triggered each symptom and inquiring about precipitating
factors such as a meal, position of the body, use of caffeine, or alcohol and smoking will lead to a
differential diagnosis.
2.
Information regarding episodes of anorexia, dyspepsia, dysphagia, heartburn, nausea, regurgitation,
vomiting, painful or difficult defecation, diarrhea, tenesmus, or constipation can be clustered to form a
differential diagnosis.
3.
The physical examination is often unremarkable, and laboratory findings may not provide diagnostic
information because the presentation of illness in an older adult is usually subdued.
4.
Ask about the severity of pain by having the patient rate her pain on a scale of 1 to 10. Realize, however,
that in older adults, pain may be blunted despite the underlying pathology.
1. Mrs. Williams is 76 years old and comes in to have a wound checked on her right leg. She fell a month
ago and the wound has not healed. She is concerned that something is wrong. The nurse practitioner
examines the wound and sees that it has been cleaned properly and has no signs of infection. The edges
are approximated, but the skin around the wound is red and tender to touch. The best response
regarding Mrs. Williams' concern is:
1. Wound healing for older people may take up to four times longer than it does for younger people.
2. Let us talk about what you are eating.
3. Had you come in earlier, I would have ordered medicine that would have healed that right up.
4. I will order an antibiotic to prevent infection. - Answer -1. Answer: 1
Page: 96
Feedback
1.
Skin renewal turnover time increases to approximately 87 days in older adults, compared with 20 days
during youth.
