• NR 601 FINAL EXAM 2 – QUESTION AND ANSWERS

• NR 601 FINAL EXAM 2 – QUESTION AND ANSWERS • A 77-year-old Hispanic Catholic Nun (retired) who immigrated to the United States 15 years ago lives alone but in an apartment complex where her sister lives as well. She is being discharged home after a hospitalization for congestive heart failure with prescriptions for 8 different medications. She is considered at risk for noncompliance due to the following contributing factors except: • Ethnic background • A 78-year-old patient who is dying of colon cancer with metastases to the liver is refusing to eat or drink. He is alert and oriented, and states that he has no desire to eat, which is causing the family great distress. In order to best address the client and family, you should: • Educate the family that this is normal behavior in this situation • A 79-year-old female client resides independently in the community. The client’s daughter is concerned because her mother insists on wearing a sweater and keeps all of the windows closed even though it is 90 degrees Fahrenheit outside. The nurse practitioner initially recognizes that this behavior may be related to: • age-related neurosensory changes that diminish awareness of temperature changes • An 88-year-old, being admitted to rule out lung cancer, is assessed using the short form of the Geriatric Depression Scale tool. When it is determines that the earned score is 9, the nurse practitioner initially: • asks if they have any thoughts of committing suicide • The area in which nurse practitioners have the greatest effect on the safe, effective medication therapy of an older client is: • educating the client to all aspects of the medication. • The Beers list is an effective tool for healthcare professionals prescribing and/or managing the medication therapy of older adults since it identifies medications that for this population: • have a higher than usual risk for injury • A client who reported, “a problem sleeping” shows an understanding of good sleep hygiene when: • limiting the afternoon nap to just 30 minutes • Common causes of dyspnea in the older adult may include which of the following? • Heart failure Asthma Chronic obstructive lung disease Pneumonia • Common ethical issues in the nursing home may include which of the following? • Quality of life Decision-making capacity Preservation of autonomy Surrogate decision making • The cost of nursing home care is significant. The primary payer for nursing home care is: • Medicaid and private pay. • Each of the following assessment finding is a contributor to an older client’s risk for falls except: • client has a history of contact dermatitis and psoriasis • Each of the following data supports the diagnosis of sleep apnea in the older adult except: • followed a vegetarian diet for last 28 years • Factors that affect the pharmacokinetics of lipophilic medications in older include: • greater adipose tissue ratio to body mass • The following precautions are beneficial in minimizing an older adult’s risk of being a victim of fraud except: • Rely on the advice of people who only friends have recommended. • In order to focus on the older population with the greatest risk for suicide the nurse practitioner would conduct a depression that targets: • White men • In planning teaching for a client with diabetes, which precaution related to fall prevention is particularly important for the nurse practitioner to include? • Rising slowly from the table after meals • It is imperative that nursing take a leadership role in providing effective health care across the lifespan and in various health care settings. Which intervention will have the greatest impact on achieving positive outcomes concerning that issue? • A baccalaureate degree nursing program including a geriatric care course into the curriculum • The nurse is most concerned by observing which of the following during an older client’s physical assessment: • a slightly raised irregular patch that is bluish black in color • The nurse is providing care to a client diagnosed with dementia. What option is an example of the appropriate use of implied consent by the nurse? • Changing the client's dressing when the client asks, "Will you change this bandage now?" • The nurse practitioner demonstrates an understanding of the older client’s preventable risk factors for early death when: • providing clients with information regarding the effectiveness of a nicotine patch monitoring the blood pressure of those living at a homeless shelter each month weighing the clients who visit a walk-in clinic that is located in an economically depressed neighborhood educating the diabetic residents of a low rent apartment complex on how to monitor their blood glucose levels • The nurse practitioner documents that an older adult client is living independently in a safe environment. Which assessment data supports this evaluation? • The client demonstrates the home's security alarm system. Various safety features were installed when the bathroom was remodeled. The nurse observes the client wearing a safety alarm bracelet. The client's home is within walking distance of a grocery store. • The nurse practitioner educates the older client that the greatest risk related to poor foot care results is: • loss of independent mobility. • The nurse practitioner has the obligation to ask questions and obtain specific information about the use of herbs and supplements. Which of the following statements is most accurate regarding herbal therapy? • may interact with prescription medications