Comprehensive Nrs 146 Final Exam

45 Questions

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Comprehensive Nrs 146 Final Exam

Comprehensive NRS 146


Questions and Answers
  • 1. 
    Bladder Training may be the most helpful in the prevention and management of which type of incontinence?
    • A. 

      Overflow

    • B. 

      Stress

    • C. 

      Functional

    • D. 

      Urge

  • 2. 
    Your older adult client is complaining of night time incontinence. Her incontinence occurs after she awakens and starts coughing. You suspect her type of incontinence is:
    • A. 

      Overflow

    • B. 

      Stress

    • C. 

      Functional

    • D. 

      Urge

  • 3. 
    An older adult man who is complaining about difficulty starting his urine flow and then dribbling urine after he urinates is most likely exhibiting signs of:
    • A. 

      Stress Incontinence

    • B. 

      Benign Prostatic Hypertrophy

    • C. 

      Pyelonephritis

    • D. 

      Nocturia

  • 4. 
    A nurse is providing care to an older adult with cystitis. Which of the following type of medication would most likely b prescribed?
    • A. 

      Tricyclic antidepressant

    • B. 

      Anticholinergic

    • C. 

      Antispasmodic

    • D. 

      Antibiotic

  • 5. 
    A nurse is providing care to a older adult with BPH (Benign prostatic hypertrophy). which of the following medications would most likely be prescribed?
    • A. 

      Keflex (cephalosporin)

    • B. 

      Togranil (imipramine)

    • C. 

      Flomax (tamsulosin)

    • D. 

      Detrol (tolterodine)

  • 6. 
    Your older adult client has been diagnosed with Gastroesophageal Reflux Disease (GERD). She is also experiencing diminished kidney function. Based on this diagnosis and his condition, you anticipate, she will have which type of drug ordered:  
    • A. 

      Histamine h2 Antagonist

    • B. 

      Stool Softener

    • C. 

      Stimulant Laxative

    • D. 

      Protein Pump Inhibitor

  • 7. 
    Older adults may exhibit which of the following if they are also experiencing sleep disturbances?
    • A. 

      Confusion

    • B. 

      Decreased memory

    • C. 

      Morning headaches

    • D. 

      Constipation

  • 8. 
    Your client asks you what changes normally occur in sleep patterns in the older adult: You tell them:
    • A. 

      The elderly retain sleep patterns from their younger years

    • B. 

      The elderly fall asleep more easily than younger adults

    • C. 

      The elderly have a longer total sleeping period

    • D. 

      The elderly tend to wake up earlier

  • 9. 
    Which non-pharmacological nursing interventions can assist an older adult with sleep: Check all that apply.
    • A. 

      Noise level (silence or using a fan to muffle sounds)

    • B. 

      Dark room (lighting)

    • C. 

      Benadryl

    • D. 

      Temperature of the room (cold or warm)

  • 10. 
    Your older adult client has been losing weight and you are considering the NANDA stem of Nutrition less than body requirements. You expect that his weight loss could be a result of all of the following: (Select all that apply)
    • A. 

      Ill Fitting Dentures

    • B. 

      Age related decrease in saliva production

    • C. 

      Access to food due to limited mobility

    • D. 

      Small diverticuli

  • 11. 
    You understand that your older adult client is at risk for poisoning due to all of the following normal age related changes except:
    • A. 

      Decreased sense of smell

    • B. 

      Decreased blood supply to the liver

    • C. 

      Decreased tolerance of lactose

    • D. 

      Decreased in near sighted vision

  • 12. 
    Your older adult client is complaining that his stool is very hard and dry. What medication would you anticipate will be ordered to soften his stool?
  • 13. 
    Along with administering this medication, what other education would you give your client to assist with his constipation?
    • A. 

      Increase water intake

    • B. 

      Decrease fiber intake

    • C. 

      Eat earlier in the day to aid peristalsis

    • D. 

      Limit his activity until his stool is normal

  • 14. 
    Which nursing intervention may help maximize existing pulmonary function:
    • A. 

      Deceasing oral fluid intake

    • B. 

      Taking vital signs

    • C. 

      Sculpting once a week

    • D. 

      Elevating the head of the bed

  • 15. 
    You make the following suggestions for your healthy 70 year old healthy neighbor to reduce her cardiac workload:
    • A. 

      Increase caffeine intake

    • B. 

      Space out daily activities

    • C. 

      Take up gardening

    • D. 

      Decrease drinking water

  • 16. 
    Which of the following activities would best promote health maintenance among older adults when we consider normal cardiovascular changes that occur with aging?
    • A. 

      Running a marathon once a year

    • B. 

      Watching sports for an hour on television every night

    • C. 

      Taking 12 hour hikes in the mountains every weekend

    • D. 

      Swimming or yoga for 20 minutes 3-5 times a week

  • 17. 
    You know your 70 year old healthy neighbor is at increased risk for complications if she gets a respiratory infection because of these normal changes in the aging pulmonary system.
    • A. 

      Increased flexibility of her rib cage

    • B. 

      Increased total body water causing thinner mucus

    • C. 

      Decrease in cilia that helps move mucus out of respiratory tract

    • D. 

      Changes in respiratory muscles that cause increased respiratory rate

  • 18. 
    There are many changes in the cardiovascular and pulmonary systems that are a result of primary aging. Which one did we discuss in class?
    • A. 

      Ribs and vertebral joints expand

    • B. 

      Valves in veins become less competent

    • C. 

      Pericardium softens

    • D. 

      Heart valves become floppy

  • 19. 
    When assessing the older adult regarding sleep, which of the following would be appropriate?
    • A. 

      The nurse will ask about the parent history regarding sleep

    • B. 

      The nurse will ask key points about the environment during sleep hours

    • C. 

      The nurse will ask about sleep routines, including any sleep aides usually utilized

    • D. 

      The nurse will ask about dietary intake and medications schedules

  • 20. 
    Which of the following medications are commonly used to assist a client with sleep?
    • A. 

      Iphenhydramine/ Benadryl

    • B. 

      Methotrexate/Rhematrex

    • C. 

      Zolpidem/Ambien

    • D. 

      Temazepam/Restoril

  • 21. 
    Which of the following criteria indicates that an older patient has become a victim of polypharmacy?
    • A. 

      Medications that are contraindicated are not used

    • B. 

      Medications that interact concurrently are not used

    • C. 

      There is no improvement after discontinuation of medications

    • D. 

      Medications are used to counteract side effects of previous medications

  • 22. 
    The definition of polypharmacy according to the World Health Organization (WHO) supports which statement?
    • A. 

      The cost of medications for older adults should be better covered by Medicare

    • B. 

      Middle age adults are the greatest consumer of drugs in western countries

    • C. 

      Adverse drug events (ADEs) are decreasing in older adults due to better vigilence

    • D. 

      Polypharmacy exists when more medicines are used that are clinically necessary

  • 23. 
    Mr. Penta was receiving an oral antibiotic for an infection. The nurse noticed that the peak level of antibiotic  was not in therapeutic range. The physiological reason for this was that:
    • A. 

      The patient took the antibiotic with milk, which was contraindicated

    • B. 

      The patient was not taking the antibiotic as prescribed

    • C. 

      Decreased gastrointestinal motility delayed the peak effects of the oral drug

    • D. 

      The rate of absorption was fast due to increased cardiac input

  • 24. 
    What is a contributing factor to multiple drug use by older adults?
    • A. 

      No changes have occurred in older adults' lifestyles

    • B. 

      The occurrence of adverse drug reactions has decreased

    • C. 

      Health care providers fail to coordinate medication regimens

    • D. 

      Compliance with medication regimens has increased

  • 25. 
    The BEERS criteria describes:
    • A. 

      How medication is absorbed, distributed and metabolized differently by adults

    • B. 

      Limits on alcoholic beverages that are considered safe for older adults

    • C. 

      Medication that is recommended for use by older adults

    • D. 

      Rationale for medication considered inappropriate for use by older adults

  • 26. 
    Your client has presbyopia. You know this means they are experiencing a:
    • A. 

      Common visual disturbances that is secondary aging

    • B. 

      Decline in hearing

    • C. 

      Decline in their ability to focus on nearby objects

    • D. 

      Decline in smell

  • 27. 
    Your client has presbycusis. You know this means they are experiencing a:
    • A. 

      Common visual disturbance that is secondary aging

    • B. 

      Decline in hearing

    • C. 

      Decline in their ability to focus on nearby objects

    • D. 

      Decline in smell

  • 28. 
    Your client has hypoguesia. You know this means they are experiencing a(n):
    • A. 

      Absence of taste

    • B. 

      Decline in taste

    • C. 

      Absence of smell

    • D. 

      Decline in smell

  • 29. 
    What group is the most common perpetrator in elder abuse?
    • A. 

      Family members of the older adult

    • B. 

      Nursing Assistants

    • C. 

      Strangers

    • D. 

      Nurses

  • 30. 
    Because your client who has alterations in proprioception but no other significant sensory deficits, they are at risk for which of the following (select all that apply):
    • A. 

      Social Isolation

    • B. 

      Falls

    • C. 

      Food poisoning

    • D. 

      Dehydration

  • 31. 
    Your client has anosmia. You know this means they are experiencing a:
    • A. 

      Absence of taste

    • B. 

      Absence of smell

    • C. 

      Decline in smell

    • D. 

      Decline in taste

  • 32. 
    Which is NOT considered to be a vulnerable adult?
    • A. 

      A 17 year old with a developmental disability

    • B. 

      A 50 year old resident in a nursing home

    • C. 

      An 80 year old woman receiving Chore services in her home

    • D. 

      A 65 year old who needs assistance with dressing and eating

  • 33. 
    1-866-ENDHARD should be called in WA state to report abuse or neglect of an older adult who lives in their own home.
    • A. 

      True

    • B. 

      False

  • 34. 
    You witness a vulnerable adult being threatened by a family member while they are visiting the nursing home. Your initial response must be:
    • A. 

      Call to report the incident because you are a mandatory reportor

    • B. 

      Tell your supervisor

    • C. 

      Document what you saw

    • D. 

      Make sure the nursing home resident is safe

  • 35. 
    Your client has asked what you know about advanced directives in WA state. You tell them about the _________ form that you learned about in class.
    • A. 

      PLAST

    • B. 

      Physician Orders

    • C. 

      POLST

    • D. 

      Vial of Life

  • 36. 
    The psychosexual stage of development describes an older adult who expresses themselves through relationships and friendships.
    • A. 

      Latent Stage

    • B. 

      Genital Stage

    • C. 

      Intuitive Stage

    • D. 

      Generativity Stage

  • 37. 
    What is the term that describes when someone views older people as different and not having the same desires, needs and concerns as themselves?
    • A. 

      Ageism

    • B. 

      Gerontology

    • C. 

      False Imprisonment

    • D. 

      Ego Integrity

  • 38. 
    Which is Erickson's development crisis for the older adult?
    • A. 

      Generativity vs. Stagnation

    • B. 

      Identity vs. Role Confusion

    • C. 

      Ego Integrity vs. Despair

    • D. 

      Trust vs. Mistrust

  • 39. 
    Life Expectancy refers to:
    • A. 

      The maximum length of time a person can possibly live

    • B. 

      The targeting of someone who is different from yourself

    • C. 

      The average length of time an organism will survive

    • D. 

      The probable number of years a person will live

  • 40. 
    Using Erickson's theory, nurses can help older adults meet their developmental task by...
    • A. 

      Encouraging early retirement from their jobs

    • B. 

      Listening to their stories and recognizing achievements

    • C. 

      Relieving them from responsibility in self-care

    • D. 

      Shielding them from family and community problems

  • 41. 
    Your client asks you about risk factors associated for osteoporosis. Which of the following facts about your client would be a risk factor for osteoporosis?
    • A. 

      High calcium diet

    • B. 

      Maintaining joint cartilage

    • C. 

      Decreased height

    • D. 

      Post menopausal age

  • 42. 
    Your client asks you what changes to expect in her musculoskeletal system as she ages. Which of the folloing facts will be in your explanation? Check all that apply.
    • A. 

      Stiffened ligaments

    • B. 

      Decreased joint cartilage

    • C. 

      Decreased height

    • D. 

      Increased lung expansion

  • 43. 
    Your client has experienced a transient ischemic attack (TIA). His symptoms are gone and he has a new prescription for a new medication. Which of the following would you expect to see ordered?
    • A. 

      Methotrexate/Rheumatrex (DMARD)

    • B. 

      Ibuprofen (NSAID

    • C. 

      Aspirin/ ASA (NSAID

    • D. 

      Aceteminophin (analgesic)

  • 44. 
    Your client has been diagnosed with Osteoarthritis. Knowing appropriate medications for pain management for this disorder, which of the following medications would you expect to see ordered?
    • A. 

      Methotrexate/Rheumatrex (DMARD)

    • B. 

      Clopidogrel/Plavix (antiplatelet)

    • C. 

      Aspirin/ ASA (NSAID)

    • D. 

      Ibuprofen (NSAID)

  • 45. 
    Your client has been recently diagnosed with Parkinson's disease. Which of the following statements made by your client would indicate she needs more education about living with and managing her disease?
    • A. 

      Tremors, rigid muscles, impaired balance and possible dementia may occur

    • B. 

      The disease involves a lack of dopamine production in her brain

    • C. 

      Parkinson's is a neurological degenerative disease

    • D. 

      Most people with Parkinson's are diagnosed when they are under 50 years old