Download Advanced Practice Nursing in the Care of the Older Adult and more Exams Nursing in PDF only on Docsity! Kennedy-Malone Ch. 8 Advanced Practice Nursing in the care of the older adult Latest 2024-2025. Questions & Correct, Verified Answers. Graded A+ A 55-year-old post-menopausal woman with a history of hypertension complains of jaw pain on heavy exertion. There were no complaints of chest pain. Her ECG indicates normal sinus rhythm without ST segment abnormalities. Your plan may include: A. Echocardiogram B. Exercise stress test C. Cardiac catheterization D. Myocardial perfusion imaging - ANSB. Exercise stress test A 72-year-old woman and her husband are on a cross-country driving vacation. After a long day of driving, they stop for dinner. Midway through the meal, the woman becomes very short of breath, with chest pain and a feeling of panic. Which of the following problems is most likely? A. Pulmonary edema B. Heart failure C. Pulmonary embolism D. Pneumonia - ANSC. Pulmonary embolism A common auscultatory finding in advanced CHF is: A. Systolic ejection murmur B. S3 gallop rhythm C. Friction rub D. Bradycardia - ANSB. S3 gallop rhythm A key symptom of ischemic heart disease is chest pain. However, angina equivalents may include exertional dyspnea. Angina equivalents are important because: A. Women with ischemic heart disease many times do not present with chest pain B. Some patients may have no symptoms or atypical symptoms. Diagnosis may only be made at the time of an actual myocardial infarction C. Elderly patients have the most severe symptoms D. A & B only - ANSD. A & B only An older adult may present with atypical clinical signs of pneumonia. The nurse practitioner needs to be aware that the clustering of all of the following signs and symptoms may be indicative of pneumonia in an older person except: A. Bradycardia B. Malaise C. Anorexia D. Confusion - ANSA. Bradycardia Aortic regurgitation requires medical treatment for early signs of CHF with: A. Beta blockers B. ACE inhibitors C. Surgery D. Hospitalization - ANSB. ACE inhibitors Dan G., a 65-year-old man, presents to your primary care office for the evaluation of chest pain and left-sided shoulder pain. Pain begins after strenuous activity, including walking. Pain is characterized as dull, aching; 8/10 during activity, otherwise 0/10. Began a few months ago, intermittent, aggravated by exercise, and relieved by rest. Has occasional nausea. Pain is retrosternal, radiating to left shoulder, definitely affects quality of life by limiting activity. Pain is worse today; did not go away after he stopped walking. BP 120/80. Pulse 72 and regular. Normal heart sounds, S1 and S2, no murmurs. Which of the following differential diagnoses would be most likely? A. Musculoskeletal chest wall syndrome with radiation B. Esophageal motor disorder with radiation C. Acute cholecystitis with cholelithiasis D. Coronary artery disease with angina pectoris - ANSD. Coronary artery disease with angina pectoris In mitral stenosis, p waves may suggest: A. Left atrial enlargement B. Right atrial enlargement C. Left ventricle enlargement D. Right ventricle enlargement - ANSA. Left atrial enlargement Jose M. is a 68-year-old man who presents to your primary care practice for a physical. Jose has had type 2 diabetes mellitus for 5 years, diet controlled. His BMI is 32. Smoker, pack per day for 25 years. He denies other medical problems. Family history includes CAD, CABG x4 for father, now deceased; CHF, type 2 diabetes mellitus, HT for mother. According to the AHA/ACC guidelines, what stage is Jose? A. Stage A B. Stage B C. Stage C D. Stage D - ANSA. Stage A Preceding a stress test, the following lab work might include: A. CBC and differential to differentiate ischemic heart disease from anemia B. Liver enzymes to rule out underlying gall bladder disease B. Stress test C. Chest x-ray D. Echocardiography - ANSD. Echocardiography
