MSSC – SAFETY EXAM 2024/2025 WITH 100% ACCURATE SOLUTIONS, Exams of Nursing

Download MSSC – SAFETY EXAM 2024/2025 WITH 100% ACCURATE SOLUTIONS and more Exams Nursing in PDF only on Docsity! NRNP 6540 DIDACTIC EXAM 2024/2025 WITH 100% ACCURATE SOLUTIONS There are benign and lethal murmurs. Which of the following are true of lethal murmurs - Answer ✔✔hospitalization is required when arrhythmias result from hemodynamic compromise Cardioversion pre hospitalization may be needed Aggressive therapeutic treatment is needed when symptomatic Underlying cardiac problems need to be discovered What are the classes of BMI for obesity - Answer ✔✔Class 1 30-35 Class II 35-39.9 Class morbid >40 What is the screening tool for alcohol - Answer ✔✔Cage It is positive if they answer yes to two or more and then perform a SMAST-G screening tool What are the hypertension guidelines for patients greater than 60 years of age - Answer ✔✔150/90 for patients without DM or CKD 140/90 for patients with DM or CKD Why would you initiate statins on elderly patients - Answer ✔✔1-cvd 2 - LDL >190 3-in patients age 40-75, LDL of 70-189 Was what is a positive malnutrition score - Answer ✔✔Greater than 10 lb weight loss in 6 months Use the MUST tool Elderly population should you screen for hyperlipidemia - Answer ✔✔Patients that have known hypertension, smoking, or diabetes What is the scales nutrition screening tool - Answer ✔✔S-sadness, C- cholesterol, A-albumin, L- loss of weight E- eating problems, S - shopping problems What are the vision screening requirements of patients > 65 - Answer ✔✔Snelling chart - annually Patients with hypertension or diabetes must have a dilated exam annually What are the hearing screening requirements of patients > 65 - Answer ✔✔Asking questions about whether people say they appear to have problems with turning the volume up the major impact of the physiological changes that occur with aging is - Answer ✔✔Reduced physiological Reserve-Particularly the cardiac, respiratory, and renal systems Reduced homeostatic mechanisms-That fail to adjust regulatory systems such as temperature control and fluid and electrolyte balance Changes in the sympathetic response-which contribute to orthostasis and Falls as well as a lack of hypoglycemic response Impaired immunologic response the strongest evidence regarding normal physiological aging is available through - Answer ✔✔Longitudinal studies the following statements are true about laboratory values in older adults - Answer ✔✔Reference ranges are preferable Normal ranges may not be applicable for older adults Reference ranges are not necessarily acceptable values biochemical individuality is best described as - Answer ✔✔Each individual's variation is often much smaller than that of a larger group polypharmacy is best described as - Answer ✔✔Even a single med if there is not a clear indication for its use pharmacokinetic changes with aging is reflective of - Answer ✔✔What the body does to the drug All of the following statements are false about drug absorption except - Answer ✔✔Underlying chronic disease has little impact on drug absorption all of the following statements are true about drug distribution in the elderly - Answer ✔✔drugs distributed in fat have less intense, more prolonged effect drugs highly protein bound have greater potential to cause an adverse drug reaction the fastest way to deliver a drug to the action site is by inhalation men have faster and more efficient biotransformation of drugs and this is thought to be due to - Answer ✔✔testosterone the cytochrome P system involves enzymes that are generally - Answer ✔✔Inhibited or induced by drugs a statement not shown to be true about pharmacodynamics changes with aging - Answer ✔✔and hand sensitivity to central nervous system drugs drug responsiveness can be influenced by patients activity level decreased sensitivity to beta blockers they do not have a decrease sensitivity to oral anticoagulants a typical presentation of disease in the elderly is reflected by all of the following - Answer ✔✔infection without fever depression without dysphoric mood cardiac manifestations of thyroid disease functional abilities are best assessed by - Answer ✔✔Observed assessment of function What is a reference range in laboratory values - Answer ✔✔How age or sexcan attribute to An example of an active strategy of health promotion for an individual to accomplish would be - Answer ✔✔Beginning a Stress Management program You are working with an older male adult with a long history of alcohol abuse and a 30-year history of smoking. In recommending an intervention for this client you're responsibility is to - Answer ✔✔Chest x-ray at the same time of PPD test What is primary prevention - Answer ✔✔measures to decrease the incidence of disease What is secondary prevention? - Answer ✔✔treating or controlling a disease or condition after it occurs What is tertiary prevention? - Answer ✔✔Rehabilitative therapies and monitoring of health to prevent complications or further illness, injury, or disability - Answer ✔✔ What are some recommendations not to use with dementia patients - Answer ✔✔Do not use antipsychotics as first line drug Do not recommend percutaneous feeding tubes Only use metformin in patients with - Answer ✔✔Hemoglobin A1c of less than 7.5 What trip details are considered high risk in the elderly patient - Answer ✔✔Longer than 3 weeks Mission, medical tourism, volunteerism, visiting friends or relatives Traveling alone Adventure-backpacking scuba diving Hostile, Budget Hotel, camp What is malaria chemoprophylaxis - Answer ✔✔Subtropical areas in Africa South America, and South Asia What is travelers diarrhea - Answer ✔✔-bacterial or parasitic -usually lasts 2-3 days -self limiting usually -only treat if severely ill, high fever, or lasts >7 days Treat with fluoroquinolones What are the exercise recommendations for older adults - Answer ✔✔Strengthen muscles The best recommendation for a patient who states they have no equipment to exercise would be - Answer ✔✔Improvise with recommended objects at home that can be used When the nurse practitioner recommends exercise for sedentary older adult, which of the following pieces of advice should be considered for all types of exercise - Answer ✔✔Start low and go slow The evidence reflects that comprehensive geriatric assessment should be conducted - Answer ✔✔Targeting the vulnerable and frail elderly Evidence-based geriatric assessment instruments available to the clinician - Answer ✔✔Include screening, evaluation, and measurement instruments in multiple domains When interviewing the older adult with the suspected dementia, it is most important that - Answer ✔✔The Examiner should use short simple questionand recognize nonverbal signs of discomfort What are dimensions of symptomology - Answer ✔✔Onset, location, absence of associated symptoms The term geriatric syndrome is best described as - Answer ✔✔Condition that has multiple underlying factors and involves multiple systems The anal wink reflex is used to test - Answer ✔✔Sensation and Prudential nerve function Atypical presentation of acute coronary syndrome is - Answer ✔✔More common in females What disease can mimic an often coexist with myocardial infarctions in elderly with coronary artery disease - Answer ✔✔Esophageal disease Thoracic aortic dissection presents typically as - Answer ✔✔Severe retrosternal CP that radiates to the back and both arms Medications known to contribute to constipation include - Answer ✔✔Stimulant laxatives Anticholinergic drugs Iron Bordetella pertussis is best described as - Answer ✔✔Subacute cough lasting greater than 2 weeks The routine testing of tuberculosis should occur in all of the following vulnerable populations - Answer ✔✔Nursing home residents Prison inmates Immunocompromised patients What is true about fluid balance in the elderly - Answer ✔✔Thirst response decreases as a person ages Total body water decreases with age African Americans have higher rates of dehydration than white Americans Distinguishing delirium from dementia can be problematic since they may coexist the primary consideration in the differential is - Answer ✔✔Rapid change and fluctuating course of cognitive function Presbystasis - Answer ✔✔age-related decline in equilibrium or dynamic balance If dizziness has a predictable pattern associated with it common the clinician should first consider - Answer ✔✔Hypoglycemia What are contributing factors to dysphagia - Answer ✔✔Anticholinergics Drugs that increase reflux Inadequate intake of fluids with medication and meals Evidence shows that the most important predictor of a fall is - Answer ✔✔A prior history of Falls The most cost-effective intervention used to prevent Falls - Answer ✔✔Home modifications and Vitamin D supplements Chronic fatigue syndrome is best described as - Answer ✔✔Fatigue lasting longer than 6 months and not relieved by rest Which form of headache is bilateral - Answer ✔✔Tension Microscopic hematuria is defined as - Answer ✔✔3 or more RBCs on 3 or more samples of urine What are the associated risk factors of finding malignancy in a patient with hemoptysis - Answer ✔✔Male sex Smoking history Over the age of 40 Recent weight loss is defined as - Answer ✔✔A loss of greater than 10 lb over the past 3 to 6 months When should cystoscope be performed on a patient after hematuria - Answer ✔✔Renal ultrasoundin addition with patients micro hematuria categorized as intermediate risk for malignancy What is life-threatening hemoptysis - Answer ✔✔Greater than 100 ml in less than 24 hours Sudden onset of hemoptysis - Answer ✔✔Probable PE What are common medications that can cause weight loss - Answer ✔✔Antidepressants, digoxin, ACE inhibitors, beta blockers,laxatives,Flagyl,calcium carbonate, iron, potassium, NSAIDs,theophiland, Synthroid, anticolinergics What should be performed on a geriatric assessment for joint pain - Answer ✔✔Swelling, deformity, decreased range of motion, crepitus,and whether there are multiple joints involved If applicable additional maneuver such as the McMurray test for a meniscus tear Should you check uric acid during a gout flare-up - Answer ✔✔No because it is not useful since the urate will be sequestered in the affected joint Which electrolyte balances are related to muscle cramps - Answer ✔✔Hypocalcemia Hypokalemia Hyponatremia Hypomagnesemia What lab value should you pay attention to with restless leg syndrome - Answer ✔✔Iron if the ferritin is low iron replacement is required What is the Wells clinical rule - Answer ✔✔Useful with DVT What is the primary diagnostic tool for Lymphedema - Answer ✔✔Leg lymphoscintigraphy What is the most important diagnostic test with syncope - Answer ✔✔EKG What should be placed for the long-term evaluation of syncope - Answer ✔✔Loop recorder What are effective treatments for essential tremor - Answer ✔✔Propanolol, primidone, and Topamax What medications can be used to treat stress incontinence - Answer ✔✔Alpha adrenergics Serotonin norepinephrine reuptake inhibitors What is a measure of overall muscle strength - Answer ✔✔Hand grips What is primary prevention - Answer ✔✔Health promotion and illness prevention What is the best factor for predicting increased risk of malnutrition? - Answer ✔✔Unexplained weight loss The NP is monitoring the immune response following hepatits B vaccination in an elderly hemodialysis patient. What test should be ordered and when to assess the immune response? - Answer ✔✔HBsAb completed 2 months after the last dose As a general rule, patients over 65 years of age and in general good health can receive which immunizations? - Answer ✔✔PCV 15, Tdap, and Quadrivalent high dose inactivated influenza vaccine,Two doses of RZV administered 2 to 6 weeks apart The NP sees a 69-year-old patient who recently moved to town and does not remember his last tetanus shot. The patient did not receive any immunizations as a child. What would you do? - Answer ✔✔One does 89-year-old is reporting bouts of agitation. The apron is counseling her family that these periods of agitations can be triggered by which of the following - Answer ✔✔Approaches from other people The APRN is considering ordering medications to help control an older patient's agitationWhich medication should they order - Answer ✔✔Psychotropic medications-including antipsychotics, anxiolytics and antidepressants An APRN is admitting a patientWho has diminished ability to ambulate and as difficulty with ADLs. When asked if he drinks alcohol he says yes the practitioner follows up with a psychosocial evaluation because - Answer ✔✔His condition could be related to a long-term usage of alcohol or a new occurrence The daughter of a 7-year-old woman asked the APR and why her mother has had a change in functional ability recently.The mother has regularly been drinking for 40 years however her behavior is changingThe reply from the APRN should be - Answer ✔✔Physical changes due to aging affect the body's metabolism of alcohol differently Older adults often have trouble sleeping due to age-related issues. What can the APRN suggest to help with insomnia - Answer ✔✔Maximize daytime exposure to Bright Light during the day to help promote sleep What are some signs of bipolar with Mania or hypomania in a 67 year old - Answer ✔✔Flight of ideas, rapid speech, grandiosity The APRN is assessing a 69-year-old man for possible bipolar. Which for the following are appropriate tests for to screen a patient for cognitive disorders related to bipolar disorder - Answer ✔✔Diagnostic studies - CBC, CMP, toxicology, urinalysis, thyroid function test,Rapid plasma rhinogen, HIV, EKG Mini mental state examination St Louis University mental statu (slums) In 82-year-old is in rehab for a knee replacement. The APRN is visiting and find some confused, disoriented, and having difficulty speakingThe staff nurse says that his condition chain quickly over the last few hoursSome suggested orders would be - Answer ✔✔Pulse oximetry,Evaluation for infection,Brain scan,Assessment for change in medications A 69-year-old is beginning to experience some cognitive decline. His son brings him to the practitioner for evaluation. The APRN assesses for which of the following signs or symptoms - Answer ✔✔Cognitive decline is complex attention, executive function, learning, and memory Gradual onset and slow course of illness and progression Impaired ability to care for oneself Total or partial loss of ability to recognize familiar people A 75 year old is suffering from depression. He tells the API and that he is tired of feeling so low. He asked if depression is a normal part of aging.The APRN tells him the depression is which of the following - Answer ✔✔Not a normal part of aging Can be related to nutritional deficiencies, especially vitamin B12 and D Triggered by one life event Compounded by learned helplessness, loss, and bereavement A 70-year-old being treated for geriatric depression. What would the APRN do for the treatment of the patient's depression - Answer ✔✔Evaluate the present medication regimen Treat any comorbidity Order and SSRI Order Abilify A 90-year-old has a daytime caregiver. her daughter stays with her during the evening. The daughter suspect her mother is being abused. An 88 year old comes to the APRN with a complaint about a growth on her hand. She wants to have a biopsy done. Which question should they appear in ask the patient for a biopsies ordered - Answer ✔✔Growths that weren't biopsy are those that have changed, blood, or are painful A 60-year-old male enters the burn center for triage and treatment due to a burn he has received at a campfire. His left arm has an area that is erythematis and painful, and another area has a blister. What is the degree of these Burns - Answer ✔✔First and second degree What is a first degree burn? - Answer ✔✔-Superficial burn involving the epidermis -Caused by sunburn and minor flash injuries -No edema, no blisters What is the second degree burn? - Answer ✔✔epidermis and partial thickness of the dermis are involved. area is painful and blisters are present What is a third degree burn? - Answer ✔✔epidermis full thickness of the dermis, and potentially deeper tissues are involved area is painless, white, and charred The APRN is concerned with primary prevention strategies. What primary prevention strategy with the APRN Implement for an 80 year old male patient who smokes - Answer ✔✔Primary prevention includes educational programs designed to educate the public. The individual smoking in bedblah blah blah The aparn is conducting a safety class with Community-living older adults. Which risk of burn should they appear include for this population - Answer ✔✔Thinner skin Less vascularity Diminished nerve function A weakened immune system In a puren is seeing a patient with herpes zoster rash on the right sideand face near their eyes. The areas are painful and weeping. Which of the following is true treatment of herpes zoster - Answer ✔✔Acyclovir 800 mg is given five times a day for 7 days Glucocorticoids can be given as an adjunct IV antivirals are to be given to immunocompromised patients Ms Thomas is an 82-year-old and burned her hand while cooking. The APRN assess is second and third degree burns over approximately half of the back of her handthe APRN chooseswhich of the following initial treatments - Answer ✔✔Rinse with cool tap water Remove any loose tissue but allow the blisters to remain A 75-year-old comes to the Urgent Care Center with complaints of fever, fast heartbeat, a swollen gland under her right arm, and redness in his upper left arm that is hurt for 2 to 3 days. The patient says that he has redness in his arm for months without any difficulty. The APRN suspects which primary and secondary conditions - Answer ✔✔Cellulitis of the upper left arm Lymphangitis The treatment for cellulitis resulting from an open wound includes which of the following - Answer ✔✔Oral antibiotics for mild cellulitis Dicloxacillin 500 mg four times a day as the antibiotic of choice Drug of choices typically given for 7 days Patient being treating for chemotherapy comes in and describes a couple of days of itching, burning, tingling on the left sidethe APRN advises the nursing staff to observe her vesicles for a few days. The patient ask why she is so sick. Which of the following responses from the APRN would What is a deep tissue injury? - Answer ✔✔Localized area of discolored (purple or maroon) intact skin or blood-filled blister caused by underlying soft tissue damage resulting from pressure or shear. May be difficult to detect among individuals with dark skin tone. May include a blister over a dark wound bed; wound may become covered with eschar. What is the main contributing factor to pressure injury - Answer ✔✔Pressure, Shear, adverse microclimate, and malnutrition Additionally moisture is cited as a related condition because it Alters the resiliency of the epidermis to external forces What are the main treatments for pressure injury - Answer ✔✔I- infection-eliminate, reduced bioburden D-debride necrotic tissue -consider surgical, conservative, sharp, mechanical, enzymatic, biologic, autolytic I -insulate the wound P - protect the periwound tissue A - absorb excess exudate M-maintain a constant moisture level O - obliterate Dead Space P - prevent further injury Pharmacological treatment of pressure injury - Answer ✔✔Most moisture retentive dressings are available without a prescription. Some antimicrobials such as silver sulfonamide and Bactroban, some antifungals fluconazole and some enzymatic debriding agents collagenase Common treatments for herpes zoster - Answer ✔✔Acyclovir 800 mg 5 times a day for 7 days Patience with disseminated disease and those who are immunocompromised may need IV antivirals Glucocorticoids Capsaicin cream or Lidocaine patches Gabapentin or Lyrica Patients with involvement of the ocular should be consulted to see an ophthalmologist What are the common causes of cellulitis - Answer ✔✔Beta - hemolytic streptococci,staphylococcus aureus,MSSA and MRSA, and occasional gram-negative organism What are the typical diagnostic test for cellulitis - Answer ✔✔CBC,CRP,erythrocyte sediment rate, Patients with diabetes mellitus should have a radiograph of the area and an ESR to rule out the presence of osteomyelitis or necrotizing infection. Ultrasound can detect an abscess fascicular inflammation Common treatment for cellulitis - Answer ✔✔clindamycin 300 to 600 mg four times daily po doxycycline 200 mg once followed by 100 mg every 12 hours bactrim 160 mg/800 mg one to two tablets twice daily linezolid 600 mg every 12 hours If wound culture is positive total duration of therapy is 7 to 14 days What is the most common mimicker of cellulitis - Answer ✔✔Stasis dermatitis What is stasis dermatitis? - Answer ✔✔Stasis dermatitis occurs with venous insufficiency and valvular incompetency. The proximal skin appears thin and brown, and may occur with distal macules, papules, red irritation, skin thickening and edema. Cellulitis is almost never - Answer ✔✔bilateral Always unilateral Temporomandibular joint Eye health education should be provided to maintain or minimize visual problems. Which of the following should be included in patients education - Answer ✔✔The importance of protecting the eyes from sunlight Information on age-related visual changes Nosebleeds are generally minor and non reoccurring, but when a patient is seen for this, a consultation with an ent specialist has indicated when which of the following conditions occurs - Answer ✔✔Bleeding that is not controlled after 15 minutes of compression A second episode were occurs within a week Massive bleeding Being losses a decreased ability or inability to hear. The loss may involve the external, middle, or inner ear and can be unilateral or bilateral. Which of the following ideologies may result in hearing loss - Answer ✔✔Sensorineural abnormalities Conductiveissues There is no specific diagnostic test for hordeolum or chalazion Unless it becomes recurrent. Which of the following may be a differential diagnosis for these conditions - Answer ✔✔orbital cellulitis Contact dermatitis Acute dacryocystitis Which of the following systemic ideologies can cause retinopathy - Answer ✔✔Hypertension Macular degeneration Diabetes1/2 A patient comes into the emergency department complaining of itching, burning, scaling, and redness in their eye. Symptoms have been going on for some time and are affecting vision. The aprn diagnosis blepharitis. Which of the following should the patient be educated on regarding treatment - Answer ✔✔Cleanse the eyelid once per day with diluted baby shampoo Apply a warm compress to the eye once a day Oral tetracycline should be taken as ordered What causes eyelid swelling when you pull down the lid there is redness treat conservatively or if unresolved with injectable steroids into the eye - Answer ✔✔Chalazion-disorder of the eyelid Disorder of the eyelid that causes small pustule or stye at the edge of the eyelid, treat with warm compresses or antibiotics if unresolved - Answer ✔✔Hordeolum Greasy scales or dandruff like on the eyelid, treat with gentle shampoo and cotton balls - Answer ✔✔Blepharitis Ectropian - Answer ✔✔eversion or turning outward of the eyelid entropion - Answer ✔✔inward turning of the rim of the eyelid What is orbital cellulitis? - Answer ✔✔Inflammation of eye tissues behind the orbital septum. It most commonly refers to an acute spread of infection into the eye socket, usually from untreated sinusitis. MC in ages 7-12 It is a medical emergency What is the treatment for orbital cellulitis - Answer ✔✔*HOSPITALIZE WITH IV ANTIBX*, and possible surgery if recalcitrant An older adult patient presents with a systolic bp of 150 and a diastolic bp of 80. Which statement is correct regarding the blood pressure reading - Answer ✔✔isolated systolic hypertension is defined as sbp greater than 160 and a dbp of less than 90 A 79 year old man who lives with his daughter. His daughter provides excellent care for her father and wants to know which changes in his heart and circulatory system are due to aging in which to lifestyle choices - Answer ✔✔Structural and physiological changes in the aging cardiovascular system can cause decreased capacity to endure stresses and a decline in ability pertaining to physical activity performance The aprn sees a patient in the emergency department with reports of chest pain and nausea. To analyze the patient's condition what further information is needed - Answer ✔✔A description of the pain Asking about precipitating factors, quality, radiation, severity, and timing (pqrst) The APRN in a student are examining the apical pulse of an 82 year old man. The student perceives that there is an s4 sound. This is likely - Answer ✔✔An s4 sound in the absence of other findings is considered normal in older adults The np identifies a late systolic cardiac murmur in an older adult. A student nurse asks what condition this suggests. Which statement should the aprn state and their response? - Answer ✔✔Papillary muscle dysfunction Mitral annular calcification Weakening valves What causes diastolic murmurs in older adults - Answer ✔✔Heart blockages What is of the most common causes of mitral regurgitation - Answer ✔✔Papillary muscle dysfunction Mitral annular calcification 89-year-old female presents to the emergency department with epigastric pain that has been ongoing for about two hours and fatigue. The patient states she is not becoming dyspneic the pain is radiating to her arms and neck. The np suspects ischemic heart disease and angina. Which of the following would be recommended treatments for this patient to prevent a myocardial infarction - Answer ✔✔ASA 162 milligrams is recommended to prevent an mi Anti ischemic medications are recommended such as CCBs or sublingual nitro Blood pressure management is recommended to prevent mi after an anginal event. Blood pressure should be maintained under 140 / 90 What are modifiable risk factors for heart failure - Answer ✔✔Inactivity is a modifiable risk factor Systolic bp of greater than 140 is a modifiable risk factor Which of the following should be considered as presenting symptoms for the older adult suffering in mi - Answer ✔✔Vague ache in the sternum Stroke Dyspnea Weakness A 64 year old man has been feeling weak, lightheadedness, and slightly nauseous. He goes to the urgent care with an np initiates an assessment. Which of the following suggest an arrhythmia - Answer ✔✔In age- related factor associated with tachyarrhythmias is increased left atrial size (chest x-ray showing an increased size of the left atria) What is recommended for heart failure patients as a combination therapy in patients who experience hypotension, hyperkalemia, angioedema, or renal insufficiency with ACE/ARB therapy Can be indicated in african American patients - Answer ✔✔As is orbited and hydralazine What can cause potential harm in heart failure patients receiving ace/arb - Answer ✔✔Aldosterone antagonist Which should be considered in the primary workup for hypertension - Answer ✔✔Cmp, cbc, lipid panel, tsh, urinalysis, 12 lead ekg, echocardiogram and uric acid level What is postprandial hypertension - Answer ✔✔A frequent cause of syncope and older adults. Defined as a drop in sbp by 20 mms within two hours of a meal, increase the risk of falls in older adults Is orthostatic hypotension - Answer ✔✔Reduced barrow flex sensitivity with age and loss of arterial comp compliance, hypovolemia or polypharmacy A decrease in systolic bp of 20 mms or decrease in diastolic pressure of 10mm 's within 3 minutes of standing What is the hallmark of acute coronary syndrome - Answer ✔✔A sudden imbalance between myocardial oxygen consumption and demand, which is usually the result of ca obstruction Angina in the absence of cad could be an early sign of - Answer ✔✔Aortic stenosis The physical findings of mitral regurgitation - Answer ✔✔S3 gallop holosystolic blowing murmur, radiates to the carotids Eccentric LVH Hypotension 67 year old female came in for an office visit presenting with symptoms of nasal congestion, itching, and sneezing and was diagnosed with rhinitis. Which of the following is true about the types of rhinitis - Answer ✔✔Allergic rhinitis has an increased occurrence in those older than age 60 An 85 year old female who comes in to urgent care setting with reports of pleuritis, nasal congestion, fever, and general malaise. Influenza is diagnosed. Which comorbid issues would increase risk of severe illness and hospitalization - Answer ✔✔Heart failure A patient presents to the clinic with flu like symptoms. The np knows that older adults a typically present with symptoms of influenza. Which influenza symptom is absent in patients who have received the flu vaccine - Answer ✔✔Fever An older adult male comes to the clinic with worsening symptoms of dyspnea, cough, and sputum production. Spirometry is performed in fev slash fvc is less than .07 and fev1 is less than 80% predicted. According to the gold criteria in which stage of copd is this patient diagnosed - Answer ✔✔Moderate copd is diagnosed with an fev fvc less than .07andand fev one less than 80 What is mild copd - Answer ✔✔FEV1 > 80% What is severe copd - Answer ✔✔FEV1 30-49% What is very severe COPD? - Answer ✔✔FEV1 <30% 80 year old male was diagnosed with copd about 10 years ago and the symptoms are getting progressively worse. The patient is on a combination bronchodilation therapy with a saba and LABA he needs better symptom management. What would be the best addition to the medication regimen to control his symptoms - Answer ✔✔Inhaled glucocorticoid Control of comorbidities Monitoring of appropriate use of medications A 69 year old female seeks medical advice because she is having trouble breathing. She is experiencing dyspnea, chronic cough with sputum production, decreased activity intolerance, and wheezing. She states that she has not been near anyone within a uri and wonders why this is happening - Answer ✔✔Have you ever worked in a factory or foundry How long have you experienced these symptoms Do you have any past history of respiratory difficulties Have your symptoms increased as you've gotten older the most common diagnostic test for ar in the skin testing, which involves scratching the surface of the skin with a single stylus for each allergen. Which of the following are possible if further testing is needed - Answer ✔✔Skin prick testing is a next step but intradermal testing may be needed if results are negative Imaging, such as ct scan, can be performed to help with diagnosis An older adult comes to the emergency department with hemoptysis, night sweats, fatigue and dyspnea. He states that he has never received treatment or been diagnosed with tb. What factors put this older adult at risk for development of active pulmonary tb - Answer ✔✔Substance abuse Prolonged corticosteroids silicosis Heart failure And the assessment for pvd the clinician should begin with which of the following after the general history and physical examination - Answer ✔✔Auscultation of the carotid arteries bilaterally Which of the following conditions is signaled by symptoms of swelling of the affected body part, usually the limb, because of impaired flow of lymph fluid - Answer ✔✔Chronic lymphadenopathy Which of the following is the best screening test for diagnosis of a aaa - Answer ✔✔Ultrasound of the abdominal aorta Was diagnosed with a symptomatic aaa. The initial treatment is aggressive blood pressure control at which of the following readings should mean arterial pressure be maintained - Answer ✔✔Between 60 and 70 Which medical specialist is the best referral for patients with symptomatic aaa - Answer ✔✔Vascular surgeon Pvd is a disease that alters blood flow to and from the extremities and vital organs other than the heart. According to studies which of the following remains the most important risk factor for pvp - Answer ✔✔Smoking Which of the following differential diagnosis should be considered with the diagnosis of pad - Answer ✔✔Raynaud's phenomenon Patient education is very important for individuals with pid what educating about conservative management, which of the following are true regarding pad - Answer ✔✔Controlling blood pressure Managing diabetes Smoking cessation is the most important thing to do Exercise and is an essential element of management