Download NR 601 Midterm Exam with Well Updated Questions and Verified Answers Latest 2026 Update and more Exams Nursing in PDF only on Docsity!
NR 601 Midterm Exam with Well Updated
Questions and Verified Answers Latest 2026
Update
The percentage of the FVC expired in one second is FEV1/FVC ratio The aging process causes what normal physiological changes in the heart The heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis A 55 yo Caucasian male follows up after referral to cardiologist. He thinks his med is causing a cough and sometimes he has difficulty breathing. Which med was most likely prescribed? Lisinopril MJ presents with h/o structural damage with current s/s of HF. Treatment will be based on his stage of HF which is Stage C 65 yo Caucasian presents with mitral valve stenosis, physical exam is unremarkable. you know her stage of HF is Stage B
The best way to diagnose structural heart disease/dysfunction noninvasively is Echocardiogram Chronic pain can have major impact on patients ability to function and have profound impact on overall QOL. Ongoing pain may be linked to Depression, sleep disturbance, decreased socialization The Beers criteria are appropriate for use in evaluating use of certain meds in patients >65 y/o All of the following statements are true about lab values in older adults except Abnormal findings are often due to physiological aging According to the 2017 ACC HTN guidelines, the recommended BP goal for a 65y/o African American woman with a h/o HTN and DM and no h/o CKD is <140/ THe pathophysiology of HF is due to Inadequate cardiac output to meet the metabolic and O demands of the body The volume of air a patient to exhale for total duration of the test during maximal effort is
new tremor in both hands. Which of the following would you suspect Hyperthyroidism Which patient is more likely to have osteoporosis 80 y/o. Underweight male who smokes and has been on steroids for psoriasis Post menopausal woman with osteoporosis is taking bisphosphonate daily po. What action info statement would indicate she understood your instructions regarding this med? Take med with full glass of water when up in the AM 30 min before other food and meds 60 y/o obese male has T2DM and lipid panel of TC= 250 HDL=32, LDL=165. You teach him about his modifiable cardiac risk factors which include DM, obesity, hyperlipidemia OA of cervical and lumbar spine causes pain related to all of the following except Crystal deposition In differentiating OA from chronic gout, pseudo gout, or septic arthritis, the most valuable diagnostic study would be Synovial fluid analysis
Patients with OA of the hip and knee often have a distinguishable gait described as Antalgic Which of the following best describes pain associated with OA Begins upon arising and after prolonged weight bearing and or use of the joint Joint effusions typically occurs later in the course of OA, especially in the Knee You ordered CBC for your patient you suspect has polymyalgia rheumatica. Which 2 clinical findings are common in patients with PMR Normochromic, normocytic anemia and thrombocytosis You suspect your patient has PMR and now are concerned that they may have Giant Cell Arteritis too. Which of the following 2 symptoms are most indicative of GCA and PMR Scalp tenderness and aching in shoulder and pelvic girdle 63 yo Caucasian patient with PMR will begin tx corticosteroids until the condition has resolved. You look over her records and it has been 2 years since her last physical exam and any labs or diagnostic tests as she relocated and had not yet ID'd a provider. In prioritizing your management plan your first orders should include
You order bilateral wrist XR on 69 yo man with c/o both wrists x6 weeks, not related to any known trauma. You suspect early RA. The initial XR finding in apatien with elderly onset RA would be Soft tissue swelling A 72 female has been diagnosed with gout. She also has chronic HF. The most likely contributing factor to development of gout in this older female is Thiazide diuretics Which of the following statements about OA is true It affects primarily weight bearing joints In considering the specificity of lab data, the most reliable diagnostic test listed below would be Synovial fluid analysis to differentiate between infectious versus inflammatory infusion When examining the spine of an older adult you notice a curvature with a sharp angle. This is referred to as Gibbus The prevalence of depression in nursing home residents is __________________ greater than adults living in the community 3 - 4 times
The majority of depressed older adults remain untreated because of Misdiagnosis, social stigma, environmental barriers Symptoms of depression distinct to the elderly include Lack of emotions The justification for ordering CBC, TSH, serum B12 for a patient you may suspect have clinical depression is Because of overlapping symptoms with anemia, thyroid dysfunction, and nutritional deficiencies One major difference that us useful in the DD of dementia versus delirium is that Dementia develops slowly and delirium develops quickly Which of the following is the most appropriate screening tool for delirium Confusion Assessment Method The proposed mechanism by which diphenhydramine causes delirium is Anticholinergic effects The elderly are at risk for delirium because of Multisensory declines, polypharmacy, multiple medical problems
Which of the following should be avoided in countries where food and water precautions are to be observed Salad buffet What insect precautions are not necessary to prevent insect borne diseases in the Tropics Using 100% DEET on skin to prevent bites An example of secondary prevention you could recommend/order for older adults would be to Check for fecal occult blood Ali is a 72 year old male who recent came to the US from Nigeria. He reports having BCG vax as a child. Which of the following is correct regarding a TB skin test Vax hx is irrelevant, read as usual A local chapter on NP organization has begun planning a community based screening for HTN at a local congregate living facility. The organization was select3d on the basis of A regcognized element of high risk within this group Performing ROM exercises on a patient who has had a CVA is an example of which level of prevention Tertiary You demonstrate an understanding of primary prevention of falling among the elderly through which management plan
Provide info about meds, SE and interactions An example of an active strategy of health promotion for an individual to accomplish would be Beginning stress management program The 4 main domains of clinical preventive services that you will provide are Counseling interventions, screening tests, immunizations, chemoprophylaxis What is the appropriate method for TB screening of an older adult entering a nursing home 5 TBU intradermal PPD injection and if negative, repeat with same dose one week later The term "geriatric syndrome" is best described Condition that has multiple underlying factors and involves multiple systems Atypical presentation of acute coronary syndrome is More common in females What disease can mimic and often co-exists with MI in elderly with CAD Esophageal disease Thoracic aortic dissection presents typically as
Arthritis Drug-induced pruritis is distinguished because it May occur right after drug is taken or months later A key symptom of ischemia heart disease is chest pain. However, angina equivalents may include exertional dyspnea. Angina equivalents are important because Women with ischemic heart disease many times don't present with chest pain. Some patient's may have no symptoms or atypical symptoms so diagnosis may only be made at the time of the actual MI Which test is clinic standard for assessment of aortic stenosis Echocardiogram Ischemic heart disease is Defined as an imbalance between O2 supply and demand, frequently manifested as angina, leading cause of death in the elderly Preceding a stress test, the following lab work might include CBC with diff to differentiate ischemic heart disease from anemia, thyroid studies to rule out hyperthyroidism On exam, what type of murmur can be auscultation with aortic regurgitation Austin Flint
Which of the following statements is true regarding anti- arrhythmic drugs Most anti-arrhythmic have low toxic/therapeutic ratio and some are exceeding toxic In mitral stenosis, p waves may suggest Left atrial enlargement Aortic regurgitation requires medical treatment for early signs of CHF with ACEi The best evidence rating drugs in a post MI pt include ASA, ACEi/ARB, BB, aldosterone blockade 55 year old post-menopausal woman with h/o HTN c/o jaw pain on heavy exertion. No c/o CP. EKG is normal sinus rhythm without ST segment abnormalities. Your plan may include Exercise stress test What is the most common valvular heart disease in the elderly Aortic stenosis Elderly may present with atypical signs of pneumonia. You may need to be aware that clustering of all of the following s/s may indicate pneumonia in the elderly except
Improvise with recommended objects at home that can be used When you recommend exercise for the elderly which of the following pieces of advice should be considered for all types of exercise Start low and go slow Biochemical individuality is best described as Each individual's variation is often much smaller than that of a larger group All of the following statements about drug absorption are false except Underlying chronic disease has little impact on drug absorption The cytochrome p system involves enzymes that are generally: Inhibited or induced by drugs A statement not shown to be true about pharmacodynamic changes with aging is Decreased sensitivity to oral anticoagulants The major impact of the physiological changes that occur w/aging is: Reduced physiological reserve, reduced homeostatic mechanisms, impaired immunological respons
The strongest evidence regarding normal physiological aging is available through Longitudinal studies Pharmacokinetic changes with aging is reflective of What the body does to the drug All of the following statements are true about drug distribution in the elderly except Drugs distributed in water have a lower concentration Men have faster and more efficient biotransformation of drugs and this is thought to be due to: Testosterone Atypical presentation of disease in elderly is reflected by all of the following exept MI with CP and diaphoresis Polypharmacy is best described as Even a single med if there is not a clear indication for its use What is the major difference between varicose veins and atherosclerosis Vessels that are affected Patient has poorly controlled HTN for >10 years. Indicate the most likely position of his PMI
Which statement correctly describes normal changes of aging Individual variations are enormous at every age and in every part of the body Compared with acute pain, persistent chronic pain requires in the nurse practitioner to Educate the patient to the benefit of specific lifestyle changes When considering Erikson's developmental stages, the task for later life is referred to as Ego integrity What is the method of action of anticholinergics Block the effect of acetylcholine on muscarinic type 3 receptors resulting in bronchodilation What is the method of action of beta agonists Stimulates beta-2 adrenergic receptors, increasing cyclic AMP, resulting in relaxing airways What is tuberculosis Chronic, necrotizing infection caused by slow-growing acid fast bacillus (mycobacterium tuberculosis). Most common cause of death related to infectious disease worldwise What is aortic regurgitation?
Retrograde blood flow through an incompetent aortic valve into left ventricle during ventricular diastole What is aortic stenosis abnormal narrowing of the aortic valve What is mitral stenosis Abnormal narrowing of the mitral valve orifice What is mitral regurgitation Retrograde blood flow during systole from the left ventricle into the left atrium through incompetent mitral valve What is mitral valve prolapse? Mitral regurgitation associated with bulging of one or both mitral valve leaflets into the left atrium during ventricular systole What happens in valvular regurgitation Portion of the ejected blood leaks back into the upstream cardiac chamber What happens in valvular stenosis Usually results in elevated pressures in the chamber upstream from the stenosis What is the purpose of functional assessment of the elderly Discovers the ability to care for themselves on a daily basis
