NURSING 3271 NURSING CARE OF ADULTS AND OLDER ADULTS EXAM Q & A 2024, Exams of Nursing

Download NURSING 3271 NURSING CARE OF ADULTS AND OLDER ADULTS EXAM Q & A 2024 and more Exams Nursing in PDF only on Docsity! NURSING 3271 Nursing Care of Adults and Older Adults LATEST EXAM w/ RATIONALES 2024 1. A nurse is caring for an older adult client with hypertension. Which nursing intervention is the highest priority for this client? a. Assessing vital signs every hour b. Administering anti-hypertensive medications as scheduled c. Educating the client on lifestyle modifications to reduce hypertension d. Encouraging the client to participate in aerobic exercise regularly Answer: b. Administering anti-hypertensive medications as scheduled Rationale: Hypertension is a chronic condition that requires medication management. Administering anti- hypertensive medications as scheduled is the highest priority to help control blood pressure levels and reduce the risk of complications. 2. An adult client is diagnosed with heart failure. Which nursing assessment finding is most concerning? a. Mild dyspnea on exertion b. Decreased urine output c. Slight weight gain d. Mild peripheral edema Answer: b. Conducting regular foot assessments and providing education Rationale: Diabetic foot ulcers are common complications in clients with diabetes. Regular foot assessments and providing education about foot care, proper footwear, and hygiene are essential preventive measures in decreasing the risk of foot ulcers. 6. An adult client is diagnosed with chronic obstructive pulmonary disease (COPD). Which nursing intervention should be prioritized for this client? a. Administering bronchodilators as ordered b. Assisting the client with smoking cessation c. Providing supplemental oxygen therapy d. Encouraging frequent ambulation and physical activity Answer: a. Administering bronchodilators as ordered Rationale: Bronchodilators are the cornerstone of managing COPD symptoms, providing bronchial smooth muscle relaxation and improving breathing. Administering bronchodilators as ordered is a priority intervention to help with symptom control and promote optimal lung function. 7. An older adult client is admitted with a hip fracture. Which nursing intervention is crucial to prevent complications associated with immobility? a. Encouraging adequate fluid intake b. Providing regular turning and repositioning c. Administering intravenous pain medications d. Assisting with activities of daily living (ADLs) Answer: b. Providing regular turning and repositioning Rationale: Immobility can lead to various complications, including pressure ulcers and respiratory complications. Providing regular turning and repositioning every two hours helps prevent pressure ulcers by relieving pressure on bony prominences and promotes respiratory function. 8. A nurse is caring for a client with acute kidney injury. Which laboratory result indicates the importance of strict fluid balance monitoring? a. Increase in urine output b. Decrease in serum creatinine levels c. Increase in blood urea nitrogen (BUN) d. Decrease in serum potassium levels Answer: c. Increase in blood urea nitrogen (BUN) Rationale: Blood urea nitrogen (BUN) is a waste product filtered by the kidneys. Elevated BUN levels indicate impaired kidney function. Monitoring strict fluid balance is crucial to prevent fluid overload or depletion, contributing to the worsening of acute kidney injury. 9. An adult client is suspected to have a peptic ulcer. Which diagnostic test should the nurse anticipate to confirm the diagnosis? a. Barium swallow b. Endoscopy c. Stool culture d. Echocardiogram Answer: b. Endoscopy Rationale: Endoscopy allows direct visualization of the esophagus, stomach, and duodenum. It enables the detection of peptic ulcers, determination of the size and location, and obtaining tissue samples for biopsy. It is considered the gold standard for diagnosing peptic ulcers. 10. A nurse is caring for an adult client with sepsis. Which intervention should be prioritized during the initial management of sepsis? a. Administering broad-spectrum antibiotics bleeding." d. "Report any unusual bleeding, such as blood in the urine or stool." Answer: d. "Report any unusual bleeding, such as blood in the urine or stool." Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. Clients on Warfarin should be educated to report any signs of unusual bleeding, such as blood in the urine or stool, as it may indicate bleeding or hemorrhage that requires immediate medical attention. 14. A nurse is caring for an adult client who just had a stroke. Which intervention is essential during the acute phase of stroke management? a. Administering thrombolytic therapy within the specified timeframe b. Assisting the client with activities of daily living (ADLs) c. Implementing rigorous physical therapy to regain motor function d. Providing emotional support and counseling to the client and family Answer: a. Administering thrombolytic therapy within the specified timeframe Rationale: During the acute phase of stroke, the administration of thrombolytic therapy within the specified timeframe (usually within 4.5 hours) is crucial to dissolve the clot and restore blood flow to the affected area. It can significantly improve the client's outcomes. 15. An older adult client is admitted with a suspected urinary tract infection (UTI). Which nursing action is a priority during initial assessment? a. Obtaining a urine sample for culture and sensitivity b. Administering a broad-spectrum antibiotic c. Encouraging increased fluid intake d. Assessing the client's vital signs Answer: d. Assessing the client's vital signs Rationale: Assessing the client's vital signs, including temperature, heart rate, blood pressure, and respiratory rate, is the priority during the initial assessment. This helps identify any signs of systemic infection and helps guide interventions such as fluid resuscitation and appropriate antibiotic administration. Obtaining a urine sample for culture and sensitivity should follow the initial assessment. B: Which of the following statements best describes the concept of advanced primary care for older adults? a) It focuses on specialized care for older adults with chronic illnesses. b) It emphasizes preventive care to promote healthy aging in older adults. c) It involves providing palliative care for older adults in end-of-life situations. d) It focuses on care coordination between primary care providers and specialists. Answer: b) It emphasizes preventive care to promote healthy aging in older adults. Rationale: Advanced primary care for older adults aims to prevent illness and promote wellness by focusing on proactive measures, such as regular screenings, immunizations, and lifestyle modifications. This approach helps older adults maintain their independence and quality of life. 2. What is the primary goal of the geriatric assessment in advanced primary care for older adults? a) To identify chronic illnesses and provide disease management. changes and potential drug interactions. Adjusting medication doses based on renal function is an example of this intervention that ensures safe and effective medication use in older adults. 4. Which of the following is a key component of the Care Transitions Model in advanced primary care for older adults? a) Providing home healthcare services for older adults. b) Coordinating care across different healthcare settings. c) Offering support groups for older adults and their families. d) Conducting routine screenings for early detection of diseases. Answer: b) Coordinating care across different healthcare settings. Rationale: The Care Transitions Model focuses on ensuring smooth transitions of care for older adults as they move between different healthcare settings, such as hospitals, home healthcare, and rehabilitation centers. Coordinated care reduces the risk of medical errors, improves communication, and enhances patient outcomes. 5. In advanced primary care for older adults, what is the primary goal of implementing comprehensive care plans? a) To address the physical and psychosocial needs of older adults. b) To provide specialized care for older adults with multiple chronic conditions. c) To offer end-of-life care services for terminally ill older adults. d) To manage acute illnesses and hospital admissions. Answer: a) To address the physical and psychosocial needs of older adults. Rationale: Comprehensive care plans in advanced primary care for older adults aim to address the holistic needs of older adults, including physical, mental, and social aspects. These plans usually involve interdisciplinary care teams and consider the preferences and goals of the older adult and their family. 6. Which of the following is an example of a community- based support service that promotes healthy aging in older adults? a) Providing comprehensive geriatric assessments at home. b) Offering meal delivery programs for frail older adults. c) Conducting medication reconciliation during hospital admission. d) Providing palliative care services in a hospice facility. Answer: b) Offering meal delivery programs for frail older adults. Rationale: Community-based support services, such as meal delivery programs, are designed to support healthy aging and independence in older adults. These programs ensure access to nutritious meals, particularly for frail older adults who may have difficulty preparing their own meals. 7. Which of the following is a key principle of the Geriatric Resource Nurse (GRN) role in advanced primary care for older adults? a) Providing specialized palliative care for older adults. b) Coordinating care transitions for older adults at end of life. c) Promoting evidence-based practice in geriatric care. d) Offering counseling and therapy services to older adults. Answer: c) Promoting evidence-based practice in geriatric care. Rationale: The Geriatric Resource Nurse (GRN) plays a vital role in advanced primary care for older adults by promoting evidence-based practice in geriatric care. They provide education and support to healthcare providers, ensuring the use of the best available evidence in managing older adults' health and well-being. 8. Which of the following is a common screening tool used to assess cognitive function in older adults during advanced primary care? Answer: a) Geriatricians Rationale: Geriatricians are specialized physicians who are experts in providing comprehensive care for older adults. They often lead and coordinate interdisciplinary care teams, consisting of various healthcare professionals, to optimize the health and well-being of older adults. 12. Which of the following best defines the concept of age- friendly healthcare in advanced primary care for older adults? a) Providing specialized geriatric care for older adults. b) Offering community-based social programs for older adults. c) Ensuring healthcare environments are accessible and inclusive. d) Coordinating care transitions in long-term care facilities. Answer: c) Ensuring healthcare environments are accessible and inclusive. Rationale: Age-friendly healthcare focuses on creating healthcare environments that are accessible, inclusive, and responsive to the unique needs of older adults. It involves making physical adaptations, increasing communication support, and implementing policies that enhance older adults' experience and outcomes in healthcare settings. 13. What is the primary role of the physical therapist in advanced primary care for older adults? a) Prescribing medications and managing chronic diseases. b) Conducting comprehensive geriatric assessments. c) Providing rehabilitative services and improving mobility. d) Coordinating care transitions and discharge planning. Answer: c) Providing rehabilitative services and improving mobility. Rationale: Physical therapists play a key role in advanced primary care for older adults by providing rehabilitative services, improving mobility, and promoting independence. They design exercise programs, assess and treat musculoskeletal conditions, and facilitate functional recovery following illness or injury. 14. Which of the following is a common geriatric syndrome that is often addressed in advanced primary care for older adults? a) Congestive heart failure b) Type 2 diabetes mellitus c) Urinary tract infections d) Delirium Answer: d) Delirium Rationale: Delirium is a common geriatric syndrome characterized by acute confusion and a rapid change in mental status. Advanced primary care for older adults involves recognizing and managing delirium promptly to prevent complications, identify underlying causes, and provide appropriate interventions for a positive outcome. 15. What is the role of the nurse in a home healthcare setting within advanced primary care for older adults? a) Coordinating hospice care for terminally ill older adults. b) Administering medications and monitoring vital signs. c) Providing nutritional counseling and meal planning. d) Conducting comprehensive geriatric assessments at home. Answer: b) Administering medications and monitoring vital signs B: 1. A 75-year-old patient with hypertension, diabetes, and chronic kidney disease presents to the primary care clinic with fatigue, dyspnea, and edema. The nurse practitioner suspects heart failure and orders a B-type natriuretic peptide (BNP) test. What is the rationale for ordering this test? rectal wall, but it is usually located higher up in the prostate bed and may be associated with elevated prostate-specific antigen (PSA) levels. BPH and prostatitis are benign conditions that affect the prostate gland and can cause urinary symptoms, but they do not cause rectal masses. 4. A 78-year-old patient with Alzheimer's disease and dementia lives in a long-term care facility. The nurse practitioner visits the patient for a routine assessment and observes that the patient has poor oral hygiene, dry mouth, and halitosis. The nurse practitioner also notes that the patient has difficulty swallowing and frequently coughs after eating or drinking. What is the most likely complication that the nurse practitioner should prevent in this patient? A) Dental caries B) Oral candidiasis C) Aspiration pneumonia D) Dehydration Answer: C Rationale: Aspiration pneumonia is an infection of the lungs caused by inhalation of food, saliva, or other foreign material. It is a common and serious complication in patients with dementia, who may have impaired cognition, oral hygiene, salivation, and swallowing. The nurse practitioner should assess the patient's risk factors for aspiration pneumonia and implement strategies to prevent it, such as providing oral care, encouraging hydration, modifying diet consistency, elevating head position during feeding, and monitoring for signs of respiratory distress. 5. A 66-year-old patient with chronic obstructive pulmonary disease (COPD) and smoking history visits the primary care clinic for a follow-up. The nurse practitioner reviews the patient's spirometry results and notes that the patient has a forced expiratory volume in one second (FEV1) of 60% of predicted and a FEV1/forced vital capacity (FVC) ratio of 65%. How would the nurse practitioner classify the severity of the patient's COPD according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria? A) GOLD 1 (mild) B) GOLD 2 (moderate) C) GOLD 3 (severe) D) GOLD 4 (very severe) Answer: B Rationale: The GOLD criteria are used to assess the severity of COPD based on spirometry results and clinical symptoms. The FEV1 is a measure of the volume of air that can be exhaled in one second, and the FVC is a measure of the total volume of air that can be exhaled. The FEV1/FVC ratio reflects the degree of airflow obstruction in COPD. The GOLD criteria classify COPD into four stages based on the FEV1 as a percentage of predicted: GOLD 1 (mild): FEV1 ≥ 80%, GOLD 2 (moderate): FEV1 50-79%, GOLD 3 (severe): FEV1 30-49%, and GOLD 4 (very severe): FEV1 < 30%. The patient in this case has a moderate COPD with an FEV1 of 60% and an FEV1/FVC ratio of 65%. 6. A 70-year-old patient with Parkinson's disease and depression visits the primary care clinic for a medication review. The nurse practitioner notes that the patient is taking levodopa/carbidopa, pramipexole, and sertraline. What is the most important drug interaction that the nurse practitioner should monitor for in this patient? A) Serotonin syndrome B) Neuroleptic malignant syndrome C) Dopamine dysregulation syndrome D) Orthostatic hypotension Answer: A Rationale: Serotonin syndrome is a potentially life- threatening condition caused by excessive serotonin activity in the central nervous system. It can occur when two or more drugs that increase serotonin levels are combined, such as selective serotonin reuptake inhibitors (SSRIs) like sertraline and dopamine agonists like pramipexole. Serotonin syndrome can manifest with symptoms such as agitation, confusion, tremor, hyperthermia, tachycardia, hypertension, diarrhea, and muscle rigidity. The nurse practitioner should monitor the patient for signs of serotonin syndrome and adjust the doses or discontinue the drugs if necessary. 7. A 69-year-old patient with type 2 diabetes mellitus and peripheral neuropathy visits the primary care clinic for a foot examination. The nurse practitioner inspects the patient's feet and observes that the patient has dry, cracked skin, calluses, and ulcers on the plantar surface of both feet. The nurse practitioner also performs a monofilament test