Nokea
A 78 yr old female presents to the ED with complaints of nausea and sudden onset shortness of breath. The initial workup includes ____________.
- A. upper endoscopy
- B. CT of the head
- C. liver function studies
- D. EKG and serial enzymes for determination of an MI
Correct Answer: D
Rationale: The correct answer is D, EKG and serial enzymes for determination of an MI. In this scenario, the patient's symptoms of nausea and sudden onset shortness of breath raise concern for a possible myocardial infarction (MI). Conducting an EKG and serial enzymes helps in diagnosing an MI by assessing for cardiac ischemia or injury. Upper endoscopy (choice A) is not indicated for these symptoms. A CT of the head (choice B) is unnecessary as the symptoms are suggestive of a cardiac issue, not a neurological one. Liver function studies (choice C) do not align with the presenting symptoms and are not a priority in this acute setting. Conducting an EKG and serial enzymes is the most appropriate initial workup to assess for a possible MI in this elderly patient with concerning symptoms.
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All of the following nursing actions except____________ will help maintain safety for the elderly.
- A. Modify environment to reduce obstacles and barriers to ambulation
- B. Provide for consistent, regular checks of clients' ambulation abilities
- C. Orient to new surroundings and repeat frequently as needed
- D. Promote independence without assistance to all clients
Correct Answer: D
Rationale: The correct answer is D because promoting independence without assistance to all clients may not always maintain safety for the elderly. Elderly individuals may require some level of assistance for certain activities to prevent falls or other safety risks. Providing assistance when needed is crucial for ensuring their safety.
A: Modifying the environment to reduce obstacles and barriers to ambulation helps prevent falls.
B: Consistent checks of ambulation abilities ensure early detection of any decline in mobility.
C: Orienting to new surroundings and repeating as needed helps prevent confusion and disorientation.
An older man is transferred to a hospice facility with end-stage disease. Which is a suitable nursing intervention for this older adult and his family according to the goals of long-term care?
- A. Decrease the analgesic dose to prevent sedation.
- B. Provide a basin and towels for morning self-care.
- C. Inform family members about strict visiting hours.
- D. Facilitate family rituals related to death and dying.
Correct Answer: D
Rationale: The correct answer is D: Facilitate family rituals related to death and dying. In end-of-life care, it is essential to support the older adult and their family in their cultural and spiritual practices to promote comfort and closure. This intervention aligns with the goals of long-term care by addressing the psychological and emotional needs of the patient and family. Providing a basin and towels (B) focuses on physical self-care, which may not be a priority in end-stage disease. Decreasing analgesic dose (A) can compromise pain management and quality of life. Informing family members about strict visiting hours (C) can hinder emotional support and connection during this critical time.
Intra-renal renal failure can be caused by all of the following conditions except______
- A. certain aminoglycoside antibiotics
- B. glomerulonephritis
- C. kidney stones
- D. diabetic or hypertensive nephrosclerosis
Correct Answer: C
Rationale: The correct answer is C: kidney stones. Intra-renal renal failure refers to damage within the kidney itself. Kidney stones mainly affect the urinary tract rather than directly causing damage within the kidney. A: certain aminoglycoside antibiotics can cause intra-renal renal failure by damaging the kidney tubules. B: glomerulonephritis is inflammation of the glomeruli in the kidney, leading to intra-renal renal failure. D: diabetic or hypertensive nephrosclerosis can cause intra-renal renal failure due to long-term damage to the kidney's blood vessels and structures.
What is the most common cause of hospitalization for older adults with diabetes?
- A. Stroke
- B. Hypoglycemia
- C. Diabetic ketoacidosis
- D. Infection
Correct Answer: D
Rationale: The correct answer is D: Infection. Older adults with diabetes are more vulnerable to infections due to weakened immune systems caused by high blood sugar levels. Infections can lead to severe complications and hospitalization. Stroke (A) is a common complication of diabetes but not the most common cause of hospitalization. Hypoglycemia (B) and diabetic ketoacidosis (C) are acute complications of diabetes but are less common causes of hospitalization compared to infections.
All of the following except___ can occur due to the decreased tactile sensations that occur in the older person.
- A. Burns on feet and hands due to inability to feel the temperature of bath water
- B. Social isolation due to not wanting to be touched
- C. Development of sores on feet due to inability to feel pressure and injury
- D. Increased tendency to fall due to decreased sensation of feet to floor
Correct Answer: B
Rationale: The correct answer is B because social isolation is not directly related to decreased tactile sensations. A, C, and D are consequences of decreased tactile sensations in older individuals. A can occur due to not feeling the temperature, C due to not feeling pressure and injury, and D due to decreased sensation causing falls. Social isolation is more related to emotional or psychological factors rather than physical sensations. It is crucial to differentiate between physical consequences and social consequences when considering the effects of decreased tactile sensations in older individuals.