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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Which of the following factors contributes the most to aging-related cognitive decline?
- A. Chronic stress
- B. Poor nutrition
- C. Social isolation
- D. Lack of physical exercise
Correct Answer: D
Rationale: The correct answer is D: Lack of physical exercise contributes the most to aging-related cognitive decline. Regular physical exercise increases blood flow to the brain, promotes neurogenesis, and enhances cognitive function. It also reduces the risk of developing conditions such as dementia and Alzheimer's disease. Chronic stress (A) can impact cognitive function, but it is not the primary factor in aging-related decline. Poor nutrition (B) can negatively affect brain health, but exercise has a more significant impact. Social isolation (C) is also detrimental to cognitive health, but physical exercise has been shown to have a more substantial influence on cognitive decline in aging individuals.
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.
What is the most common cause of delirium in hospitalized older adults?
- A. Medication side effects
- B. Sleep deprivation
- C. Urinary tract infections (UTIs)
- D. Electrolyte imbalances
Correct Answer: C
Rationale: The correct answer is C: Urinary tract infections (UTIs). UTIs are a common cause of delirium in hospitalized older adults due to their impact on the central nervous system. UTIs can lead to systemic inflammation and affect cognitive function, resulting in delirium. Other choices like medication side effects, sleep deprivation, and electrolyte imbalances can contribute to delirium but are not as common or direct as UTIs in this population.
An older female patient states reading is difficult in the evening. Which intervention should the nurse implement?
- A. Put a high-intensity lamp at the head of her bed.
- B. Explain that the arcus senilis is interfering with vision.
- C. Put more powerful tubes in the fluorescent lights.
- D. Examine her retinas for signs of damage.
Correct Answer: A
Rationale: The correct answer is A because a high-intensity lamp can provide better lighting for reading, addressing the difficulty the patient experiences in the evening. This intervention can improve visibility and reduce strain on the eyes. Option B is incorrect as arcus senilis is a common age-related condition but not a direct cause of difficulty reading. Option C is incorrect as simply increasing the power of fluorescent lights may not address specific visual needs for reading. Option D is incorrect as examining the retinas may not directly address the patient's difficulty in reading and is not the most appropriate initial intervention.
An 81 yr old female presents to the ED with altered level of consciousness. All of the following except____ are possible causes for this condition.
- A. peripheral arterial disease
- B. hypoglycemia
- C. pneumonia
- D. hypotension from dehydration
Correct Answer: A
Rationale: The correct answer is A: peripheral arterial disease. Altered level of consciousness in an 81-year-old female is unlikely to be directly caused by peripheral arterial disease. Instead, hypoglycemia, pneumonia, and hypotension from dehydration are common causes of altered mental status in the elderly. Hypoglycemia can lead to brain dysfunction, pneumonia can cause low oxygen levels affecting brain function, and dehydration-induced hypotension can reduce blood flow to the brain. Therefore, peripheral arterial disease is not typically a direct cause of altered consciousness in this scenario.