Health Care of the Older Adult NCLEX

Health Care of the Older Adult NCLEX Related

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A client with a history of hypertension and peripheral vascular disease underwent an aortobifemoral bypass graft. Preoperative medications included pentoxifylline (Trental); metoprolol (Toprol XL); and furosemide (Lasix). On postoperative day 1, the 12 noon vital signs are: Temperature 37.2°C; heart rate 132 beats per minute; respiratory rate 20; blood pressure 126/78. Urine output is 50 to 70 mL/hour. The hemoglobin and hematocrit are stable. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse recommends to the primary care provider:

  • A. Continues the pentoxifylline
  • B. Increases the I.V. fluids
  • C. Restarts the metoprolol
  • D. Resumes the furosemide
Correct Answer: C

Rationale: SBAR: Situation€”postop day 1, heart rate 132 bpm. Background€”aortobifemoral bypass, history of hypertension, on metoprolol preop. Assessment€”tachycardia suggests inadequate beta-blockade, other vitals stable. Recommendation€”restart metoprolol to control heart rate and blood pressure. Pentoxifylline is less urgent, fluids are adequate (urine output normal), and furosemide may cause dehydration.

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A client with acute renal failure is prescribed a low-potassium diet. Which food should be avoided?

  • A. Bananas.
  • B. Rice.
  • C. Apples.
  • D. Bread.
Correct Answer: A

Rationale: Bananas are high in potassium, unsuitable for a low-potassium diet.

The nurse receives a prescription from the primary healthcare provider (PHCP) for metoprolol 5 mL intravenous (IV) push x 1 dose. The nurse should take which priority action before administering the medication?

  • A. Clarify the prescription with the primary healthcare provider (PHCP)
  • B. Assess vital signs
  • C. Review the prescription with the pharmacist
  • D. Assess the client's allergies
Correct Answer: A

Rationale: Metoprolol IV push prescriptions require clarification to ensure correct dosage and administration rate.

Which of the following medications would be appropriate for the treatment of an allergic reaction to a blood transfusion? Select all that apply.

  • A. Epinephrine
  • B. Acetaminophen
  • C. Diphenhydramine
  • D. Hydrocortisone
  • E. Pantoprazole
Correct Answer: A,C,D

Rationale: Epinephrine treats severe allergic reactions (anaphylaxis), diphenhydramine manages mild to moderate allergic symptoms, and hydrocortisone reduces inflammation in allergic reactions. Acetaminophen is for fever or pain, and pantoprazole is for gastric issues, not allergic reactions.

A client with an ileal conduit asks how to reduce pouch odor. The nurse suggests:

  • A. Avoiding broccoli.
  • B. Using bleach to clean the pouch.
  • C. Drinking less water.
  • D. Applying powder to the stoma.
Correct Answer: A

Rationale: Odor-producing foods like broccoli should be avoided to minimize pouch odor.

The nurse is taking care of a client with a spinal cord injury. The extent of the client's injury is shown below. Which of the following findings is expected when assessing this client?

  • A. Inability to move his arms.
  • B. Loss of sensation in his hands and fingers.
  • C. Incontinence of bowel and bladder.
  • D. Spasticity of the lower extremities.
Correct Answer: C

Rationale: Incontinence is expected with spinal cord injuries due to disruption of neural control over bowel and bladder.

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