A gerontologic nurse is advocating for diagnostic testing of an 81-year-old patient who is experiencing personality changes. The nurse is aware of what factor that is known to affect the diagnosis and treatment of brain tumors in older adults?
- A. The effects of brain tumors are often attributed to the cognitive effects of aging.
- B. Brain tumors in older adults do not normally produce focal effects.
- C. Older adults typically have numerous benign brain tumors by the eighth decade of life.
- D. Brain tumors cannot normally be treated in patient over age 75.
Correct Answer: A
Rationale: Brain tumor symptoms in older adults are often misattributed to aging, delaying diagnosis. Tumors produce focal effects, are not typically benign, and treatment is not age-restricted.
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A patient who was diagnosed with Parkinsons disease several months ago recently began treatment with levodopa-carbidopa. The patient and his family are excited that he has experienced significant symptom relief. The nurse should be aware of what implication of the patients medication regimen?
- A. The patient is in a honeymoon period when adverse effects of levodopa-carbidopa are not yet evident.
- B. Benefits of levodopa-carbidopa do not peak until 6 to 9 months after the initiation of treatment.
- C. The patients temporary improvement in status is likely unrelated to levodopa-carbidopa.
- D. Benefits of levodopa-carbidopa often diminish after 1 or 2 years of treatment.
Correct Answer: D
Rationale: Levodopa-carbidopa benefits peak early but often wane after 1-2 years, with increasing side effects. There is no defined honeymoon period, and improvement is drug-related.
A patient who has been experiencing numerous episodes of unexplained headaches and vomiting has subsequently been referred for testing to rule out a brain tumor. What characteristic of the patients vomiting is most consistent with a brain tumor?
- A. The patients vomiting is accompanied by epistaxis.
- B. The patients vomiting does not relieve his nausea.
- C. The patients vomiting is unrelated to food intake.
- D. The patients emesis is blood-tinged.
Correct Answer: C
Rationale: Brain tumor-related vomiting is typically unrelated to food intake due to increased ICP. Epistaxis, blood-tinged emesis, or nausea relief are not characteristic.
A patient with an inoperable brain tumor has been told that he has a short life expectancy. On what aspects of assessment and care should the home health nurse focus? Select all that apply.
- A. Pain control
- B. Management of treatment complications
- C. Interpretation of diagnostic tests
- D. Assistance with self-care
- E. Administration of treatments
Correct Answer: A,B,D,E
Rationale: Home care for inoperable brain tumors focuses on pain control, complication management, self-care assistance, and treatment administration. Diagnostic test interpretation is not a nursing role.
A patient with a new diagnosis of amyotrophic lateral sclerosis (ALS) is overwhelmed by his diagnosis and the known complications of the disease. How can the patient best make known his wishes for care as his disease progresses?
- A. Prepare an advance directive.
- B. Designate a most responsible physician (MRP) early in the course of the disease.
- C. Collaborate with representatives from the Amyotrophic Lateral Sclerosis Association.
- D. Ensure that witnesses are present when he provides instruction.
Correct Answer: A
Rationale: An advance directive legally documents care wishes for ALS progression. Other options lack legal binding or specificity.
A male patient presents at the free clinic with complaints of impotency. Upon physical examination, the nurse practitioner notes the presence of hypogonadism. What diagnosis should the nurse suspect?
- A. Prolactinoma
- B. Angioma
- C. Glioma
- D. Adrenocorticotropic hormone (ACTH)-producing adenoma
Correct Answer: A
Rationale: Prolactinoma often causes impotence and hypogonadism in males due to prolactin excess. ACTH-producing adenomas cause different symptoms, and angiomas or gliomas are less likely.
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