Nokea
All of the following conditions except___ can cause renal failure, especially in the older adult.
- A. diabetes mellitus
- B. prostate hypertrophy causing obstruction of urine thru the urethra
- C. heart failure
- D. ingesting more than 4 gms of acetaminophen (Tylenol) per day consistently for 2 years
Correct Answer: D
Rationale: The correct answer is D. Ingesting excessive acetaminophen can lead to liver damage, not renal failure. Diabetes mellitus, prostate hypertrophy causing urinary obstruction, and heart failure are known to cause renal failure due to their effects on kidney function. Diabetic nephropathy can damage the kidneys over time, prostate hypertrophy can obstruct urine flow and lead to kidney damage, and heart failure can result in decreased blood flow to the kidneys, causing renal failure. Thus, D is the correct answer as it does not directly cause renal failure, unlike the other choices.
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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.
Which of the following best describes the pathophysiology of delirium in older adults?
- A. It is caused by an acute inflammatory response to infection.
- B. It results from reversible metabolic changes, such as electrolyte imbalances.
- C. It is primarily related to neurodegeneration in the brain.
- D. It is caused by chronic stress responses and cortisol overproduction.
Correct Answer: B
Rationale: The correct answer is B: Delirium in older adults results from reversible metabolic changes, such as electrolyte imbalances. Delirium is a multifactorial condition often triggered by physiological imbalances, including electrolyte disturbances. These imbalances can disrupt normal brain function, leading to confusion and cognitive impairment. Other choices are incorrect: A is more typical of sepsis, C is more associated with conditions like dementia, and D is not a primary cause of delirium.
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.
The nurse is performing an assessment on an older client. What would indicate a potential complication associated with the skin?
- A. Crusting
- B. Wrinkling
- C. Thinning/loss of elasticity
- D. Crusting
Correct Answer: A
Rationale: The correct answer is A: Crusting. Crusting on the skin of an older client can indicate a potential complication such as an infection or skin condition. It suggests that there may be an issue with the skin's integrity, leading to the formation of crusts. Wrinkling (B) and thinning/loss of elasticity (C) are common age-related changes and not necessarily indicative of a complication. Choice D is a duplicate of choice A, so it is incorrect. In summary, crusting is a sign of a potential skin complication, while the other choices are more likely to be normal age-related changes.
The nurse plans care for older adults who are in good health but isolated from their families. If the nurse's goal is to move the adults toward gerotranscendence, which intervention should the nurse use in the plan of care?
- A. Give a daily tea party for the group.
- B. Call each family to encourage visiting.
- C. Assist them to resume midlife patterns.
- D. Help each person with individual activities.
Correct Answer: D
Rationale: The correct answer is D: Help each person with individual activities. This intervention aligns with promoting gerotranscendence, as it focuses on supporting older adults in engaging in personal growth and reflection. By assisting individuals with meaningful activities tailored to their preferences and abilities, the nurse encourages self-discovery and personal fulfillment.
A: Giving a daily tea party for the group may foster social interaction but does not necessarily address individual growth or self-reflection.
B: Calling each family to encourage visiting may help reduce isolation but does not directly promote gerotranscendence.
C: Assisting them to resume midlife patterns may not be suitable as older adults may benefit more from exploring new activities and perspectives in their later years.