Nokea
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.
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What is the best indicator of a successful transition to hospice care for older adults?
- A. Complete cessation of all medical treatments
- B. Improvement in physical strength
- C. Relief from physical, emotional, and spiritual suffering
- D. Long-term emotional stability
Correct Answer: C
Rationale: The correct answer is C: Relief from physical, emotional, and spiritual suffering. This is the best indicator of a successful transition to hospice care for older adults because hospice care focuses on providing comfort and improving quality of life rather than curative treatments. Relief from suffering aligns with the goals of hospice care, addressing the holistic needs of patients. Choice A is incorrect as complete cessation of all medical treatments may not be appropriate for all patients in hospice care. Choice B is incorrect as improvement in physical strength may not be the primary goal in hospice care. Choice D is incorrect as long-term emotional stability is important but not necessarily the best indicator of a successful transition to hospice care.
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.
In managing frailty, what is the most important factor for improving strength and overall function in older adults?
- A. High-protein diet
- B. Medication management
- C. Regular strength training exercises
- D. Limiting physical activity to prevent injury
Correct Answer: C
Rationale: Certainly! Regular strength training exercises are crucial for improving strength and overall function in older adults with frailty. Strength training helps build muscle mass, improve balance, and increase mobility, leading to enhanced functional abilities. It also helps prevent falls and maintain independence. High-protein diet (A) supports muscle health but alone is not sufficient. Medication management (B) is important but not the primary factor for physical function. Limiting physical activity (D) can worsen frailty by causing deconditioning and loss of muscle strength.
The nurse prepares an older woman, who is Polish, for discharge through an interpreter and notes that she becomes tense during the instructions about elimination. Which intervention should the nurse implement?
- A. Move on to the discussion about medication.
- B. Ask the older woman how she feels about this topic.
- C. Instruct the interpreter to repeat the instructions.
- D. Have the older woman repeat the instructions for clarity.
Correct Answer: B
Rationale: The correct answer is B because it directly addresses the older woman's emotional response to the instructions, showing empathy and understanding. By asking how she feels, the nurse can uncover any concerns or fears she may have, leading to effective communication and tailored support. Moving on to medication (A) ignores the woman's distress, potentially worsening the situation. Instructing the interpreter to repeat instructions (C) may not address the underlying issue. Having the woman repeat instructions (D) does not acknowledge her emotional state and may not resolve her tension.
An older adult reports increasing loss of balance. Which teaching should the nurse implement?
- A. Exercise with light weights.
- B. Stand on one foot at a time while supported.
- C. Train with the use of sit-ups.
- D. Work out in a swimming pool.
Correct Answer: B
Rationale: The correct answer is B: Stand on one foot at a time while supported. This exercise helps improve balance by challenging the proprioceptive system. By standing on one foot while supported, the older adult can gradually strengthen their muscles and improve their balance. Other choices like exercising with light weights may not specifically target balance, training with sit-ups focuses more on core strength, and working out in a swimming pool may provide buoyancy but may not directly address the balance concern.