Nokea
The nurse is assessing an older client who is at risk for falls. Which of the following should be prioritized in the care plan?
- A. Frequent repositioning of the client
- B. Improving the client's strength and balance
- C. Encouraging the client to use a walker at all times
- D. Promoting regular sleep patterns
Correct Answer: B
Rationale: Strengthening balance and improving mobility are essential in reducing the risk of falls in older adults.
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What further diagnostic steps are required for the seven patients receiving atypical antipsychotics?
- A. All patients should receive 1 week of actigraphy monitoring both on and off their current antipsychotic.
- B. All patients should be immediately referred for cognitive behavioral therapy for insomnia (CBTI).
- C. All patients should receive referral to both psychiatry and neurology, neuroimaging, and screening polysomnography to identify underlying sleep disorder.
- D. Unless there is an underlying suspicion of obstructive sleep apnea (OSA) or other sleep disorder, these patients already meet criteria for irregular sleep-wake phase disorder, and no further diagnostic steps are required.
Correct Answer: C
Rationale: Comprehensive diagnostic steps involving psychiatry, neurology, and neuroimaging are necessary to assess underlying conditions and ensure proper management.
A 70-year-old man walks 20 minutes most days of the week. He has begun to complain of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 20-minute walks without stopping to rest. What choice best describes the pain associated with peripheral artery disease?
- A. A sharp, stabbing pain
- B. A dull pain and cramp
- C. An electric shock
- D. A pulsating pain
Correct Answer: B
Rationale: Claudication pain due to peripheral artery disease is typically dull and cramp-like during exercise.
A 17-year-old is diagnosed with mild bronchospasm. Which of the following would provide relief?
- A. Inhaled mometasone (Asmanex)
- B. Inhaled levalbuterol (Xopenex)
- C. Oral montelukast (Singulair)
- D. Oral dextromethorphan/guaifenesin product
Correct Answer: B
Rationale: Levalbuterol is a fast-acting bronchodilator that provides relief from bronchospasm.
A 67-year-old female with a history of congestive heart failure and myocardial infarction is admitted to the hospital because of increasing altered mental status and decreased arousal over the last week. Which one of the following features best distinguishes delirium from depression or dementia?
- A. Irritability
- B. Inattention
- C. Paranoia
- D. Aggressiveness
Correct Answer: B
Rationale: Inattention and waxing and waning of alertness are key features distinguishing delirium from depression or dementia.
Headaches with symptoms of nausea and vomiting may be associated with all of the following, EXCEPT:
- A. Migraine headache
- B. Brain tumors
- C. Subarachnoid hemorrhage
- D. Tension headache
Correct Answer: D
Rationale: Tension headaches typically do not present with nausea and vomiting.