Nokea
Which one of the following is most true about aging changes?
- A. Stage 3 and 4 sleep decreases.
- B. Renal perfusion is not reduced, but renal function is reduced.
- C. Hearing acuity declines beginning in middle age.
- D. Prostatic enlargement occurs only in a minority of men.
Correct Answer: A
Rationale: Aging leads to a decrease in the deeper stages of sleep (Stage 3 and 4).
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A 74-year-old man who recently lost his spouse of 50 years in an auto accident tells the NP that "he has no purpose in this life":
- A. Have you told your family how you feel?
- B. Have you thought about hurting yourself?
- C. Are you taking your medication?
- D. Do you have any friends?
Correct Answer: B
Rationale: This is a key screening question to assess for suicidal ideation.
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.
Risk factors for elder mistreatment include all except:
- A. Physical disability of patient
- B. Dementia of patient
- C. Caregiver burden
- D. Substance abuse of caregiver
Correct Answer: E
Rationale: Financial independence of the caregiver is not a recognized risk factor for elder mistreatment.
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 75-year-old man presents with the chief concern, “I may have a bladder infection.” Further questioning reveals for several months he has been needing to void every couple of hours (can’t sit through a whole ball game), feels he must go as soon as he feels the urge (he tried putting it off and had urinary leakage), and is getting up two to three times at night to void. He denies delay in voiding or straining to initiate voiding, slow stream, feeling of incomplete emptying, or dribbling after completion of urination. He also denies dysuria and abdominal pain. Which of the following best describes the category or type of his lower urinary tract symptoms?
- A. Prostatism
- B. Overactive bladder
- C. Postmicturition
- D. Storage (irritative)
Correct Answer: D
Rationale: Storage symptoms (irritative) include urgency, frequency, and nocturia, which are characteristic of overactive bladder.