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1.

A 75-year-old female patient, whose marriage ended in divorce after


two years, has lived alone for the past 50 years. Feeling as if her life that abnormal responses to the aging process determine the
has had little meaning, the patient is terrified of living out her remaining appropriate nursing diagnoses.
years and of dying. The age-related issue to be resolved is:
that the health status data of older adults be documented in a
disengagement versus activity. retrievable form.

ego integrity versus despair.


7. A 65-year-old patient exhibits symptoms of hemianopia. The most
appropriate nursing intervention is to:
self-determination versus resignation.
arrange the patient's meal tray so that all the food is in the
self-esteem versus self-actualization. patient's field of vision.

2. An 80-year-old male patient, who lives at home with his wife, is explain all tasks thoroughly to help allay the patient's fears.
instructed to follow a 2-g sodium diet. The patient states, I've always
eaten the same way all my life, and I'm not going to change now." To look directly at the patient when speaking to maximize
promote optimal dietary adherence, the gerontological nurse's initial comprehension.
approach is to:
minimize the operating stimuli to reduce distractions to the
inform the patient about the need to follow the diet. patient.

inquire about the patient's current food preferences and eating


8. For older adults who are taking neuroleptic medication, the primary
habits.
concern is the development of:
list the variety of foods that are allowed on the diet.
lethargy.
provide dietary instruction to the patient's wife who prepares the
nausea.
meals.
poor appetite.
3. Signs and symptoms of age-related macular degeneration include:
tardive dyskinesia.
deficits in peripheral vision.
9. After a complaint about the care of a nursing home resident is made,
decreases in depth perception.
a state ombudsman initiates an investigation. Which statement about
the investigation process is true?
distortion of lines and print.
The ombudsman may proceed with the investigation without
reports of flashes of light. identifying the individual who made the complaint, and without
obtaining a court order or written consent.
4. A 90-year-old patient comes to the clinic with a family member.
During the health history, the patient is unable to respond to questions The ombudsman must identify the individual who made the
in a logical manner. The gerontological nurse's action is to: complaint.

ask the family member to answer the questions. The ombudsman must obtain a court order to review
documentation, if the resident described in the complaint does not give
ask the same questions in a louder and lower voice. written permission.

determine if the patient knows the name of the current president. The ombudsman must obtain the written permission of the
resident who is described in the complaint.
rephrase the questions slightly, and slowly repeat them in a
lower voice. 10. When teaching an independent, older adult patient how to self-
administer insulin, the most productive approach is to:
5. An effective way to adequately provide nourishishment to a patient
with moderate dementia is: facilitate involvment in a small group where the skill is being
taught.
allowing the patient to choose foods from a varied menu.
gather information about the patient's family health history.
hand-feeding the patient's favorite foods.
provide frequent, competitive skills testing to enhance learning.
routinely reminding the patient about the need for adequate
nutrition. use repeated, return demonstrations to promote the patient's
retention of the involved tasks.
serving soup in a mug, and offering finger foods.
11. The gerontological nurse assesses a 78-year-old patient, who has
6. The American Nurses Association's Gerontological Nursing: Scope had a thyroidectomy, for spasm or edema of the vocal chords by:
and Standards of Practice emphasizes:
auscultating the patient's neck over the vocal chords.
the role of the older adult as the sole decision maker in planning
his or her care. checking the patient's tone of voice and ability to speak.

the unchanging nature of the goals and plans of care for older monitoring the patient for dysphagia.
adult patients.
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observing the patient for changes in mental status. Your mother seems to be happy with the arrangement. Have
you discussed this situation with her?"
12. A male resident in a nursing home requests a new room because
he does not like the view from his current room. While the resident is 17. Which patient is at greatest risk for developing arteriosclerotic heart
away from the home on a provider visit, the staff moves the resident's disease?
belongings to another room with a better view. The resident and his
family later file a formal complaint regarding the move. Which A 60-year-old female patient with a triglyceride level of 135
statement gives the best justification for the resident's complaint? mg/dL, and a high-density lipoptrotein level of 68 mg/dL

The change was made without a provider's order. A 70-year old male patient with a total cholesterol level of 181
mg/dL, and a low-density lipoprotein level of 90 mg/dL
The resident was not included in the decision making.
A 75-year old female patient with a triglyceride level of 189
The resident's belongings were moved without his assistance. mg/dL, and a low-density lipoprotein level of 149 mg/dL

The resident's family was not included in the decision making. An 86-year-old male patient with a low-density lipoprotein level
of 100 mg/dL, and a high-density lipoprotein level of 50 mg/dL
13. A nursing home resident, who was recently admitted, and her
family only speak Spanish. One evening during a visit, the resident 18. An 82-year-old male patient has a painful, vesicular rash that burns
and her family begin to wail and sob loudly. The gerontological nurse over his left abdomen. The patient indicates that he has tried multiple
is unable to determine what is wrong. The nurse's most appropriate creams which have not helped. Which question does the
action is to: gerontological nurse first ask?

ask the supervisor to get an interpreter. Did you have the pain before the rash appeared?"

attempt to make the resident and her family comfortable. Do you have any food or drug allergies?"

contact the provider for orders. Have you been around anyone with a rash?"

find an escort to take the resident and her family to the chapel Have your grandchildren visited recently?"
for privacy.
19. Which question does the gerontological nurse prioritize for an 86-
14. Which condition do older adults with Down syndrome tend to year-old male patient with abdominal pain, muscle weakness, and leg
develop? cramps?

Alzheimer disease Do you eat a lot of meat?

Muscular dystrophy Do you have heart problems?

Paget disease Do you take a diuretic?

Parkinson disease Do you walk everyday?

15. Which ethical principle underlies nursing actions respecting each 20. A frail 80-year-old woman, who cares for her husband at home
patient's values and beliefs? without assistance, requires minor surgery. Lacking any family
members residing in the area, the wife expresses concern about her
Autonomy husband's care while she is recovering. The gerontological nurse's
recommendation is:
Beneficence
arranging inpatient, respite care for the husband.
Justice
hiring around-the-clock help for two weeks.
Responsibility
hospitalizing the husband.
16. An older adult woman, who lives in an apartment in a housing
remaining in the hospital during the postoperative period.
complex for senior citizens, began residing with an older adult man
from the same complex three months ago. Upon learning of the
situation, the woman's daughter expresses concern to the housing 21. An older adult patient currently takes phenytoin (Dilantin) and
administrator, who reports that both residents have reported tolterodine (Detrol). The gerontological nurse reinforces the need for
satisfaction with the arrangement. When the daughter requests advice, routine dental visits because these two medications decrease:
the gerontological nurse's initial response is:
calcium levels in the blood.
I can understand why you are upset. Has she ever done
something like this before?" innervations of the trigeminal nerve.

Why don't we all talk to your mother to get her side of the the muscle strength of the tongue.
story?"
the production of saliva.
Your mother has the right to do what she wants because she is
mentally competent."

2
22. An older adult, who is terminally ill with multiple myeloma, is Question 7
followed by hospice. Which situation best illustrates that the principles The right answer was arrange the patient's meal tray so that all the
of hospice care are being met? food is in the patient's field of vision.
Question 8
The caregiver asks if hospice includes weekend care. The right answer was tardive dyskinesia.
Question 9
The caregiver has been calling the provider on his or her own. The right answer was The ombudsman may proceed with the
investigation without identifying the individual who made the complaint,
and without obtaining a court order or written consent.
The patient reports enjoying daily excursions.
Question 10
The right answer was use repeated, return demonstrations to promote
The patient reports no breakthrough pain medications are the patient's retention of the involved tasks.
needed. Question 11
The right answer was checking the patient's tone of voice and ability to
23. A 76-year-old male patient reports hesitancy, decreased force of speak.
the urinary flow, a sensation of incomplete emptying of the bladder, Question 12
and dribbling. The gerontological nurse first asks: The right answer was The resident was not included in the decision
making.
Have you experienced abdominal pain?" Question 13
The right answer was ask the supervisor to get an interpreter.
Have you had a daily bowel movement?" Question 14
The right answer was Alzheimer disease
Question 15
Have you had low back pain?"
The right answer was Autonomy
Question 16
Have you noticed blood in your urine?" The right answer was Your mother seems to be happy with the
arrangement. Have you discussed this situation with her?"
24. A gerontological nurse is monitoring signs of suspected abuse in an Question 17
89-year-old patient who was admitted from home. When planning for The right answer was A 75-year old female patient with a triglyceride
the patient's discharge, the nurse's first action is to: level of 189 mg/dL, and a low-density lipoprotein level of 149 mg/dL
Question 18
delay discharge by informing the provider of the suspected The right answer was Did you have the pain before the rash
abuse. appeared?"
Question 19
enlist the help of family members with transitioning the patient The right answer was Do you take a diuretic?
home. Question 20
The right answer was arranging inpatient, respite care for the husband.
Question 21
notify Adult Protective Services of the patient's discharge.
The right answer was the production of saliva.
Question 22
restrict the family members' access to the patient prior to The right answer was The patient reports no breakthrough pain
discharge. medications are needed.
Question 23
25. The gerontological nurse manager involves the nursing staff in the The right answer was Have you noticed blood in your urine?"
utilization of trend data and analysis for quality improvement by: Question 24
The right answer was notify Adult Protective Services of the patient's
encouraging staff to volunteer for The Joint Commission's onsite discharge.
Question 25
surveys.
The right answer was informing how data and outcomes are directly
related to the staff's daily work.
highlighting the quality improvement work of experts in the
specialty area. 1. A 40-year-old patient with rheumatoid arthritis develops a new onset
of nocturnal pain and swelling of the fingers. Examination reveals
informing how data and outcomes are directly related to the asymmetrical swelling of the small joints of the fingers of the right
hand. The patient was recently prescribed hydrochlorothiazide
staff's daily work.
(Microzide) 25 mg daily for hypertension. The patient's new symptoms
are caused by:
using scatter diagrams to identify the root cause of unresolved
concerns. carpal tunnel syndrome.

You have made the following errors gout.


Question 1
The right answer was ego integrity versus despair. osteoarthritis.
Question 2
The right answer was inquire about the patient's current food Reiter syndrome.
preferences and eating habits.
Question 3
The right answer was distortion of lines and print. 2. A male patient's daughter telephones an adult-gerontology primary
Question 4 care nurse practitioner to inquire about the patient's illness. The
The right answer was rephrase the questions slightly, and slowly daughter reports that her father relies upon her to explain everything to
repeat them in a lower voice. him. The nurse practitioner's initial response is to:
Question 5
The right answer was serving soup in a mug, and offering finger foods. ask the daughter to provide a copy of the patient's advance
Question 6 directive document.
The right answer was that the health status data of older adults be
documented in a retrievable form. assure the daughter that the nurse practitioner can disclose the
requested information.
3
inform the daughter that she must come to the clinic to discuss take garlic supplements.
her father's case.
8. An adult-gerontology primary care nurse practitioner is evaluating a
tell the daughter that the nurse practitioner can discuss the patient who has cold symptoms, reports smoking half a pack of
information only with the patient. cigarettes a day, and shows no interest in quitting. The nurse
practitioner's most appropriate approach is to treat the cold symptoms
3. An adult-gerontology primary care nurse practitioner reminds a 16- and:
year-old male patient, who just received his driver's license, to wear a
seat belt at all times when in a car. The patient replies that he does not advise the patient to stop smoking.
need to wear a seat belt, because nothing will happen to him if he is
involved in an automobile collision. According to the Health Belief prescribe bupropion (Zyban).
Model, what chief component is this patient lacking?
raise the issue of smoking cessation at the next visit.
Enabling factors
recommend that the patient select a low nicotine cigarette.
Motivation
9. A patient comes to the adult-gerontology primary care nurse
Perceived role conflict
practitioner with reports of pain in the right shoulder, which began after
the patient started to swim. Physical examination reveals point
Perceived severity tenderness over the greater tuberosity of the humerus and pain with
abduction from 60 to 120 degrees. The diagnosis is:
4. A 14-year-old male patient has some general concerns about
eczema, as his twin brother was recently diagnosed with this condition. adhesive capsulitis.
The patient reports urticaria and a rash on his posterior knees
bilaterally. The three factors that put the patient at risk for eczema are glenohumeral joint instability.
a family history of eczema, a personal history of allergic rhinitis, and a
history of: osteoarthritis.

asthma. supraspinatus tendinitis.

bee allergy.
10. A patient comes to the clinic with reports of acute pain and loss of
vision in the right eye. The adult-gerontology primary care nurse
otitis media.
practitioner informs the patient that these symptoms require:
psoriasis.
assessment with a split lamp.

5. An adult-gerontology primary care nurse practitioner is counseling a examination with an otoscope.


patient who lives in a homeless shelter about his or her pre-
hypertension. The nurse practitioner anticipates that, for this patient, a immediate referral to an ophthalmologist.
significant barrier to effective blood pressure control is:
treatment with several ophthalmologic agents.
lack of access to healthy food choices.

lack of access to medication. 11. An adult-gerontology primary care nurse practitioner evaluates a
new patient with hypertension. The patient is African American and has
been taking lisinopril (Prinivil). To optimize the patient's response, a
sodium content of meal program foods.
more effective pharmacological treatment is:
sodium content of ready-to-eat foods.
a beta-blocker.

6. Which is an accurate statement about treating Trichomonas a direct-acting vasodilator.


vaginalis infections with metronidazole (Flagyl)?
a thiazide diuretic.
Common side effects of treatment include a pruritic rash and
blurred vision. an angiotensin-converting enzyme inhibitor.

Sexual partners do not require treatment.


12. Which is covered under Medicare, Part A?
The patient should avoid all milk products for 48 hours after
treatment. Assisted living

Treatment consists of one 2 g dose. Hospice benefits

Medical equipment and supplies


7. A 58-year-old patient has a blood pressure reading of 138/85 mm
Hg. The adult-gerontology primary care nurse practitioner instructs the Outpatient services
patient to:

reduce his or her daily salt intake. 13. An adult-gerontology primary care nurse practitioner orders cancer
screening tests for a 69-year-old patient because of the age-related
return for reevaluation in one year. cancer risk from a:

return for reevaluation in six months.


4
decline in cell-mediated immunity. A brain natriuretic peptide test

decline in humoral-mediated immunity. A D-dimer assay

decreased hypersensitivity reaction. A spirometry study

decreased production of antibodies. An ankle-brachial index

14. An adult-gerontology primary care nurse practitioner conducts a 19. An adult-gerontology primary care nurse practitioner is conducting
research study to evaluate a new method for non-pharmaceutical pain a small group class on weight management. The nurse practitioner
control. After making a statistically significant finding, the nurse anticipates that the patient who may have the greatest difficulty
practitioner informs and consults his or her research colleagues. The implementing the counseling is the:
nurse practitioner's next action is to:
extroverted patient who is raising his or her grandchildren.
critique and determine the applicability of these research
findings to practice. introverted patient who does not speak in the group.

incorporate the information gleaned from the research findings personable patient who lives with his or her children.
into patient care.
worried patient whose son is serving in military conflict.
offer the research findings as a treatment option to future
patients.
20. When disseminating research findings in a peer-reviewed journal,
an adult-gerontology primary care nurse practitioner:
publish the information in a widely read journal on pain
management.
concludes that the study proves the hypothesis.

15. A patient has hyperactive reflexes of the lower extremities. The excludes the discussion section because the conclusion
adult-gerontology primary care nurse practitioner assesses for ankle contains this information.
clonus by:
recommends incorporating the results directly into clinical
firmly applying a low-pitched tuning fork to the lateral malleolus. practice.

flexing the leg at the knee, rotating it externally, and striking the uses the methodology section to support the validity of the study.
Achilles tendon with the percussion hammer.

sharply dorsiflexing the foot and maintaining this position while 21. An adult-gerontology primary care nurse practitioner has developed
supporting the knee. a new protocol that changes the practice for nurses who administer
warfarin (Coumadin) in a busy urban clinic. Using change theory to
introduce this new practice, the nurse practitioner:
stroking the lateral aspect of the sole from the heel to the ball of
the foot with the sharp end of the percussion hammer.
excludes the facility administrator.

16. A 69-year-old female patient reports dyspareunia. Physical maintains the current culture.
examination reveals sparse hair, an introitus that admits two fingers,
and a pale, dry vagina. The adult-gerontology primary care nurse minimizes the restraining forces.
practitioner's initial management is to recommend:
quickly implements the protocol.
daily douching.

topical antibiotic cream. 22. An 84-year-old male patient arrives at the office for an initial visit.
The patient questions the need for colorectal screening since 10 years
topical antifungal cream. have passed since his last colonoscopy. The adult-gerontology primary
care nurse practitioner recommends:
topical hormonal cream.
a colonoscopy.

17. When treating an older adult for gastroesophageal reflux disease, a fecal DNA test.
which drug does an adult-gerontology primary care nurse practitioner
prescribe cautiously, because of possible central nervous system
flexible sigmoidoscopy.
toxicity?
watchful waiting. Question 1
Metoclopramide (Reglan)
The right answer was gout..
Question 2
Nizatidine (Axid)
The right answer was tell the daughter that the nurse
practitioner can discuss the information only with the
Omeprazole (Prilosec)
patient..
Question 3
Ranitidine (Zantac) The right answer was Perceived severity.
Question 4
18. To screen for heart failure, which diagnostic test does the adult- The right answer was asthma..
gerontology primary care nurse practitioner order for a patient who has Question 5
swelling in his or her lower extremities? The right answer was lack of access to healthy food choices..

5
Question 6
disorganized thinking, and altered level of consciousness.
The right answer was Treatment consists of one 2 g dose..
Question 7 Which of the following assessment tools is most indicated?
The right answer was reduce his or her daily salt intake.. A. Mini-mental state exam (MMSE)
Question 8
The right answer was advise the patient to stop smoking.. B. Mini-Cog
Question 9 C. Confusion assessment method (CAM)
The right answer was supraspinatus tendinitis..
Question 10 D. Geriatric depression scale (GDS)
The right answer was immediate referral to an 4. A 76-year-old patient has developed slight dependent
ophthalmologist..
Question 11 rubor in both feet. The best procedure to assess peripheral
The right answer was a thiazide diuretic.. arterial insufficiency of the lower extremities is
Question 12
The right answer was Hospice benefits. A. nylon monofilament tests.
Question 13 B. toe-brachial index.
The right answer was decline in cell-mediated immunity..
C. capillary refill test.
Question 14
The right answer was critique and determine the applicability D. ankle-brachial index.
of these research findings to practice..
5. A frail 82-year-old female has developed second-
Question 15
The right answer was sharply dorsiflexing the foot and degree uterovaginal prolapse. Which of the following
maintaining this position while supporting the knee.. treatments is most indicated?
Question 16
The right answer was topical hormonal cream.. A. Ring pessary
Question 17 B. Hodge pessary
The right answer was Metoclopramide (Reglan).
Question 18 C. Donut pessary
The right answer was A brain natriuretic peptide test. D. Referral to surgeon for surgical repair
Question 19
The right answer was worried patient whose son is serving in Answers
military conflict..
Question 20 1. A: These symptoms are characteristic of dementia with Lewy bodies.
The right answer was uses the methodology section to
support the validity of the study.. Cognitive and physical decline is similar to Alzheimer's, but symptoms
Question 21 may fluctuate frequently. This form of dementia may include visual
The right answer was minimizes the restraining forces..
hallucinations, muscle rigidity, and tremors. Frontotemporal dementia
Question 22
The right answer was watchful waiting.. may cause marked changes in personality and behavior and is
1. A 77-year-old male patient has increasing dementia with characterized by difficulty using and understanding language. Normal
short-term memory loss and symptoms that fluctuate pressure hydrocephalus is characterized by ataxia, memory loss, and
frequently. The patient experiences visual hallucination and urinary incontinence. Parkinson's dementia may involve impaired
exhibits muscle rigidity and tremors. These symptoms are decision making and difficulty concentrating, learning new material,
characteristic of which type of non-Alzheimer's dementia? understanding complex language, and sequencing as well as
A. Dementia with Lewy bodies inflexibility and short- or long-term memory loss.
B. Frontotemporal dementia 2. D: These symptoms are consistent with a duodenal ulcer, and the
C. Normal pressure hydrocephalus positive urea breath test indicates a Helicobacter pylori infection,
D. Parkinson's dementia which is usually treated with a proton pump inhibitor plus
2. An older woman complains of a history of nausea and clarithromycin and amoxicillin/metronidazole. About 90% of duodenal
burning, stabbing epigastric pain which is relieved for short ulcers are associated with H. pylori infection. H. pylori weakens the
periods by antacids or intake of food. The patient denies mucosa and results in hypersecretion of gastric acid. Eating may
NSAID use but is a heavy smoker. A urea breath test is increase pain with gastric ulcers but usually relieves pain with
positive. Which of the following treatment protocols is most duodenal ulcers. Smoking increases the risk of peptic ulcer disease, and
common? use of NSAIDs increases risk of serious complications, such as bleeding
A. Histamine-2 blocker plus bismuth plus tetracycline or perforation.
B. Proton pump inhibitor only 3. C: CAM: Assesses development of delirium. Factors indicative of
C. Proton pump inhibitor plus tetracycline delirium include
D. Proton pump inhibitor plus clarithromycin and Onset: Acute change in mental status.
amoxicillin/metronidazole Attention: Inattentive, stable, or fluctuating.
3. A 76-year-old male is recovering from surgery but exhibits Thinking: Disorganized, rambling conversation, switching topics,
sudden onset of confusion with fluctuating inattention, illogical.
Level of consciousness: Altered, ranging from alert to coma.

6
4. The average number of medications taken daily by
Orientation: Disoriented (person, place, time).
an older adult patient who does not live in an
Memory: Impaired. institution is ____.
Perceptual disturbances: Hallucinations, illusions. A 2-
. 3
Psychomotor abnormalities: Agitation (tapping, picking, moving) or
B 8-
retardation (staring, not moving). . 9
Sleep-wake cycle: Awake at night and sleepy in the daytime. C 4-
. 5
MMSE and Mini-Cog are used to assess evidence of dementia or short-
D
term memory loss, often associated with Alzheimer's disease. GDS is a 6
.
self-assessment tool to identify older adults with depression. 5. What percent of all sensory information is received
through the eyes.
4. D: Ankle-brachial index: Used to evaluate peripheral artery disease
A7
by combining use of blood pressure and Doppler readings of the arms . 0
(brachial artery) and ankles to determine difference in pressure from B4
. 5
upper extremities to lower. Toe-brachial index: Used if ABI is positive
C9
to provide additional information. Nylon monofilament test: Used to . 1
evaluate neuropathy and risk of ulcers. A piece of monofilament is D5
. 7
touched and pressed against parts of foot and toes to determine if
6. What percent of all hospital patients are
patient can feel it. Capillary refill: Used to assess perfusion. Nail is 65 or older
grasped and pressure applied for a few seconds and then released. A7
. 5
Arterial occlusion is indicated with times >2-3 seconds.
B5
5. A: Because of age and frailty, this patient is a poor candidate for . 0
surgical repair, so a ring pessary, which is used for first- and second- C6
. 5
degree uterovaginal prolapse is indicated. Hodge pessary is used for
D4
mild cystocele and cube pessaries for third-degree uterovaginal . 5
prolapse. Pessaries are plastic or silicone removable prosthetic devices 7. Beers Criteria
is ____________________.
that are placed in the vagina for management of pelvic muscle support A A list of appropriate medications which can be safely
defects, such as cystocele and rectocele. They are also frequently used . given to older adult patients
for stress incontinence. B A list of over the counter medications which can be
1. The term geriatric refers to what type of . given to older adult patients
adult patient? C A list of medications which are considered
A Those in nursing . inappropriate when given to older patients
. homes Beers criteria is an outline of characteristics that help
D
B nursing home patients define older adult patients who can drink a prescribed
.
. over 65 amount of alcholic beverages under a doctors care.
C any adult patient 65 or 8. Approximately ____ percent of the elderly who
. older fracture a hip die within 12 months of their injury.
D adult patients 85 or A5
. older . 0
2. Geriatric patients account for what percent of all B2
prescription medications consumed in the United . 5
States? 9. The lack of _______________________ can lead nurses,
A 22 who care for older adult patients, to preconceptions,
. % or bias, or prejudice in their attitudes toward their
B 73 patients.
. % A Patient
C 34 . History
. % B Medical
D 52 . Knowledge
. % C Psychiatric
3. Which group has the highest rate of depression, . Competence
and suicide? D Cultural
A men 65 and . Competence
. older 10. nOver the next 15 years the projected number of
B women 65 and adults 65 and over is projected to grow to what
. older percent _______?
C men 65 and older who are A1
. widowers . 5
D women 65 and older who are B2
. widows . 0

7
C2 more complicated questions by saying, I don't know. Which test is
. 5 included in a further assessment?
D3
. 0 Barthel Index
11. The five major components of a comprehensive
Functional Independence Measure
nursing assessment of the older adult patient
include which of these (choose the best answer)? Geriatric Depression Scale
A functional, spiritual, financial, physical,
. cognitive aspects Lawton Life Satisfaction Scale
B physical, cognitive, social, spiritual, and
. family aspects 6. The most reliable means for assessing hydration in an older adult is:
C spiritual, psychological, social, functional, and
. physical aspects mucous membrane condition.
D spiritual, psychological, social, functional, and
. financials aspects skin texture.

ANSWERS: 1. C 2. C 3. A 4. C 5. 6. C 7. C 8. A 9. D 10. B 11. C skin turgor.

urinary frequency.
1. A 73-year-old patient reports dizzy spells for the past several
weeks. The patient describes three similar episodes during which the 7. Differences between the IQ scores of a group of 20-year-old
patient experienced a swimming in my head, loss of balance without individuals and a group of 80-year-old individuals suggest:
falling, and numbness in the left arm. These episodes lasted 10 to 30
minutes. This patient is experiencing: a cortical atrophy.

carotid artery stenosis. an accumulation of lipofuscin.

Mnire's disease. cohort differences.

postural hypotension. vascular changes.

transient ischemic attacks. 8. Which group of older adults has the highest risk for suicide?

2. Which is the main principal age-related change that causes an African-American men
alteration in drug distribution in older adults?
African-American women
A decrease in absorption
White men
A decrease in total body weight
White women
An increase in body water
9. In a quality review of pressure ulcers among nursing home
An increase in the ratio of body fat to lean body mass residents, appropriate outcome criteria include the:

3. An 85-year-old patient has an intestinal viral infection with severe availability of supplies for wound care.
diarrhea. Laboratory studies are ordered. Which result confirms a
diagnosis of dehydration? incidence of pressure ulcers correlated with staffing levels.

Hyperchloremia and hypernatremia percentage of pressure ulcers that demonstrate healing each
month.
Hyperglycemia and hyponatremia
rate of nurse compliance with the protocol for treating pressure
Hyperkalemia and hypercapnia ulcers.

Hypermagnesemia and hyponatremia 10. Ever since the death of her husband a year ago, an older woman's
ability to care for herself has significantly diminished. The older woman
4. In older women, the onset of physical discomfort and bleeding expresses increased feelings of inadequacy and decreased
associated with sexual intercourse often indicates: satisfaction with life. The daughter has become the primary caregiver
for the woman and has become increasingly resentful of this role. The
a friable cervix with possible cellular abnormalities. mother and daughter's feelings are best explained in terms of:

decreased distensibility and mucosal changes of the vaginal ego integrity versus despair.
vault.
role theory.
infrequent sexual activity.
social exchange theory.
thickening of the vaginal mucosa with decreased lubrication.
unresolved grieving.
5. A gerontological clinical nurse specialist is administering a mental
status examination to an 80-year-old patient. The patient answers the
8
11. Persons who have chronic open-angle glaucoma are advised to 16. In teaching older adults in a group setting, the gerontological
wear medical alert bracelets because they have the potential for clinical specialist minimizes the impact of presbycusis by:
developing acute glaucoma if they are administered:
increasing the volume of the audio system.
angiotensin converting enzyme (ACE) inhibitors.
providing soft background music.
anticholinergic agents.
raising voice pitch and facing the group.
adrenergic blocking agents.
reducing voice pitch, speaking slowly, and enunciating.
osmotic agents.
17. After presenting a talk on breast health, a gerontological clinical
12. To decrease the complications of hypercalcemia caused by specialist discovers that at least 60% of the women who attend a large
prolonged immobilization, the most appropriate nursing intervention is urban senior center do not believe in the benefits of mammography,
to: have never had a mammogram, or had a painful experience and
refuse to get another one. Which initial approach is most likely to
encourage a high fluid intake unless contraindicated. motivate change?

monitor renal function. Administering a survey to assess the exact nature of the
women's self-care behaviors before planning the next step
monitor serum calcium and phosphorous levels.
Arranging for reduced-cost mammograms and free
observe the patient for signs of muscle twitching. transportation to the local hospital

Planning some small group sessions with these women to allow


13. A gerontological clinical specialist is conducting a study on risk them to explore their beliefs and feelings
factors for osteoporosis and has developed a questionnaire covering
risk-reducing and risk-increasing behaviors of older women. The
Presenting another educational session that includes a speech
clinical specialist asks experts in the area of osteoporosis to review this
by a physician and then distribute additional literature
tool to establish:

concurrent validity. 18. When encouraging adult learners to use the concept of critical
reflection, the gerontological clinical specialist:
content validity.
emphasizes the how and how to instead of the why.
interrater reliability.
encourages and engages learners in problem formation and
test-retest reliability. problem-solving activities.

explains the definition of the issue or problem under discussion


14. A gerontological clinical nurse specialist plans to investigate the so the definition is understood by all.
relationship between educational levels and adherence to prescribed
hypertensive medication, as measured by changes in blood pressure
focuses on the present and minimizes discussions regarding
readings. Which research design is most appropriate to study this
learners' past experiences.
issue?

Descriptive correlation 19. An 81-year-old patient has right-sided pleuritic pain with shortness
of breath. The patient reports falling during the night, and has a large
Nonequivalent control group ecchymosis on the right flank area. Which nursing diagnoses is a
priority for this patient?
Pretest-posttest
Anxiety
Quasi-experimental
Impaired skin integrity

15. A gerontological clinical nurse specialist is asked to provide Ineffective breathing pattern
consultation on ways to reduce the use of restraints in a nursing home.
In the initial meeting with the nursing home administration, the clinical
Sleep pattern disturbance
specialist's primary goal is to:

complete a written contract for services that covers expected 20. The Framingham heart study examined the effect of blood
outcomes, time commitments, support systems, and financial pressure, cholesterol levels, smoking, exercise, and other variables on
arrangements. the development of coronary artery disease in a cohort of healthy men
and women. The subjects were studied at specific intervals over a
conduct a force field analysis of the variables in the nursing period of years. The Framingham study is an example of which type of
home that includes use of existing data on restraint use and staff research study?
strengths and weaknesses.
Cross-sectional
discuss the need for consultation, the overall goal of the project,
and the working relationship with the staff. Longitudinal

plan a review of how the use of restraints has been Predictive


accomplished elsewhere and the models used for education and for
changing practice. Retrospective

9
21. To be an effective consultant in a new setting, the gerontological Question 1
clinical nurse specialist first explains to the staff members the: The right answer was transient ischemic attacks.
Question 2
clinical nurse specialist's ability to plan care. The right answer was An increase in the ratio of body fat to lean body
mass
clinical nurse specialist's expertise as a consultant. Question 3
The right answer was Hyperchloremia and hypernatremia
Question 4
need for consultation.
The right answer was decreased distensibility and mucosal changes of
the vaginal vault.
role of the consultant. Question 5
The right answer was Geriatric Depression Scale
22. The gerontological clinical nurse specialist is asked to speak to a Question 6
chronic obstructive pulmonary disease support group about the ethical The right answer was mucous membrane condition.
issues surrounding physician-assisted suicide. At the beginning of the Question 7
presentation, the clinical nurse specialist asks the group to identify The right answer was cohort differences.
what they fear most about death and dying. This technique is used to Question 8
achieve objectives in which domain? The right answer was White men
Question 9
Affective The right answer was percentage of pressure ulcers that demonstrate
healing each month.
Cognitive Question 10
The right answer was social exchange theory.
Question 11
Psychomotor
The right answer was anticholinergic agents.
Question 12
Spiritual The right answer was encourage a high fluid intake unless
contraindicated.
23. To ensure the successful implementation of the humanistic model Question 13
of organizational theory, nurse managers and gerontological clinical The right answer was content validity.
nurse specialists prioritize activities that: Question 14
The right answer was Descriptive correlation
eliminate at least one organizational level to decentralize. Question 15
The right answer was discuss the need for consultation, the overall
eliminate or minimize the informal grapevine. goal of the project, and the working relationship with the staff.
Question 16
The right answer was reducing voice pitch, speaking slowly, and
emphasize informal communication and minimize formal
enunciating.
communication.
Question 17
The right answer was Planning some small group sessions with these
emphasize job satisfaction to improve productivity. women to allow them to explore their beliefs and feelings
Question 18
24. An 88-year-old patient is reluctant to use the call light for The right answer was encourages and engages learners in problem
assistance and is often incontinent. The gerontological clinical nurse formation and problem-solving activities.
specialist tells the staff to praise the patient each time the call light is Question 19
used to request toileting assistance. The clinical nurse specialist's The right answer was Ineffective breathing pattern
suggestion is based on which theory? Question 20
The right answer was Longitudinal
Behavioral learning Question 21
The right answer was role of the consultant.
Question 22
Cognitive reorganization
The right answer was Affective
Question 23
Person-environment fit The right answer was emphasize job satisfaction to improve
productivity.
Social cognitive Question 24
The right answer was Behavioral learning
25. A 92-year-old patient with advanced dementia has had three Question 25
episodes of aspiration pneumonia in five months. The patient has no The right answer was organize a family and staff meeting to discuss
written advance directives. The speech therapist recommends feeding the risks and benefits and consider the patient's wishes.
tube placement. The patient's son would like a feeding tube placed, the
daughter is unsure, and the patient's spouse states that the patient 1. The gerontological nurse practitioner performs a speculum
would never want a feeding tube. The gerontological clinical nurse examination for a 71-year-old female patient without symptoms, and
specialist's next action is to: finds a thin, whitish, nonodorous mucoid discharge high in the patient's
vagina. The nurse practitioner's most appropriate intervention is to:
bring the case to the attention of the ethics committee.
explain to the woman that the discharge is normal.
emphasize to the family that a feeding tube will decrease
prescribe estrogen cream, twice a week.
recurrent pneumonias.
prescribe a topical antifungal medication, applied vaginally each
obtain a surgical consult to schedule a feeding tube placement. night for one week.

organize a family and staff meeting to discuss the risks and recommend the daily use of a vaginal lubricant, for three days.
benefits and consider the patient's wishes.
2. Temporal arteritis requires immediate treatment in order to prevent:

10
8. A 69-year-old female patient reports dyspareunia. Physical
blindness in the affected eye. examination reveals sparse hair, an introitus that admits two fingers,
and a pale, dry vagina. The gerontological nurse practitioner's initial
facial nerve palsy. management of this problem is to prescribe:

transient ischemic attack. a local, topical antifungal cream.

trigeminal neuralgia. a topical hormonal cream.

a water-soluble lubricating jelly.


3. The test of choice for diagnosing iron deficiency anemia is a:
daily douching.
reticulocyte count.

serum ferritin level. 9. An older patient, who has chronic obstructive pulmonary disease,
develops a fever and changes in sputum production. The
gerontological nurse practitioner prescribes:
total iron binding capacity.
a corticosteroid.
transferrin saturation level.
an antibiotic.
4. Which profile characterizes the older adult with the highest risk for
suicide? an inhaled bronchodilator.

Divorced, Asian, and female nebulizer treatments.

Married, Amish, and female


10. The charge nurse at a nursing home consults a gerontological
nurse practitioner about a resident with dementia who fell two weeks
Single, White, and male
ago. The patient's x-ray on the day of the fall was negative, but the
resident continues to limp and exhibits increasing agitation. The nurse
Widowed, African-American, and male practitioner advises the charge nurse to:

5. A patient has hyperactive reflexes of the lower extremities. The administer the prescribed pain medication to the resident.
gerontological nurse practitioner assesses for ankle clonus by:
apply heat to the affected hip and monitor the resident's
applying a low-pitched tuning fork firmly to the lateral malleolus. ambulation.

sharply dorsiflexing and maintaining the foot in this position, initiate physical therapy for the resident.
while supporting the knee.
obtain another x-ray of the affected hip and pelvis.
striking the Achilles tendon with the percussion hammer after
flexing the leg at the knee and rotating it externally.
11. Which patient has the greatest nutritional risk?
stroking the lateral aspect of the sole with the sharp end of the
A patient who has dementia and is living with family
percussion hammer from the heel to the ball of the foot.
A patient who has hypothyroidism and is 30% overweight
6. The gerontological nurse practitioner notes a well-demarcated, dry,
rough, tan-colored area that measures 1 cm on the forearm of a retired A patient who has multiple dental caries and lives alone
man who worked as a park ranger. The man says that the lesion has
been present for years. The lesion is suggestive of:
A patient who is wheelchair-bound from a stroke and receives
live-in care
actinic keratosis.

keratoacanthoma. 12. For two to three months, an older adult patient has not been taking
his or her levothyroxine (Synthroid) as prescribed. The patient now has
symptoms of increasing constipation, lethargy, and weakness. The
seborrheic keratosis.
gerontological nurse practitioner anticipates that laboratory tests will
show that the patient's:
senile lentigo.
T4 level is decreased and TSH level is increased.
7. An 87-year-old patient, who has multiple, fluid-filled and unilateral
lesions on an erythematous base that follows a dermatome, reports T4 level is increased and TSH level is decreased.
severe pain and burning at the site. The patient asks how long the pain
will last. The gerontological nurse practitioner responds that the pain: T4 level is increased and TSH level is unchanged.

might never completely disappear. T4 level is unchanged and TSH level is decreased.

will disappear in four to six weeks.


13. The primary reason for reassessing patients' alcohol use is to:
will disappear in six months to one year.
advise about safe levels of consumption.
will disappear once the lesions are gone.
evaluate the risk for peripheral neuropathy.

prevent or reduce associated health risks.


11
screen for liver dysfunction. A brain natriuretic peptide test

14. The medical history of a robust, 64-year-old patient is negative for A D-dimer assay
hypertension, heart disease, and diabetes. Upon examination, the
gerontological nurse practitioner detects a new grade 3 crescendo- A spirometry study
decrescendo systolic murmur that is heard loudest at the base of the
heart, with radiation to the carotid arteries. The gerontological nurse An ankle brachial index
practitioner's next action is to order:
20. The purpose of a Long-Term Care Ombudsman Program is:
a C-reactive protein test.
implementing quality assurance activities.
a troponin level.

an echocardiogram. performing comprehensive resident assessments.

an electrocardiogram. preserving the rights of nursing home residents.

15. Which drug puts an older adult at the highest risk for injury after a providing training requirements for nursing assistants.
fall?
Question 1
Acetaminophen/hydrocodone (Vicodin) The right answer was explain to the woman that the discharge is
normal.
Alendronate (Fosamax) Question 2
The right answer was blindness in the affected eye.
Loratadine (Claritin) Question 3
The right answer was serum ferritin level.
Warfarin (Coumadin). Question 4
The right answer was Single, White, and male
Question 5
16. In addition to altered mental status, which is the best early indicator The right answer was sharply dorsiflexing and maintaining the foot in
of pneumonia in an older adult? this position, while supporting the knee.
Question 6
Cough The right answer was actinic keratosis.
Question 7
Fever The right answer was might never completely disappear.
Question 8
Malaise The right answer was a topical hormonal cream.
Question 9
Tachypnea The right answer was an antibiotic.
Question 10
The right answer was obtain another x-ray of the affected hip and
17. A 65-year-old woman comes to the geriatric clinic for a routine pelvis.
checkup. Her history includes a 10 lb (4.5 kg) weight loss over the past Question 11
two months. On physical examination, an enlarged (2 cm), radiating, The right answer was A patient who has multiple dental caries and
nontender and rubbery lymph node is palpated on the left lives alone
supraclavicular chain. The gerontological nurse practitioner's next Question 12
action is to: The right answer was T4 level is decreased and TSH level is
increased.
order a throat culture and monospot test. Question 13
The right answer was prevent or reduce associated health risks.
order a two-step tuberculin skin test. Question 14
The right answer was an echocardiogram.
prescribe antibiotic therapy. Question 15
The right answer was Warfarin (Coumadin).
Question 16
refer the patient to a surgeon for a lymph node biopsy.
The right answer was Tachypnea
Question 17
18. Which type of urinary incontinence is lessened by pelvic floor The right answer was refer the patient to a surgeon for a lymph node
exercises? biopsy.
Question 18
Functional The right answer was Stress
Question 19
Overflow The right answer was A brain natriuretic peptide test
Question 20
Stress The right answer was preserving the rights of nursing home residents.

Transient 1. Which factor is associated with the highest risk of falls in older
persons living in the community?

19. Which diagnostic test does the gerontological nurse practitioner A history of previous falls
order for a patient who has swelling in his or her lower extremities to
screen for heart failure?
Living alone

Osteoporosis
12
48 hours ago from the tunneled catheter, show preliminary results of
Use of an assistive device gram-negative bacilli. The patient's most recent echocardiogram report
reveals an ejection fraction of 40%. The adult-gerontology acute care
nurse practitioner determines that:
2. An older adult patient complains of recent lapses in memory and
decreased alertness. The patient's laboratory test results indicate a
a pulmonary artery catheter insertion is indicated, to manage
mild, macrocytic anemia. Which additional test does the adult-
septic shock.
gerontology acute care nurse practitioner order to confirm a diagnosis?
fluid resuscitation will be limited to no more than 4 liters.
A reticulocyte count
indwelling vancomycin (Vancocin) should be placed in the ports
A serum folate level
of the tunneled catheter.
An erythrocyte sedimentation rate
piperacillin-tazobactam (Zosyn) is indicated for the line-related
infection.
Iron studies

8. Which research design has the greatest strength in determining if an


3. An 80-year-old male patient with dementia requires long-term care intervention is effective?
placement. To which funding agency does the patient apply, after
spending down" to qualify?
Case control
Medicaid
Clinical trial
Medicare
Cohort
The American Association of Retired Persons
Cross-sectional
The United States Social Security Administration
9. A 55-year-old man who has no history of diabetes mellitus, heart
disease, hypertension, or thrombotic events is diagnosed with
4. A 70-year-old patient with acute systolic heart failure denies any paroxysmal atrial fibrillation. Based on national stroke prevention
functional limitations, is able to walk five blocks before tiring, and is guidelines, the recommended antithrombotic management for this
euvolemic. Which medication is the first-line therapy for this patient? patient is:

Amlodipine (Norvasc) aspirin (Bayer).

Digoxin (Lanoxin) aspirin with dipyridamole (Aggrenox).

Furosemide (Lasix) clopidogrel (Plavix).

Lisinopril (Zestril) warfarin (Coumadin).

5. A patient has hyperactive reflexes of the lower extremities. The 10. An adult-gerontology acute care nurse practitioner who specializes
adult-gerontology acute care nurse practitioner assesses for ankle in cardiology is asked to give a presentation on lipid-lowering drugs. A
clonus by: major drug company that markets a lipid-lowering medication plans to
pay the presenter an honorarium, but asks the nurse practitioner to
applying a low-pitched tuning fork firmly to the lateral malleolus. limit his or her remarks to its drug. This situation presents a:

sharply dorsiflexing and maintaining the foot in this position, breach of contract.
while supporting the knee.
conflict of interest.
striking the Achilles tendon with the percussion hammer after
flexing the leg at the knee and rotating it externally. personal choice.

stroking the lateral aspect of the sole with the sharp end of the reasonable request.
percussion hammer from the heel to the ball of the foot.

11. A 32-year-old patient who underwent an open splenectomy for a


6. A 15-year-old patient with type 1 diabetes mellitus reports elevated ruptured spleen, is preparing for discharge. An adult-gerontology acute
blood glucose levels in the morning. An adult-gerontology acute care care nurse practitioner reviews the potential complications with the
nurse practitioner determines that the patient's hyperglycemia is due to patient. The nurse practitioner emphasizes which instruction to the
the dawn phenomenon and: patient?

increases the insulin dosage at bed time. Continue antibiotics for 14 days

reduces the insulin dosage at bed time. Follow up with primary care provider for vaccinations

tests the blood glucose level at 3:00 AM every morning. No international travel for five years

tests the blood glucose level in the evening. No weight lifting restrictions

7. A patient with profound hypotension is transferred from the medical- 12. A 65-year-old female patient has a confirmed diagnosis of terminal
surgical unit to the intensive care unit. The patient is started on fluids liver disease. The patient's advance directive designates comfort
and norepinephrine (Levophed) IV. The blood cultures that were drawn

13
measures, only. An adult-gerontology acute care nurse practitioner's
action is to: Xanthines

discuss the patient's decision with the patient's family members.


18. What legislation allowed nurse practitioners to be recognized
Medicare providers in all geographical areas with their own provider
persuade the patient to participate in a hepatitis clinical trial. number?

reconfirm the patient's end-of-life decision. The Affordable Care Act

refer the patient for a psychological evaluation. The Balanced Budget Act

13. A 68-year-old patient had surgery three days ago, for repair of an The Civilian Health and Medical Program of the Uniformed
abdominal aortic aneurysm. The patient remains intubated, is Services
neurologically intact, and has active bowel sounds. The patient's liver
function is within normal limits and the patient has no signs or The Omnibus Budget and Reconciliation Act
symptoms of heart failure. The patient's laboratory values are: blood
urea nitrogen of 12 mg/dL, creatinine of 0.8 mg/dL, PaCO2 of 37 mm
Hg. The preferred form of nutritional support for this patient is: 19. A 19-year-old male patient arrives at the emergency department
exhibiting symptoms of lower abdominal pain that radiates to the groin,
and that the patient rates as an 8 on a scale of 1 to 10. That patient
enteral feeding to the duodenum via a nasogastric small-bore
states that the pain came on suddenly, while he was playing football
tube.
with friends. The patients physical examination reveals positive bowel
sounds in all quadrants; a soft, non-tender abdomen; no rebounding
enteral feeding to the stomach via a gastrostomy tube. and no guarding; and no palpable mass in the abdomen or groin.
Examination of the patients genitalia reveals a unilateral cremasteric
peripheral parenteral nutrition via an 18-gauge IV catheter. reflex. What is the adult-gerontology acute care nurse practitioner's
leading differential diagnosis, based on the patients presentation?
total parenteral nutrition via a central venous line.
Appendicitis
14. A hospital requires adult-gerontology acute care nurse practitioners
to submit credentialing applications for the purpose of: Epididymitis

authorizing clinical roles and responsibilities. Inguinal hernia

delineating therapeutic and diagnostic services. Testicular torsion

monitoring the nurse practitioner's clinical activities. 20. An exception to the practice of maintaining patient confidentiality is
when:
verifying education, licensure, and experience.
a family member of the patient gives consent.
15. Assessment of which endocrine system response to sepsis-
induced hypotension is essential in guiding subsequent therapy? a family member of the patient is paying for the treatment.

Adrenal the patient is unresponsive.

Pancreatic the patient plans to hurt someone.

Pituitary 21. When reading a systematic review, an adult-gerontology acute care


nurse practitioner ensures that the review:
Thyroid
describes the intended audience.
16. A patient with a history of atrial fibrillation, who has maintained
normal sinus rhythm with sotalol (Betapace) is hospitalized for acute describes the study inclusion criteria.
pyelonephritis. The appropriate antibiotic regimen for this patient is
parenteral: is published in a peer-reviewed journal.

cefoxitin (Mefoxin). is written by experts in the field.

ceftriaxone (Rocephin). 22. An adult-gerontology acute care nurse practitioner needs to


communicate the findings of HIV to a patient. The nurse practitioner
ciprofloxacin (Proquin). enters the patient's room and the spouse is at the bedside. To discuss
the diagnosis, the nurse practitioner:
levofloxacin (Levaquin).
asks the nurse to step into the room.
17. Generally healthy patients, who are diagnosed with acute
bronchitis, inappropriately ask for which category of drugs? asks the spouse to step out of the room.

Antibiotics speaks with the patient and spouse together.

Beta-agonists speaks with the spouse privately.

Corticosteroids

14
23. When discharging an 85-year-old patient who has a diagnosis of Question 13
stasis dermatitis, an adult-gerontology acute care nurse practitioner The right answer was enteral feeding to the duodenum via a
includes instructions to: nasogastric small-bore tube..
Question 14
keep legs elevated while seated. The right answer was verifying education, licensure, and
experience..
maintain systolic blood pressure greater than 120 mm Hg. Question 15
The right answer was Adrenal.
soak legs in warm water daily. Question 16
The right answer was ceftriaxone (Rocephin)..
wear compression stockings of 65 mm Hg below the knee. Question 17
The right answer was Antibiotics.
24. A patient is brought to the emergency department after being found Question 18
unresponsive in a car. The patient's spouse arrives at the hospital to The right answer was The Balanced Budget Act.
find the patient comatose, on mechanical ventilation, and brain death Question 19
has been established. The spouse informs the staff that the patient has The right answer was Testicular torsion.
an advance directive and did not want to be kept alive, artificially. The Question 20
spouse struggles with the decision to remove the patient from life The right answer was the patient plans to hurt someone..
support. The adult-gerontology acute care nurse practitioner: Question 21
The right answer was describes the study inclusion criteria..
consults the ethics committee to help with the decision-making Question 22
process. The right answer was asks the spouse to step out of the
room..
discusses with the spouse that removing the patient is the right Question 23
thing to do. The right answer was keep legs elevated while seated..
Question 24
encourages the spouse to have a family meeting to make the The right answer was reviews the patients advance directive
decision as a group. with the spouse..
Question 25
reviews the patients advance directive with the spouse. The right answer was an increase in capillary hydrostatic
pressure..
25. A patient with a history of heart failure arrives at the emergency
department exhibiting shortness of breath and lower extremity swelling.
Both of the patients symptoms are a result of:

a decrease in plasma oncotic pressure.

an increase in capillary hydrostatic pressure.

an increase in capillary membrane permeability.

an obstruction of lymphatic drainage.

Question 1
The right answer was A history of previous falls.
Question 2
The right answer was A serum folate level.
Question 3
The right answer was Medicaid.
Question 4
The right answer was Lisinopril (Zestril).
Question 5
The right answer was sharply dorsiflexing and maintaining
the foot in this position, while supporting the knee..
Question 6
The right answer was increases the insulin dosage at bed
time..
Question 7
The right answer was piperacillin-tazobactam (Zosyn) is
indicated for the line-related infection..
Question 8
The right answer was Clinical trial.
Question 9
The right answer was aspirin (Bayer)..
Question 10
The right answer was conflict of interest..
Question 11
The right answer was Follow up with primary care provider
for vaccinations.
Question 12
The right answer was reconfirm the patient's end-of-life
decision..
15

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