Critical thinking questions for FON midterm :/ – Flashcards
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Ask if the patient would like to have a pet.
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The family reports increasing feelings of loneliness expressed by an elderly patient whose spouse recently passed away. What intervention does the nurse suggest to the family? 1 "Provide a time-out place for the patient." 2 "Ask if the patient would like to have a pet." 3 "Take the patient to crowded places." 4 "Ask the patient to speak about loss."
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Monitor for liver toxicity.
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An elderly patient is prescribed tacrine (Cognex) for Alzheimer disease. What precautions does the nurse take after administering the drug? 1 Monitor for liver toxicity. 2 Increase the patient's nutritional intake. 3 Assess the patient's risk for suicide. 4 Assess for increased anxiety
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Validation therapy
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The nurse is teaching the caregivers of an elderly patient how to promote self-esteem and communication in the patient. What intervention does the nurse suggest? 1 Validation therapy 2 Reality orientation 3 Remotivation therapy 4 Resocialization
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Asks directly if the patient wants to end his or her life
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An elderly patient with depression makes vague references to suicide while conversing with the nurse. What action does the nurse take? 1 Asks directly if the patient wants to end his or her life 2 Cuts short the conversation and asks the patient to rest 3 Says that the patient should not think about suicide 4 Keeps quiet and lets the patient talk more about it
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1 Provide consistent interactions with the staff or the patient's family. 2 Continually remind the patient of the day, time, and year. 3 Provide consistent activities of daily living and mealtimes.
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The nurse is caring for an elderly patient with an altered mental state. What does the nurse include in the patient's plan of care to increase orientation? Select all that apply. 1 Provide consistent interactions with the staff or the patient's family. 2 Continually remind the patient of the day, time, and year. 3 Provide consistent activities of daily living and mealtimes. 4 Reduce the use of media like TV or radio in the patient's room. 5 Provide a time-out place for the patient in the evening
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Giving coffee to the patient in the evening
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The caregiver of a geriatric patient complains that the patient gets irritated in the late evening; the mood continues until night. Which nursing intervention should the nurse exclude from the patient's care plan? 1 Giving milk to the patient at bedtime 2 Giving coffee to the patient in the evening 3 Giving sprouts to the patient in the morning 4 Giving yogurt to the patient in the afternoon
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Orthostatic hypotension
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A patient is taking a psychotropic medication for agitation associated with dementia. What is a common side effect of psychotropics? 1 Accelerated hypertension 2 Orthostatic hypotension 3 Diarrhea 4 Chest pain
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Keeping a staff member with the patient when wandering
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A patient with dementia wanders throughout the skilled nursing facility. A nursing intervention for wandering may include what? 1 Administering a sedative 2 Maintaining a regular activity program 3 Locking the patient's room from the outside 4 Keeping a staff member with the patient when wandering
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You need to implement psychosocial interventions.
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The family members of an elderly patient with an altered mental state tell the nurse that they cannot deal with the patient's increasing confusion and disorientation. They ask if any medications can help alleviate the problem. What does the nurse respond? 1 You may need to discuss this with the primary health care provider. 2 You need to implement psychosocial interventions. 3 The patient may need to be institutionalized. 4 You need to appoint a caregiver if you can afford one.
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Delirium
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An elderly patient has acute confusion after undergoing abdominal surgery. The patient most likely has what condition? 1 Delirium 2 Anxiety 3 Dementia 4 Depression
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Hallucinations
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A patient in the middle stage of Alzheimer's disease (AD) may exhibit which characteristic or behavior? 1 Mild depression 2 Hallucinations 3 Weight loss 4 Impaired mobility
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How often do you attend family get-togethers? 2 What medications have you been taking? 3 Which nearby places do you visit often? 4 Who is the breadwinner of your family?
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The nurse is assessing an elderly patient to identify the changes brought about by aging. What questions does the nurse ask to verify these changes? Select all that apply. 1 How often do you attend family get-togethers? 2 What medications have you been taking? 3 Which nearby places do you visit often? 4 Who is the breadwinner of your family? 5 How long have you been living in this town?
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Patients with paranoia
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Which patients misinterpret their environment and believe others to be untrustworthy? 1 Patients with delirium 2 Patients with paranoia 3 Patients with dementia 4 Patients with depression
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That the patient is not confused about directions
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An elderly patient with cognitive impairment tells the nurse, "I love driving. That is one thing that makes me feel good." Which assessment is a priority in this case? 1 That the patient does not have low self-esteem 2 That the patient is not confused about directions 3 That the patient does not display agitated behavior 4 That the patient does not display signs of anxiety
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Phenelzine sulfate
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Which drug causes hypertensive crisis when taken along with a tyramine-rich diet? 1 Amoxapine 2 Phenelzine sulfate 3 Paroxetine hydrochloride 4 Amitriptyline hydrochloride
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Slow onset of symptoms 4 Slow progression of symptoms 5 Impairment of recent and remote memory
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An older adult is in the early stages of Alzheimer disease. The patient has been forgetful in the last few months and has difficulty memorizing events or numbers. What clinical presentations would indicate the development of dementia in this patient? Select all that apply. 1 Altered consciousness 2 Disorientation to person 3 Slow onset of symptoms 4 Slow progression of symptoms 5 Impairment of recent and remote memory
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Increasing acetylcholine in the cerebral cortex
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Medications taken early in Alzheimer's disease to improve memory and alertness work by doing what? 1 Increasing dopamine in the frontal lobe 2 Decreasing dopamine in the frontal lobe 3 Increasing acetylcholine in the cerebral cortex 4 Decreasing acetylcholine in the cerebral cortex
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2 Limit activities to the morning hours. 3 Ask the patient to avoid daytime naps. 4 Ask the patient to perform light exercises in the daytime
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The nurse is caring for an elderly patient with sundown syndrome. Which intervention(s) does the nurse include in the patient's care plan? Select all that apply. 1 Provide caffeinated drinks in the evening. 2 Limit activities to the morning hours. 3 Ask the patient to avoid daytime naps. 4 Ask the patient to perform light exercises in the daytime. 5 Use a light therapy box in the evening.
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Ensure adequate fluid and nutritional intake. 2 Use concise and direct interactions. 3 Use strategies to enhance orientation. 4 Ask relatives to visit more often.
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The nurse is caring for an elderly patient with depression. What does the nurse include in the plan of care for this patient? Select all that apply 1 Ensure adequate fluid and nutritional intake. 2 Use concise and direct interactions. 3 Use strategies to enhance orientation. 4 Ask relatives to visit more often. 5 Refuse to talk about death or suicide.
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1 Delirium can be resolved with treatment; dementia is never resolved. 2 Delirium has a sudden onset; dementia develops gradually. 4 In delirium, the patient's remote memory is disturbed; in dementia it is intact. 5 In delirium, the patient's mood varies; in dementia the patient's mood is inappropriate
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The nursing student is learning about different mental conditions in the elderly. In which ways does the student differentiate delirium from dementia? Select all that apply. 1 Delirium can be resolved with treatment; dementia is never resolved. 2 Delirium has a sudden onset; dementia develops gradually. 3 Speech is incoherent in patients with delirium; in dementia it is coherent. 4 In delirium, the patient's remote memory is disturbed; in dementia it is intact. 5 In delirium, the patient's mood varies; in dementia the patient's mood is inappropriate
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Amoxapine (Asendin)
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The nurse is caring for an 80-year-old patient with depression. The patient had been prescribed antidepressants. The patient reports dry mouth and constipation. What drug was likely prescribed by the primary health care provider? 1 Amoxapine (Asendin) 2 Phenelzine sulfate (Nardil) 3 Tranylcypromine (Parnate) 4 Duloxetine (Cymbalta)
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Positron emission tomography (PET)
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The nurse knows that Alzheimer's disease may be suggested in its early stages by what diagnostic tool? 1 Magnetic resonance imaging (MRI) 2 Computed tomography (CT) 3 Positron emission tomography (PET) 4 Autopsy
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1 Do not attach identification to key rings. 2 Do not give information to strangers. 4 Carry few valuables. 5 Attend a crime prevention program
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The nurse is teaching a group of elderly citizens at a community center how to reduce crimes against them. What safety measures does the nurse encourage? 1 Do not attach identification to key rings. 2 Do not give information to strangers. 3 Do not keep a pet. 4 Carry few valuables. 5 Attend a crime prevention program
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Confusion and forgetfulness are not always age-related
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The family member of an elderly patient tells the nurse that old age is causing confusion and forgetfulness in the patient. What is the nurse's best response? 1 The patient needs to be assessed for paranoia. 2 The patient will be prescribed medications for that. 3 Confusion and forgetfulness are not always age-related. 4 The patient needs to be admitted to the hospital soon.
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Tranylcypromine
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Which drug is classified as a monoamine oxidase inhibitor (MAOI)? 1 Citalopram 2 Amoxapine 3 Duloxetine 4 Tranylcypromine
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1 Risk for injury 2 Sleep deprivation 3 Fatigue 4 Acute confusion
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The nurse is using the Short Portable Mental Status Questionnaire (SPMSQ) to assess the mental status of an elderly patient. Which conditions is the nurse likely to find in the patient? Select all that apply. 1 Risk for injury 2 Sleep deprivation 3 Fatigue 4 Acute confusion 5 Body temperature
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Asks the patient to name pictures of people, animals, or things
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A family member of an elderly patient tells the nurse, "My parent hardly talks about feelings at all. What other things can I talk about? How can I increase interaction with my parent?" What action does the nurse take? 1 Asks the patient to name pictures of people, animals, or things 2 Advises the patient to be consistent with mealtimes 3 Advises the family member to take the patient on a vacation 4 Encourages the patient to speak about any past unresolved issues
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The patient has been abused
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The nurse is caring for an elderly patient. The nurse observes that the patient is dressed inappropriately, and the clothes are unkempt. What conclusion does the nurse draw from the patient's condition? 1 The patient has been abused. 2 The patient has dementia. 3 The patient has mania. 4 The patient is depressed
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1 Do not attach your identification to your key ring. 2 Do not let anyone know when you are alone 4 Do not give information to people over the phone. 5 Lock your windows and draw your curtains at night..
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The nurse is teaching a group of elderly patients ways to reduce crime against them. What suggestions does the nurse include in the lesson? Select all that apply. 1 Do not attach your identification to your key ring. 2 Do not let anyone know when you are alone. 3 Memorize important contact numbers. 4 Do not give information to people over the phone. 5 Lock your windows and draw your curtains at night.
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Correct 1 Age alone does not cause confusion in the patient. Correct 2 Depression might lead to alcohol abuse in the patient. Correct 3 There may be a slight decline in the patient's cognitive skills. Correct 4 Major decline in cognitive functioning may be due to dementia.
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An elderly patient is admitted to the hospital with an acute onset of confusion and an unstable gait. What does the nurse tell the patient's family members about aging in elderly patients? Select all that apply. 1 Age alone does not cause confusion in the patient. 2 Depression might lead to alcohol abuse in the patient. 3 There may be a slight decline in the patient's cognitive skills. 4 Major decline in cognitive functioning may be due to dementia. 5 The patient is not capable of learning new things now.
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amitriptyline hydrochloride (Elavil)
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The nurse knows that a patient with depression may be prescribed what medication? 1 phenytoin (Dilantin) 2 lorazepam (Ativan) 3 quetiapine (Seroquel) 4 amitriptyline hydrochloride (Elavil)
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The lenses of the patient's eyes are discolored.
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An older adult is unable to distinguish between the colors blue and black. What is the most likely reason for this condition? 1 The patient has a hereditary syndrome. 2 The patient is malnourished. 3 The patient has a vision problem. 4 The lenses of the patient's eyes are discolored
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To moisten the mouth
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The nurse asks an elderly patient to drink fluids before oral administration of tablets or capsules. What might be the reason for this? 1 To dissolve the tablet 2 To hydrate the patient 3 To moisten the mouth 4 To minimize infection
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Impairment in the ability to hear high-pitched sounds
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The nurse is caring for a diabetic patient with presbycusis. Which symptom is the nurse likely to find in the patient? 1 Impairment in the ability to hear high-pitched sounds 2 Difficulty distinguishing between dark colors such as blue and black 3 Difficulty with vision when moving from bright to dark environments 4 Decline in the ability of the eyes to focus on near objects
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Oral hypoglycemics
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Which medication may induce age-related macular degeneration in the elderly? 1 Oral hypoglycemics 2 Oxybutynin chloride (Ditropan) 3 Oxazosin mesylate (Cardura) 4 Diuretics
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1 Telescopic lenses 3 Large-print books 5 Talking books
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The nurse is arranging the room for a patient who has low vision. Which items may be kept in the patient's room? Select all that apply. 1 Telescopic lenses 2 E-books 3 Large-print books 4 Newspapers 5 Talking books
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"You are unable to focus on near or far objects."
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The nurse informs a patient after assessment that the patient has difficulty related to visual accommodation. Which statement by the nurse correctly explains visual accommodation to the patient? 1 "Fluid has accumulated inside your eye." 2 "There is a clouding on your lens." 3 "There is accumulation of cerumen." 4 "You are unable to focus on near or far objects."
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Decrease in body temperature
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An elderly patient suffering from constipation was administered a suppository. After a considerable time, the suppository was expelled undissolved. What might be the reason for this? 1 Decrease in tissue elasticity 2 Increase in adipose tissue 3 Decrease in body temperature 4 Decrease in cardiac output
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1 Amount of body water 3 Ratio of fat to muscle 4 Rate of cardiac output 5 Rate of metabolism
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An elderly patient is suffering from drug toxicity. Which factors enhance the chance of drug toxicity in older adults? Select all that apply. 1 Amount of body water 2 Level of serum creatinine 3 Ratio of fat to muscle 4 Rate of cardiac output 5 Rate of metabolism 6 Count of blood platelets
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3 Decreased bone density
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The nurse is assessing a geriatric patient who reports an impaired ability to move about. What does the nurse anticipate as the most probable cause for the patient's condition? 1 Dysphagia 2 Otosclerosis 3 Decreased bone density 4 Decreased bowel motility
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1 Uneven pigmentation of the skin 2 Wrinkles on the face and neck 5 Thinning and graying of the hair
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Physiological changes occur due to aging. What changes can be observed in the integumentary system due to aging? Select all that apply. 1 Uneven pigmentation of the skin 2 Wrinkles on the face and neck 3 Resilient and supple skin 4 Unaffected elastic collagen fibers 5 Thinning and graying of the hair
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4 Multiple medical problems
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A student nurse is preparing a list of common physical problems that an elderly can come across. Which problem is identified for polypharmacy? 1 Impaired mobility 2 Presbyopia 3 Adrenopause 4 Multiple medical problems
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1 Poor lighting 2 Inappropriate footwear 4 Improper use of assistive devices 5 The unfamiliar environment of a hospital room
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What are the extrinsic factors that increase the risk for falls among older adults? Select all that apply. 1 Poor lighting 2 Inappropriate footwear 3 Adverse medication reactions 4 Improper use of assistive devices 5 The unfamiliar environment of a hospital room
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1 Cystocele 3 Altered sphincter control 5 Uterine prolapse
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An elderly patient is suffering from urinary incontinence. Under what conditions may urinary incontinence occur in the elderly? Select all that apply. 1 Cystocele 2 Presbyopia 3 Altered sphincter control 4 Decreased bowel motility 5 Uterine prolapse
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The lenses of the patient's eyes are discolored
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An older adult is unable to distinguish between the colors blue and black. What is the most likely reason for this condition? 1 The patient has a hereditary syndrome. 2 The patient is malnourished. 3 The patient has a vision problem. 4 The lenses of the patient's eyes are discolored.
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The patient has dyspareunia
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A 76-year-old patient complains of significant discomfort while having sex with her partner. How does the nurse interpret the patient's symptoms? 1 The patient has dyspareunia. 2 The patient has vaginitis. 3 The patient has a vaginal yeast infection. 4 The patient has hypertension
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Retention of drugs in the system
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An elderly patient with diminished renal function is given digoxin (Lanoxin). What drug effect may be seen in this patient? 1 Decreased body water 2 Increased ratio of fat to muscle 3 Decreased effectiveness of liver 4 Retention of drugs in the system
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2 When there is a documented reason4 When the primary health care provider orders so 5 When there is permission from the patient's guardian
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The nurse is helping a patient to use a protective device. When would the nurse require the application of a protective device to a patient? Select all that apply. 1 When the patient's condition requires one 2 When there is a documented reason 3 When the patient's family wishes to use one 4 When the primary health care provider orders so 5 When there is permission from the patient's guardian
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Oxybutynin chloride (Ditropan
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An elderly patient suffers from urinary incontinence. Which drug does the nurse anticipate to be prescribed for this patient? 1 Oral hypoglycemics 2 Oxybutynin chloride (Ditropan) 3 Sildenafil citrate (Viagra) 4 Digoxin (Lanoxin
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Chronic illness may affect the ability to participate in sexual activity.
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The nurse's knowledge of sexuality in the older adult population should include what? 1 Chronic illness may affect the ability to participate in sexual activity. 2 Sexual response time is unchanged. 3 Ability to achieve orgasm declines. 4 Dryness of the vaginal walls is associated with pelvic inflammatory disease.
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A Include pumpkin seeds in the patient's diet. B Encourage the patient to use protective pads. E Provide a condom catheter for the patient.
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While caring for a geriatric patient, the nurse learns that the patient has urinary incontinence. Which nursing interventions will be beneficial to this patient? Select all that apply. A Include pumpkin seeds in the patient's diet. B Encourage the patient to use protective pads. C Instruct the patient to drink lime juice on an empty stomach. D Ensure that the patient's fluid consumption is kept to a minimum. E Provide a condom catheter for the patient.
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Older adults are more prone to the adverse effects of medicines.
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The nurse speaks to older adults about the effects of drugs on older people. After this communication the nurse finds that the older adults avoid adhering to their prescribed dosing schedule. What is the most likely reason for it? 1 Older adults prefer using herbal medicine. 2 Older adults may forget the proper timing of their medications. 3 Older adults are confused about medicine dosages. 4 Older adults are more prone to the adverse effects of medicines.
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Obtain a thorough medication history.
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What is the initial nursing intervention in preventing polypharmacy? 1 Obtain a thorough medication history. 2 Discontinue all herbal preparations. 3 Refer the patient to a geriatric practitioner. 4 Consult a pharmacist to review all medications.
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Hip fractures resulting from falls are a leading cause of placement in long-term care facilities
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The nurse knows that which statement is true regarding falls in the elderly? 1 Most falls occur in the garage. 2 Hip fractures resulting from falls are a leading cause of placement in long-term care facilities. 3 Fall risk decreases with addition of medications. 4 Sedatives reduce the risk of falls.
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A patient with dysphagia
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The nurse is preparing parenteral feeding for an elderly patient. In which condition will a patient most likely need parenteral feeding? 1 A patient with a broken wrist 2 A patient with dysphagia 3 A patient with fecal impaction 4 A patient with insomnia
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"Vitamin D can enter the body only through diet."
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The nursing student is discussing the requirement of nutrients with an elder patient. The nursing student submitted a project about nutritional requirements of elderly patients. Which statement indicates that the student needs further teaching? 1 "Bone demineralization is common among the elderly." 2 "Vitamin D can enter the body only through diet." 3 "Protein maintains a positive nitrogen balance." 4 "Energy requirements tend to decrease with age."
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1 Blueberries 2 Oranges 4 Carrots
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The nurse is preparing the diet plan for an elderly patient suffering from age-related macular degeneration (AMD). Which food items should the nurse include in the diet? Select all that apply. 1 Blueberries 2 Oranges 3 Sugars 4 Carrots 5 Whole wheat bread
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Tinnitus
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An elderly patient complains of ringing in the ears. What disorder is the patient likely to be suffering from? 1 Tinnitus 2 Dyspareunia 3 Presbyopia 4 Hypokalemia
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Decline in the eyes' ability to focus on near objects
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A patient has presbyopia. What visual manifestation will most likely be present upon examination of the patient? 1 Difficulty distinguishing between blues and greens 2 Difficulty distinguishing between colors such as blue and black 3 Difficulty with vision when moving from bright to dark environments 4 Decline in the eyes' ability to focus on near objects
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Presbyopia
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The primary health care provider prescribes bifocals for an elderly patient with reading difficulty. Which type of visual impairment is the patient suffering from? 1 Tinnitus 2 Glaucoma 3 Presbyopia 4 Cataract
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Debrox removes wax impaction
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While reviewing an elderly patient's medical records, the nurse finds that the patient was advised to use carbamide peroxide (Debrox) periodically. What does the nurse understand from this report? 1 Debrox stabilizes dry AMD. 2 Debrox removes wax impaction. 3 Debrox treats dysphagia. 4 Debrox treats urinary incontinence
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The vagina of older females is thinner and dryer.
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While counseling an elderly patient, the nurse says, "Older women are at greater risk of HIV infection." What statement best explains the reason for this? 1 Menopause increases the risk of HIV infection. 2 HIV is more virulent in older females. 3 The vagina of older females is thinner and dryer. 4 Older females have sex more frequently than younger females.
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Indian American
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A certain patient believes in the cyclic nature of birth, life, and death. To which cultural group of America does this patient belong? 1 Indian American 2 African American 3 Arab American 4 European American
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Seventh-Day Adventist
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A Protestant patient is admitted to a health care facility. The nurse is asked to avoid pork in the patient's diet. To which Protestant denomination might the patient belong? 1 Unitarian Universalist Association 2 Church of Jesus Christ of Latter-day Saints 3 Christian Science 4 Seventh-Day Adventist
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Hinduism
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Which religion might the patient that excludes beef from the diet belong to? 1 Judaism 2 Christianity 3 Islam 4 Hinduism
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4 Islam 5 Judaism
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Autopsy or a post-mortem examination is performed to determine the cause of death. In which religious faith(s) is autopsy prohibited? Select all that apply. 1 Taoism 2 Hinduism 3 Buddhism 4 Islam 5 Judaism
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Folk medicine
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A patient in the in-patient unit continues to have a particular type of tea with honey and lemon as treatment for a cough. What is this treatment called? 1 Folk medicine 2 Ayurvedic treatment 3 Antibiotic treatment 4 Alternative therapy
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1 Speak in a soft tone. 3 Maintain distance while speaking 5 Ask the patient how she would like to be addressed
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The male nurse has been assigned to care for a Middle Eastern female. Which nursing behaviors are appropriate when communicating with this patient? Select all that apply. 1 Speak in a soft tone. 2 Start a conversation with a handshake. 3 Maintain distance while speaking. 4 Maintain eye contact while speaking. 5 Ask the patient how she would like to be addressed
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Islam
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A patient refuses to eat pork and drink alcohol and fasts during the month of Ramadan. The nurse knows that the patient's religion is likely to be: 1 Judaism. 2 Buddhism. 3 Islam. 4 Hinduism.
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1 Judaism 2 Seventh-Day Adventist
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The Sabbath is a day or time of rest from labor and is used for worship. Which religious faiths observe the Sabbath? Select all that apply. 1 Judaism 2 Seventh-Day Adventist 3 Jehovah's Witness 4 Buddhism 5 Hinduism
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Judaism
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A patient has just delivered a son. When the nurse inquires the infant's name, the family replies that their religious faith prohibits them to name the baby right away. To which faith does the infant belong? 1 Hinduism 2 Taoism 3 Buddhism 4 Judaism
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Christian Science
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A patient who has declared himself a Protestant refuses traditional health care. To which faith might the patient belong? 1 Unitarian Universalist Association 2 Church of Jesus Christ of Latter-day Saints 3 Christian Science 4 Mennonite
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2 Having periods of silence 5 Avoiding eye contact
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An American Indian patient is in a conversation with a nurse. What nonverbal communication might be demonstrated by the patient during the conversation? Select all that apply. 1 Hugging the nurse 2 Having periods of silence 3 Patting the nurse on the back 4 Giving the nurse a peck on the cheek 5 Avoiding eye contact
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Ayurvedic
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The nurse educator is teaching students about certain medicine type that balances the disease state by prescribing to "hot" and "cold" foods in the patient's diet. Which medicine type is the educator referring to? 1 Ayurvedic 2 Acumassage 3 Acupressure 4 Acupuncture
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Does not eat milk and meat products at the same meal
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Which restriction would the nurse expect a Jewish patient, who keeps Kosher dietary rules, to follow? 1 Abstains from meat on Fridays 2 Abstains from alcoholic beverages 3 Eats only vegetables, eggs, and milk products 4 Does not eat milk and meat products at the same meal
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Calls the priest for the "anointing of the sick" sacrament
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A patient from the Catholic faith is dying. What does the nurse do? 1 Calls the priest for the "anointing of the sick" sacrament 2 Calls the priest to pray with the patient and family 3 Calls the priest to read the Bible with the patient and family 4 Calls the priest to sing songs of comfort to the patient and family
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Assess if the patient's religion accepts abortion.
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The primary health care provider suggests abortion as the line of treatment for an expectant mother. Which of these would be a priority? 1 Arrange the necessary equipment for abortion. 2 Assess if the patient's religion accepts abortion. 3 Call the priest for the sacrament of baptism. 4 Consult the patient's family for communion.
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2 Obtain the patient's health beliefs. 3 Self-examine the nurse's own culture. 4 Assess cultural and biophysical factors that influence treatments.
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The nurse is caring for an Asian-American male patient at a clinic; he is joined by his family. The nurse is developing a transcultural care plan for him that identifies both with his native and American cultures. Which nursing actions are required for providing culturally congruent care? Select all that apply. 1 Ignore cross-cultural learning. 2 Obtain the patient's health beliefs. 3 Self-examine the nurse's own culture. 4 Assess cultural and biophysical factors that influence treatments. 5 Work in the patient's culture and practice nursing within his or her cultural limitations.
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Listen carefully, and allow the patient to express his thoughts.
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A patient tells the nurse that he wonders whether the accident that caused his injuries and long rehabilitation is due to the sinful life he led when he was young. How should the nurse initially respond to the patient? 1 Listen carefully, and allow the patient to express his thoughts. 2 Encourage the patient to look to the future and not dwell on the past. 3 Ask the patient if he would like to speak to the chaplain, and then contact the chaplain. 4 Explain that it is better to discuss this with a trusted family member who knows him well.
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Eastern Orthodox
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Which faith opposes organ donation? 1 Roman Catholic 2 Eastern Orthodox 3 Protestant 4 Hinduism
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Religious prohibitions may influence treatment.
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The nurse leaves the religion-related information of the patient chart blank, believing that it is unimportant. The nurse manager insists that all details are completed. Why is religion-related information important? 1 Religious prohibitions may influence treatment. 2 Religious beliefs do not affect treatment. 3 Religion is detrimental to the growth of health care. 4 Religion speeds up the treatment.
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Tell them face-to face, but provide privacy.
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The nurse has to schedule a meeting between the patient's family and the health care provider. The agenda of the meeting is to inform the patient's family that the patient has acquired immunodeficiency syndrome (AIDS). How will the primary health care provider inform the family if the patient is Asian? 1 Write a note with the medical report. 2 Hand the medical report to the family. 3 Send the medical report by post. 4 Tell them face-to face, but provide privacy.
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Provide a certified medical interpreter (CMI).
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What should the nurse do before starting the admission assessment for a patient with limited English proficiency? 1 Use the patient's family member as an interpreter. 2 Provide a certified medical interpreter (CMI). 3 Use a nursing colleague as an interpreter. 4 Provide a translating device through the internet.
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Orthodox Jews
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The nurse knows that which branch of Judaism follows the strictest interpretation of Jewish law? 1 Reconstructionist Jews 2 Reform Jews 3 Conservative Jews 4 Orthodox Jews
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Cultural awareness
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The nurse knows that which term involves knowledge of a people's history and an appreciation for their customs? 1 Cultural sensitivity 2 Cultural awareness 3 Cultural competence 4 Cultural practice
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Document the baptism in the nurse's notes.
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In the absence of the priest, the nurse has baptized a newborn baby. What should the nurse do next? 1 Arrange for a prayer with the patient's family and friends. 2 Read the Bible to the mother and the newborn baby. 3 Document the baptism in the nurse's notes. 4 Check the prescriptions required for the newborn baby.
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The patient must not eat or drink for 15 minutes before communion.
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A patient with terminal cancer has been admitted to hospice. The patient's family wishes for communion. What precautions does the nurse take? 1 The patient must not move out of bed until communion ends. 2 The patient must read the Bible before communion starts. 3 The patient must not eat or drink for 15 minutes before communion. 4 The patient will need assistance to kneel down for communion.
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Meditation
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The nurse understands that the patient under medication is distressed and questions the presence of God. Which intervention should the nurse suggest? 1 Meditation 2 Diagnostic test 3 Exercise 4 Surgery
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1 Islam 2 Judaism
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A patient admitted to the medical-surgical unit insists that the nurse provide a private space for prayers. To which religion(s) might this patient belong? Select all that apply. 1 Islam 2 Judaism 3 Hinduism 4 Christianity 5 Taoism
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2 Look for physical problems and address them. 3 Educate the family members about hallucination. 4 Encourage family members to talk to the patient. 5
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A terminally ill patient who is on the verge of dying is experiencing hallucinations and exhibits an altered mental status. What nursing interventions should the nurse perform to help relieve the patient's symptoms? Select all that apply. 1 Administer scopolamine to the patient. 2 Look for physical problems and address them. 3 Educate the family members about hallucination. 4 Encourage family members to talk to the patient. 5 Administer antipsychotic medications.
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1 Ask the patient if there is anything he would like to discuss including his care.
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A patient, who was told he has a terminal condition several months ago, is very pleasant while receiving nursing care and does not seem to be aware of his condition. How should the nurse deal with this situation? 1 Ask the patient if there is anything he would like to discuss including his care. 2 Explain that reviewing his life should be done to improve the quality of his death experience. 3 Ask the health care provider to repeat the information given earlier about the terminal condition. 4 Explain that persons often fluctuate through various stages of grief such as denial when they have a fatal condition.
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Meperidine (Demerol)
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A nurse is caring for a patient who has a renal dysfunction and severe cancer-related pain. Which opioid should be avoided in this patient? 1 Fentanyl (Duragesic) 2 Morphine (Avinza) 3 Methadone (Dolophine) 4 Meperidine (Demerol)
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Administering oxygen
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A terminally ill patient is in a state of impending death, and the patient's respirations are noisy, irregular, and labored. On auscultation, the nurse finds crackles in the lungs, likely to be caused by the accumulated secretions. What nursing intervention does the nurse perform? 1 Suctioning the airways 2 Administering oxygen 3 Withholding morphine 4 Withholding scopolamine
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2 Hospice is a philosophy for terminally ill patients. 3 Hospice manages patients' pain and provides comfort. 5 Hospice services are available at home as well as hospital settings.
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The nurse is explaining hospice care to the family members of a patient who has had a massive stroke. What information should the nurse provide to the family members? Select all that apply. 1 Hospice is a place to care for terminally ill patients. 2 Hospice is a philosophy for terminally ill patients. 3 Hospice manages patients' pain and provides comfort. 4 Hospice meets the economic needs of the terminally ill patients. 5 Hospice services are available at home as well as hospital settings.
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Absence of electroencephalogram (EEG) waves
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The nurse is caring for a critical patient in the intensive care unit (ICU). What is the clinical event that marks the development of death? 1 Absence of breathing 2 Absence of heartbeat 3 Absence of electrocardiogram (ECG) waves 4 Absence of electroencephalogram (EEG) waves
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hand a tissue to the patient
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A patient has experienced the recent death of a spouse. During a conversation with a nurse, the patient begins to cry. An appropriate response from the nurse is to: 1 hand a tissue to the patient. 2 tell the patient, "Don't cry." 3 avoid crying with the patient. 4 tell the patient, "I know just how you feel."
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Methadone (Dolophine)
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A terminally ill cancer patient with renal dysfunction needs opioid administration for pain relief. Which opioid may not need dose adjustments and monitoring? 1 Morphine (Avinza) 2 Oxycodone (Percocet) 3 Methadone (Dolophine) 4 Hydrocodone (Vicodin
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Kübler-Ross
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The nurse knows that who identified the five stages of the dying process? 1 King 2 Freud 3 Erikson 4 Kübler-Ross
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1 Provide biofeedback. 4 Promote hypnosis or self-hypnosis. 5 Encourage breathing exercises.
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A terminally ill cancer patient resists the use of pharmacological pain medications for pain relief. What nursing measures can help relieve pain in the patient? Select all that apply. 1 Provide biofeedback. 2 Insist on the use of nerve blocks. 3 Insist on the use of implanted pumps. 4 Promote hypnosis or self-hypnosis. 5 Encourage breathing exercises.
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3 Family support 4 Behaviors indicating a grief response 5 The patient's point of view of the loss
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A patient in a rehabilitation clinic is recovering from the loss of a limb in a motor vehicle accident. In addition to wound care and physical therapy, what factors should the nurse assess to help the patient recover? Select all that apply. 1 Religion 2 Culture 3 Family support 4 Behaviors indicating a grief response 5 The patient's point of view of the loss
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Retain the IV lines.
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A patient who was admitted to the hospital a few hours ago dies due to complications of the disease. The coroner is informed to investigate the cause of death. Which nursing intervention is appropriate for this patient? 1 Retain the IV lines. 2 Remove all tubes. 3 Retain the drains. 4 Remove the catheters
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Provide medication on round-the-clock basis.
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A terminally ill patient with breast cancer has severe pain. What is an appropriate nursing intervention related to pain medication? 1 Educate the patient about risk of addiction. 2 Discourage the use of pain medication for minimal pain. 3 Provide medication on round-the-clock basis. 4 Educate the patient about risk of respiratory depression.
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Using an air pressure mattress Using elbow and heel protectors 5 Turning and positioning the patient
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A terminally ill patient has skin breakdown due to physical immobility. Which nursing interventions would have prevented the skin breakdown? Select all that apply. 1 Using an air pressure mattress 2 Discouraging the use of sheepskin 3 Keeping the skin clean and moist 4 Using elbow and heel protectors 5 Turning and positioning the patient
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2 Promoting exercises 4 Encouraging a fiber diet 5 Encouraging fluid intake
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A terminally ill cancer patient who is on opioids for pain relief develops constipation. What are the direct nursing measures that would be helpful to this patient? Select all that apply. 1 Using laxatives 2 Promoting exercises 3 Using stool softeners 4 Encouraging a fiber diet 5 Encouraging fluid intake
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2 Alzheimer's disease
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The nurse knows that which medical problem is included in the top 10 leading causes of death? 1 Renal failure 2 Alzheimer's disease 3 HIV/AIDS 4 Pneumonia
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1 Remove drainage bag from the patient 3 Remove IV fluid container from the patient 5 Convert IV catheters to intermittent locks
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A body is to be taken for autopsy following the person's death in a hospital. What care does the nurse provide while preparing the body for autopsy, pertaining to lines and tubes? Select all that apply. 1 Remove drainage bag from the patient. 2 Avoid cutting the tubing attached to the patient. 3 Remove IV fluid container from the patient. 4 Avoid folding the tubing attached to the patient. 5 Convert IV catheters to intermittent locks.
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Moistening the mouth
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A terminally ill cancer patient is experiencing dysphagia. What nursing measure is helpful to this patient? 1 Moistening the mouth 2 Using hard candies (sour balls) 3 Serving homemade favorite foods 4 Reducing the food intake
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Use anti-depressants.
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A terminally ill elderly patient has depression. What measures would help this patient? 1 Administer morphine. 2 Use anti-depressants. 3 Consider it as normal in the elderly. 4 Utilize recreational aids.
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1 Close the eyelids 4 Use supine position. 5 Elevate head of bed to 20 degrees.
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After death, the nurse is preparing the body for transport to the funeral home. How should the nurse position the body? Select all that apply. 1 Close the eyelids. 2 Avoid using pillows. 3 Use prone position. 4 Use supine position. 5 Elevate head of bed to 20 degrees.
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2 Make the patient feel safe and secure. 3 Encourage family members to perform rituals after death. 4 Encourage family members to spend time with the patient. 5 Provide opportunity for patient to say goodbye to loved ones
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The nurse is caring for a terminally ill patient who is in the final stages of life. What are the standards of care that a nurse should provide to this patient? Select all that apply. 1 Consider pain control as a secondary goal. 2 Make the patient feel safe and secure. 3 Encourage family members to perform rituals after death. 4 Encourage family members to spend time with the patient. 5 Provide opportunity for patient to say goodbye to loved ones.
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4 Explain that the patient will eventually get mentally prepared for the loss. 5 Explain that this grief cannot be controlled by willpower because it is an unconscious process.
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A patient is upset due to a terminal illness of his parent. How should the nurse educate the patient about anticipatory grief and its management? Select all that apply. 1 Emphasize high-dose sedation. 2 Instruct the patient to avoid meeting his parents to overcome grief. 3 Explain to the patient that grief may aggravate the situation. 4 Explain that the patient will eventually get mentally prepared for the loss. 5 Explain that this grief cannot be controlled by willpower because it is an unconscious process.
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3 The goal is to allow a pain-free death.
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Which statement is true regarding pain control in the dying patient? 1 Only scheduled pain medication is needed. 2 Addiction to pain medications should be a concern for the nurse. 3 The goal is to allow a pain-free death. 4 Pain relief is possible in the dying patient less than 50% of the time.
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1 Any drainage or intravenous tubes should be left in place. 2
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A patient dies, and an autopsy will be performed. Which statement is true regarding performing postmortem care? 1 Any drainage or intravenous tubes should be left in place. 2 Family members are not allowed to touch the deceased person. 3 Post-mortem care is the same whether or not an autopsy is planned. 4 The coroner is contacted to determine if special precautions are needed.
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The dose should be reduced
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A terminally ill cancer patient in severe cancer-related pain also has renal dysfunction. While administering fentanyl (Duragesic) to the patient, what should the nurse keep in mind? 1 The dose should be reduced. 2 The drug should be replaced. 3 The patient needs oxygen. 4 The drug can be safely administered.
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Rates pain as tolerable and is able to rest and sleep
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Which observation indicates adequate pain control in a patient who is terminally ill? 1 Rates pain as tolerable and is able to rest and sleep 2 Does not experience any side effects from the medication 3 Rates pain as a 4 or less on a 0 to 10 scale 50 percent of the time 4 Receives the maximum recommended dose of the analgesic in 24 hours
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1 Gives away treasured possessions 2 Enjoys a friend's visit but talks little
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Which patient behavior is associated with the acceptance stage of coping with death according to Kübler-Ross? Select all that apply. 1 Gives away treasured possessions 2 Enjoys a friend's visit but talks little 3 Has a sad facial expression and cries at times 4 Asks for a referral to another health care provider 5 Plans a trip to attend a religious healing ceremony
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Placing protective pads under the rectum
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The nurse is preparing a body for transportation to the funeral home. What nursing intervention is helpful in managing leakage of stool and urine due to the relaxation of the sphincters? 1 Surgical securing of sphincters 2 Washing the body with water 3 Spraying perfume on the perineum 4 Placing protective pads under the rectum
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1 Methicillin-resistant Staphylococcus aureus (MRSA) 2 Extended-spectrum beta-lactamase-producing (ESBL) gonorrhea 3 Clostridium difficile (C. diff) 5 Vancomycin-resistant Enterococcus (VRE)
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Which is a multidrug-resistant organism? Select all that apply. 1 Methicillin-resistant Staphylococcus aureus (MRSA) 2 Extended-spectrum beta-lactamase-producing (ESBL) gonorrhea 3 Clostridium difficile (C. diff) 4 Influenza 5 Vancomycin-resistant Enterococcus (VRE)
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After contact with every patient
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in which situations does a nurse change his or her gloves? 1 Only if the gloves tear off 2 After contact with every patient 3 Only if the gloves are visibly soiled with blood or fluids 4 Gloves can be washed after contact with every patient and do not need to be changed.
