A nurse manager is discussing social services for older adults during a staff meeting in a long- term acute care (LTAC) facility. Which statement about Medicare made by one of the employees requires correction by the nurse manager?

Medicare covers people under 65-years who have end-stage renal disease.

Low-income people who have Medicare can also qualify for Medicaid.

People who qualify for Medicare will have no out-of-pocket medical expenses.

Medicare is federally-funded health insurance for people 65-years or older.

Answer and Explanation

The Correct Answer is C

A.   Medicare does cover individuals under 65 years old who have end-stage renal disease (ESRD) and meet certain criteria.
B.   There are programs that allow individuals with both Medicare and low income to qualify for Medicaid, which can help cover additional healthcare costs that Medicare may not fully cover.
C.   While Medicare does provide significant coverage for healthcare services, it is not entirely free of out- of-pocket costs. Medicare Part A typically covers hospital stays, skilled nursing facility care, hospice, and some home health care services with no premiums for most people.
D.   Medicare is indeed federally-funded health insurance primarily for individuals aged 65 and older. It also covers certain younger individuals with disabilities and those with ESRD.

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Correct Answer is B

Explanation

A. Fluticasone is an inhaled corticosteroid used primarily for maintenance therapy in COPD and asthma. It helps reduce airway inflammation and prevent exacerbations but is not used for immediate relief of acute symptoms such as bronchospasm or sudden shortness of breath.
B. Fluticasone, like other corticosteroids delivered by inhalation, can increase the risk of oral thrush (candidiasis) due to its local immunosuppressive effects in the mouth. It's important for clients to monitor their oral cavity regularly for signs such as white patches or soreness. Including this instruction is crucial to detect thrush early so that appropriate treatment can be initiated if necessary.
C. Monitoring heart rate is not specifically necessary before each dose of fluticasone. Fluticasone is not known to cause significant cardiovascular effects such as changes in heart rate. Heart rate monitoring may be more relevant for medications that can affect cardiovascular function or in clients with pre- existing cardiac conditions.

D. Fluticasone should be used regularly as prescribed for maintenance therapy to control airway inflammation and prevent exacerbations in COPD. Skipping doses, even if symptoms are not present, can lead to inadequate control of the disease and potential worsening of symptoms over time.

A. "I feel short of breath when I lie down flat." B. "The sputum I have been coughing up is pink." C. "The nurse I had yesterday said she could hear fluid in my lungs." D. "I feel like fluid has been building up in my abdominal area."

Correct Answer is D

Explanation

A. This symptom is consistent with orthopnea, which is common in left-sided heart failure rather than right-sided heart failure. In orthopnea, patients experience shortness of breath when lying flat because fluid accumulates in the lungs due to impaired left ventricular function.
B. Pink-tinged or blood-tinged sputum, known as hemoptysis, can occur in left-sided heart failure due to pulmonary congestion and elevated pressures in the pulmonary circulation. This symptom is not typically associated with right-sided heart failure.
C. This finding suggests pulmonary congestion, which is more indicative of left-sided heart failure. In left- sided heart failure, fluid backs up into the lungs, leading to crackles or rales on auscultation.
D. This statement is consistent with right-sided heart failure. In right-sided heart failure, the right ventricle fails to effectively pump blood into the pulmonary circulation, causing fluid to back up into the venous system. This can lead to peripheral edema (such as in the legs and abdomen) and abdominal distension due to ascites (fluid accumulation in the peritoneal cavity).

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A nurse manager is discussing social services for older adults during a staff meeting in a long- term acute care (LTAC) facility. Which statement about Medicare made by one of the employees requires correction by the nurse manager?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education to a client who has chronic obstructive pulmonary disease and will begin using fluticasone by metered dose inhaler every 12 hours for maintenance. Which of the following instructions should the nurse include?

Correct Answer is B

Explanation

The nurse is performing an admission assessment on a client who is being admitted for right- sided heart failure. Which statement made by the patient would be consistent with right-sided heart failure?

Correct Answer is D

Explanation

A client presents to the emergency department with complaints of numbness and weakness which began in the feet and has progressed symmetrically in an ascending pattern through the bilateral lower extremities. The nurse understands that this pattern most closely fits which neurological disorder?

Which type of elder mistreatment is demonstrated by a caregiver leaving a nursing home resident alone in his room for long periods at a time with no opportunity for social stimulation?

A client has been diagnosed with Bell's Palsy. Which statement should the nurse include in the client education?

Which of the following describes a characteristic of cancer cells?

The nurse is reviewing the results of the client's echocardiogram and notes that the ejection fraction is 35%. The nurse anticipates that which of the following medications will be ordered to increase the client's cardiac output?

A nurse is caring for a client who has myasthenia gravis which has not responded to medication treatments. Which of the following surgeries can treat myasthenia gravis?

Which nursing intervention is the most appropriate for managing relocation stress syndrome in an older adult in addition to supportive long-term care facility?