Review Ati nurs 538 med surg exam 2 (geatrics)

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Ati nurs 538 med surg exam 2 (geatrics)

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Total Questions : 46

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Question 1:

What is the most common sleep disorder?

A. Insomnia B. OSA insomnia C. Circadian rhythm sleep disorders D. Restless leg syndrome

Answer and Explanation

Choice A:

Insomnia is the most common sleep disorder. It involves difficulty falling asleep, staying asleep, or waking up too early and not being able to return to sleep, leading to daytime impairment.

Choice B:

OSA insomnia is not a recognized standalone disorder; obstructive sleep apnea (OSA) and insomnia are separate conditions, though they can co-occur.

Choice C:

Circadian rhythm sleep disorders are less common and involve disruptions in the timing of sleep, such as shift work disorder or delayed sleep phase disorder.

Choice D:

Restless leg syndrome is a neurological condition that can impact sleep but is not as prevalent as insomnia

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Question 2:

Consequences of hearing loss in the elderly include all of the following except (Select All that Apply.)

A. Decreased function B. Falls C. All of the above D. Depression E. None of the above F. Miscommunication

Answer and Explanation

Choice A:

Decreased function is a known consequence of hearing loss, as it can interfere with communication, social interaction, and performing daily activities.

Choice B:

Falls are associated with hearing loss due to impaired spatial awareness and balance issues.

Choice C:

All of the above is incorrect because not all the listed items are consequences that should be excluded—most are true consequences.

Choice D:

Depression can result from social isolation and frustration related to hearing loss.

Choice E:

None of the above is incorrect because several of the options listed are consequences of hearing loss.

Choice F:

Miscommunication is a direct and common result of hearing impairment.

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Question 3:

Untreated OSA can lead to all of the following except:

A. Heart disease B. Stroke C. Type 2 diabetes D. Cardiac dysrhythmias

Answer and Explanation

Choice A:

Heart disease is a known complication of untreated obstructive sleep apnea (OSA) due to chronic hypoxia and increased cardiovascular strain.

Choice B:

Stroke risk is elevated in individuals with untreated OSA because of vascular inflammation and hypertension.

Choice C:

Type 2 diabetes is associated with OSA but is not a direct consequence; while there is a correlation, OSA does not cause diabetes in the same way it contributes to cardiovascular conditions.

Choice D:

Cardiac dysrhythmias, such as atrial fibrillation, can occur due to repeated oxygen desaturation and arousal episodes in OSA.

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Question 4:

An older patient is diagnosed with sensorineural hearing loss. You know that causes of sensorineural hearing loss include: (Select all that apply.)

A. Tumors of the middle ear B. Cerumen impaction C. Age-related hearing impairment D. Infections of the external and middle ear E. Excessive and loud noise

Answer and Explanation

Choice A:

Tumors of the middle ear are more likely to cause conductive hearing loss, not sensorineural.

Choice B:

Cerumen impaction blocks sound conduction in the external auditory canal and is a cause of conductive hearing loss.

Choice C:

Age-related hearing impairment (presbycusis) is a common cause of sensorineural hearing loss, involving damage to inner ear structures or the auditory nerve.

Choice D:

Infections of the external and middle ear (such as otitis media or externa) typically result in conductive hearing loss.

Choice E:

Excessive and loud noise can damage the hair cells in the cochlea, a hallmark of sensorineural hearing loss.

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Question 5:

An older resident in a long-term care facility reports to the nurse that she has been noticing changes in her vision, including the appearance of halos around objects and a yellow tint to most objects. The nurse knows that these complaints are most often associated with:

A. Cataracts B. Age-related macular degeneration C. Glaucoma D. Diabetic retinopathy

Answer and Explanation

Choice A:

Cataracts commonly cause symptoms such as blurred vision, halos around lights, and a yellow or faded tint to colors. These changes occur due to the clouding of the lens in the eye.

Choice B:

Age-related macular degeneration typically affects central vision and causes straight lines to appear wavy or a blind spot in the central visual field, but not halos or yellow tinting.

Choice C:

Glaucoma may cause halos around lights in some cases, especially with acute angle-closure glaucoma, but it is more commonly associated with peripheral vision loss, not color changes.

Choice D:

Diabetic retinopathy causes vision changes due to damage to retinal blood vessels, but halos and yellow tinting are not primary symptoms.

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Question 6:

An older client reports to a nurse. "My daughter says there is something wrong with my hearing. I am not so sure. Yes, I have some problems hearing, but I am 78 years old. What does she expect? I noticed that at Christmas dinner, with all the racket around, I had some trouble. I think it is that my granddaughters mumble a lot, just like all young people. I guess it has been getting steadily worse; it seems to be both ears as well." Based on the client's description, the nurse suspects which of the following?

A. A perforated eardrum B. Otosclerosis C. Tinnitus D. Presbycusis

Answer and Explanation

Choice A:

A perforated eardrum typically causes sudden hearing loss, pain, or drainage from the ear, and usually affects one ear—not both.

Choice B:

Otosclerosis is a hereditary condition involving abnormal bone growth in the middle ear that leads to conductive hearing loss, usually starting in one ear and affecting younger adults.

Choice C:

Tinnitus is characterized by ringing or buzzing in the ears, not by gradual, bilateral hearing loss or difficulty hearing in noisy environments.

Choice D:

Presbycusis is age-related sensorineural hearing loss that occurs gradually in both ears. It commonly involves difficulty hearing high-pitched sounds and distinguishing speech in noisy environments—exactly as described by the client.

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Question 7:

An older nursing home resident reports that her hearing loss is getting worse. What is the first action of the nurse?

A. Raise her voice when speaking to the resident B. Examine the resident's ears for cerumen impaction C. Teach the resident to read lips D. Refer the resident for an evaluation for a hearing aid

Answer and Explanation

Choice A:

Raising the voice may distort speech further and can be perceived as yelling, which is not respectful or always helpful.

Choice B:

Examining the resident’s ears for cerumen impaction is the first and most appropriate action, as impacted earwax is a common and reversible cause of hearing loss in older adults.

Choice C:

Teaching the resident to read lips may be beneficial later, but it is not a first-line action before identifying a possible correctable cause.

Choice D:

Referring for a hearing aid evaluation is appropriate if a physical cause like cerumen impaction is ruled out.

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Question 8:

You are caring for a 92-year-old female patient who was admitted to the hospital 1 day after outpatient cataract surgery. The patient who lives in an assisted living facility became very confused and agitated and was found wandering in the lobby of the building in her nightgown. The patient refused to return to their room and stated that there were "bad men" in the room. The patient has a history of dementia, diabetes, heart failure, and is on seven different medications. The patients lost their spouse 1 year ago. The nurse suspects that the patient is experiencing delirium. What are the patient's risk factors for delirium? (Select all that apply.)

A. Recent cataract surgery B. History of dementia C. Age of 92 D. Female gender E. Residing in an assisted living facility

Answer and Explanation

Choice A:

Recent cataract surgery is a risk factor because acute illness, surgical procedures, and changes in routine or environment can trigger postoperative delirium, especially in older adults.

Choice B:

History of dementia is one of the strongest risk factors for developing delirium due to decreased cognitive reserve.

Choice C:

Age of 92 increases vulnerability to delirium due to general age-related changes in the brain and increased susceptibility to stressors.

Choice D:

Female gender is not an independent risk factor for delirium; both men and women can be equally affected, though some studies suggest slightly higher risk in men.

Choice E:

Residing in an assisted living facility may be associated with other risks, but it is not a direct risk factor for delirium. The environmental change (e.g., hospitalization) is more relevant.

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Question 9:

Individual fall risk factors can be categorized as either intrinsic or extrinsic. Which of the following is an example of an intrinsic fall risk factor?

A. Poor lighting B. Height of bed C. Reduced vision D. Lack of support equipment for bathtubs and toilets

Answer and Explanation

Choice A:

Poor lighting is an extrinsic (environmental) factor that increases fall risk by making it difficult to see obstacles.

Choice B:

Height of bed is also an extrinsic factor, as it relates to the physical environment and equipment setup.

Choice C:

Reduced vision is an intrinsic factor because it is related to the individual's physical condition and internal health status.

Choice D:

Lack of support equipment for bathtubs and toilets is an extrinsic factor tied to environmental setup and safety aids.

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Question 10:

Health benefits of physical activity include all of the following except:

A. Increase in walking speed B. Prevention of weight gain C. Increased risk of hypertension D. Improved bone and functional health

Answer and Explanation

Choice A:

Increase in walking speed is a common benefit of regular physical activity, especially in older adults, as it enhances mobility and endurance.

Choice B:

Prevention of weight gain is supported by physical activity through improved metabolism and energy balance.

Choice C:

Increased risk of hypertension is not a health benefit; in fact, regular physical activity helps lower blood pressure and reduces the risk of developing hypertension.

Choice D:

Improved bone and functional health results from weight-bearing and resistance exercises, which enhance muscle strength, coordination, and bone density.

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Total Questions : 46

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Ati nurs 538 med surg exam 2 (geatrics)

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