Review Smith Chason College Son Los Angeles ADN NURS 146 gero final Exam

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Smith Chason College Son Los Angeles ADN NURS 146 gero final Exam

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Total Questions : 100

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Question 1:

Diabetes, dementia, Parkinson’s disease, stroke, and vitamin B deficiencies may cause neurological damage leading to what condition?

A. Aphasia B. Traumatic brain injury (TBI) C. Gait disturbances D. Postprandial hypotension (PPH) E. Fallophobia

Answer and Explanation

Choice A:

Aphasia is a language disorder that affects the ability to communicate, not the ability to walk or balance.

Choice B:

Traumatic brain injury (TBI) is caused by external forces, such as a blow to the head, not by internal factors, such as diseases or deficiencies.

Choice C:

Gait disturbances are problems with walking or balance that can result from neurological damage affecting the motor system.

Choice D:

Postprandial hypotension (PPH) is a drop in blood pressure after eating that can cause dizziness or fainting, but it is not directly related to neurological damage.

Choice E:

Choice E reason: Fallophobia is a fear of falling or heights, not a condition caused by neurological damage.

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Question 2:

When assessing an older male client, what are some issues that might put him at risk for dehydration? (Select all that apply.)

A. Heart failure B. Functional impairments C. Longitudinal furrows on the tongue D. Hypertension E. Diabetes

Answer and Explanation

Choice A:

Heart failure can cause fluid retention, which can lead to dehydration if the fluid is not properly balanced.

Choice B:

Functional impairments can limit the ability to drink or access fluids, which can increase the risk of dehydration.

Choice C:

Longitudinal furrows on the tongue are a sign of dehydration, as the tongue loses moisture and becomes dry and cracked.

Choice D:

Hypertension is not directly related to dehydration, although it can be affected by fluid intake and electrolyte balance.

Choice E:

Diabetes can cause increased urination, which can lead to dehydration if the fluid loss is not replaced.

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Question 3:

Which of the following is a true statement concerning suicide among older adults?

A. Older African American women have the highest risk of suicide among older adults. B. Older adults and younger adults manifest suicidal intent in a similar manner. C. A major crisis experienced by the client can contribute to the risk of suicide. D. Ethics require that the nurse respects a person’s intent to terminate his or her own life.

Answer and Explanation

Choice A:

Older African American women do not have the highest risk of suicide among older adults. According to the CDC, suicide rates are highest among adults age 75 and older, and highest among males age 75 and older.

Choice B:

Older adults and younger adults do not manifest suicidal intent in a similar manner. Older adults tend to plan suicide more carefully, use more lethal means, and have fewer warning signs than younger adults.

Choice C:

A major crisis experienced by the client can contribute to the risk of suicide. Older adults may face various stressors, such as bereavement, loneliness, chronic illness, or loss of independence, that can trigger suicidal thoughts or behavior.

Choice D:

Ethics do not require that the nurse respects a person’s intent to terminate his or her own life. Nurses have a duty to protect the safety and well-being of their clients, and to intervene if they suspect suicidal risk.

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Question 4:

When teaching a client about foods that do not increase blood glucose, which should the nurse include?

A. Corn B. White bread C. Baked beans D. Broccoli

Answer and Explanation

Choice A:

Corn is not a food that does not increase blood glucose. Corn is a starchy vegetable that contains carbohydrates, which can raise blood glucose levels.

Choice B:

White bread is not a food that does not increase blood glucose. White bread is made from refined flour, which has a high glycemic index and can spike blood glucose levels.

Choice C:

Baked beans are not a food that does not increase blood glucose. Baked beans are high in sugar and carbohydrates, which can affect blood glucose levels.

Choice D:

Broccoli is a food that does not increase blood glucose. Broccoli is a non-starchy vegetable that is low in carbohydrates and high in fiber, which can help regulate blood glucose levels.

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Question 5:

Pressure ulcers are defined as an injury to the skin and/or underlying tissue resulting from pressure or in combination with shear, usually over a bony prominence. As a nurse, what do you know you must do to prevent pressure ulcers? (Select all that apply.)

A. Turn immobile clients every 2 hours off bony prominences. B. Use lift or draw sheets to move clients in bed. C. Keep the moist D. Ensure that your client maintains a healthy nutritional status. E. Apply pressure-relieving devices to vulnerable areas.

Answer and Explanation

Choice A:

Turning immobile clients every 2 hours off bony prominences can reduce the pressure and friction that can cause skin breakdown and ulcer formation.

Choice B:

Using lift or draw sheets to move clients in bed can prevent dragging or pulling the skin, which can cause shear and damage the underlying tissue.

Choice C:

Keeping the skin moist is not a correct way to prevent pressure ulcers. Moisture can weaken the skin and make it more prone to injury. The skin should be kept dry and clean, and moisturized if needed.

Choice D:

Ensuring that your client maintains a healthy nutritional status can promote wound healing and prevent infection. Adequate protein, calories, vitamins, and minerals are essential for skin integrity and tissue repair.

Choice E:

Applying pressure-relieving devices to vulnerable areas can distribute the pressure and protect the skin from damage. Examples of pressure-relieving devices are foam pads, air mattresses, or cushions.

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Question 6:

An older adult client has been admitted to a skilled nursing facility. Which of the following can be caused by physical restraints? (Select all that apply.)

A. Pressure ulcers B. Death C. Sepsis D. Decreased circulation/perfusion to the extremities E. Fractures

Answer and Explanation

Choice A:

Choice A: Pressure ulcers - Physical restraints can lead to immobility, which increases the risk of pressure ulcers due to prolonged pressure on the skin.

Choice B:

Choice B: Death - Restraints can cause fatal accidents. For example, a person might try to remove the restraint, fall, and suffer a fatal injury.

Choice C:

Choice C: Sepsis - While sepsis is a severe condition often caused by an infection, it's not a direct result of physical restraints. However, if a pressure ulcer (caused by restraints) becomes severely infected, it could potentially lead to sepsis.

Choice D:

Choice D: Decreased circulation/perfusion to the extremities - Restraints can restrict movement, leading to decreased blood flow to the extremities.

Choice E:

Choice E: Fractures - Struggling against restraints can lead to falls and subsequent fractures.

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Question 7:

During an assessment, an older adult male client reports that he fell the night before. What should you follow up with? (Select all that apply.)

A. Ask about the circumstances behind the fall(s). B. Assess for any injuries the client might have. C. Evaluate the client for gait and balance. D. Ask about the history or frequency of falls.

Answer and Explanation

Choice A:

Asking about the circumstances behind the fall(s) can help you identify the possible risk factors and causes of the fall(s), such as environmental hazards, medications, chronic conditions, or acute illnesses. Asking about the circumstances can also help you determine the severity and urgency of the situation, and whether the client needs further evaluation or referral.

Choice B:

Assessing for any injuries the client might have is important, but it is not the first thing you should do after a client reports a fall. You should first ask about the circumstances to rule out any life-threatening or serious injuries that may require immediate attention. Assessing for injuries is part of the comprehensive fall risk assessment that should be done after the initial screening.

Choice C:

Evaluating the client for gait and balance is also important, but it is not the first thing you should do after a client reports a fall. You should first ask about the circumstances to rule out any underlying medical conditions that may affect the client's gait and balance. Evaluating gait and balance is part of the comprehensive fall risk assessment that should be done after the initial screening.

Choice D:

Asking about the history or frequency of falls can help you assess the client's fall risk and identify any patterns or trends in the client's fall history. Asking about the history or frequency of falls can also help you tailor the appropriate interventions and prevention strategies for the client.

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Question 8:

Which are potential results of end-organ damage from chronic hypertension? (Select all that apply.)

A. Isolated systolic hypertension B. Atrial fibrillation C. Renal insufficiency D. Stroke E. Cardiac disease

Answer and Explanation

Choice A:

Isolated systolic hypertension is not a result of end-organ damage from chronic hypertension, but rather a risk factor for it. Isolated systolic hypertension is a condition where the systolic blood pressure is elevated (>140 mmHg) while the diastolic blood pressure is normal (<90 mmHg). It is common in older adults due to the stiffening of the arteries, and can increase the risk of cardiovascular and cerebrovascular events.

Choice B:

Atrial fibrillation is a result of end-organ damage from chronic hypertension. Atrial fibrillation is an irregular and often rapid heart rate that can cause poor blood flow and increase the risk of stroke and heart failure. Chronic hypertension can damage the heart muscle and the electrical system of the heart, leading to atrial fibrillation.

Choice C:

Renal insufficiency is a result of end-organ damage from chronic hypertension. Renal insufficiency is a condition where the kidneys are unable to filter waste and fluid from the blood adequately. Chronic hypertension can damage the blood vessels and the nephrons of the kidneys, leading to renal insufficiency.

Choice D:

Stroke is a result of end-organ damage from chronic hypertension. Stroke is a sudden interruption of blood supply to the brain, causing brain cell death and neurological deficits. Chronic hypertension can damage the blood vessels in the brain, making them prone to rupture (hemorrhagic stroke) or blockage (ischemic stroke).

Choice E:

Cardiac disease is a result of end-organ damage from chronic hypertension. Cardiac disease is a broad term that encompasses various disorders of the heart, such as coronary artery disease, heart attack, heart failure, and cardiomyopathy. Chronic hypertension can damage the heart by increasing the workload and the oxygen demand of the heart, causing the heart to enlarge and weaken over time.

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Question 9:

When an older female adult client complains of itching and pain and several days later shows you a rash, what do you realize she has?

A. Scabies B. Herpes zoster C. Skin cancer D. Actinic keratosis

Answer and Explanation

Choice A:

Scabies is a skin infestation caused by tiny mites that burrow into the skin and lay eggs. It causes intense itching and a pimple-like rash, usually in the folds of the skin, such as the armpits, groin, or between the fingers. Scabies is highly contagious and can spread through direct skin contact or shared clothing or bedding.

Choice B:

Herpes zoster, also known as shingles, is a viral infection that affects the nerves and the skin. It causes a painful, blistering rash that usually appears on one side of the body or face. Herpes zoster is caused by the same virus that causes chickenpox, which can reactivate later in life, especially in older adults or people with weakened immune systems.

Choice C:

Skin cancer is an abnormal growth of skin cells that can be caused by exposure to ultraviolet (UV) radiation from the sun or tanning beds. It can appear as a new or changing mole, a sore that does not heal, or a scaly or crusty patch of skin. Skin cancer can vary in appearance, size, shape, and color, depending on the type and stage of the cancer.

Choice D:

Actinic keratosis is a precancerous skin condition that is caused by chronic sun damage. It appears as rough, scaly, or crusty spots on the skin, usually on the face, ears, scalp, or hands. Actinic keratosis can sometimes develop into squamous cell carcinoma, a type of skin cancer, if left untreated.

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Question 10:

You notice that your older adult male client frequently knocks his arm or hand against door frames or chair backs and then develops a purpura. What do you advise your client to do? (Select all that apply.)

A. Protect the skin from trauma. B. Remind the health care personnel to be gentle when handling this client’s skin. C. Wear a long-sleeved shirt. D. Tape a nonadherent dressing over the site of a skin tear.

Answer and Explanation

Choice A:

Choice A: Protect the skin from trauma. This is a correct answer. Purpura is the discoloration of the skin or mucous membranes due to hemorrhage from small blood vessels¹. It can be caused by various factors, such as blood clotting disorders, medications, infections, or weak blood vessels². Older adults are more prone to develop purpura because their skin becomes thinner and more fragile with age³. Therefore, protecting the skin from trauma, such as knocking against hard surfaces, can help prevent or reduce purpura.

Choice B:

Choice B: Remind the health care personnel to be gentle when handling this client’s skin. This is also a correct answer. Health care personnel should be aware of the risk of purpura in older adults and handle their skin with care. They should avoid applying excessive pressure, friction, or shear forces to the skin, as these can cause damage to the blood vessels and result in purpura. They should also use soft and smooth materials, such as cotton or silk, when dressing or cleaning the skin.

Choice C:

Choice C: Wear a long-sleeved shirt. This is not a correct answer. Wearing a long-sleeved shirt may provide some protection to the skin, but it is not enough to prevent purpura. Moreover, wearing tight or rough clothing can actually worsen the condition by causing irritation or injury to the skin. Therefore, this is not a good advice for the client.

Choice D:

Choice D: Tape a nonadherent dressing over the site of a skin tear. This is another correct answer. A skin tear is a type of wound that occurs when the skin is separated from the underlying tissue, usually due to trauma. Skin tears are common in older adults and can lead to purpura if the blood vessels are damaged. Taping a nonadherent dressing over the site of a skin tear can help protect the wound from infection, promote healing, and prevent further bleeding.

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Smith Chason College Son Los Angeles ADN NURS 146 gero final Exam

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