Question 1

A critically ill older adult is placed on a continuous infusion of high-dose loop diuretic for diuresis.The nurses knows to monitor for

Accepted Answer

A)  hyperkalemia. 
B)  bradycardia. 
C)  metabolic acidosis. 
D)  hyperchloremic alkalosis. 
A)  hyperkalemia. 
B)  bradycardia. 
C)  metabolic acidosis. 
D)  hyperchloremic alkalosis. C

Question 2

Which of the following nonsteroidal anti-inflammatory drugs (NSAIDs)has the side effect of renal failure,HTN,heart failure,and GI bleed in the elderly population?

Accepted Answer

A)  Indomethacin 
B)  Ketorolac 
C)  Aspirin greater than 325 mg 
D)  Naproxen 
A)  Indomethacin 
B)  Ketorolac 
C)  Aspirin greater than 325 mg 
D)  Naproxen D

Question 3

Which of the following contribute to a higher risk for myocardial ischemia in an older patient?

Accepted Answer

A)  Increased diastolic filling pressures 
B)  Decreased intracellular free calcium 
C)  Thinning left ventricular wall thickness 
D)  Increased myocardial collagen content 
E)  Increased myocardial oxygen consumption 
A)  Increased diastolic filling pressures 
B)  Decreased intracellular free calcium 
C)  Thinning left ventricular wall thickness 
D)  Increased myocardial collagen content 
E)  Increased myocardial oxygen consumption A,D,E

Question 4

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.Dopamine 3 mcg/kg/min has been ordered for this patient.What nursing implications should be considered when administering this drug to an older patient?

Accepted Answer

A)  No changes are noted in older patients with this drug. 
B)  Drug effect is enhanced by increased receptor site action. 
C)  Increased breakdown by liver hepatocytes occurs, increasing dosage requirements. 
D)  Drug metabolism and detoxification are slowed, increasing the risks of drug toxicity. 
A)  No changes are noted in older patients with this drug. 
B)  Drug effect is enhanced by increased receptor site action. 
C)  Increased breakdown by liver hepatocytes occurs, increasing dosage requirements. 
D)  Drug metabolism and detoxification are slowed, increasing the risks of drug toxicity.

Question 5

Which of the following can be a normal assessment finding for an older patient?

Accepted Answer

A)  Asymptomatic dysrhythmias 
B)  Decreased urine output 
C)  Increased respiratory effort 
D)  Difficulty problem solving 
A)  Asymptomatic dysrhythmias 
B)  Decreased urine output 
C)  Increased respiratory effort 
D)  Difficulty problem solving

Question 6

Which medications are considered an alternative to angiotensin-converting enzyme (ACE)inhibitors in older adult hypertension patients with diabetes mellitus and heart failure (HF)?

Accepted Answer

A)  Angiotensin-receptor blockers 
B)  Beta-blockers 
C)  Calcium antagonists 
D)  Direct renin inhibitors 
A)  Angiotensin-receptor blockers 
B)  Beta-blockers 
C)  Calcium antagonists 
D)  Direct renin inhibitors

Question 7

Which of the following can contribute to an accelerated incidence of osteoporosis?

Accepted Answer

A)  Immobility 
B)  Increase in calcium 
C)  Smoking 
D)  Decreased glucocorticoid secretion 
E)  Decreased intake of dietary calcium 
A)  Immobility 
B)  Increase in calcium 
C)  Smoking 
D)  Decreased glucocorticoid secretion 
E)  Decreased intake of dietary calcium

Question 8

An older patient is starting a new medication that is metabolized in the liver and excreted by the kidneys.Which is the best assessment to monitor the patient's ability to tolerate the medication?

Accepted Answer

A)  Liver function tests 
B)  Drug side effects experienced by the patient 
C)  Kidney function tests 
D)  Therapeutic drug levels 
A)  Liver function tests 
B)  Drug side effects experienced by the patient 
C)  Kidney function tests 
D)  Therapeutic drug levels

Question 9

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.The patient awakens during the night confused and disoriented.This may be in part because of

Accepted Answer

A)  impaired sensation of peripheral receptors. 
B)  increased nerve impulse conduction resulting in increased anxiety. 
C)  deficiency in the temporofrontal function of the brain. 
D)  inevitable dementia. 
A)  impaired sensation of peripheral receptors. 
B)  increased nerve impulse conduction resulting in increased anxiety. 
C)  deficiency in the temporofrontal function of the brain. 
D)  inevitable dementia.

Question 10

A nurse is teaching an older patient about the signs and symptoms of a myocardial infarction.Which statement by the patient would indicate that the teaching was effective?

Accepted Answer

A)  "The pain in my chest may last a long time." 
B)  "I will feel like I have an elephant sitting on the center of my chest." 
C)  "The chest pain will be sharp and over the center of my chest." 
D)  "The pain may not be severe and may not be in my chest." 
A)  "The pain in my chest may last a long time." 
B)  "I will feel like I have an elephant sitting on the center of my chest." 
C)  "The chest pain will be sharp and over the center of my chest." 
D)  "The pain may not be severe and may not be in my chest."

Question 11

An older patient is admitted to the hospital with an acute onset of mental changes and recent falls.The nurse knows that the most common cause of mental changes is

Accepted Answer

A)  hypoxia. 
B)  infection. 
C)  cerebrovascular accident. 
D)  electrolyte imbalance. 
A)  hypoxia. 
B)  infection. 
C)  cerebrovascular accident. 
D)  electrolyte imbalance.

Question 12

Which of the following would be a normal assessment finding for an older patient?

Accepted Answer

A)  Inability to remember what was eaten yesterday 
B)  An increase in resting heart rate 
C)  Hypoactive bowel sounds 
D)  Brisk papillary response to light 
A)  Inability to remember what was eaten yesterday 
B)  An increase in resting heart rate 
C)  Hypoactive bowel sounds 
D)  Brisk papillary response to light

Question 13

Chemical changes in a drug that renders it active or inactive is known as

Accepted Answer

A)  absorption. 
B)  metabolism. 
C)  excretion. 
D)  distribution. 
A)  absorption. 
B)  metabolism. 
C)  excretion. 
D)  distribution.

Question 14

Which method is used to measure bone mineral density (BMD)and fracture prediction?

Accepted Answer

A)  fracture risk assessment tool (FRAX) 
B)  Computed tomography 
C)  Dual-energy x-ray absorptiometry (DX
A)  
D)  positron emission tomography (PET) 
A)  fracture risk assessment tool (FRAX) 
B)  Computed tomography 
C)  Dual-energy x-ray absorptiometry (DX
A)  
D)  positron emission tomography (PET)

Question 15

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.When caring for this patient,the nurse will give increased attention to skin integrity because of the

Accepted Answer

A)  thickening of the epidermal skin layer. 
B)  loss of sebaceous glands. 
C)  increased fragility from loss of protective subcutaneous layers. 
D)  decreased melanocyte production. 
A)  thickening of the epidermal skin layer. 
B)  loss of sebaceous glands. 
C)  increased fragility from loss of protective subcutaneous layers. 
D)  decreased melanocyte production.

Question 16

An older patient is receiving a nephrotoxic medication.Which of the following would be a priority for the nurse to monitor?

Accepted Answer

A)  Electrocardiogram 
B)  Lung sounds 
C)  Blood pressure 
D)  Level of consciousness 
A)  Electrocardiogram 
B)  Lung sounds 
C)  Blood pressure 
D)  Level of consciousness

Question 17

Nurses should be alert for immune deficiencies in older patients because of which of the following?

Accepted Answer

A)  Nutritional deficiencies 
B)  Presence of chronic illnesses 
C)  Insertion of invasive devices 
D)  Decreased total lung capacity 
E)  Increased peristaltic action in the esophagus 
A)  Nutritional deficiencies 
B)  Presence of chronic illnesses 
C)  Insertion of invasive devices 
D)  Decreased total lung capacity 
E)  Increased peristaltic action in the esophagus

Question 18

Age-related pulmonary changes that may affect this patient include

Accepted Answer

A)  increased tidal volumes. 
B)  weakening of intercostal muscles and the diaphragm. 
C)  improved cough reflex. 
D)  decreased sensation of the glottis. 
A)  increased tidal volumes. 
B)  weakening of intercostal muscles and the diaphragm. 
C)  improved cough reflex. 
D)  decreased sensation of the glottis.

Question 19

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.Age-related changes in myocardial pumping ability may be evidenced by

Accepted Answer

A)  increased contractility. 
B)  decreased contractility. 
C)  decreased left ventricle afterload. 
D)  increased cardiac output. 
A)  increased contractility. 
B)  decreased contractility. 
C)  decreased left ventricle afterload. 
D)  increased cardiac output.

Question 20

An older patient is started on spironolactone to control hypertension.The nurse knows to monitor for

Accepted Answer

A)  hyperkalemia. 
B)  irregular heart rate. 
C)  confusion. 
D)  pulmonary edema. 
A)  hyperkalemia. 
B)  irregular heart rate. 
C)  confusion. 
D)  pulmonary edema.

Exam 41: The Older Adult Patient

A critically ill older adult is placed on a continuous infusion of high-dose loop diuretic for diuresis.The nurses knows to monitor for

Which of the following nonsteroidal anti-inflammatory drugs (NSAIDs)has the side effect of renal failure,HTN,heart failure,and GI bleed in the elderly population?

Which of the following contribute to a higher risk for myocardial ischemia in an older patient?

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.Dopamine 3 mcg/kg/min has been ordered for this patient.What nursing implications should be considered when administering this drug to an older patient?

Which of the following can be a normal assessment finding for an older patient?

Which medications are considered an alternative to angiotensin-converting enzyme (ACE)inhibitors in older adult hypertension patients with diabetes mellitus and heart failure (HF)?

Which of the following can contribute to an accelerated incidence of osteoporosis?

An older patient is starting a new medication that is metabolized in the liver and excreted by the kidneys.Which is the best assessment to monitor the patient's ability to tolerate the medication?

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.The patient awakens during the night confused and disoriented.This may be in part because of

A nurse is teaching an older patient about the signs and symptoms of a myocardial infarction.Which statement by the patient would indicate that the teaching was effective?

An older patient is admitted to the hospital with an acute onset of mental changes and recent falls.The nurse knows that the most common cause of mental changes is

Which of the following would be a normal assessment finding for an older patient?

Chemical changes in a drug that renders it active or inactive is known as

Which method is used to measure bone mineral density (BMD)and fracture prediction?

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.When caring for this patient,the nurse will give increased attention to skin integrity because of the

An older patient is receiving a nephrotoxic medication.Which of the following would be a priority for the nurse to monitor?

Nurses should be alert for immune deficiencies in older patients because of which of the following?

Age-related pulmonary changes that may affect this patient include

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.Age-related changes in myocardial pumping ability may be evidenced by

An older patient is started on spironolactone to control hypertension.The nurse knows to monitor for

Critical Care Nursing Practice

Ethical Issues

Legal Issues

Genetics and Genomics in Critical Care

Patient and Family Education

Psychosocial and Spiritual Alterations and Management

Sleep Alterations and Management

Nutrition Alterations and Management

Pain and Pain Management

Sedation,Agitation,Delirium: Assessment and Management

End-Of-Life Issues

Cardiovascular Anatomy and Physiology

Cardiovascular Clinical Assessment

Cardiovascular Diagnostic Procedures

Cardiovascular Disorders

Cardiovascular Therapeutic Management

Pulmonary Anatomy and Physiology

Pulmonary Clinical Assessment

Pulmonary Diagnostic Procedures

Pulmonary Disorders

Pulmonary Therapeutic Management

Neurologic Anatomy and Physiology

Neurologic Clinical Assessment and Diagnostic Procedures

Neurologic Disorders and Therapeutic Management

Kidney Anatomy and Physiology

Kidney Clinical Assessment and Diagnostic Procedures

Kidney Disorders and Therapeutic Management

Gastrointestinal Anatomy and Physiology

Gastrointestinal Clinical Assessment and Diagnostic Procedures

Gastrointestinal Disorders and Therapeutic Management

Endocrine Anatomy and Physiology

Endocrine Clinical Assessment and Diagnostic Procedures

Endocrine Disorders and Therapeutic Management

Trauma

Shock,sepsis,and Multiple Organ Dysfunction Syndrome

Burns

Organ Donation and Transplantation

Hematologic Disorders and Oncologic Emergencies

The Obstetric Patient

The Pediatric Patient

The Perianesthesia Patient

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