nrsg 126 quiz questions all weeks

Question 1

While working with an 87-year-old client in long term care the nurse is assessing if the client potentially has a urinary tract infection. What would be assessment findings, more typical to the older adult, that may alert the nurse that there is an infection? SELECT ALL THAT APPLY

Altered mental status
Fever
Falls
Dehydration
Redness
Pain

Answer 1

correct answers:
Altered LOC
Falls Dehydration

Question 2

While providing care of the older adult which of the following are considered normal age-related physiological changes? SELECT ALL THAT APPLY

• Increased heart rate
• Decline of visual acuity
• Decreased respiratory rate
• Decline in long-term memory
• Increased susceptibility to urinary tract infections
• Increased incidents of awakening after sleep onset

Answer 2

answer: Heart rate typically decreases with age and respiratory rate stays the same. Short term memory may be impacted, but not typically long-term memory

• Decline in visual acuity
• Increased susceptibility to UTI
• Increased incidents of awakening after sleep onset

Question 3

Nurses have the responsibility to dispel myths and replace stereotypes of older persons with accurate information. Which of the following does the nurse know is TRUE about most older persons?

• Older adults are unable to understand and learn new information, especially on computers.
  
  • Most older adults have a reduced ability to maintain their independence.
  • Older adults are confused and forgetful.
  • Older adults have a reduced ability to respond physically to stress.

Answer 3

As cellular function changes, older adults may have a reduced ability to respond physically to stress. For example, hormone levels can decrease, the immune system can become less effective, therefore putting the patient at risk for having a reduced ability to respond to stress.

Correct answer: Older adults have a reduced ability to respond physically to stress

Question 4

A nurse is caring for an older adult with decreased skin turgor. How does this age-related change impact the risk of skin infections in the elderly?

• It enhances the skin’s ability to resist microbial invasion
• It reduces the risk of pressure ulcers and skin breakdown
• It compromises the skin’s protective barrier
• It accelerates wound healing

Answer 4

Decreased skin turgor is associated with a loss of elasticity, which compromises the skin’s protective barrier and increases susceptibility to skin infections.

Answer: It compromises the skin’s protective barrier

Question 5

When caring for the older person the nurse should do which of the following?

• Offer client-centered and individualized care.
• Speak in a louder voice because many older persons are hard of hearing.
• Be aware that older persons are often forgetful, always write it down for them to review later.
• Most older adults require assistance so be prepared to provide full care.

Answer 5

Answer: Offer client-centered and individualized care

Question 6

In Canada, the leading cause of death in older persons include __ and __

Answer 6

answer: cancer and heart disease

Question 7

An older adult is prescribed antibiotics for a respiratory infection. What nursing action is essential in preventing the development of antibiotic-resistant infections?

• Administering the antibiotics as prescribed
• Encouraging the patient to stop the antibiotics when symptoms improve
• Using a broad-spectrum antibiotic to ensure complete coverage
• Skipping doses to reduce the risk of side effects

Answer 7

Answer: Administering the antibiotics as prescribed

Question 8

A nurse is caring for an older adult with a compromised immune system due to medications. Which infection control measure is most appropriate in protecting the client from environmental sources of infection?

• Placing the client on airborne precautions
• Administering prophylactic antibiotics daily
• Limiting visitors to immediate family only
• Ensuring a well-balanced diet for immune support

Answer 8

Answer: Limiting visitors to immediate family only

Question 9

Which of the following physiological changes of ageing increases the older adults risk of infection?

• Atypical signs and symptoms to infectious agents
• Altered inflammatory response
• Enhanced immune response in the elderly
• Greater efficiency of the respiratory system

Answer 9

Answer: Altered inflammatory response

Question 10

What is the best method for older adults to protect themselves against influenza?

• Routinely cleaning surfaces in their home
• Washing their hands often
• Avoiding those who are, or may be, sick with influenza
• Receiving the influenza vaccine every year

Answer 10

Answer: Receiving the influenza vaccine every year

Question 11

A nurse discovers a client crying. The client says “I am just so overwhelmed with everything and I do not know what to do!”
Which response by the nurse would be an example of a therapeutic clarifying statement?

• “I’m sorry to hear that you’re feeling overwhelmed. Can you tell me more about why you are feeling overwhelmed?”
• “I see you have been biting your nails; is this due to the stress?”
• “When you get overwhelmed do you have any physical symptoms?”
• “So, you feel like you have too much going on and you are not sure of what to do?”

Answer 11

Answer: “So, you feel like you have too much going on and you are not sure of what to do?”

Question 12

An 86-year-old client with a history of Alzheimer’s disease is admitted to the hospital for surgery. The client lives at home alone with mild cognitive impairment. Over the course of the day the nurse notices that the client is hallucinating and has increased verbal rambling. Which of the following health problems should the nurse assess for in this client?

• Delirium
• Depression
• Cancer
• Dementia

Answer 12

Answer: Delirium

Question 13

The nurse is working with an older adult who is struggling with depression. The client has chronic pain and is diagnosed with multiple chronic health conditions. The client says to the nurse “nothing ever goes right for me, I just want to die”.

Which response demonstrates therapeutic communication?

• “this feeling is because of your depression, I am so sorry you feel this way” (nurse holds clients hand)
• “It sounds like you are going through a tough time” (nurse then sits in silence)
• “I have some information for you about depression, I think if you can use these resources you will see your depression will improve” (nurse provides pamphlet to client)
• “do not say that, we have some fantastic doctors here and they will help you to feel better” (nurse exits room)

Answer 13

Answer: “It sounds like you are going through a tough time” (nurse then sits in silence)

Question 14

Which of the following best describes dementia?

• Loss of cognitive abilities, impairing ability to perform activities of daily living
• Difficulty coping with physical and psychological change
• Memory loss occurring as part of the natural consequence of aging
• Severe cognitive impairment that occurs rapidly

Answer 14

Answer: Loss of cognitive abilities, impairing ability to perform activities of daily living

Question 15

A nurse states to a client, “things will look better tomorrow after a good night’s sleep.” This is an example of which communication technique?

Pick the best answer.

• The therapeutic technique of “sharing empathy”
• The nontherapeutic technique of “giving false reassurance”
• The therapeutic technique of “sharing hope”
• The nontherapeutic technique of “giving personal opinion”

Answer 15

Answer: The nontherapeutic technique of “giving false reassurance”

Question 16

____ is the most common form of dementia, ____ dementia is most commonly caused from stroke and ____ dementia is associated with Parkinson’s.

Answer 16

Answer: Alzheimer’s, Vascular, Lewy body

Question 17

A student nurse is learning about the appropriate use of touch when communicating with clients. Which statement by the instructor best provides information about this aspect of therapeutic communication?

• “Touch is always appropriate to show emotional support and encouragement”
• “Touch is best combined with empathy when dealing with anxious clients.”
• “Touch carries a different meaning for different individuals.”
• “Touch is often used when deescalating client situations where the client is upset”

Answer 17

Answer: “Touch carries a different meaning for different individuals.”

Question 18

Which nursing response is an example of the nontherapeutic communication block of requesting an explanation?

• “That was wrong.”
• “Why did you say that?”
• “Keep your chin up. I’ll explain the procedure to you.”
• “There is always an explanation for both good and bad behaviors.”

Answer 18

Answer: “Why did you say that?”

Question 19

The nurse records the client’s breakfast intake as “tea 240 mL, milk 125 mL, 1 egg, 1 slice of toast.” The nurse knows that this documentation is part of which phase of the nursing process?

• Assessment
• Planning
• Diagnosis
• Implementation

Answer 19

Answer: Assessment

Question 20

Which of the following behaviours is most representative of the nursing diagnosis phase of the nursing process?

• The nurse identifies that the client is unable to mobilize without the use of a walker due to impaired mobility.
• The nurse completes a respiratory assessment.
• The nurse writes in the care plan a goal of the client being able to mobilize 30 feet independently.
• The nurse administers a pain medication to the client for chest pain.

Answer 20

Answer: The nurse identifies that the client is unable to mobilize without the use of a walker due to impaired mobility

Question 21

Which of the following behaviours would indicate that the nurse was using the assessment phase of the nursing process?

• Establishing short-term and long-term goals
• Creating a plan of care
• Proposing diagnoses.
• Reviewing lab (laboratory) results

Answer 21

Answer: Reviewing lab (laboratory) results

Question 22

The planning phase of the nursing process would include which of the following activities?

• Collecting data
• Evaluating goal achievement
• Performing nursing actions and documenting them
• Setting goals

Answer 22

Answer: Setting goals

Question 23

Which of the following is considered a secondary source of data?

• Literature
• Nurses experience
• A family member
• The client

Answer 23

Answer: A family member

Question 24

What is an example of a nursing diagnosis?

• Pneumonia
• Ineffective airway clearance
• Wet cough
• Blood pressure is low at 92/57

Answer 24

Answer: Ineffective airway clearance

Question 25

Which of the following strategies can be implemented to ensure culturally safe assessments? Select all that apply. * Asking the client about health care preferences * Describing personal health care values to help the client make decisions * Taking part in professional development opportunities related to Indigenous health * Recognizing that the clients culture will direct their care needs * Empowering the client through sharing knowledge

Answer 25

Answering: * Asking the client about health care preferences * Taking part in professional development opportunities related to Indigenous health * Recognizing that the clients culture will direct their care needs

Question 26

What would be the highest priority? * A client has to use the washroom * A client is confused * A client is vomiting (puking) * A client is feeling short of breath

Answer 26

Answer: A client is feeling short of breath

Question 27

During which phase of the nursing process does the nurse use clinical judgement to identify a client's response to actual or potential health issues? * Intervention * Diagnosis * Evaluation * Assessment * Planning

Answer 27

Answer: Diagnosis

Question 28

Which of the following strategies would be appropriate to utilize during an interview assessment with an 87 year old client to ensure the nurse is maintaining culturally safe, trauma-informed and therapeutic interactions? SELECT ALL THAT APPLY * Utilize knowledge of atypical presentations of illness * Share their personal values so the client can understand their perspective * Ensure to speak very loudly so the client can hear * Sit facing the client in their personal zone of space * Recognize stigma associated with trauma

Answer 28

Answer: * Utilize knowledge of atypical presentations of illness * Sit facing the client in their personal zone of space * Recognize stigma associated with trauma

Question 29

Which of the following factors can negatively impair the integrity of the integumentary system? Select all that apply * Obesity * Smoking * Sun exposure * A healthy diet * Steroids

Answer 29

Answers: * Obesity * Smoking * Sun exposure * Steroids

Question 30

While completing an assessment on a wound, the nurse notices that the wound bed in nice, pink, and pebbly. Which of the following best describes the phase of healing? * Inflammation * Remodelling * Proliferation * Hemostasis

Answer 30

Proliferation

Question 31

The client has a documented stage 3 pressure ulcer on the right hip. Other than wound care, which of the following measures will promote wound healing? * Providing adequate hydration * Every 1/2 hour turning schedule, back to left side only * Clean dressing changes three times a day * Every 4 hour turning schedule, back to left side only

Answer 31

* Providing adequate hydration

Question 32

Some proteins are manufactured in the body, and others are not. Those that must be obtained through diet are known as which of the following? * Essential amino acids * Amino acids * Ketone bodies * Triglycerides

Answer 32

Essential amino acids

Question 33

Knowing that protein is required for tissue growth, maintenance, and repair, the nurse must understand that for optimal tissue healing to occur, the client must be in which state? *Ketosis *Neutral nitrogen balance *Negative nitrogen balance *Positive nitrogen balance

Question 34

True/False: Uncontrolled blood glucose levels can delay wound healing

Answer 34

True

Question 35

Which of the following clients may be at increased risk for bleeding? *A client taking acetaminophen (Tylenol) daily *A client taking morphine daily *A client taking multivitamins daily *A client taking aspirin (ASA) daily

Answer 35

*A client taking aspirin (ASA) daily

Question 36

True/False: Incontinence can increase the risk for pressure injury

Answer 36

True

Question 37

The nurse is working with a client who has had a cerebrovascular accident (CVA). Which of the following potential complications would the nurse assess for? Select all that apply. *Diarrhea *Pressure injury *Decreased nutritional intake *Dysphagia *Increased protein intake *Muscle atrophy

Answer 37

*Pressure injury *Decreased nutritional intake *Dysphagia *Muscle atrophy

Question 38

What is the first intervention the nurse should implement for a client with a pressure injury? Start intravenous (IV) fluids to support hydration Check the clients BMI Increase nutrition Offload

Answer 38

Offload

Question 39

A nurse is assessing a client with an open area that extends through the epidermis, dermis and into the fat tissue. The client reports they have had this wound for 2 months and "it just won't heal". Select the best answer that describes this wound. Chronic, stage 3, likely to heal through tertiary wound healing. Acute, stage 3, will likely heal through primary intention. Acute, stage 4, will heal through secondary intention. Chronic, stage 4, will heal through tertiary intention.

Answer 39

Chronic, stage 3, likely to heal through tertiary wound healing.

Question 40

Which of the following best describes what is occurring during S1? *Semilunar valves are closing, atria are relaxed and ventricles are in systole. *Semilunar valves are opening, atria are contracting and ventricles are in diastole. *Atrioventricular valves are closing, atria are contracting and ventricles are in diastole. *Atrioventricular valves are closing, atria are relaxed and ventricles are at the beginning of systole. *Atrioventricular valves are opening, atria are relaxing and ventricles are in systole.

Answer 40

*Atrioventricular valves are closing, atria are relaxed and ventricles are at the beginning of systole. S1 results from the closing of the mitral and tricuspid valves (atrioventricular valves). These are the valves between the atria and ventricles. They close AFTER the atria empty- post ventricle diastole, so as they close the ventricles begin to contract (systole) and the atria relax to fill once again. S2 results from the closing of the pulmonic and aortic valves (semilunar valves).

Question 41

Which of the following are normal age-related changes in the heart? SELECT ALL THAT APPLY *Vessel walls lose elasticity increasing risk of HTN *Thickening of ventricle walls decreasing cardiac output *Dysphagia causes decreased fluid intake, therefore decreasing preload * Valves become thicker and can cause murmurs * Ventricular hypertrophy causing increased stroke volume * Thickening of ventricle walls increasing cardiac output

Answer 41

*Vessel walls lose elasticity increasing risk of HTN *Thickening of ventricle walls decreasing cardiac output = Decreased cardiac output is considered an age related change to the heart (decreased contractility). Increased stroke volume and cardiac output would not be an expected age related changes. Decreased preload would also not be an expected age related change. * Valves become thicker and can cause murmurs

Question 42

The nurse needs to implement a plan of care for a client with right sided heart failure. What would be an appropriate intervention to include? *Increase sodium (Na+) intake *Apply oxygen therapy *Encourage fluids *Daily weights

Answer 42

*Daily Weights

Question 43

When does myocardial oxygen perfusion occur? *During expiration *During systole *During inspiration *During diastole

Answer 43

*During diastole

Question 44

The nurse is giving medication to a client who has Atrial Fibrillation. They know that the following medication is beneficial for some clients with Atrial Fibrillation. Anticoagulant Diuretic Antihypertensive Antibiotics

Answer 44

Anticoagulant (part mark) Antihypertensive (fr mark)

Question 45

When caring for a client with heart failure. The nurse understands that activation of the SNS (sympathetic nervous system) will produce which of the following? Bradycardia Decreased myocardial contractility Hypotension Tachycardia

Answer 45

Tachycardia

Question 46

Which of the following diagnostics is the most sensitive indicator of heart failure? BNP - brain natriuretic peptide Troponin CRP – C-reactive protein CBC – complete blood count

Answer 46

BNP! Note: Troponin is useful in detecting MI damage and will increase during MI. CRP is an inflammatory marker, not specific to cardiac markers. CBC is useful in ruling out other potential issues like infection or anemia.

Question 47

Which of the following is a compensatory response to decreased cardiac output? Bradycardia Vasodilation Alteration in LOC (level of consciousness) Vasoconstriction

Answer 47

Vasoconstriction The body compensates for a decrease in cardiac output with vasoconstriction, due to the stimulation of the SNS and RAAS (not testable). Vasodilation would not be expected as a compensatory response. Alteration in LOC will occur only if the decreased cardiac output persists.

Question 48

Define the following: Preload Afterload Contractility Cardiac Output

Answer 48

The amount of ventricular stretch at the end of diastole The force against which the ventricle must expel blood The ability to contract Amount of blood expelled by the heart per minute

Question 49

There are four organs that are often damaged due to hypertension. Which of the following are examples of these more common complications of hypertension? Select all that apply. MI Pneumonia Aneurysm Renal Disease CVA/Stroke Liver Damage

Answer 49

MI Aneurysm Renal Disease CVA/Stroke Hypertension is referred to as the silent killer for adults, because until the adult has significant damage to other systems, the hypertension may go undetected. CVA’s can be related to long-term hypertension. An aneurysm is when a blood vessel ruptures and with HTN this increases presure, therefore increasing the risk of rupture. Renal (kidney) Disease can be caused by HTN as there is changes to vasculature (stenosis, weakness) decreasing O2 and nutrients to the kidneys. Liver disease can lead to portal hypertension but overall hypotension (due to albumin loss). Pneumonia is not typically associated with hypertension.

Question 50

Which of the following statements made by a client with COPD indicates appropriate understanding of the condition and how to manage it? Select all that apply "I should report increased sputum production" "I will eat a low-calorie diet" "I need to use an incentive spirometer to prevent complications" "I will use my bronchodilator (Salbutamol) if I am short of breath" "I will get a pneumococcal vaccine"

Answer 50

"I should report increased sputum production" "I need to use an incentive spirometer to prevent complications" "I will get a pneumococcal vaccine" Correct: Report increased sputum- increased risk of infection and should report changes. Pneumonia vaccine- extra protection Use bronchodilator- this is a rescue inhaler and should be used when needed. Incorrect: Incentive Spirometer- not effective for COPD. Low calorie diet- need increased calories

Question 51

A client with dysphagia has been drinking thin fluids when they are ordered thickened fluids. The nurse is completing an assessment and identifies that the client has aspirated. After some diagnostics, including a CXR (chest x-ray), the physician has diagnosed the client with left lower lobe aspiration pneumonia. Which of the following indicates the nurse understands aspiration pneumonia? Select All That Apply. Fluid is in the Alveoli Crackles will be auscultated to the left chest Fluid is in the pleural space Absent breath sounds will be noted SpO2 may be decreased Wheezes will be auscultated to the left chest Crackles will be auscultated bilaterally

Answer 51

Fluid is in the alveoli Crackles in left side- due to fluid in alveoli. SpO2 may be decreased- diffusion is impacted as alveoli have fluid in them. Wheezes- can be from the fluid or inflammation occurring from the infection.

Question 52

A client who has had COPD for 15 years often experiences infections due to increased susceptibility. Which of the following clinical findings would indicate that this client is experiencing an exacerbation? *Tachypnea, bradycardia and increased dyspnea *Bradypnea, tachycardia and deep respirations *Tachypnea, tachycardia and increased dyspnea *Bradypnea, tachycardia and increased dyspnea

Answer 52

Tachypnea, tachycardia and increased dyspnea Patients experiencing a COPD exacerbation will often have increased respiratory rate, increased HR (SNS and/or dysrhythmia) and dyspnea. A decreased heart rate and respiratory rate are not typically found in a patient with a COPD exacerbation.

Question 53

Which of the following is a normal age related finding? *Increased number of alveoli *Increased airway resistance *Decreased airway resistance *Increased number of cilia

Answer 53

Increased airway resistance = Increased airway resistance is an age related change. The number of alveoli and cilia decrease with age.

Question 54

The nurse knows that the primary function of the alveoli is which of the following? Diffusion Perfusion Regulate tidal volume Regulate respiratory rate

Answer 54

Diffusion The alveoli are where the lungs and the blood exchange oxygen and carbon dioxide. Tidal volume and respiratory rate are largely determined by the nervous system.

Question 55

A client is admitted with COPD. They are very weak and cannot produce an effective cough. The nurse should monitor for which of the following complications? Pleural effusion Pulmonary edema Atelectasis Oxygen toxicity

Answer 55

Atelectasis In a client with COPD, an ineffective cough impedes secretion removal. This, in turn, causes mucus plugging, which leads to localized airway obstruction — a known cause of atelectasis. An ineffective cough doesn’t cause pleural effusion (fluid accumulation in the pleural space). Pulmonary edema usually results from left-sided heart failure, not an ineffective cough. Although many noncardiac conditions may cause pulmonary edema, an ineffective cough isn’t one of them. Oxygen toxicity results from prolonged administration of high oxygen concentrations, not an ineffective cough

Question 56

A client with COPD calls the nurse for help reporting that they cannot breath. Vitals are stable and the client's SpO2 is 90% on 2L O2 via nasal prongs. Breath sounds are clear and the client seems nervous. Which of the following is the [most appropriate] action by the nurse? Administer a corticosteroid (Flovent) Increase the clients oxygen to 4L Coach the client through controlled breathing exercises. time. Ask the client what triggered this event to help them avoid it in the future.

Answer 56

Correct- coach the client through breathing exercises. By helping them to calm down and focus on breathing we can support them through their episode. Completing the assessment can occur later once the patient is more stable. If they are having trouble breathing it is not a great time for a conversation. A corticosteroid is a stabilizer and not rescue inhaler- a more appropriate medication would be a bronchodilator. A COPD client SpO2 is acceptable at this percentage and it is not appropriate to increase O2 at this time.

Question 57

Some clients with COPD are treated with oxygen therapy. Which of the following best describes the considerations when applying O2 therapy to a client with COPD? *The goal is to keep the clients SpO2 over 95% to ensure adequate perfusion. *Due to CO2 retention treatment often includes high flow oxygen therapy to meet the body's oxygenation needs. *The hypoxic drive is decreased due to chronic CO2 retention so O2 therapy is ordered with caution. *The hypoxic drive is increased due to chronic CO2 retention so low flow O2 therapy is required.

Answer 57

Correct: The hypoxic drive is decreased due to chronic CO2 retention so O2 therapy is ordered with caution. SpO2 goal with COPD is 88-92%, high flow oxygen therapy can be used with severe cases of COPD exacerbation but we do not apply this automatically due to CO2 retention- it is used if they are unable to maintain adequate saturations, Incorrect statement- hypoxic drive is increased due to chronic CO2 retention so low flow O2 therapy is required.

Question 58

Which of the following interventions would be beneficial to include in a treatment plan for any client with either COPD or Asthma? oral corticosteroids use oxygen avoid triggers take antibiotics

Answer 58

Correct- avoid triggers to prevent flare-ups and exacerbations Incorrect- O2 is not always required. O2 is treated as a medication and should only be used if needed. Patients with asthma typically only require O2 with severe exacerbations. Antibiotics are typically only used if there is an infection and are more common with COPD exacerbations. Occasionally if exacerbations are frequent the COPD client may be on them prophylactically but this would not be a typical plan of care. Oral corticosteroids are generally only given with acute exacerbations and can be given for both asthma and COPD.

Question 59

A nurse is caring for a client in acute care (in the hospital) who is waiting for surgery. The client reports anxiety and shortness of breath. Their heart rate is regular at 110 beats/minute and their respiratory rate is 24 breaths/minute. What would be the priority action for the nurse to take? administer morphine (opioid) place the client in high fowlers request a bronchodilator from the physician reassure the client it is normal to feel anxious

Answer 59

Correct- place the client in high fowlers- optimal positioning for ventilation. Incorrect- Morphine may be helpful if the patient is in pain but can also cause hypoventilation if too much is given. A bronchodilator may be needed if repositioning does not relieve SOB. Reassurance is not going to help with how the client is feeling at this time- it can be useful to help with anxiety but the focus here is respiratory.

Question 60

The nurse is reviewing lab results for a client with an asthma exacerbation. Which of the following would indicate this exacerbation was triggered by an allergic response? increased neutrophils increased lymphocytes increased eosinophils increased reticulocytes

Answer 60

Correct- increased eosinophils are seen with allergic reaction. lymphocytes- major part of immune system and if increased it is related to virus and blood cancers, neutrophils- increase is related to infection, reticulocytes are immature RBC and increased numbers are related to blood loss (hemolytic anemia and hemorrhage) as the body quickly tries to rebuild to replace.

Question 61

Which client would the nurse identify as being most at risk for experiencing a stroke? A client with uncontrolled hypertension A client with osteoarthritis A client with COPD A client with heart failure

Answer 61

A client with uncontrolled hypertension

Question 62

Which risk factors below is a modifiable or preventable risk factor for stroke? Select all that apply Obesity Atherosclerosis Family history Genetics Age

Answer 62

Obesity Atherosclerosis Can change the following through diet

Question 64

The nurse would be most concerned about the risk of malnutrition for a client with which sensory deficit? Peripheral neuropathy Xerostomia Presbycusis Cataracts

Answer 64

Xerostomia Xerostomia is a decrease in production of saliva; this decreases the ability and desire to eat and can lead to nutritional problems. The other options (peripheral neuropathy, cataracts, presbycusis) do not address taste- or nutrition-related concerns.

Question 65

Which of the following sensory changes are normal with aging? Increase in taste discrimination Reduced night vision Difficulty hearing low pitch Heightened sense of smell

Answer 65

Reduced night vision Night vision becomes impaired as physiological changes in the eye occur. Older adults lose the ability to distinguish high-pitched noises and consonants. Senses of smell and taste are also decreased with aging.

Question 66

Which action would be most important for a nurse to include in the plan of care for an 85 year-old client who has presbycusis? Obtaining large-print written material Speaking distinctly, using lower frequencies Initiating a physiotherapy regime Decreasing tactile stimulation

Answer 66

Speaking distinctly, using lower frequencies Speaking distinctly, using lower frequencies can assist those with hearing loss such as presbycusis. Obtaining large-print written material can assist those with vision loss. Decreasing tactile stimulation does not relate to hearing. Initiating a physiotherapy regime is not related to hearing loss.

Question 67

Provide the proper conditions for the following descriptions: The leading eye disease causing vision loss in older adults in Canada is macular degeneration. The leading eye disease in adults under the age of 50 in Canada is diabetic retinopathy.

Answer 67

Macular Degeneration Diabetic Neuropathy

Question 69

A healthcare provider prescribes an anticoagulant for an older adult with a history of thrombosis. How does age-related changes in blood vessels impact the risk of bleeding in this population? Decreased vascular integrity Enhanced clotting factor production Increased vascular elasticity Improved platelet function

Answer 69

Decreased vascular integrity Aging can result in changes to blood vessels, including decreased elasticity and integrity, which may contribute to an increased risk of bleeding in older adults.

Question 70

A nurse is providing education to a client recently diagnosed with a transient ischemic attack (TIA). Which of the statements by the client indicates understanding of the information? "TIAs are often caused from small bleeds in the brain that resolve on their own” "It is important to seek immediate medical attention if the symptoms reoccur, as it may mean I am having a stroke" "TIAs are usually caused by large bleeds that resolve on their own" "TIAs do not cause permanent damage, so I do not have to worry about this event"

Answer 70

"It is important to seek immediate medical attention if the symptoms reoccur, as it may mean I am having a stroke"

Question 71

he nurse is assisting a client with right sided hemiparesis and dysphagia. Which of the following interventions would be appropriate? keep the head of the bed less than 30 degrees have the client extend their neck upward, away from their neck, while swallowing ensure the client has thin liquids check for pouching of food in the right cheek

Answer 71

check for pouching of food in the right cheek

Question 72

A stroke client has expressive aphasia. What are some ways to effectively communicate with this client? Select all that apply. *provide time for the client to respond *use a communication board *discourage the client from using difficult words *only state the question once *ask questions that require simple responses

Answer 72

*provide time for the client to respond *use a communication board *ask questions that require simple responses

Question 73

A client who had a stroke experiences issues understanding speech.

Answer 73

receptive Wernicke's area