Caring for the Adult Test 1 Review

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Caring for the Adult Test 1 Review
2012-09-10 22:29:30
Caring Adult

Chapters 11, 13, 32-34
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  1. Which of the following statements about aging is correct?
    a.       Many older people continue to enjoy sexual activity.
    b.      Older people generally lack family and other support networks.
    c.       Almost 50% of people over age 65 have dementia.
    d.      25% of the older population resides in nursing homes.
  2. Neurologic changes commonly found in the healthy older adults include the following:
    a.       Impaired short-term memory
    b.      Inability to learn new material
    c.       Decline in intellectual capability
    d.      Loss of creative abilities
  3. Mr. J. had been a healthy 90-year-old man until he developed pneumonia. While acutely ill with the pneumonia, he showed signs of early heart and renal failure. He became weak, and his tolerance for physical activity declined. Even though the pneumonia resolved, several months had passed before he returned to his previous level of functioning. How would you explain this delay?
    a.       At age 90, immune function is severely impaired.
    b.      He probably did not seek treatment for his pneumonia soon enough.
    c.       Acute illness overwhelmed his already limited cardiac and renal function.
    d.      He wanted to continue getting the attention he received when he was acutely ill.
  4. You observe that an older patient's thoracic spine is curved, causing her to bend forward. The term used to describe this condition is:
  5. When a patient has presbycusis which of the following nursing interventions is most important?
    a.       Be sure room lighting is adequate.
    b.      Lower the pitch of your voice.
    c.       Monitor her blood pressure.
    d.      Implement body fluid precautions.
  6. Which of these statements by older adults reflects movement toward ego integrity?
    a.       "Since I cannot drive now, I rarely get out or see other people."
    b.      "After my children grew up and my husband died, I just wasn't needed anymore."
    c.       "In my day, when you got married, you stayed married, no matter how bad it was."
    d.      "I can't run marathons anymore, but I still enjoy a brisk walk around the neighborhood."
  7. An older post operative patient is receiving pain medications that depress the central nervous system. Based on your knowledge of drug therapy and aging, what adverse effect is most likely?
    a.       Respiratory depression
    b.      Difficulty sleeping
    c.       Vomiting and diarrhea
    d.      Agitation
  8. A clinic patient reports that she bruises very easily. She cut herself this morning, and the wound continues to ooze blood. An assessment of her medication history reveals that she takes the diuretic Diuril and verapamil for hypertension, Maalox for heartburn, and aspiring for arthritis pain. Which drug would you suspect is related to her bleeding?
  9. A condition in which the body's immune system destroys its own tissues is:
    a.       Immunodeficiency
    b.      Health care-associated infection
    c.       Autoimmunity
    d.      Inflammation
  10. Bacteria that reside on the skin but do not cause infection serve what purpose?
    a.       They stimulate the development of antibodies against pathogens.
    b.      They prevent pathogens from gaining access to the body.
    c.       They secrete sebum, which inhibits the growth of microorganisms.
    d.      They phagocytose pathogenic bacteria that invade the body.
  11. Which of the following are classic signs of local inflammation?
    a.       Heat
    b.      Drainage
    c.       Redness
    d.      Fever
    • a
    • c
  12. In the first phase of the inflammatory process, capillary permeability increases. What purpose does this increase serve?
    a.       Reduces pain in the inflamed tissue by diluting bradykinin
    b.      Draws excess fluid out of inflamed tissue to reduce swelling
    c.       Allows monocytes and neutrophils to pass into the inflamed tissue
    d.      Counteracts bronchoconstriction in antigen-antibody reactions
  13. Why have numerous antibacterial drugs been developed but relatively few antiviral drugs?
    a.       Viruses have a more advanced ability to develop resistance to drugs.
    b.      Making antibacterial drugs is more profitable because only a few viruses exist.
    c.       Very few chemicals have been developed that are capable of killing viruses.
    d.      The virus lives inside the host cell, and drugs that harm viruses often harm host cells too.
  14. The last factor in the chain of infection is the:
    a.       Portal of entry
    b.      Reservoir
    c.       Susceptible host
    d.      Mode of transfer
  15. Characteristics of the incubation period of the infectious process include which of the following?
    a.       The infected person is often very contagious.
    b.      Signs and symptoms are most severe.
    c.       A high fever is usually present but not other symptoms.
    d.      The patient is in the recovery phase of the infection.
  16. Which of the following are health care-associated infections?
    a.       Gonorrhea
    b.      Hepatitis A
    c.       Tuberculosis
    d.      Vancomycin-resistant Enterococcus
  17. Which of the following measures help prevent the development of bacterial resistance?
    a.       All infections are promptly treated with broad-spectrum antimicrobials.
    b.      Antimicrobial selection is based on results of culture and sensitivity tests.
    c.       Antimicrobials are discontinued as soon as symptoms resolve.
    d.      Antimicrobials are prescribed only for serious infections.
  18. The primary mode of transmission of health care-associated infections is:
    a.       Soiled caregiver hands
    b.      Direct contact between patients
    c.       Organisms brought in by visitors
    d.      Faulty sterilization procedures
  19. Which statement is true regarding the need to use Standard Precautions?
    a.       Standard Precautions are required only when caring for patients who have open wounds.
    b.      Standard Precautions are required when caring for any patient in any setting.
    c.       Standard Precautions are required only when caring for patients with tuberculosis, hepatitis, or HIV infection.
    d.      Standard Precautions are required only when caring for patients who are highly susceptible to infection.
  20. The advantage of using HEPA filter respirators rather than surgical masks is that:
    a.       Surgical masks are too expensive for routine use.
    b.      HEPA filter respirators protect the caregiver by filtering inspired air.
    c.       Surgical
    masks protect the caregiver against tuberculosis but not other infections.
    d.      HEPA filter respirators protect the patient but not the caregiver.
  21. After vaccination for measles, a person will not become ill if exposed to the measles virus. The patient's ability to resist the measles virus is called:
    a.       Innate immunity
    b.      Nonspecific defense mechanism
    c.       Active acquired immunity
    d.      Passive acquired immunity
  22. The rejection of transplanted organs is the result of:
    a.       Passive acquired immunity
    b.      Antibody-mediated immunity
    c.       Cell-mediated immunity
    d.      Innate immunity
  23. Nursing care of the immunosuppressed patient should include which of the following?
    a.       Take rectal temperatures every 4 hours to detect low-grade fever.
    b.      Encourage consumption of fresh fruits and vegetables to increase vitamin intake.
    c.       Encourage the family to bring in live plants to increase oxygen in the room.
    d.      Emphasize the need for proper hand washing by patients, visitors, and staff.
  24. If a person has no A or B antigens, then what is his or her blood type?
    Type O
  25. When inspecting a patient's skin, you notice multiple ecchymosis and petechiae. This should lead you to suspect a deficiency of which blood component?
  26. A patient says he is a "universal donor." This means his blood type is what?
    Type O
  27. While receiving a blood transfusion, a patient complains of chest and back pain and chills. Which of the following should be your initial action?
    a.       Notify the blood bank.
    b.      Take vital signs.
    c.       Administer acetaminophen.
    d.      Stop the transfusion.
  28. Which of the following nursing interventions is or are appropriate for a patient with a low RBC count?
    a.       Avoid taking rectal temperatures and using suppositories.
    b.      Allow for rest between periods of activity.
    c.       Encourage increased fluids and dietary fiber.
    d.      Do not allow fresh flowers in the room.
  29. A deficiency of RBCs, WBCs, and platelets is characteristic of which of the following?
    a.       Aplastic anemia
    b.      Hemolytic anemia
    c.       Sickle cell anemia
    d.      Iron-deficiency anemia
  30. Sickle cell crisis occurs when which of the following is seen?
    a.       Cells lack sufficient Hb to transport O2.
    b.      Sickled cells are unable to transport adequate O2.
    c.       Sickled cells form clumps that obstruct blood flow.
    d.      The bone marrow stops producing RBCs.
  31. Pain management during the acute phase of a sickle cell crisis usually requires which of the following?
    a.       NSAIDs
    b.      Physical therapy
    c.       Nerve blocks
    d.      Opioid analgesic agents
  32. Overstimulation of the normal blood-clotting process can result in which of the following?
    a.       DIC
    b.      ITP
    c.       TTP
    d.      Hemophilia
  33. Hemophilia A is treated with which factor?
  34. A patient has a neutrophil count that is 70% of his total WBC count. You should suspect infection caused by what?
  35. Mr. B. has chickenpox as a child. When he was exposed to chickenpox years later, he did not become infected. His resistance was most likely the result of which type of acquired immunity?
  36. Which of the following is a priority when collecting data about the patient with an immune disorder?
    a.       Signs and symptoms of infection
    b.      Unexplained changes in weight
    c.       Increased blood pressure
    d.      Characteristics of urine
  37. During report, it is noted that a shift occurs to the right on your patient's CBC. Which of the following could this mean?
    a.       Your patient has a mild infection.
    b.      Your patient's infection is resolving.
    c.       Your patient has an overwhelming infection
    d.      Your patient is producing excess neutrophils.
  38. When caring for a patient with leukemia who is undergoing chemotherapy, which of the following data should you report immediately?
    a.       The patient states that he is tired all the time.
    b.      The patient's skin is pale and dry.
    c.       The patients oral temperature is 101⁰ F.
    d.      The patient eats only half of the food served at lunch.
  39. HIV can best be described as which of the following?
    a.       DNA virus
    b.      Messenger RNA (mRNA) virus
    c.       Transfer RNA (tRNA) virus
    d.      Retrovirus
  40. During the latent stage of HIV infection, which of the following cells host the HIV?
    a.       CD4 cells
    b.      CD8 cells
    c.       Antibodies
    d.      Natural Killer Cells
  41. Through which of the following does HIV enter the body?
    a.       The respiratory tract
    b.      Blood and body fluids
    c.       Contaminated food
    d.      Skin contact
  42. What is the leading cause of death in persons with AIDS?
  43. Under what circumstances is it possible for a person with HIV infection to have negative HIV blood tests?
    a.       Prescribed antibiotic agents are effectively destroying the HIV.
    b.      The patient has produced too few antibodies to be detected.
    c.       Some strains of HIV do not induce antibody production.
    d.      The patient did not fast for 24 hours before the test.
  44. Which of the following tests is usually done first to screen for HIV antibodies?
    a.       ELISA
    b.      CD4/CD8 ratio
    c.      Western blot
    d.       CBC
  45. As which of the following can anal or vaginal sex with a condom be classified?
    a.       Very high-risk behavior
    b.      Little-risk behavior
    c.       Moderate-risk behavior
    d.      No-risk behavior
  46. As which of the following drug categories can AZT be classified?
    a.       NNRTIs
    b.      Nucleotide reverse transcriptase inhibitors
    c.       Protease inhibitors
    d.      NRTIs
  47. A patient with HIV infection has recently become confused. Which of the following explanations should you provide to the patient's partner?
    a.       "Confusion with HIV is rare and irreversible."
    b.      "The patient's confusion is probably related to something other than HIV."
    c.       "The patient's mental status may improve with drug therapy."
    d.      "Confusion usually occurs shortly before death."