Jeopardy- Home Care Afternoon Wrap Up

Ins and Outs

100

A client with acute heart failure is receiving IV antibiotics mixed in 100-ml bags of fluid q4h. The nurse should monitor for signs and symptoms of: A) Decrease in afterload B) Reduction in preload C) Increase in Cardiac workload D) Improvement in pulmonary gas exchange

C) Increase in Cardiac workload

200

A client who is 70 years old and lives alone has stress incontinence. To prevent incontinence, the nurse advises the client to: A) Ask someone else to lift heavy objects B) Wear disposable protective underwear C) Perform perineal muscle exercises (ie kegel) D) Apply estrogen vaginal cream to the urinary meatus after each intentional voiding

C) Perform perineal muscle exercises (ie kegel)

300

A client with acute renal failure has a 24-hr urine output of 400ml. To maintain fluid and electrolyte balance the nurse should: A) Restrict IV and PO fluids to 200 ml/hr B) Maintain IV and PO fluid intake at 3000 ml/24hr C) Replace fluid loss with 400 ml/24hr D) Place the client on NPO and offer lemon lozenges

C) Replace fluid loss with 400 ml/24hr

400

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? a) Restricting fluid intake to reduce the need to void b) Establishing a predetermined fluid intake pattern for the client c) Encouraging the client to increase the time between voidings d) Assessing present voiding patterns

Assessing present voiding patterns

500

An older adult client admitted with heart failure and a sodium level of 113 mEq/L is behaving aggressively toward staff and does not recognize family members. When the family expresses concern about the client's behavior, the nurse would respond most appropriately by stating A)"The client may be suffering from dementia, and the hospitalization has worsened the confusion." B)"Most older adults get confused in the hospital." C) "The sodium level is low, and the confusion will resolve as the levels normalize." D) "The sodium level is high and the behavior is a result of dehydration."

C) "The sodium level is low, and the confusion will resolve as the levels normalize."

Cognition

100

The son of an elderly client who has cognitive impairments approaches the nurse and says, "I'm so upset. The physician says I have 4 days to decide on where my dad is going to live." The nurse responds to the son's concerns, gives him a list of types of living arrangements, and discusses the needs, abilities, and limitations of the client. The nurse should intervene further if the son makes which comment? A) "Boy, I have a lot to think about before I see the social worker tomorrow." B) "I think I can handle most of Dad's needs with the help of some home health care." C) "I'm so afraid of making the wrong decision, but I can move him later if I need to." D) "I want the social worker to make this decision so Dad won't blame me."

D) "I want the social worker to make this decision so Dad won't blame me."

200

A client diagnosed with dementia wanders the halls of the locked nursing unit during the day. To ensure the client's safety while walking in the halls, the nurse should do which of the following? 1. Administer PRN haloperidol (Haldol) to decrease the need to walk. 2. Assess the client's gait for steadiness. 3. Restrain the client in a geriatric chair. 4. Administer PRN lorazepam (Ativan) to provide sedation.

2. Assess the client's gait for steadiness.

300

Which of the following statements accurately describes Alzheimer's disease? A) Alzheimer's Disease is a form of dementia, with reversible manifestations of memory loss and altered cognition B) Alzheimer;s Disease is a form of dementia that begins with memory loss, which is immediately noticeable C) Alzheimer's Disease results from complex interactions between genetic and environmental factors D) Alzheimers Disease is a rapid, progressie, degenerative neurologic disease, which causes brain degeneration without inflammation

C) Alzheimer's Disease results from complex interactions between genetic and environmental factors

400

The three common conditions affecting cognition in the older adults are: A. Stroke, MI, Cancer B. Cancer, Alzheimer's disease, Stroke C. Delirium, Depression, Dementia D. Blindness, Hearing loss, Stroke

C. Delirium, Depression, Dementia

500

A client has been recently diagnosed with Alzheimer's disease. When teaching the family about the prognosis, the nurse must explain that: A. Diet and exercise can slow the process considerably B. It usually progresses gradually with a deterioration of function C. Many individuals can be cured if the diagnosis is made early D. Few clients live more than 3 years after the diagnosis

B. It usually progresses gradually with a deterioration of function

Eyes & Ears

100

What is the normal intraocular pressure of the eye? A) 2-7 mm hg B) 10-21 mm hg C) 22-30 mm hg D) 31-35 mm hg

B) 10-21 mm hg

200

You are caring for a patient who had a right eye cataract removal. What discharge instruction would you want to include in the plan of care? A) Do not sleep on right side B) Do not sleep on left side C) Do not sleep with head elevated D) Do wear glasses until physician says its ok

A) Do not sleep on right side

300

You are the nurse assigned to care for an elderly client. While assessing the ears of the patient, you observed dry, hard cerumen developing in the ear canal. Which of the following actions should you take? A) Do nothing, since this a normal finding in the older adult. B) Document finding and report your concern to the physician. C) Irrigate the ear canal with a mixture of hydrogen peroxide and normal saline. D) Ask the patient if he is experiencing any discomfort.

B) Document finding and report your concern to the physician.

400

Before inserting a client's hearing aid, the nurse should: A) Turn the volume all the way down B) Remove the batteries C) Turn the volume all of the way up D) Soak the hearing aid in warm water to clean it

A) Turn the volume all the way down

500

When the client who has undergone cataract extraction is preparing to go home, the nurse reinforces which of the following instructions? A) Remove the dressing at bedtime B) A headache for the first few days after surgery should be expected C) Avoid sleeping on the operative side D) Set a new appointment with the surgeon for 1 month from today

What is C) Avoid sleeping on the operative side

Other

100

After teaching a group of clients with osteoarthritis about using regular exercise, which of the following client statements indicates effective teaching? 1. "Performing range-of-motion exercises will increase my joint mobility." 2. "Exercise helps to drive synovial fluid through the cartilage." 3. "Joint swelling should determine when to stop exercising." 4. "Exercising in the outdoors year-round promotes joint relaxation."

2. "Exercise helps to drive synovial fluid through the cartilage."

200

Assessing the laboratory findings, which result would the nurse most likely expect to find in a client with chronic renal failure? A. BUN 10 to 30 mg/dl, potassium 4.0 mEq/L, creatinine 0.5 to 1.5 mg/dl B. Decreased serum calcium, blood pH 7.2, potassium 6.5 mEq/L C. BUN 15 mg/dl, increased serum calcium, creatinine l.0 mg/dl D. BUN 35 to 40 mg/dl, potassium 3.5 mEq/L, pH 7.35, decreased serum calcium

B. Decreased serum calcium, blood pH 7.2, potassium 6.5 mEq/L

300

Which of the following should the nurse assess when completing the history and physical examination of a client diagnosed with osteoarthritis? 1. Anemia. 2. Osteoporosis. 3. Weight loss. 4. Local joint pain.

4. Local joint pain.

400

The nurse is assessing a client with acute renal failure. Which of the following are expected findings? A) Irregular apical pulse, hypoactive bowel sounds B) Irregular apical pulse, slow heart rate, tall peaked T waves on ECG C) Tall peaked T waves on ECG, confusion, hypoactive bowel sounds D) Confusion, Irregular apical pulse

B) Irregular apical pulse, slow heart rate, tall peaked T waves on ECG

500

The nurse includes the definition of HF in the teaching plan for the client. An accurate description of the mechanism of HF is that: A) there is too much fluid in the heart. B) the heart cannot get oxygen. C) the heart is unable to pump effectively. D) there is too much fluid in the lungs.

C) the heart is unable to pump effectively.

Other

100

A 68-year-old client in the hospital with a chronic illness is 25 percent overweight. This client refuses to eat vegetables and continues to ask for food to be delivered from the local pizza restaurant. Which of the following might this client be experiencing? A) Overnutrition B) Protein-calorie malnutrition C) Undernutrition D) Both over and undernutrition

D) Both over and undernutrition

200

At which of the following times should the nurse instruct the client to take ibuprofen (Motrin), prescribed for left hip pain secondary to osteoarthritis, to minimize gastric mucosal irritation? 1. At bedtime. 2. On arising. 3. Immediately after a meal. 4. On an empty stomach.

3. Immediately after a meal.

300

Which complication is a client with obesity at a greater risk of suffering than a client without the disease? A) Electrolyte imbalance B) Delayed healing C) Seizures D) Constipation

B) Delayed healing

400

To prevent development of acute renal failure in a client with diabetes mellitus the nurse should emphasize which of the following care measures? A) Conduct a urine glucose test prior to each meal and at bedtime B) Follow a “no concentrated sweets” meal plan C) Limit physical activity that requires lifting D) Manage daily blood glucose

D) Manage daily blood glucose

500

A client with history of glaucoma was diagnosed by the community nurse as experiencing Visual Sensory/Perceptual Alterations R/T increased intraocular pressure. The plan of care should focus on: A) Encouraging compliance with drug therapy to prevent loss of vision. B) Recognition that damage to the eye caused by glaucoma can be reversed until the late stages of the disease. C) Management of the severe pain experienced until the optic nerve atrophies. D) Anticipatory guidance, since with or without treatment, the patient eventually will lose peripheral vision.

A) Encouraging compliance with drug therapy to prevent loss of vision.