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NRNP 6540 MIDTERM EXAM 2024 -2025 UPDATED
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Mrs. James is 78 years old and comes to the clinic for an annual checkup. The nurse practitioner addresses the psychosocial needs of older adults and specifically the need for which of the following?
- Dependence.
- Dignity, credibility, and respect.
- Being alone.
- Not being touched.
- Dignity, credibility, and respect.
Mr. Slobinsky, 80 years old, is unable to leave his home due to mobility problems. The nurse practitioner conducts a social support assessment because Mr. Slobinsky:
- May not want to see anyone.
- Is not missing the cultural traditions of community activities.
- Has made frequent appointments for consultation with the practitioner.
- Looks forward to sharing his loneliness with the nurse practitioner.
- Has made frequent appointments for consultation with the practitioner.
Mrs. Khan is 89 years old and is reported to have bouts of agitation. The nurse practitioner is counseling her family that these periods of agitation can be triggered by which of the following?
- Silence and soft music.
- Dim lights.
- Approaches from other people.
- A feeling of appetite satiety
- Approaches from other people.
The nurse practitioner is considering ordering medications to help control an older patient's agitation. She chooses which of the following?
- Psychotropic medications
- Seizure medications
- Stimulants
- Depressants
- The concentration of alcohol in her body remains the same as she ages.
- Her change in behavior has nothing to do with any drugs she is taking.
- There are different types of alcoholism in older adults, and the change in behavior is related to the specific type.
- Physical changes due to aging affect the body's metabolism of alcohol differently.
- Physical changes due to aging affect the body's metabolism of alcohol differently.
The son of a 72-year-old man brings his father into the practitioner to plan for treatment of the patient's alcoholism. The nurse practitioner has several options available. Which is the first choice?
- Treat for anxiety.
- Begin with higher doses of anti-anxiety medications.
- The last choice for medication is serotonin uptake inhibitors
4.Buspirone and gabapentin are used as first-line choices.
- Treat for anxiety.
Elisabeth, 67 years old, comes to the practitioner with her daughter, who is her caregiver. The nurse practitioner notices that Elizabeth is very busy and always moving and placing things
in order within the waiting room. Along with this increase in energy, which of the following suggest bipolar with mania or hypomania? Select all that apply.
- Ability to focus on a task
- Flight of ideas
- Rapid speech
- Impulsivity
- Thoughtfulness
- Flight of ideas
- Rapid speech
- Impulsivity
The nurse practitioner is assessing a 69-year-old man for possible bipolar disorder. Which of the following will contribute to diagnosing this patient? Select all that apply.
- Complete blood count (CBC) and comprehensive metabolic panel, toxicology screen, urinalysis, thyroid function tests.
- Electroencephalogram (EEG) and magnetic resonance imaging (MRI).
- Mini-Mental State Examination.
- Saint Louis University Mental Status (SLUMS).
evaluation. The nurse practitioner assesses for which of the following signs or symptoms? Select all that apply.
- Cognitive decline in complex attention, executive function, learning, and memory.
- Gradual onset and the course of illness and progression are typically slow.
- Impaired ability to care for oneself.
- Total or partial loss of the ability to recognize familiar people.
- Improvement in symptoms in time.
- Cognitive decline in complex attention, executive function, learning, and memory.
- Gradual onset and the course of illness and progression are typically slow.
- Impaired ability to care for oneself.
- Total or partial loss of the ability to recognize familiar people.
Mr. Dan is 75 years old and suffering from depression. He tells the nurse practitioner that he is tired of feeling so low. He asks if depression is a normal part of aging. The nurse practitioner tells him that depression is which of the following? Select all that apply.
- Not a normal part of aging.
- Related to nutritional deficiencies, especially vitamin B12 and vitamin D.
- Triggered by one life event.
- Learned helplessness, loss, and bereavement
- A state of balanced neurotransmitters in the brain.
- Not a normal part of aging.
- Related to nutritional deficiencies, especially vitamin B12 and vitamin D.
- Triggered by one life event
Ms. Smith, 70 years old, is being treated for geriatric depression. What choices does the nurse practitioner have to order? Select all that apply.
- Evaluate the present medication regimen.
- Treat any comorbidity.
- Maintain basic daily needs.
- Order a selective serotonin reuptake inhibitor (SSRI).
- Order Abilify.
ALL
Mrs. Smith is 90 years old and has a daytime caregiver. Her daughter stays with her during the evening and nighttime. The daughter suspects her mother is being abused. Which of the
- Educate him on normal signs of grieving.
- Take time to remember his wife and discuss memories.
- Provide emotional support.
- Monitor current chronic medical conditions.
- Encourage him to stay quiet at home and decrease his physical activity.
- Educate him on normal signs of grieving.
- Take time to remember his wife and discuss memories.
- Provide emotional support.
- Monitor current chronic medical conditions.
Polypharmacy is a primary predictor for any undesired or unwanted consequences that can occur because of taking medications. Which is of the following is the correct term for these undesired or unwanted consequences?
- Adverse drug reaction (ADR)
- Prototype drug
- Adverse drug event
- Schedule II drugs
- Adverse drug reaction (ADR)
Which of the following is related to the incidence of gastric acidity declining with age because of decreased intestinal blood flow?
- Drug metabolism
- Drug distribution
- Drug absorption
- Drug elimination
- Drug absorption
Biotransformation means chemical alteration of things such as nutrients, amino acids, toxins, and drugs in the body. In which organ does biotransformation occurs?
- Intestines
- Liver
- Pancreas
- Bile
- Liver
Which of the following is most affected by pharmacokinetic change?
- Distribution of drugs.
- Beers criteria
After consultation with the patient, which of the following is prevented by prescribing only necessary drugs?
- Pharmacodynamics
- Polypharmacy
- Pharmacokinetics
- Pharmacy
- Polypharmacy
Initial and ongoing assessment should be the protocol when prescribing medications. Designating and training office staff to do the initial medication review can save time but still requires review by the provider. Which of the following terms refers to a patient bringing in all current medications for review?
- Brown bag
- OTC
- Rational polypharmacy
- Magic bag
- Brown bag
The aging process may alter the dynamic processes that drugs undergo to produce therapeutic effects. Which of the following are terms that refer to these changes? Select all that apply.
- Pharmacodynamics
- Prophylaxis
- Pharmacology
- Pharmacokinetics
- Pharmacist
- Pharmacodynamics
- Pharmacokinetics
Which of the following factors affect drug absorption? Select all that apply.
- Metabolic diseases
- Esophageal erosion
- Kidney diseases
- Drug-food interactions
- Huntington's disease
- Metabolic diseases
- Esophageal erosion
- Generic drug.
- Solubility of the drug.
- Route of administration.
It is important to know the pharmacodynamic influences of the drug. Which of the following statements are true regarding pharmacodynamics? Select all that apply.
- A drug's pharmacodynamics describes the effect at the site of action.
- Pharmacodynamics is concerned with the movement of drugs within the body.
- A drug's pharmacodynamics describes the time and intensity of the drug effect.
- Pharmodynamics describes the rate and pathways by which drugs re eliminated from the body by metabolism and excretion
- Pharmacodynamics' fundamental concept is drug clearance
- A drug's pharmacodynamics describes the effect at the site of action.
- A drug's pharmacodynamics describes the time and intensity of the drug effect.
A patient sees the nurse practitioner for a post-hospitalization follow-up and presents new complaints with change in
functional status. Which of the following should the nurse practitioner do? Select all that apply.
- Evaluate for ADR.
- Prescribe patient medications for the new symptoms.
- Consult current resources for precautions before prescribing.
- Prescribe antibiotics for the patient.
- Leave as status quo.
- Evaluate for ADR.
- Consult current resources for precautions before prescribing.
Which of the following is true regarding STOPP/START criteria for prescribing medications? Select all that apply.
- Lists potential alternative drugs that can safely be used in older adults.
- Valuable tool for prescribers, but they are not meant to be mandates for prescribing.
- Screening tool to alert doctors to correct treatment.
- Screening tool of older persons' potentially inappropriate prescriptions.
- It is the Beers criteria that mandates prescribing.
- Seventy percent of the cohort older than 65 years dies of chronic conditions.
- Conditions that contribute to significant chronic illness include fractures.
- The number one cause of deaNthUoRfSbIotNhGolTdBer.mCeOnMand women is heart disease.
- Dyslipidemia is the leading cause of mortality of people over 65 years of age
- Seventy percent of the cohort older than 65 years dies of chronic conditions.
While teaching a family about the risks of chronic illness for James, who is 69 years old and the patriarch of the family, the nurse practitioner includes which of the following information?
- The American Heart Association reports that there is an increase in cardiovascular disease
with low levels of smoking, excluding second-hand smoke.
- Drinking high levels of alcohol contributes to an increase in chronic obstructive lung disease.
- Obesity is correlated with a higher risk of type 2 diabetes
- The lower the body mass index (BMI) the lower the risk of chronic illness
- Obesity is correlated with a higher risk of type 2 diabetes
The U.S. health-care system functions by managing and paying for illness by focusing on one problem at a time. The nurse practitioner analyzes this system and concludes it is ineffective because:
- As the number of comorbidities increases, so do the risks.
- Unintended outcomes of the one disease model include the collaboration of medical advice.
- There is no knowledge gap regarding people with multiple chronic conditions (MCCs).
- One in ten Medicare recipients has more than one chronic illness.
- As the number of comorbidities increases, so do the risks.
The nurse practitioner whose practice consists of geriatric-aged patients must consider which of the following when working with patients who experience multiple chronic illnesses?
- Addictions in older adults are predicted to decline in the next 20 years.
- Mental illness or behavior problems must be included as chronic conditions.
