A 78-year-old male is being treated for hypertension. The nurse knows that the most appropriate first-line therapy in older adults is:

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Question 1 of 5

A 78-year-old male is being treated for hypertension. The nurse knows that the most appropriate first-line therapy in older adults is:

Correct Answer: A

Rationale: The correct answer is A: Diuretics. In older adults, diuretics are considered the most appropriate first-line therapy for hypertension due to their effectiveness in reducing blood pressure and preventing complications such as heart failure. Diuretics are well-tolerated, have a long history of use, and are cost-effective. They are especially beneficial in older adults with volume overload or fluid retention. Beta-blockers (B) may be less effective in older adults and can have more side effects. ACE inhibitors (C) are commonly used but may pose risks of hyperkalemia and renal dysfunction in older adults. Calcium channel blockers (D) are effective but may increase the risk of falls and fractures in older adults.

Question 2 of 5

The nurse is caring for an older adult who is having difficulty with swallowing. Which intervention should the nurse implement to prevent aspiration?

Correct Answer: B

Rationale: The correct answer is B: Provide thickened liquids and soft foods. This intervention helps prevent aspiration by reducing the risk of food or liquids entering the airway. Thickened liquids are easier to control while swallowing, decreasing the chance of aspiration. Soft foods are also easier to chew and swallow, further reducing the risk. Choice A is incorrect because eating quickly can increase the risk of choking and aspiration. Choice C is incorrect as lying down after meals can actually increase the risk of aspiration. Choice D is incorrect as large meals can increase the likelihood of swallowing difficulties and aspiration.

Question 3 of 5

The following information is recorded in the health history: "I feel really tired." Which category does it belong to?

Correct Answer: B

Rationale: The correct answer is B: Present illness. The statement "I feel really tired" falls under the present illness category because it describes the current health concern the individual is experiencing. This section focuses on the details of the current symptoms, their duration, severity, and any associated factors. It helps in understanding the progression and impact of the current health issue. A: Chief complaint typically refers to the main reason for seeking medical help, usually a symptom or problem that brought the individual to the healthcare provider. C: Personal and social history covers information about the individual's lifestyle, habits, and social support system. D: Review of systems involves systematically asking about symptoms related to different body systems, which is not the case in the given statement.

Question 4 of 5

A 19-year-old-college student presents to the emergency room with fever, headache, and neck pain/stiffness. She is concerned about the possibility of meningococcal meningitis. Several of her dorm mates have been vaccinated, but she hasn't been. Which of the following physical examination descriptions is most consistent with meningitis?

Correct Answer: C

Rationale: The correct answer is C. Meningitis typically presents with neck stiffness due to meningeal irritation. In choice C, the patient has a tender neck to palpation and is unable to perform range of motion, indicating meningeal inflammation. Choices A, B, and D all describe a normal head and fundi exam, which is not consistent with meningitis. Choice B mentions muscle spasm and limited range of motion to the right, but this is more suggestive of a musculoskeletal issue rather than meningitis. Choice D describes a normal neck exam, which is not in line with the presentation of meningitis.

Question 5 of 5

You are interviewing an elderly woman in the ambulatory setting and trying to get more information about her urinary symptoms. Which of the following techniques is not a component of adaptive questioning?

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Adaptive questioning involves tailoring the questioning style to the patient's responses and needs to gather more detailed information. 2. Reassuring the patient that the symptoms are benign and not related to cancer is not a component of adaptive questioning as it can lead to bias and may hinder the patient from providing accurate information. 3. Directed questioning (A) helps to gather specific information systematically, offering choices (C) helps clarify symptoms, and asking for specific details (D) aids in understanding the patient's experiences. 4. By reassuring the patient prematurely, you may miss important details or dismiss potential concerns that could be relevant to the patient's condition.

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