ATI RN
bates physical assessment test bank Questions
Question 1 of 5
An older client is diagnosed with osteoarthritis. Which of the following should the nurse encourage the client to do?
Correct Answer: B
Rationale: In the case of an older client diagnosed with osteoarthritis, it is crucial for the nurse to encourage the use of heat and cold therapy for pain management, which is the correct answer (B). Heat therapy helps to improve blood circulation, relax muscles, and reduce stiffness in the joints, providing relief from pain and discomfort associated with osteoarthritis. On the other hand, cold therapy helps to reduce inflammation, numb the area, and alleviate acute pain. Encouraging joint immobility (option A) would actually worsen the symptoms of osteoarthritis as movement and exercise are essential for maintaining joint flexibility and strength. Taking aspirin in large doses (option C) can lead to adverse effects, especially in older adults, such as gastrointestinal bleeding and kidney damage. It is important to use medications for pain relief under the guidance of a healthcare provider. Resting in bed for long periods of time (option D) can lead to muscle weakness, joint stiffness, and limited mobility, exacerbating the symptoms of osteoarthritis. Encouraging physical activity within the limits of the individual's capabilities is vital for managing osteoarthritis effectively. In an educational context, understanding the rationale behind the recommended interventions for osteoarthritis is essential for nurses to provide optimal care to their patients. It is important to promote evidence-based practices that prioritize patient safety and well-being while effectively managing their symptoms and improving their quality of life.
Question 2 of 5
The nurse is assessing an older client who is at risk for falls. Which of the following should be prioritized in the care plan?
Correct Answer: B
Rationale: In caring for an older client at risk for falls, improving strength and balance should be prioritized in the care plan. This is because enhancing these factors can directly reduce the risk of falls by improving the client's stability and ability to navigate their environment safely. By focusing on strength and balance, the client is better equipped to prevent falls and maintain independence. Repositioning the client frequently, while important for comfort and preventing pressure injuries, does not address the root cause of falls. Encouraging the client to use a walker at all times may limit their mobility and independence if not necessary. Promoting regular sleep patterns, although important for overall health, does not directly address the risk of falls in this case. Educationally, it is crucial for nurses to understand the multifactorial nature of falls in older adults and prioritize interventions that target modifiable risk factors like strength and balance. By focusing on evidence-based practices like strength training and balance exercises, nurses can effectively reduce the incidence of falls and promote the well-being of their older adult patients.
Question 3 of 5
An 84-year-old male with a history of stroke without residual deficit, systolic heart failure, and type 2 diabetes presents to clinic for follow-up. He is independently living in a retirement community and still works part-time on a golf course. He currently takes aspirin 81 mg, metoprolol tartrate 25 mg BID (twice a day), furosemide 20 mg BID, and lisinopril 10 mg daily. He reports his last colonoscopy was 8 years ago, with no abnormality. He reports he is sexually active with men and women, engaging in receptive oral, receptive anal, and penetrative sex. He states he has had over three sexual partners in the last year with intermittent condom use.
Correct Answer: D
Rationale: The correct answer is D) Urine testing, blood testing, anal swab, and oropharyngeal swab. In this case, the patient's sexual history, including engaging in high-risk sexual behaviors, puts him at risk for sexually transmitted infections (STIs). Given his age and medical history, it is crucial to conduct a comprehensive screening for STIs. Urine testing can detect infections like chlamydia and gonorrhea, while blood testing can screen for HIV and syphilis. An anal swab is necessary to check for infections like rectal chlamydia and gonorrhea, which are common in individuals engaging in receptive anal sex. Additionally, an oropharyngeal swab is important to screen for STIs like gonorrhea and chlamydia in the throat, especially considering the patient's sexual practices. Options A, B, and C are incorrect because they do not encompass the comprehensive testing needed for this patient based on his sexual history. Failing to conduct the appropriate screenings could result in undiagnosed and untreated STIs, leading to serious health consequences for the patient. From an educational standpoint, this case highlights the importance of taking a thorough sexual history and conducting appropriate screenings for STIs in all patients, especially in older adults who may engage in risky behaviors. It emphasizes the need for healthcare providers to be nonjudgmental, thorough, and proactive in addressing sexual health concerns to provide comprehensive care for their patients.
Question 4 of 5
Which is the most reasonable first step in the treatment of older men with erectile dysfunction?
Correct Answer: B
Rationale: In older men with erectile dysfunction, the most reasonable first step in treatment is often addressing any underlying hormonal imbalances. Testosterone supplementation (Option B) can be a crucial intervention as testosterone levels naturally decline with age and can contribute to erectile dysfunction. By replenishing testosterone levels, improvements in sexual function may be observed. Regarding the other options: - Sex therapy (Option A) may be beneficial in some cases, but addressing hormonal imbalances should be prioritized in older men with erectile dysfunction. - Yohimbine (Option C) is an herbal supplement that has shown some efficacy in treating erectile dysfunction, but it is not typically recommended as the first-line treatment. - Sildenafil (Option D) is a phosphodiesterase type 5 inhibitor commonly prescribed for erectile dysfunction. While effective, it is usually considered after ruling out hormonal issues in older men due to the potential side effects and interactions with other medications. Educationally, understanding the importance of assessing and addressing hormonal imbalances in older men with erectile dysfunction is crucial for healthcare providers. This knowledge helps in tailoring treatment plans to individual needs, considering both the efficacy and safety of interventions. By prioritizing the correction of hormonal imbalances, healthcare professionals can optimize outcomes for this patient population.
Question 5 of 5
On admission to the hospital, an 85-year-old woman was found to have a fungating mass on her right breast. The mass is 9 cm in diameter, partially ulcerated, and associated with edema of the arm and obvious pain. The patient has no children and had lived alone until recently, when a neighbor became concerned for what appeared to be a progressive loss of memory and neglect of the house. A nephew living in another city eventually came to take care of the situation and arranged for the admission. The patient appears confused and withdrawn; her appearance is disheveled, but she seems to be independent in her ADLs. The medical history is negative for any serious illnesses. She was able to drive her own car until shortly before this admission. The nephew does not wish to authorize hospice “right now.” A positron-emission tomography scan was negative for metastatic disease. In addition to determining the cause of her delirium, which of the following is the best way to address the breast mass?
Correct Answer: E
Rationale: The correct answer is likely missing from the options provided, but based on the scenario described, the best way to address the breast mass in this 85-year-old woman would be to consider a multidisciplinary approach involving a palliative care team. Given her advanced age, presence of a fungating mass, associated pain, edema, and confusion, focusing on quality of life and symptom management would be paramount. Option A suggests initiating Tamoxifen and potentially chemotherapy, which may not be appropriate in a palliative care context where the primary goal is to alleviate symptoms and improve quality of life rather than aggressive treatment for cure. Option B recommends biopsying the mass to study hormone receptor and HER2/neu antigen status. While this information may be valuable in certain cases, in this scenario with a patient who is elderly, confused, and with advanced disease, the focus should be on symptom management rather than further invasive procedures. Option C suggests surgery as initial treatment, which may not be suitable for a patient of this age with advanced disease and multiple comorbidities. Surgical interventions can be aggressive and may not align with the patient's goals of care and quality of life at this stage. Option D proposes radiation therapy, which again may not be the most appropriate choice for a patient in palliative care. Radiation therapy can be burdensome for elderly patients, especially those with advanced disease and limited life expectancy. In an educational context, it is crucial for healthcare providers to understand the principles of palliative care and individualized treatment plans based on a patient's goals, values, and quality of life. Palliative care focuses on holistic symptom management, psychosocial support, and enhancing the patient's comfort and well-being in situations where curative treatment is not the primary goal.