A nurse is preparing a presentation at a senior center about age-related musculoskeletal changes. Which of the following changes should the nurse plan to include?
Reduced chest width
Increased force of isometric contraction
Decreased muscle mass
Thickened vertebral discs
The Correct Answer is C
Choice A reason:
Reduced chest width: Aging does not typically result in a reduced chest width. Instead, changes in posture and the curvature of the spine can make the chest appear less prominent. The primary musculoskeletal changes with aging involve bone density, muscle mass, and joint flexibility
Choice B reason:
Increased force of isometric contraction: This is incorrect. Aging is associated with a decrease in muscle strength and mass, not an increase. The force of muscle contractions generally diminishes with age due to the loss of muscle fibers and changes in muscle composition.
Choice C reason:
Decreased muscle mass: This is correct. One of the most significant age-related musculoskeletal changes is sarcopenia, which is the loss of muscle mass and strength. This process begins around the age of 30 and accelerates with age, leading to decreased physical strength and increased risk of falls and fractures.
Choice D reason:
Thickened vertebral discs: Aging typically leads to the thinning and dehydration of intervertebral discs, not thickening. This can result in a reduction in height and increased susceptibility to spinal issues such as herniated discs and spinal stenosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Place a black tag on the client’s upper body and attempt to help the next client in need: In mass casualty incidents, triage is used to prioritize treatment based on the severity of injuries and the likelihood of survival. A black tag indicates that the victim is deceased or has injuries that are not compatible with life and that resources should be directed to those who have a better chance of survival. Since the client remains apneic even after repositioning the airway, it indicates that they are not breathing and have a very low chance of survival.
Choice B reason:
Reposition the client’s upper airway a second time before assessing his respirations: While ensuring the airway is open is crucial, if the client remains apneic after the initial repositioning, further attempts are unlikely to be successful in a mass casualty scenario where time and resources are limited2. The priority is to move on to other victims who may have a higher chance of survival.
Choice C reason:
Start CPR: In a mass casualty situation, CPR is typically not initiated for victims who are apneic and pulseless due to the need to allocate resources to those who have a higher likelihood of survival3. The focus is on providing immediate care to those who can benefit the most from it.
Choice D reason:
Place a red tag on the client’s upper body and obtain immediate help from other personnel: A red tag is used for victims who require immediate life-saving interventions and have a high chance of survival if treated promptly4. Since the client is apneic and remains so after airway repositioning, they do not meet the criteria for a red tag.
Correct Answer is ["A","E"]
Explanation
Choice A Reason: Administer acetaminophen
Administering acetaminophen is a common intervention for reducing fever. In this case, the child’s temperature has risen significantly from 37.3°C (99.1°F) at 0900 to 39.9°C (103.8°F) at 1300. A fever of 39.9°C is considered high and can cause discomfort and other complications if not managed. Acetaminophen is an antipyretic medication that helps lower body temperature and provides relief from fever. It is important to monitor the child’s temperature and ensure it returns to a normal range, which is typically around 36.5°C to 37.5°C (97.7°F to 99.5°F) for school-age children.
Choice B Reason: Have the child wear a mask
Having the child wear a mask is a preventive measure to reduce the spread of respiratory infections. While this intervention is important in certain contexts, such as during flu season or in the presence of contagious illnesses, it is not directly related to managing an acute asthma exacerbation. Masks can help prevent the spread of infections, but they do not address the immediate respiratory distress and wheezing observed in the child. Therefore, this choice is not the most appropriate intervention for the current situation.
Choice C Reason: Administer a dose of montelukast
Montelukast is a leukotriene receptor antagonist used for long-term management of asthma and allergic rhinitis. It helps reduce inflammation and prevent asthma attacks. However, montelukast is not typically used for immediate relief during an acute asthma exacerbation. It is more effective as a maintenance medication taken regularly to control chronic asthma symptoms. In this scenario, the child requires immediate relief from respiratory distress, making montelukast an inappropriate choice for acute intervention.
Choice D Reason: Encourage oral fluids
Encouraging oral fluids is a supportive measure to ensure the child remains hydrated. Hydration is important for overall health and can help thin mucus secretions, making it easier for the child to breathe. However, while hydration is beneficial, it is not the primary intervention needed to address the acute respiratory distress and wheezing observed in the child. Therefore, this choice alone is not sufficient to manage the current asthma exacerbation.
Respiratory system
Choice A Reason: Administer albuterol nebulizer
Administering an albuterol nebulizer is the most appropriate intervention for managing an acute asthma exacerbation. Albuterol is a short-acting beta-agonist that works by relaxing the muscles around the airways, allowing them to open up and improve airflow. This medication provides quick relief from symptoms such as wheezing, shortness of breath, and chest tightness. In this case, the child is experiencing respiratory distress and wheezing, making albuterol the most effective choice for immediate relief. The normal respiratory rate for school-age children is 18-25 breaths per minute, and the child’s rate of 26 breaths per minute indicates respiratory distress.
Choice B Reason: Evaluate the child’s peak flow
Evaluating the child’s peak flow involves measuring the maximum speed at which the child can exhale. This assessment helps determine the severity of the asthma exacerbation and the effectiveness of the treatment. Peak flow measurements can guide clinical decisions and adjustments to the child’s asthma management plan. However, during an acute asthma attack, the priority is to provide immediate relief from symptoms. While peak flow evaluation is valuable for ongoing asthma management, it is not the primary intervention needed to address the acute respiratory distress and wheezing observed in the child.
Choice C Reason: Initiate chest percussions
Initiating chest percussions involves rhythmic tapping on the chest to help loosen and mobilize mucus in the airways. This technique can be beneficial for individuals with conditions that cause excessive mucus production, such as cystic fibrosis. However, in the context of an acute asthma exacerbation, the primary concern is bronchoconstriction and inflammation, not mucus clearance. The child requires interventions that directly address airway constriction, such as bronchodilators. Therefore, while chest percussions may be helpful in certain situations, they are not the most appropriate intervention for managing acute asthma symptoms.
Choice D Reason: Have the child sit upright in a position of comfort
Having the child sit upright in a position of comfort can help improve breathing by allowing the lungs to expand more fully. This position can reduce the work of breathing and provide some relief from respiratory distress. While this intervention is supportive and can be beneficial, it is not sufficient on its own to manage an acute asthma exacerbation. The child requires pharmacological interventions, such as bronchodilators, to relieve bronchoconstriction and improve airflow. Therefore, while sitting upright is helpful, it should be combined with other interventions for optimal management of acute asthma symptoms.
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