An older adult client comes to the healthcare provider's office for a routine follow up exam for high blood pressure, osteoarthritis, constipation, and chronic sinusitis. The client recently had a cataract removed from the left eye. Which is most important for the nurse to address when obtaining this client's health history?

Conduct an assessment of functional capacity and environmental hazards.

Obtain a medication history including prescription and non prescription drugs.

Distinguish between symptoms caused by disease and those due to aging.

Emphasize the need to place advance directives in the medical record.

Answer and Explanation

The Correct Answer is A

A.   Assessing the client's functional capacity and identifying potential environmental hazards is essential, especially in older adults, as they may face physical limitations or risks in their environment that could impact their safety and quality of life.
B.   Medication history is always important, particularly in older adults who may be taking multiple medications for chronic conditions. However, while relevant, it is not the most critical aspect in this scenario.
C.   Differentiating between symptoms of aging and those caused by disease is important for accurate diagnosis and treatment. However, the priority should be to assess the client's overall health and risks related to their daily function and environment.
D.   While discussing advance directives is essential for future care planning, it is not the immediate priority in this health history assessment. The focus should be on addressing any current health issues that impact the client’s quality of life.

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Correct Answer is D

Explanation

A. A history of a fractured patella could potentially cause crepitation if there were long-term damage or improper healing. However, it is more likely that crepitation is related to degenerative changes, such as osteoarthritis.
B. Needle aspiration of the synovial space may have been performed to relieve fluid buildup or inflammation, but it would not directly explain the crepitation in the joint. Crepitation is more commonly seen in conditions that affect cartilage or joint surfaces.
C. Crepitation following knee arthroplasty is possible if there are complications, but it is more likely due to arthritis or degenerative joint disease if the patient has not undergone surgery. Arthroplasty would usually be associated with reduced crepitation.
D. Degenerative diseases, such as osteoarthritis, are the most likely cause of crepitation. As the cartilage wears away, the bone surfaces rub together, causing the characteristic crunching or grating sound when the joint is moved.

A. Decrease the need for rapid eye movement (REM) sleep. B. He would sleep soundly during the first half of the night, with increased arousals during the second half. C. Increase sleep latency, and reduce total sleep time. D. He would have difficulty falling to sleep, and sleep very lightly with more frequent arousals.

Correct Answer is C

Explanation

A. Nicotine’s impact on REM sleep is not as direct as this option suggests. REM sleep can be reduced, but
it is not directly linked to a decreased need for REM sleep.
B. This option may be true for some individuals, but smoking typically causes disruptions throughout the night, not just in the second half.
C. Smoking has been shown to increase sleep latency (the time it takes to fall asleep) and reduce total sleep time due to nicotine’s stimulant effect and withdrawal symptoms during sleep.
D. Difficulty falling asleep and light sleep with frequent arousals are common effects of smoking due to
nicotine’s stimulant properties and withdrawal during the night.

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Naxlex Comprehensive Predictor Exams

When assessing a client's range of motion, the nurse notes crepitation with movement of the left knee. Which information in the client's history is most likely related to this finding?

Correct Answer is D

Explanation

An adult male client tells the nurse that he smokes approximately one pack of cigarettes daily. How can the nurse expect smoking to affect this client's sleep?

Correct Answer is C

Explanation

The college health clinic nurse is preparing a seminar on testicular self-examination (TSE). Which instruction should be included in the content for this seminar?

When assessing an older adult client, which finding is most indicative of dehydration?

While conducting a physical assessment, the nurse shines a pen light into a client's right eye and moves the light source to check the client's left eye. Which finding indicates the need for further evaluation?

During the precordium assessment, the nurse palpates the apical impulse of a client on the 5th intercostal space left mid-clavicular line. The pulse is more vigorous than expected. Which action should the nurse take in response to this finding?

When performing a skin and nail exam on an older adult female client, the nurse notes that she has longitudinal ridges on her fingernails. What does this finding indicate?

Which subjective assessment data supports the nurse's conclusion that a client is experiencing orthopnea?

Patient Data Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.