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NU 627 GERIATRIC HEALTHCARE EXAM HERZING UNI 2024.
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NU 627 GERIATRIC HEALTHCARE EXAM HERZING UNI 2024.NU 627 GERIATRIC HEALTHCARE EXAM HERZING UNI 2024.
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NU 627GERIATRIC
HEALTHCARE
EXAM
QNS & ANS
2023/2024
,1. A 75-year-old woman with a history of hypertension, diabetes and osteoarthritis visits the
primary care clinic for a routine check-up. She reports feeling tired, depressed and lonely
since her husband passed away six months ago. She lives alone and has limited social
support. What is the most appropriate nursing intervention for this patient?
a) Refer her to a psychiatrist for antidepressant medication.
b) Encourage her to join a bereavement support group or a senior center.
c) Advise her to exercise regularly and eat a balanced diet.
d) Assess her for signs of cognitive impairment or dementia.
*Answer: b) Encourage her to join a bereavement support group or a senior center.*
Rationale: Older adults who experience loss of a spouse are at risk of social isolation,
depression and poor quality of life. Nursing interventions should focus on promoting their
psychosocial well-being and enhancing their coping skills. Referring the patient to a support
group or a senior center can help her connect with others who share similar experiences and
provide emotional and practical support. While exercise, nutrition and cognitive assessment
are also important aspects of care, they are not the priority in this case.
2. A 68-year-old man with a history of chronic obstructive pulmonary disease (COPD) and
smoking presents to the primary care clinic with worsening dyspnea, cough and sputum
production. He has been using his rescue inhaler more frequently and has difficulty
performing his daily activities. His oxygen saturation is 88% on room air. What is the most
appropriate nursing intervention for this patient?
a) Administer supplemental oxygen via nasal cannula.
b) Teach him how to use a peak flow meter to monitor his lung function.
c) Educate him on the benefits of smoking cessation and refer him to a smoking cessation
program.
d) Perform chest physiotherapy and suctioning to clear his airway secretions.
*Answer: a) Administer supplemental oxygen via nasal cannula.*
Rationale: Older adults with COPD are at risk of hypoxemia, which can lead to
complications such as pulmonary hypertension, cor pulmonale and respiratory failure.
Nursing interventions should focus on improving their oxygenation and preventing further
deterioration. Administering supplemental oxygen is the first-line treatment for hypoxemic
patients with COPD, as it can reduce dyspnea, improve exercise tolerance and prevent organ
damage. While teaching, education and chest physiotherapy are also important aspects of
care, they are not the priority in this case.
3. A 72-year-old woman with a history of osteoporosis and falls visits the primary care clinic
for a follow-up after sustaining a hip fracture. She underwent surgical repair of the fracture
and completed a course of physical therapy. She reports pain in her hip, difficulty walking
and fear of falling again. She lives alone and has no family nearby. What is the most
appropriate nursing intervention for this patient?
a) Prescribe her analgesics for pain relief and advise her to rest.
b) Refer her to an occupational therapist for home safety evaluation and modification.
c) Recommend her to take calcium and vitamin D supplements to prevent further bone loss.
,d) Arrange for home health care services to provide assistance and supervision.
*Answer: b) Refer her to an occupational therapist for home safety evaluation and
modification.*
Rationale: Older adults who have osteoporosis and falls are at risk of fractures, which can
impair their mobility, function and independence. Nursing interventions should focus on
preventing further falls and promoting their recovery and rehabilitation. Referring the patient
to an occupational therapist can help identify and eliminate potential hazards in her home
environment, such as loose rugs, cords, clutter or poor lighting, that may increase her risk of
falling. The occupational therapist can also suggest adaptive devices or equipment that can
facilitate her mobility and self-care. While pain management, nutrition and home health care
are also important aspects of care, they are not the priority in this case.
4. A 65-year-old man with a history of coronary artery disease (CAD), myocardial infarction
(MI) and hypertension visits the primary care clinic for a routine check-up. He reports chest
pain that occurs when he walks up the stairs or carries heavy objects. He takes aspirin, beta -
blockers, statins and angiotensin-converting enzyme (ACE) inhibitors as prescribed. His
blood pressure is 150/90 mmHg and his pulse is 80 beats per minute. What is the most
appropriate nursing intervention for this patient?
a) Increase his dose of beta-blockers to lower his heart rate and blood pressure.
b) Order an electrocardiogram (ECG) and cardiac enzymes to rule out another MI.
c) Teach him how to use nitroglycerin sublingually for chest pain relief and when to seek
emergency care.
d) Advise him to avoid physical exertion and stress that may trigger his chest pain.
*Answer: c) Teach him how to use nitroglycerin sublingually for chest pain relief and when
to seek emergency care.*
Rationale: Older adults with CAD and MI are at risk of angina, which is chest pain caused
by reduced blood flow to the heart muscle. Nursing interventions should focus on reli eving
their chest pain and preventing further cardiac damage. Teaching the patient how to use
nitroglycerin sublingually can help dilate his coronary arteries and improve his blood flow to
the heart, thereby reducing his chest pain. The patient should also be instructed to take one
tablet every five minutes for up to three doses, and to call 911 if the pain persists or worsens.
While increasing beta-blockers, ordering tests and avoiding triggers are also important
aspects of care, they are not the priority in this case.
5. A 70-year-old woman with a history of Alzheimer's disease and urinary incontinence
visits the primary care clinic with her daughter, who is her primary caregiver. The daughter
reports that her mother has been more confused, agitated and restless lately. She also notices
that her mother has been urinating more frequently and sometimes has a foul-smelling urine.
She wonders if her mother has a urinary tract infection (UTI). What is the most appropriate
nursing intervention for this patient?
a) Collect a urine sample for urinalysis and culture to confirm the diagnosis of UTI.
b) Prescribe her an anticholinergic medication to reduce her urinary frequency and urgency.
c) Educate her daughter on how to provide proper perineal hygiene and change her
incontinence pads regularly.
d) Suggest her daughter to use non-pharmacological strategies such as music, massage or
, aromatherapy to calm her mother down.
*Answer: a) Collect a urine sample for urinalysis and culture to confirm the diagnosis of
UTI.*
Rationale: Older adults with Alzheimer's disease and urinary incontinence are at risk of
UTIs, which can cause behavioral changes, confusion, agitation and restlessness. Nursing
interventions should focus on diagnosing and treating their UTIs promptly, as they can lead
to complications such as sepsis, delirium or renal failure. Collecting a urine sample for
urinalysis and culture is the best way to confirm the diagnosis of UTI, as it can detect the
presence of bacteria, white blood cells, nitrites or leukocyte esterase in the urine. The patient
may then be prescribed an appropriate antibiotic based on the culture results. While
prescribing anticholinergics, educating on hygiene and suggesting non-pharmacological
strategies are also important aspects of care, they are not the priority in this case.
6. A 66-year-old man with a history of prostate cancer and radical prostatectomy visits the
primary care clinic for a follow-up. He reports erectile dysfunction, urinary incontinence and
low self-esteem since his surgery. He says he feels embarrassed and frustrated by his
condition and avoids intimacy with his wife. He wonders if there is anything that can help
him restore his sexual function and confidence. What is the most appropriate nursing
intervention for this patient?
a) Refer him to a urologist for evaluation and treatment of his erectile dysfunction and
urinary incontinence.
b) Teach him how to perform pelvic floor exercises (Kegel exercises) to strengthen his
sphincter muscles and improve his bladder control.
c) Educate him on the available options for managing his erectile dysfunction, such as oral
medications, injections, vacuum devices or implants.
d) Counsel him on the psychological and emotional impact of his condition and encourage
him to communicate with his wife about his feelings and needs.
*Answer: d) Counsel him on the psychological and emotional impact of his condition and
encourage him to communicate with his wife about his feelings and needs.*
Rationale: Older adults who have prostate cancer and radical prostatectomy are at risk of
erectile dysfunction, urinary incontinence and low self-esteem, which can affect their quality
of life, relationships and sexuality. Nursing interventions should focus on addressing their
psychosocial needs and enhancing their coping skills. Counseling the patient on the
psychological and emotional impact of his condition can help him understand that his
feelings are normal and valid, and that he is not alone in his situation. Encouraging him to
communicate with his wife can help him express his concerns, fears and desires, as well as
foster intimacy, trust and support in their relationship. While referring to a urologist,
teaching pelvic floor exercises and educating on erectile dysfunction options are also
important aspects of care, they are not the priority in this case.
When a fall results in injury and hospitalization, a cycle of disuse may occur over time. When
establishing a care plan for the patient and family to prevent this, it is important to remember
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