ANCC FNP Board Questions 100%
Verified Questions & Answers Nursing Care of
Older Adult Module 5
The nurse practitioner sees an older adult patient in the clinic with the
primary report of hearing loss and a sensation of fullness in the right
ear. The nurse practitioner suspects conductive hearing loss. Which
could contribute to this? - Answer Cerumen, commonly called earwax,
is a combination of secretions and sloughed epithelial cells that
protects the ears from infection, water, and insects. It is normally
expelled from the ear canal through natural jaw movement. When this
self-cleaning process fails, cerumen can become impacted. Cerumen
impaction occludes the ear canal and can press against the tympanic
membrane, resulting in conductive hearing loss.
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Conductive hearing is the transition of sound from the external and
middle ear to the inner ear. Conductive hearing loss is caused by
problems in the external and middle ear that interfere with the
transmission of sound and its conversion to mechanical vibration.
Causes of conductive hearing loss include obstruction of the external
auditory canal by cerumen, foreign bodies, debris from otitis externa,
and large exocytosis and osteomas.
Sensorineural hearing loss involves difficulty converting mechanical
vibrations to electrical potential in the cochlea or in auditory nerve
transmission to the brain. It is mostly caused by permanent damage in
,the organ of Corti. It can be caused by age-related hearing loss, noise
trauma, medications, autoimmune diseases, mechanical trauma,
Meniere disease, infection, and neoplasm (acoustic neuroma).
Approximately one-third of older adults between the ages of 61 and 70
years have hearing loss. More than 90% of adults older than 85 years of
age have hearing loss. The most common type of hearing loss is age-
related and sensorineural. All adults older than 60 years of age should
be screened for hearing loss at periodic health examinations.
An otherwise healthy adult patient presents to the clinic with a
diagnosis of community-acquired pneumonia and no recent antibiotic
therapy. Which is the best option for treatment? - Answer Amoxicillin
High-dose amoxicillin (Amoxil) or doxycycline are recommended as
first-line therapy for adults without comorbidities.
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Community-acquired pneumonia (CAP) is pneumonia not acquired in a
hospital or long-term care facility. Patients with suspected CAP should
receive a chest X-ray for diagnosis. The Pneumonia Severity Index
should be used to assist in decisions regarding the need for
hospitalization in patients with CAP.
According to the American Thoracic Society (ATS) and the Infectious
Diseases Society of America (IDSA) 2019 guidelines, the initial
treatment of CAP for most patients is amoxicillin or doxycycline.
Macrolides are an option for treatment, but are no longer
recommended routinely as first-line treatment, given increased
,macrolide resistance. This is a change from the 2007 ATS/IDSA
guidelines. Respiratory fluoroquinolones and amoxicillin/clavulanate
should be used in patients who fail first-line medications, have
significant comorbidities, have had recent antibiotic therapy, are
allergic to alternative agents, or have a documented infection with
highly drug-resistant pneumococci.
A patient presents to the clinic for conception counseling. She recently
stopped taking oral contraceptives and would like to become pregnant.
Which statement about conception safety after stopping oral
contraceptives is correct? - Answer
You have a 35-year-old female patient who is complaining of wrist pain.
She is an administrative assistant who does a great deal of computer
work in her job. You will test her for carpal tunnel syndrome. When you
tap at the volar surface of the wrist you are performing which of the
following tests? - Answer Tinel's sign
A gastrinoma located on the pancreas or the stomach which secretes
gastrin, stimulating high levels of acid production in the stomach is
which of the following? - Answer Zollinger-Ellison syndrome
A 16-year-old male is in the office. He has a insect bite on his left
forearm and you suspect a brown recluse spider bite. What medical
management would you provide? - Answer ice pack and elevation of
the area
, In addition to being overweight, the American Diabetes Association
recommends type 2 diabetes mellitus testing in adults who: - Answer
have an HDL level of < 35 mg/dL
Which of the following found on an ECG would confirm atrial
fibrillation? - Answer -absent P waves
-irregular ventricular rate
As an FNP you understand that all of the following statements about
chronic heart failure are accurate EXCEPT: - Answer -The
preponderance is in females until the age of 75, then there is equal
occurrence in males and females.
-Patients who are underweight have a greater risk of CHF.
The FNP has a 45-year-old male patient with BPH who has poison ivy.
The FNP plans to prescribe Benadryl for this. What is a possible adverse
effect with the use of Benadryl for this patient? - Answer urinary
retention
You are testing a client suspected of having Parkinson's disease. You
support the client's elbow with his forearm extended in your hand and
grasp his wrist, flexing the forearm. You find rigid resistance to this
motion. This is considered which of the following? - Answer
cogwheeling
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