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MARYVILLE NURS 623 EXAM 4
QUESTIONS & ANSWERS
1. What is important to note when a patient has traumatic injury
ANS If taking Blood Thinners
2. Define delirium
ANS Underlying acute cause, abrupt onset, hours to days, re- versible, hallucinations, incoherent speech, confusion
3. Define Dementia
ANS Various causes, gradual change with mental status, months to years, progressive to irreversible (speech, memory, mood, judgment)
4. An older adult with delirium would present with what type of behaviors?-
ANS Agitation and restlessness
5. At the onset of alzheimers, what category of medications should be initi-
ated? ANS Cholinesterase inhibitors
6. what factors contribute to a patient being high risk for falls?
ANS History of falls medications vision impairment heart rate/rhythm abnormalities footwear issues home environment
gait/mobility issues poor reflexes
7. What is the primary reason people have long term effects after a Stroke
ANS - living at home and calling PCP instead of 911 leads to prolonged stroke symptoms and long term effects
8. S/S of an Absense Seizure
ANS Blank stare (upward rotation of eye)
9. Red Flags of back/neck pain
ANS Incontinence Fever Cancers Unexplained wt loss Long term steroids Trauma IV drug abuse Intense local pain No comfy Position
10. Diagnosing of Alzheimer's
ANS Impaired ability to learn new info along with a disturbance in language, function, or perception
11. S/S of Alzheimer's
ANS *C/O memory problems
* ‘ cognitive difficulty
* ‘ slow response to cognitive challenge
18. Clinical manifestations of Articular disorders?
ANS *characterized by deep or diffuse pain, pain or limited ROM on active and passive movement *swelling *crepitus
19. Clinical manifestations of Non-Articular disorders?
ANS *Tend to be painful on active but not passive (assisted) ROM. *Seldom demonstrate swelling, crepitus, instability, or deformity by itself.
20. What diagnostic assessment is most useful in a patient who presents with
lumbar radiculopathy? ANS The straight leg raise (assesses L5-S1). pain would indicate most common disc herniation
21. What cranial nerve is affected in Bell's Palsy?
ANS CN VII
22. S/S of Bell's Palsy
ANS * Acute onset one-sided Facial paralysis with normal ocular movement and sensation
* Affects CN VII (facial)-VII(vestibulocochlear)
* Loss of taste (dysgeusia)
* Postauricular pain
* Sound sensitivity (hyperacusis)
* Heavy feeling in face
23. How is Bell's Palsy diagnosed?
ANS Clinical history and exam
24. What is a serious risk in patients with Bell's Palsey?
ANS Loss of the ability to blink and close the eyelid subjects the cornea to drying and ulceration
25. Patient teaching for Bell's Palsey
ANS *reassure it is self-limiting with 3-6 month recovery *prevent corneal ulceration/ use artificial tears
26. *unilateral and tends to have a throbbing or pulsatile (head)
*precipitated by aura *nausea *vomiting *photophobia *phonophobia ANS S/S of Migraine H/A
27. A patient reports seeing flashes 20 minutes before having a severe H/A
what type of H/A is it? ANS Classic migraine
28. *unilateral orbital, supraorbital, and/or temporal (headache)
*causes lacrimation, rhinorrhea, and nasal congestion) ANS S/S of cluster H/A
29. bilateral, non-pulsating, tightening (head) pain that is not aggravated
by routine physical activity. It is usually not accompanied by nausea and
36. Can cause neck pain, radiating arm pain, shoulder pain, and numbness or
tingling in the arm or hand. The quality and type of pain can vary from dull, aching, and difficult to localize to sharp, burning, and easy to pinpoint, Can cause weakness in arm (s) ANS Ruptured Cervical Disc
37. In elderly patients, fracture of WHAT would lead to potentially fatal out-
comes or problematic long term issues in elderly patients, ANS Hip Fracture
38. What is gold standard test for dx osteoporosis?
ANS DEXA Bone Density test
39. Was is an important step during examination of an ortho complaint to
be able to have a comparative value of both extremities ANS always exam the non-effected side and then effected side for comparison
40. What medications cause a patient to be at risk for developing osteoporo-
sis? ANS • Glucocorticoids
- Excessive thyroxine
- Long-term phenytoin
41. What populations are at risk for developing osteoporosis?
ANS • Age (65+)
* medications
42. In a patient who is elderly and falls (does not remember the fall), but there
is no clear cause of falls, what should your workup center around? ANS syncope associated with Cardiac and neurologic causes
43. If a patient is alert and oriented and refuses to give consent for a proce-
dure, how do you move forward as a provider? ANS Respec their wishes, Discuss risks of NOT having procedure, abort procedure, document refusal
44. In elderly patients, what factors can contribute to loss of appetite and
malnourishment? ANS *Diminished taste/smell/vision *dry mouth *poor dentition *chronic illness *meds *pain *depression *loneliness
45. How would you assess for a suspected meniscal tear with a physical
exam? ANS McMurray circumduction test.
* Adequate nutrition (Vit D, calcium, Protein)
*Vit D & Calcium Supplements
*Weight bearing exercises
53. Nodes on (distal) DIP joints secondary to osteoarthritis
ANS Heberden's nodes
54. bony nodes at the proximal interphalangeal joints associated with OA
ANS -
Bouchard's nodes
55. Inflammation of the tendon sheath, also called "mommy thumb"
ANS DeQuer- vains Tenosynovitis Use Finkelstein test (tuck thumb, abduct wrist)
56. Type of fracture secondary to systemic disease
ANS Pathologic fracture
57. an injury to the bone caused by overuse
ANS Stress fracture
58. Common cause of posterior knee pain
ANS Bakers cyst Secondary to other process - osteoarthritis #
59. A distressing Unilateral, painful electric shock sensation (cranial nerve V)
AKA
ANS tic douloureux (unbearable painful twitch). ANS Trigeminal Neuralgia
60. Differentiate between dizziness and vertigo
ANS *Dizziness - sensation of un- steady, feeling of movement in the head *Vertigo - feeling of spinning when you are not moving
61. involves vestibular system, most common causes are benign positional
vertigo, vestibular neuritis, Meniere disease, Imbalance mild to moderate, able to walk, Latency usually 20 minutes ANS Peripheral Vertigo
62. result from lesions affecting the brainstem and cerebellum, imbalance
severe cant walk, Latency usually 5 minutes ANS Central vertigo
63. What is used to treat edema in the labyrinth with Peripheral Vestibular
Disease? ANS Diamox
64. What antibiotic would not require adjusting in the elderly?
ANS Tobramycin
65. What is considered a normal age-related lab change
ANS Increased ESR
