NRNPg6540gAdvancedgPracticegCaregOfgOldergAdultsgNEWg2023gAPPROVEDgEXA
M
NRNP 6540 FINAL EXAM 2023 ACCURATE SPRINGSU
g g g g g g
MMER QUARTER COMPLETE EXAM CITED AND
g g g g g
REFERENCED EXAM (GUARANTEED PASS)
g g g
1. Mrs.gSmith,g75gyearsgold,greportsgthatgshegisgweak,ghasgdifficultygurinating,gandgisgdehydrated.g
Althoughgshegisgafebrile,gthegnursegconductsgagthoroughgphysicalgexamination,gincludinggurinalysi
sgandgcompletegbloodgcountg(CBC).gThegtotalgassessmentgisgnecessarygbecause:
1. Allgbodygsystemsginteract,gandgsymptomsgcouldgindicategagvarietygofgdiagnoses.
2. Thegsymptomsgaregvaguegandgmaygbegsignsgofgaging.
3. Theregmaygbegothergsignsgorgsymptomsgmoregindicativegofgthegcondition.
4. Mrs.gSmithgmaygnotgbegreportinggallgsignificantginformation.g-g1.gSelectedganswer:g1gPage:g2
Feedback
g1.
Thegcliniciangmustgbegawaregthatgallgthegsystemsginteractgand,gingdoinggso,gcangincreasegthegoldergpers
on'sgvulnerabilitygtogillness/disease.
2.
Thegnursegmustgnotgattributegsymptomsgonlygtogthegaginggprocess
.g3.
Theregmaygbegcomorbiditiesgaccompanyinggthisgcondition.
4.gAssumptionsgofgnotgreportinggproperlygmaygnotgbeg
true.
2. Agpatientgwithgrenalgdiseaseghasgbloodgworkgdrawn,gandgthegresultsgshowgangincreasegingseru
mgcreatinine.gThegnursegpractitionergneedsgtogknowgwhichgofgthegfollowingglaboratorygvaluesgbe
foregorderinggmedications?
1. CBC
2. Culturegandgsensitivitygofgthegurine
3. Creatininegclearance
4. Uricgacidglevelsg-g2.gSelectedganswer:g3gPage:g3
Feedback
g1.
AgCBCgwillgnotgevaluategkidneygfunctiongforgagpatientgwithgrenalgdiseas
e.g2.
Agculturegandgsensitivitygtestgreflectsgthegpresencegofganginfectiongandgthegantibioticgtogwhichgthegorg
anismgisgsensitive.
3.
,NRNPg6540gAdvancedgPracticegCaregOfgOldergAdultsgNEWg2023gAPPROVEDgEXA
M
Thegcalculationgofgcreatininegclearancegprovidesgangestimationgofgrenalgfunction.
4. Uricgacidglevelgisgelevatedgingthegpresenceg
ofggout.
3. Whichgofgthegfollowinggstatementsgisgtruegregardinggdiagnosticgtesting?
1. Agtestgisgorderedgforgagspecificgpurpose.
2. Agtestgisgthegmostginvasivegavailable.
3. Theregisgnogneedgtogdiscussgresultsgwithgthegpatient.
4. Ifgagtestgisgneeded,gitgshouldgbegorderedgregardlessgofgriskgtogthegpatient.g-
g3.gSelectedganswer:g1gPage:g3
Feedback
g1.
Thegnursegpractitionergshouldghavegagplangforgthegusegofgeachgtestgresultgvaluegobtaine
d.g2.
Whengconsideringgwhichglaboratorygtestsgtogorder,gitgisgworthgrememberinggthegdoctrinegprimumgnogn
nocere—first,gdognogharm.
3.
Onceglaboratorygtestsgaregavailablegforgreview,gtestsgresultsgshouldgbegdiscussedgwithgthegpatient,gwith
abnormalgtestgresultsginterpretedgforgthegaginggindividualgandgaddressedgwithgthegpatientgandgcaregiver
s.
4.
Anygrisksginvolvedginglaboratorygtestinggmustgbegconsideredgconcerninggthegpatient'sgclinicalgconditio
ngandgweighedgagainstgthegtest'sgexpectedgbenefits.
4. Janey,g25gyearsgold,gmaygexperiencegarthritisgdifferentlygthang65-year-oldgMrs.gJohnsongbecause:
1. Thegbodygundergoesgphysiologicalgchangesgwithgaging.
2. Aghealthygbodygdoesgnotgexperiencegsignificantgchangesgasgoneggetsgolder.
3. Oldergpatientsgdognotgfeelganygsystemicgsymptoms,gsuchgasgmalaisegandgweightgloss.
4. Evengthoughgthegsamegjointsgaregusuallygaffected,gagegmakesgitgfeelgdifferent.g-
g4.gSelectedganswer:g1gPage:g5
Feedback
g1.
Knowledgegofgthegbimodalitygofgagegonsetgofgcertaingdiseasegconditionsgwillgaidgthegadvancedgpractic
egnursegingavoidinggmisdiagnosisgorgdelaygingdiagnosisgduegtoglackgofgrecognition.
2.
Symptomsgofgrheumatoidgarthritisgmaygbegdifferentgdependinggongthegagegofgthegpatient.
g3.
Youngergpatientsgmaygnotgexperiencegconstitutionalgsymptomsgsuchgasgfever,gmalaise,gweightgloss
,gandgdepression.
4. Inglate-onsetgrheumatoidgarthritis,gthegjointginvolvementgisgmoregoftengingtheglargergjoints.
,NRNPg6540gAdvancedgPracticegCaregOfgOldergAdultsgNEWg2023gAPPROVEDgEXA
M
5. Thegnursegpractitionergisgexamininggang85-year-
oldgmangwithgreportsgofgabdominalgpain,gweakness,gandglossgofgappetite.gWhichgisgthegmostg
likelygconditiongtogbegtestedgforgandgruledgout?
1. Neoplasmsgandgcarcinomas
2. Partialgseizure
3. Sarcopenia
4. Hirschsprung'sgdiseaseg-g5.gSelectedganswer:g1gPage:g4
Feedback
g1.
Certaingdiseases,gsuchgasgneoplasmsgandgcarcinomas,garegmoregcommongingthegelderly,gandgangunders
tandinggofgthegepidemiologygisgcriticalgingtheginterpretation.
2.
Partialgseizuregisgmoregcommongingearlygoldgage.
g3.
Sarcopeniagisgmoregcommongingearlygoldgage.
4.gHirschsprung'sgdiseasegisgmostgcommonginginf
ancy.
6. Forgindividualsgoverg65gyearsgold,gthegmostgcommongmorbiditiesgaregrelatedgto:
1. Heartgdisease,garthritis
2. Respiratorygproblems,gcancer
3. Diabetes,gstroke
4. Allgofgthesegaregcommongmorbidities.g-g6.gSelectedganswer:g4gPage:g5
Feedback
g1.
Heartgdiseasegisgonegofgthegcommongmorbidities.
g2.
Cancergisgcommongingtheggeneralgpopulation;ghowever,gspecificgtypesgaregmoregcommongingthegolderg
patient.
3.
Diabetesgisgcommongingpatientsgoverg40gyearsgofgage.
4.gHeartgdisease,gcancer,gandgdiabetesgcombinedgaregthegmostgcommongmorbiditiesgingoldergpatie
nts.
7. Aggerontologicalgpatientgisgbeinggexaminedgforgagreportgofgpaingingthegshoulder.gThegnurs
egpractitionergcompletesgagthoroughgsystemicgexaminationgbecause:
1. Oldergpatientsgwithgonegmorbiditygoftengexpressgdifficultiesginggeneral.
, NRNPg6540gAdvancedgPracticegCaregOfgOldergAdultsgNEWg2023gAPPROVEDgEXA
M
2. Arthritisgofgthegshouldergisgaccompaniedgbygothergneurologicalgsymptoms.
3. Oldergpatientsgwithgarthritisgoftengexperiencegpainginglowergextremities.
4. Thegpatientgmaygnotgreportgsignificantgsignsgandgsymptoms.g-g7.gSelectedganswer:g1gPage:g5
Feedback
g1.
Oldergpatientsgwithglate-
onsetgrheumatoidgarthritisgexperiencegjointginvolvementgmoregoftengingtheglargergjoints,gsuchgasgthegsho
ulder,gandgtheygalsogexperiencegsystemicgsymptomsgsuchgasgfever,gmalaise,gweightgloss,gandgdepressio
n.
2.
Oldergpatientsgmaygexpressgsymptomsginganygothergphysicalgsystems.
g3.
Patientsgmoregoftengexperiencegarthritisgingsmallergjoints.
4.gAgthoroughgexaminationgwillgdetectgobjectivegindic
ators.
8. Thegnursegpractitionergperformsgagthoroughgsystemicgexaminationgofgagpatientgwhogreportsgdiarrhe
agandgpaingingtheguppergleftgquadrantgofgthegabdomen.gOnegpossiblegdiagnosisgwouldgbe:
1. Hirschsprung'sgdisease
2. Pancreatitis
3. Appendicitis
4. Gastrointestinalginflammatorygbowelgdiseaseg(GIBD)g-g8.gSelectedganswer:g4gPage:g5
Feedback
g1.
Hirschsprung'sgdiseasegisgangobstructiongofgthegcolonginginfancy
.g2.
Diarrheagisgnotgassociatedgwithgpancreatitis.
g3.
Appendicitisgisgmoregcommongingyoungergpatientsgthangingoldergpatients
.g4.
GIBDgisgmanifestedgdifferentlygingagbimodalgpattern.
9. Ag70-year-
oldgmangisgseeinggagnursegpractitionergbecauseghegisgfeelinggweakgandgdizzy.gThegnursegpractitionergis
gdiscussinggagcaregplangwithghimgandgmakesgwhichgofgthegfollowinggstatements?gSelectgallgthatgapply.
1. Igwantgtogordergagtestgforgyourgheartgtogevaluategitsgfunction.
2. Igwillgperformgagthoroughgexaminationgofgyourgfunctionalgabilities.
3. Igwillgordergagbloodgsugargtestgtogcheckgforgdiabetes.
4. Manygoldergpeoplegfeelgthisgway.gItgisgtogbegexpected.
5. Igwillgassessgyougforgthegpresencegofgothergconditions.g-g9.gSelectedganswer:g1,g2,g3,g5gPage:g2,g3
M
NRNP 6540 FINAL EXAM 2023 ACCURATE SPRINGSU
g g g g g g
MMER QUARTER COMPLETE EXAM CITED AND
g g g g g
REFERENCED EXAM (GUARANTEED PASS)
g g g
1. Mrs.gSmith,g75gyearsgold,greportsgthatgshegisgweak,ghasgdifficultygurinating,gandgisgdehydrated.g
Althoughgshegisgafebrile,gthegnursegconductsgagthoroughgphysicalgexamination,gincludinggurinalysi
sgandgcompletegbloodgcountg(CBC).gThegtotalgassessmentgisgnecessarygbecause:
1. Allgbodygsystemsginteract,gandgsymptomsgcouldgindicategagvarietygofgdiagnoses.
2. Thegsymptomsgaregvaguegandgmaygbegsignsgofgaging.
3. Theregmaygbegothergsignsgorgsymptomsgmoregindicativegofgthegcondition.
4. Mrs.gSmithgmaygnotgbegreportinggallgsignificantginformation.g-g1.gSelectedganswer:g1gPage:g2
Feedback
g1.
Thegcliniciangmustgbegawaregthatgallgthegsystemsginteractgand,gingdoinggso,gcangincreasegthegoldergpers
on'sgvulnerabilitygtogillness/disease.
2.
Thegnursegmustgnotgattributegsymptomsgonlygtogthegaginggprocess
.g3.
Theregmaygbegcomorbiditiesgaccompanyinggthisgcondition.
4.gAssumptionsgofgnotgreportinggproperlygmaygnotgbeg
true.
2. Agpatientgwithgrenalgdiseaseghasgbloodgworkgdrawn,gandgthegresultsgshowgangincreasegingseru
mgcreatinine.gThegnursegpractitionergneedsgtogknowgwhichgofgthegfollowingglaboratorygvaluesgbe
foregorderinggmedications?
1. CBC
2. Culturegandgsensitivitygofgthegurine
3. Creatininegclearance
4. Uricgacidglevelsg-g2.gSelectedganswer:g3gPage:g3
Feedback
g1.
AgCBCgwillgnotgevaluategkidneygfunctiongforgagpatientgwithgrenalgdiseas
e.g2.
Agculturegandgsensitivitygtestgreflectsgthegpresencegofganginfectiongandgthegantibioticgtogwhichgthegorg
anismgisgsensitive.
3.
,NRNPg6540gAdvancedgPracticegCaregOfgOldergAdultsgNEWg2023gAPPROVEDgEXA
M
Thegcalculationgofgcreatininegclearancegprovidesgangestimationgofgrenalgfunction.
4. Uricgacidglevelgisgelevatedgingthegpresenceg
ofggout.
3. Whichgofgthegfollowinggstatementsgisgtruegregardinggdiagnosticgtesting?
1. Agtestgisgorderedgforgagspecificgpurpose.
2. Agtestgisgthegmostginvasivegavailable.
3. Theregisgnogneedgtogdiscussgresultsgwithgthegpatient.
4. Ifgagtestgisgneeded,gitgshouldgbegorderedgregardlessgofgriskgtogthegpatient.g-
g3.gSelectedganswer:g1gPage:g3
Feedback
g1.
Thegnursegpractitionergshouldghavegagplangforgthegusegofgeachgtestgresultgvaluegobtaine
d.g2.
Whengconsideringgwhichglaboratorygtestsgtogorder,gitgisgworthgrememberinggthegdoctrinegprimumgnogn
nocere—first,gdognogharm.
3.
Onceglaboratorygtestsgaregavailablegforgreview,gtestsgresultsgshouldgbegdiscussedgwithgthegpatient,gwith
abnormalgtestgresultsginterpretedgforgthegaginggindividualgandgaddressedgwithgthegpatientgandgcaregiver
s.
4.
Anygrisksginvolvedginglaboratorygtestinggmustgbegconsideredgconcerninggthegpatient'sgclinicalgconditio
ngandgweighedgagainstgthegtest'sgexpectedgbenefits.
4. Janey,g25gyearsgold,gmaygexperiencegarthritisgdifferentlygthang65-year-oldgMrs.gJohnsongbecause:
1. Thegbodygundergoesgphysiologicalgchangesgwithgaging.
2. Aghealthygbodygdoesgnotgexperiencegsignificantgchangesgasgoneggetsgolder.
3. Oldergpatientsgdognotgfeelganygsystemicgsymptoms,gsuchgasgmalaisegandgweightgloss.
4. Evengthoughgthegsamegjointsgaregusuallygaffected,gagegmakesgitgfeelgdifferent.g-
g4.gSelectedganswer:g1gPage:g5
Feedback
g1.
Knowledgegofgthegbimodalitygofgagegonsetgofgcertaingdiseasegconditionsgwillgaidgthegadvancedgpractic
egnursegingavoidinggmisdiagnosisgorgdelaygingdiagnosisgduegtoglackgofgrecognition.
2.
Symptomsgofgrheumatoidgarthritisgmaygbegdifferentgdependinggongthegagegofgthegpatient.
g3.
Youngergpatientsgmaygnotgexperiencegconstitutionalgsymptomsgsuchgasgfever,gmalaise,gweightgloss
,gandgdepression.
4. Inglate-onsetgrheumatoidgarthritis,gthegjointginvolvementgisgmoregoftengingtheglargergjoints.
,NRNPg6540gAdvancedgPracticegCaregOfgOldergAdultsgNEWg2023gAPPROVEDgEXA
M
5. Thegnursegpractitionergisgexamininggang85-year-
oldgmangwithgreportsgofgabdominalgpain,gweakness,gandglossgofgappetite.gWhichgisgthegmostg
likelygconditiongtogbegtestedgforgandgruledgout?
1. Neoplasmsgandgcarcinomas
2. Partialgseizure
3. Sarcopenia
4. Hirschsprung'sgdiseaseg-g5.gSelectedganswer:g1gPage:g4
Feedback
g1.
Certaingdiseases,gsuchgasgneoplasmsgandgcarcinomas,garegmoregcommongingthegelderly,gandgangunders
tandinggofgthegepidemiologygisgcriticalgingtheginterpretation.
2.
Partialgseizuregisgmoregcommongingearlygoldgage.
g3.
Sarcopeniagisgmoregcommongingearlygoldgage.
4.gHirschsprung'sgdiseasegisgmostgcommonginginf
ancy.
6. Forgindividualsgoverg65gyearsgold,gthegmostgcommongmorbiditiesgaregrelatedgto:
1. Heartgdisease,garthritis
2. Respiratorygproblems,gcancer
3. Diabetes,gstroke
4. Allgofgthesegaregcommongmorbidities.g-g6.gSelectedganswer:g4gPage:g5
Feedback
g1.
Heartgdiseasegisgonegofgthegcommongmorbidities.
g2.
Cancergisgcommongingtheggeneralgpopulation;ghowever,gspecificgtypesgaregmoregcommongingthegolderg
patient.
3.
Diabetesgisgcommongingpatientsgoverg40gyearsgofgage.
4.gHeartgdisease,gcancer,gandgdiabetesgcombinedgaregthegmostgcommongmorbiditiesgingoldergpatie
nts.
7. Aggerontologicalgpatientgisgbeinggexaminedgforgagreportgofgpaingingthegshoulder.gThegnurs
egpractitionergcompletesgagthoroughgsystemicgexaminationgbecause:
1. Oldergpatientsgwithgonegmorbiditygoftengexpressgdifficultiesginggeneral.
, NRNPg6540gAdvancedgPracticegCaregOfgOldergAdultsgNEWg2023gAPPROVEDgEXA
M
2. Arthritisgofgthegshouldergisgaccompaniedgbygothergneurologicalgsymptoms.
3. Oldergpatientsgwithgarthritisgoftengexperiencegpainginglowergextremities.
4. Thegpatientgmaygnotgreportgsignificantgsignsgandgsymptoms.g-g7.gSelectedganswer:g1gPage:g5
Feedback
g1.
Oldergpatientsgwithglate-
onsetgrheumatoidgarthritisgexperiencegjointginvolvementgmoregoftengingtheglargergjoints,gsuchgasgthegsho
ulder,gandgtheygalsogexperiencegsystemicgsymptomsgsuchgasgfever,gmalaise,gweightgloss,gandgdepressio
n.
2.
Oldergpatientsgmaygexpressgsymptomsginganygothergphysicalgsystems.
g3.
Patientsgmoregoftengexperiencegarthritisgingsmallergjoints.
4.gAgthoroughgexaminationgwillgdetectgobjectivegindic
ators.
8. Thegnursegpractitionergperformsgagthoroughgsystemicgexaminationgofgagpatientgwhogreportsgdiarrhe
agandgpaingingtheguppergleftgquadrantgofgthegabdomen.gOnegpossiblegdiagnosisgwouldgbe:
1. Hirschsprung'sgdisease
2. Pancreatitis
3. Appendicitis
4. Gastrointestinalginflammatorygbowelgdiseaseg(GIBD)g-g8.gSelectedganswer:g4gPage:g5
Feedback
g1.
Hirschsprung'sgdiseasegisgangobstructiongofgthegcolonginginfancy
.g2.
Diarrheagisgnotgassociatedgwithgpancreatitis.
g3.
Appendicitisgisgmoregcommongingyoungergpatientsgthangingoldergpatients
.g4.
GIBDgisgmanifestedgdifferentlygingagbimodalgpattern.
9. Ag70-year-
oldgmangisgseeinggagnursegpractitionergbecauseghegisgfeelinggweakgandgdizzy.gThegnursegpractitionergis
gdiscussinggagcaregplangwithghimgandgmakesgwhichgofgthegfollowinggstatements?gSelectgallgthatgapply.
1. Igwantgtogordergagtestgforgyourgheartgtogevaluategitsgfunction.
2. Igwillgperformgagthoroughgexaminationgofgyourgfunctionalgabilities.
3. Igwillgordergagbloodgsugargtestgtogcheckgforgdiabetes.
4. Manygoldergpeoplegfeelgthisgway.gItgisgtogbegexpected.
5. Igwillgassessgyougforgthegpresencegofgothergconditions.g-g9.gSelectedganswer:g1,g2,g3,g5gPage:g2,g3
