CARE OF OLDER ADULTS - NCLEX QUESTIONS
AND CORRECT DETAILED ANSWERS ALREADY
GRADED A
A 12-year-old girl complained to the school nurse about
back pain. The nurse's assessment revealed a deviation
of the vertebrae to the right, with a raised shoulder and
hip. What is the terminology for this finding?
A) Kyphosis
B) Lordosis
C) Osteoporosis
D) Scoliosis - correct answer - Answer D. Scoliosis is an
abnormal lateral curvature of the spine.
A 20-year-old patient is being seen in the dermatology
clinic for a basal cell carcinoma on her eye. The nurse
would expect the physician to complete which
intervention?
A) Electrosurgery
B) Mohs' micrographic surgery
C) Cryosurgery
,D) Radiation - correct answer - Answer B. Mohs'
micrographic surgery is the treatment of choice and the
most effective for tumors around the eyes, nose, upper
lip, and auricular and periauricular areas. Electrosurgery
is destruction or removal of tissue by electrical surgery.
Cryosurgery destroys the tumor by deep-freezing the
tissue. Radiation therapy is frequently performed for
cancer of the eyelid, the tip of the nose, and areas in or
near vital structures. It is reserved for older patients,
because x-ray changes may be seen after 5 to 10 years,
and malignant changes in scars may be induced by
irradiation 15 to 30 years later.
A 22-year-old man is admitted to the emergency
department with a crush injury to both lower legs. He was
pinned under a car for 3 hours. On admission, his vital
signs are stable; he is alert and oriented and complaining
of extreme pain in his legs. Popliteal pulses are strong;
pedal and posterior tibial pulses are weak. The ankle and
feet appear dusky; the skin is tense, but the skin
envelope is not broken. X-rays show no broken bones.
Based upon these data, what interventions are most
appropriate?
A) Notify the provider and anticipate that a stat V˙/Q˙
scan will be performed to rule out fat emboli.
B) Notify the provider and prepare to set up skin traction
to decrease the pressure on the calf muscle.
,C) Notify the provider and anticipate that the provider will
measure the pressure in the compartment and possibly
perform a fasciotomy if elevated pressure is noted.
D) Notify the provider and prepare to give IV antibi -
correct answer - Answer C. Fat emboli would present with
signs and symptoms of pulmonary distress, mental status
changes, and a petechial rash that develops from 6 to 72
hours after injury. Skin traction is not appropriate in this
situation; skin traction is used to treat fractures,
dislocations, and long-duration muscle spasms.
Compartment syndrome is defined as increasing pressure
between bone and fascia of the limb and often presents
with complaints of extreme pain unrelieved by pain
medication, pain on passive extension, paresthesis and
pulselessness. However, pulselessness presents late in
this disorder. The patient symptoms suggest
compartment syndrome. The provider should be notified
immediately as a delay in diagnosis and treatment of
compartment syndrome can lead to permanent nerve and
muscle damage. Compartment pressure monitoring is
useful in diagnosing this complication. Osteomyelitis
presents with fever, pain, swelling, redness, drainage,
and leukocytosis and typically occurs after several days
or weeks.
A 23-year-old patient, experienced an open fracture of
the left tibia with major soft tissue damage of his lower
leg in a bicycle accident. Surgical reduction and fixation
of the tibia were performed with debridement of
, nonviable tissue and drain placement in the damaged
soft tissue. Which finding by the nurse would most likely
indicate the development of the osteomyelitis?
A) Tachycardia
B) Elevated ESR
C) Numbness in the left leg and toes
D) Muscle spasms around the affected bone - correct
answer - Answer B. The erythrocyte sedimentation rate
(ESR), is over 90% for patients who have confirmed
osteomyelitis. However, a normal or slightly elevated ESR
does not eliminate the diagnosis. In addition, the nurse
assesses for pain over the affected bone.
A 25-year-old woman experienced an open fracture of the
right fibula with major soft tissue damage of her lower leg
in a motor vehicle accident. Surgical reduction and
fixation of the fibula were performed with débridement of
nonviable tissue and drain placement in the damaged
soft tissue. Which complication is this patient at risk for?
A) Osteoporosis
B) Osteomyelitis
C) Fat emboli
AND CORRECT DETAILED ANSWERS ALREADY
GRADED A
A 12-year-old girl complained to the school nurse about
back pain. The nurse's assessment revealed a deviation
of the vertebrae to the right, with a raised shoulder and
hip. What is the terminology for this finding?
A) Kyphosis
B) Lordosis
C) Osteoporosis
D) Scoliosis - correct answer - Answer D. Scoliosis is an
abnormal lateral curvature of the spine.
A 20-year-old patient is being seen in the dermatology
clinic for a basal cell carcinoma on her eye. The nurse
would expect the physician to complete which
intervention?
A) Electrosurgery
B) Mohs' micrographic surgery
C) Cryosurgery
,D) Radiation - correct answer - Answer B. Mohs'
micrographic surgery is the treatment of choice and the
most effective for tumors around the eyes, nose, upper
lip, and auricular and periauricular areas. Electrosurgery
is destruction or removal of tissue by electrical surgery.
Cryosurgery destroys the tumor by deep-freezing the
tissue. Radiation therapy is frequently performed for
cancer of the eyelid, the tip of the nose, and areas in or
near vital structures. It is reserved for older patients,
because x-ray changes may be seen after 5 to 10 years,
and malignant changes in scars may be induced by
irradiation 15 to 30 years later.
A 22-year-old man is admitted to the emergency
department with a crush injury to both lower legs. He was
pinned under a car for 3 hours. On admission, his vital
signs are stable; he is alert and oriented and complaining
of extreme pain in his legs. Popliteal pulses are strong;
pedal and posterior tibial pulses are weak. The ankle and
feet appear dusky; the skin is tense, but the skin
envelope is not broken. X-rays show no broken bones.
Based upon these data, what interventions are most
appropriate?
A) Notify the provider and anticipate that a stat V˙/Q˙
scan will be performed to rule out fat emboli.
B) Notify the provider and prepare to set up skin traction
to decrease the pressure on the calf muscle.
,C) Notify the provider and anticipate that the provider will
measure the pressure in the compartment and possibly
perform a fasciotomy if elevated pressure is noted.
D) Notify the provider and prepare to give IV antibi -
correct answer - Answer C. Fat emboli would present with
signs and symptoms of pulmonary distress, mental status
changes, and a petechial rash that develops from 6 to 72
hours after injury. Skin traction is not appropriate in this
situation; skin traction is used to treat fractures,
dislocations, and long-duration muscle spasms.
Compartment syndrome is defined as increasing pressure
between bone and fascia of the limb and often presents
with complaints of extreme pain unrelieved by pain
medication, pain on passive extension, paresthesis and
pulselessness. However, pulselessness presents late in
this disorder. The patient symptoms suggest
compartment syndrome. The provider should be notified
immediately as a delay in diagnosis and treatment of
compartment syndrome can lead to permanent nerve and
muscle damage. Compartment pressure monitoring is
useful in diagnosing this complication. Osteomyelitis
presents with fever, pain, swelling, redness, drainage,
and leukocytosis and typically occurs after several days
or weeks.
A 23-year-old patient, experienced an open fracture of
the left tibia with major soft tissue damage of his lower
leg in a bicycle accident. Surgical reduction and fixation
of the tibia were performed with debridement of
, nonviable tissue and drain placement in the damaged
soft tissue. Which finding by the nurse would most likely
indicate the development of the osteomyelitis?
A) Tachycardia
B) Elevated ESR
C) Numbness in the left leg and toes
D) Muscle spasms around the affected bone - correct
answer - Answer B. The erythrocyte sedimentation rate
(ESR), is over 90% for patients who have confirmed
osteomyelitis. However, a normal or slightly elevated ESR
does not eliminate the diagnosis. In addition, the nurse
assesses for pain over the affected bone.
A 25-year-old woman experienced an open fracture of the
right fibula with major soft tissue damage of her lower leg
in a motor vehicle accident. Surgical reduction and
fixation of the fibula were performed with débridement of
nonviable tissue and drain placement in the damaged
soft tissue. Which complication is this patient at risk for?
A) Osteoporosis
B) Osteomyelitis
C) Fat emboli
