Free Adult-Gerontology Acute Care Nurse Practitioner Questions and Answers — Questions and Answers
Question 1: The following factors put patients who use urinary catheters for an extended period of time at risk for acquiring resistant infections:
- Trauma related to catheter movement
- Blockage of urinary catheters
- Development of biofilms in the bladder (Correct answer)
- Development of bladder ulcerations
Correct answer: Development of biofilms in the bladder
Long-term urinary catheter use significantly increases the risk of resistant infections due to the formation of biofilms. Biofilms are communities of microorganisms encased in an extracellular matrix that adhere to the catheter surface. This protective layer shields bacteria from antibiotics and the host's immune system, making infections difficult to treat and promoting antibiotic resistance.
Question 2: A patient has septic (acute nongonococcal bacterial) knee arthritis. Antibiotics are a part of immediate care together with:
- Cold compresses
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Drainage of the joint (Correct answer)
- Hot compresses
Correct answer: Drainage of the joint
For septic arthritis, immediate joint drainage (arthrocentesis or surgical lavage) is crucial alongside antibiotic therapy. This procedure removes infected synovial fluid, reduces intra-articular pressure, and decreases the bacterial load and inflammatory mediators within the joint. Prompt drainage helps prevent cartilage destruction and preserves joint function, which are critical outcomes in this acute condition.
Question 3: The NP is concerned that a stroke victim with chronic dysphagia and a coughing fit might aspirate. Which of the following recommendations is ideal?
- Occupational therapist
- Speech pathologist (Correct answer)
- Physical therapist
- Respiratory therapist
Correct answer: Speech pathologist
A speech pathologist (also known as a speech-language pathologist or SLP) specializes in evaluating and treating swallowing disorders, or dysphagia. For a stroke victim with chronic dysphagia and coughing fits, an SLP can assess the severity of the swallowing impairment, recommend appropriate dietary modifications, and teach compensatory strategies and exercises to improve swallowing safety and prevent aspiration.
Question 4: The NP aims to deploy a new technique in the provision of patient care, cognizant that the main obstacles to change are typically:
- Lack of adequate preparation
- Poor change design
- Insufficient supporting data
- Staff resistance (Correct answer)
Correct answer: Staff resistance
When implementing new techniques or changes in patient care, staff resistance is often the primary obstacle. This resistance can stem from fear of the unknown, lack of understanding, perceived increased workload, comfort with existing routines, or a feeling of not being involved in the decision-making process. Addressing staff concerns, providing adequate training, and fostering a supportive environment are crucial for successful change adoption.
Question 5: Which of the following medical services can a teenager under the age of 18 receive or reject without their parents' knowledge or permission in the majority of states?
- Chemotherapy
- Emergency contraception (Correct answer)
- Transfusions
- Abortion
Correct answer: Emergency contraception
In the majority of states, minors can consent to certain sensitive medical services without parental knowledge or permission, often under "mature minor" doctrines or specific state laws. Emergency contraception falls into this category, as laws frequently grant minors the right to consent to reproductive health services, including contraception, to protect their privacy and health. Other options like chemotherapy, transfusions, and abortion typically require parental consent or a court order for minors.
Question 6: A patient with a T-6 spinal cord injury lays flat on their back in bed when all of a sudden, they have blurred vision, a terrible headache, a piloerection with pallor below the lesion and flushing above it, as well as noticeably raised blood pressure of 280/160. The first thing to do is:
- Check bowels
- Elevate the head of the bed to 45° (Correct answer)
- Check bladder
- Loosen clothes
Correct answer: Elevate the head of the bed to 45°
The patient's symptoms are classic signs of autonomic dysreflexia (AD), a life-threatening emergency in individuals with spinal cord injuries at T6 or above. The immediate priority is to elevate the head of the bed to 45 degrees. This helps to reduce cerebral blood pressure and prevent complications like stroke or intracranial hemorrhage, while simultaneously searching for and alleviating the noxious stimulus causing the AD.
Question 7: The NP reports that one nurse on the team frequently avoids caring for elderly patients and occasionally speaks poorly about the elderly. The NP should respond in the following manner to:
- Avoid assigning the nurse to older patients
- File a complaint against the nurse
- Advise the nurse that ageism is inappropriate
- Discuss attitudes toward aging with the nurse (Correct answer)
Correct answer: Discuss attitudes toward aging with the nurse
The most appropriate initial response for an NP observing ageism in a team member is to directly address the issue through a discussion. This approach allows the NP to understand the nurse's perspective, educate them about ageism and its impact on patient care, and reinforce professional expectations. It promotes a learning opportunity and aims to correct behavior through dialogue before resorting to more formal disciplinary actions or accommodations.
Free Adult-Gerontology Acute Care Nurse Practitioner Questions and Answers
The following factors put patients who use urinary catheters for an extended period of time at risk for acquiring resistant infections: