Nursing Board Exam Reviewer Part 1 of 5

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51. During which stage of pressure ulcer development does the ulcer extend into the subcutaneous tissue?

a)      Stage III
Clinically, a deep crater with or without undermining of adjacent tissues is noted.

b)      Stage IV
A stage IV pressure ulcer extends into the underlying structure, including the muscle and possibly the bone.

c)      Stage II
A stage II ulcer exhibits a break in the skin through the epidermis or dermis.

d)      Stage I
A stage I pressure ulcer is an area of nonblanchable erythema, tissue swelling, and congestion, and the patient complains of discomfort.

52. During which stage of pressure ulcer development does the ulcer extend into the underlying structures, including the muscle and possibly the bone?

a)      Stage IV
A stage IV pressure ulcer extends into the underlying structure, including the muscle and possibly the bone.

b)      Stage III
A stage III ulcer extends into the subcutaneous tissue.

c)      Stage II
A stage II ulcer exhibits a break in the skin through the epidermis or dermis.

d)      Stage I
A stage I pressure ulcer is an area of nonblanchable erythema, tissue swelling, and congestion, and the patient complains of discomfort.

53. Which type of incontinence is associated with weakened perineal muscles that permit leakage of urine when intra-abdominal pressure is increased?

a)      Stress incontinence
Stress incontinence may occur with coughing or sneezing.

b)      Urge incontinence
Urge incontinence is involuntary elimination of urine associated with a strong perceived need to void.

c)      Reflex (neurogenic) incontinence
Neurogenic incontinence is associated with a spinal cord lesion.

d)      Functional incontinence
Functional incontinence refers to incontinence in patients with intact urinary physiology who experience mobility impairment, environmental barriers, or cognitive problems.

54. Ageism refers to

a)      Bias against older people based solely on chronological age
Individuals demonstrating ageism base their beliefs and attitudes about older people based upon chronological age without consideration of functional capacity.

b)      fear of old age.
Fear of aging and the inability of many to confront their own aging process may trigger ageist beliefs.

c)      loss of memory.
Age-related loss of memory occurs more with short-term and recent memory.

d)      benign senescent forgetfulness.
Benign senescent forgetfulness refers to the age-related loss of memory in the absence of a pathologic process.

55. When assessing the older adult, the nurse anticipates increase in which of the follow components of respiratory status?

a)      Residual lung volume
As a result, patient experience fatigue and breathlessness with sustained activity.

b)      Vital capacity
The nurse anticipates decreased vital capacity.

c)      Gas exchange and diffusing capacity
The nurse anticipates decreased gas exchange and diffusing capacity resulting in impaired healing of tissues due to decreased oxygenation.

d)      Cough efficiency
The nurse anticipates difficulty coughing up secretions due to decreased cough efficiency.

56. According to the classification of hypertension diagnosed in the older adult, hypertension that can be attributed to an underlying cause is termed

a)      secondary.
Secondary hypertension may be caused by a tumor of the adrenal gland (e.g., pheochromacytoma).

b)      primary.
Primary hypertension has no known underlying cause.

c)      essential.
Essential hypertension has no known underlying cause.

d)      isolated systolic.
Isolated systolic hypertension is demonstrated by readings in which the systolic pressure exceeds 140 mm Hg and the diastolic measurement is normal or near normal (less than 90 mm Hg).

57. Which of the following terms refers to the decrease in lens flexibility that occurs with age, resulting in the near point of focus getting farther away?

a)      Presbyopia
Presbyopia usually begins in the fifth decade of life, when reading glasses are required to magnify objects.

b)      Presbycusis
Presbycusis refers to age-related hearing loss.

c)      Cataract
Cataract is the development of opacity of the lens of the eye.

d)      Glaucoma
Glaucoma is a disease characterized by increased intraocular pressure.

58. Which of the following states is characterized by a decline in intellectual functioning?

a)      Dementia
Dementia is an acquired syndrome in which progressive deterioration in global intellectual abilities is of such severity that it interferes with the person’s customary occupational and social performance.

b)      Depression
Depression is a mood disorder that disrupts quality of life.

c)      Delirium
Delirium is often called acute confusional state.

d)      Delusion
Delusion is a symptom of psychoses.

59. When a person who has been taking opioids becomes less sensitive to their analgesic properties, that person is said to have developed a (an)

a)      tolerance.
Tolerance is characterized by the need for increasing dose requirements to maintain the same level of pain relief.

b)      addiction.
Addiction refers to a behavioral pattern of substance use characterized by a compulsion to take the drug primarily to experience its psychic effects.

c)      dependence.
Dependence occurs when a patient who has been taking opioids experiences a withdrawal syndrome when the opioids are discontinued.

d)      balanced analgesia.
Balanced analgesia occurs when the patient is using more than one form of analgesia concurrently to obtain more pain relief with fewer side effects.

60. Prostaglandins are chemical substances thought to

a)      increase sensitivity of pain receptors.
Prostaglandins are believed to increase sensitivity to pain receptors by enhancing the pain-provoking effect of bradykinin.

b)      reduce the perception of pain.
Endorphins and enkephalins reduce or inhibit transmission or perception of pain.

c)      inhibit the transmission of pain.
Endorphins and enkephalins reduce or inhibit transmission or perception of pain.

d)      inhibit the transmission of noxious stimuli.
Morphine and other opioid medications inhibit the transmission of noxious stimuli by mimicking enkephalin and endorphin.

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