Question 1

What is the most important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of heart failure (HF) in older persons who have HF?&#10;A)Control fluid balance.&#10;B)Control blood pressure.&#10;C)Prevent deconditioning.&#10;D)Maintain patient safety.

Accepted Answer

Controlling fluid balance is the most important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of heart failure in older persons who have HF. This is because HF causes fluid retention, leading to symptoms such as shortness of breath, edema, and fatigue. By controlling fluid balance, nurses can help prevent the exacerbation of HF symptoms and reduce the need for hospitalizations. Controlling blood pressure, preventing deconditioning, and maintaining patient safety are also important goals in the plan of care, but not as directly related to decreasing hospitalizations for acute exacerbations of HF in older persons.

Question 2

The Public Health Agency of Canada and the Canadian Lung Association recommend that every older person who will be entering a long-term care (LTC) facility as a resident will become part of communal living and must therefore undergo annual testing for tuberculosis (TB).Which of the following statements about TB in older persons is TRUE?

A)The principal threat from TB is its highly contagious nature.
B)The tuberculin purified protein derivative (PPD) test is a conclusive test for TB.
C)Antimicrobial drugs have made TB a thing of the past.
D)Older persons who contracted TB in their youth may suffer reactivation of TB.

Accepted Answer

Older persons who contracted TB in their youth may suffer reactivation of TB. This is because the bacteria that cause TB can remain dormant in the body for many years and reactivate later in life, especially when the immune system is weakened due to aging or other illnesses. It is important for older adults entering LTC facilities to be tested for TB regularly to prevent outbreaks and ensure prompt treatment if necessary. Choice A is incorrect because TB is not highly contagious unless it is in an active form, and it is not always symptomatic. Choice B is incorrect because the PPD test is not always conclusive and may result in false positives or false negatives. Choice C is incorrect because while antimicrobial drugs can effectively treat TB, the disease is still a major global health concern, especially in areas with high rates of drug-resistant strains.

Question 3

Clinical heart failure (HF) is categorized as left-sided, right-sided, or both-sided (biventricular) failure.Mrs.Poulin, 80 years of age, lives in a long-term care (LTC) facility and has been diagnosed as having Class II mild heart failure.She is comfortable at rest and occasionally dyspneic after completing her own morning care.Which atypical exacerbation of congestive heart failure (CHF) should the nurse be alerted to when caring for Mrs.Poulin?

A)Weight gain of 1 kg in one week
B)Swelling of lower extremities after sitting for two hours
C)Malaise and diminished desire to participate in activities
D)Nonproductive cough

Accepted Answer

Malaise and diminished desire to participate in activities can be atypical signs of heart failure exacerbation in elderly patients, indicating worsening condition even if traditional symptoms are not prominent.

Question 4

The exercise tolerance of an older person is impaired after a myocardial infarction (MI) because of a low ejection fraction.Which of the following primary interventions should the nurse use to assist this individual to restore baseline functional status?

A)Provide a well-balanced diet.
B)Assist with range of motion.
C)Instruct the older person to sit up in a chair four times daily.
D)Keep O2 saturation above 95%.

Accepted Answer

The answer of The exercise tolerance of an older person...

Question 5

Which of the following statements about heart disease in older persons is true?&#10;A)More women than men die from myocardial infarctions.&#10;B)Cardiac care for men and women is equally aggressive.&#10;C)Cardiac medications have been tested on men and women equally.&#10;D)Women generally receive less aggressive treatment than men do.

Accepted Answer

Studies have shown that women are less likely to receive aggressive treatment for heart disease compared to men. This may be due to a variety of factors, including differences in symptoms presentation and physician bias. Women are also more likely to die from myocardial infarctions compared to men.

Question 6

Pneumonia and influenza are the seventh and eighth leading causes of death for men and women over the age of 65, respectively, according to Statistics Canada (2015).To prevent pneumonia and influenza in the older person, what is the priority nursing intervention?

A)Provide the older person with supplemental oxygen therapy, if and when it is necessary.
B)Administer IV antibiotics and other medications as prescribed.
C)Administer the influenza and pneumococcal vaccines.
D)Promote maximal functional capacity and encourage older persons to quit smoking.

Accepted Answer

Administering the influenza and pneumococcal vaccines is the priority nursing intervention to prevent pneumonia and influenza in the older person. These vaccines can significantly reduce the risk of contracting and developing serious complications from these diseases. Providing supplemental oxygen therapy, administering IV antibiotics and medications as prescribed, and promoting maximal functional capacity and smoking cessation may be important interventions for managing patients with these illnesses, but they are not the priority for prevention.

Question 7

After an older person's acute exacerbation of chronic obstructive pulmonary disease (COPD), the nurse prepares the patient for discharge to home.What is the most important patient teaching for the nurse to include for the prevention of hospitalizations for exacerbation of COPD?

A)Ease breathing by sitting upright.
B)Use low-flow oxygen for dyspnea.
C)Avoid sick people and wash hands.
D)Eat nutrient- and calorie-dense food.

Accepted Answer

The most important patient teaching for the prevention of hospitalizations for exacerbation of COPD is to avoid sick people and wash hands frequently to reduce the risk of respiratory infections. This is particularly important during flu season. A, B, and D are also important interventions for COPD management, but they are not the most important for preventing exacerbations and hospitalizations.

Question 8

The nurse notices that an older female nursing home resident is not eating and that her heart rate is faster than usual at 110-120 beats per minute.What should the nurse do to eliminate pneumonia as a potential cause of the change in this resident's status?

A)Obtain a specimen for aerobic blood cultures.
B)Send the resident for a chest X-ray exam promptly.
C)Analyze sputum for colour, texture, and volume.
D)Compare tympanic temperature to the baseline.

Accepted Answer

The answer of The nurse notices that an older female...

Question 9

An older female adult who has chronic obstructive pulmonary disease (COPD) wants to perform self-care activities.Which instruction should the nurse include in patient teaching to help this older person achieve this goal?

A)Bathe and eat slowly, with periodic rest.
B)Walk short distances without oxygen.
C)Perform all activities of daily living (ADLs) together, and then rest.
D)Bathe right after eating and then rest.

Accepted Answer

Bathing and eating slowly, with periodic rest, is the most appropriate instruction for an older female adult with COPD who wants to perform self-care activities. It is important to conserve energy and avoid exacerbating respiratory distress by taking breaks and pacing activities throughout the day. Walking short distances without oxygen may not be feasible for someone with COPD, and performing all ADLs together may lead to exhaustion and increased respiratory symptoms. Bathing right after eating and then resting can also exacerbate respiratory distress.

Question 10

An older male adult in a cardiac rehabilitation exercise class refuses to participate in the cool-down phase of the activity, and two minutes later, he passes out but regains consciousness quickly.Which of the following instructions does the nurse include in patient teaching to reinforce to this older person the importance of cooling down after exercise?

A)Cardiac output diminishes with age.
B)Mobility capacity decreases with age.
C)Baroreceptor function diminishes with age.
D)Sensory perception diminishes with age.

Accepted Answer

Baroreceptor function, which helps to regulate blood pressure, diminishes with age. This can lead to issues with blood pressure regulation during sudden changes in activity, such as stopping exercise abruptly without a cool-down period. Cooling down helps to gradually return the heart rate and blood pressure to resting levels, reducing the risk of fainting or dizziness.

Question 11

Which of the following statements about heart disease in older persons is true?&#10;A)Myocardial infarction has many of the same symptoms in older patients as in middle-aged persons.&#10;B)Excessive urination at night and orthopnea can be signs of heart failure.&#10;C)Any exertion on the part of an older-person patient with heart disease can bring on another heart attack.&#10;D)A person with heart failure is likely to have trouble breathing, except when lying down.

Accepted Answer

The answer of Which of the following statements about heart...

Deck 20: Cardio-Vascular and Respiratory Disorders