Question 1

The long-term care facility nurse is discussing fall prevention measures with the charge nurse.Which replacement should the nurse suggest?

Accepted Answer

Loose area rugs should be replaced with nonslip carpets.

Question 2

The nurse is caring for a disoriented resident.Which intervention is most appropriate for the nurse to include when planning care for this patient?

Accepted Answer

Keeping a routine leads to less confusion.Changing assistive personnel care assignments frequently is confusing for the resident.Choosing clothing from an entire closet is overwhelming for the confused resident; rather,giving the resident a few items to choose from encourages autonomy without increasing confusion.Sedatives should not be given to treat confusion.

Question 3

The nurse is instructing a family about chair selection for an older adult with Parkinson disease.Which information is most important for the nurse to include?

Accepted Answer

Sturdy arms assist in rising and sitting.Soft,low,and wide chairs cause a person to lean forward to rise and to "fall into" the chair to be seated.

Question 4

Which treatment resource focuses on restorative care for people with chronic illness and disabilities?

Accepted Answer

Outpatient clinics,long-term care facilities,home care,and rehabilitation agencies are sources of rehabilitation for people with chronic illness or disability.Hospice agencies focus on care of the dying patient.

Question 5

The nurse is educating a 70-year-old patient who just had a cast removed from a broken arm.The nurse should teach the patient about which potential effect of immobility related to casting?

Accepted Answer

Immobility can cause loss of strength and flexibility in the older adult.

Question 6

The nurse is planning a group TV activity in a long-term care facility.The nurse should select a channel that offers which type of program?

Accepted Answer

Travel documentaries are colorful and do not have a plot to follow.Cartoons are juvenile,opera does not have universal appeal,and the two-part drama would require long attention spans and good short-term memory.

Question 7

When the confused resident pours his cereal in a cup and "drinks" it,how should the nurse best respond?

Accepted Answer

While this method of eating cereal is not typical,it is not harmful and allows the patient to be independent.The nurse should leave the resident alone to feed himself independently.Staff should refrain from doing what the resident can do for himself,so transferring his cereal to another container,discarding the cereal,or telling the patient that he cannot eat the cereal in a certain way is not appropriate.

Question 8

The LPN/LVN making care assignments to nursing assistants would not assign a patient who has which problem?

Accepted Answer

Nursing assistants are not assigned to patients who have an unstable condition.Care of an unstable patient does not fall into the scope of practice of the unlicensed personnel.

Question 9

Which statement describes the chief goal of a long-term care facility?

Accepted Answer

Promotion of independence is the chief goal,not complete autonomy.Other options are services directed at achieving increased independence.

Question 10

The nurse is seeking to motivate a frustrated patient who is learning to walk again after a stroke.Which intervention would be most effective?

Accepted Answer

Talking with someone who can truly understand the frustration is helpful.Showing a short movie on ambulation techniques may be an effective teaching tool,but it is not a motivational tool.Observing the resident is necessary but does not provide motivation.A 1-week break will interrupt progress that has been made,thus decreasing motivation.

Question 11

The nurse assesses a bed-bound resident,a reddened area over the coccyx that does not blanch is discovered.Which is the best intervention to prevent further skin damage?

Accepted Answer

Since this appears to be a stage 1 pressure area,the transparent film ensures the proper amount of moisture is present for healing while allowing monitoring of the area.A warm compress is not warranted.This patient will need to be turned every hour.Monitoring of the area should continue but does not meet the immediate need.

Question 12

The nurse is caring for an obese resident with a pressure ulcer on her coccyx.The patient frequently lies on her back because it is difficult to turn due to her weight.Which intervention most effectively encourages independence?

Accepted Answer

The trapeze allows for self-positioning and is less confining than are bed rails.Turning the patient on her side or using short rails for positioning do not foster independence.

Question 13

The nurse is caring for a resident who has a security device for safety purposes.What intervention should the nurse include in the plan of care?

Accepted Answer

The need for continuing the use of the security device must be assessed every 4 to 8 hours.The patient should be visually checked every 30 minutes,and turned and skin assessed every 2 hours.

Question 14

The nurse is caring for an 85-year-old patient who has been on bed rest for a fractured hip.The nurse finds that the patient is flushed,has a temperature of 100° F,a pulse of 100,and respiratory rate of 24.What assessment should the nurse perform next?

Accepted Answer

The initial assessments are the cardinal signs of pneumonia.The breath sounds should be assessed next to determine the presence of any adventitious breath sounds.BP will also need to be assessed,but the breath sounds are more important with the signs and symptoms present.Abdominal distention is indicative of a gastrointestinal problem.Amount of urinary output is important to an ongoing assessment but not a priority in the present circumstances.

Question 15

A resident with advanced Parkinson disease stays in his wheelchair all day.He reports that he is too tired to walk and is fearful of falling.Which intervention to increase the patient's mobility should the nurse add to the patient's care plan?

Accepted Answer

Walking is the best exercise to prevent problems associated with immobility.The gait belt will make the resident more secure.Canes and crutches do not diminish the weakness or the fear of falling.

Question 16

The nurse is caring for a 76-year-old patient in a long-term care facility who sent his food tray back to the kitchen untouched for the second time today.Which intervention is most effective to increase nutrition?

Accepted Answer

Taking the high-energy drink meets the immediate challenge of inadequate nutritional intake.Referral to the dietitian and sitting with the patient may be helpful.Offering to feed from a rejected tray is not supportive.

Question 17

The rehabilitation nurse describes a patient who is blind,works full time as a Spanish interpreter,and lives with his wife in a downtown apartment.How should the nurse classify this person?

Accepted Answer

The blindness is an impairment of vision that does not inhibit the patient from performing his job or enjoying a normal life.

Question 18

The nurse educates the nursing assistant about the importance of locking the wheels of a wheelchair.Which statement indicates that the nursing assistant understands the nurse's teaching?

Accepted Answer

Fall prevention is the purpose of locking the wheels of a wheelchair.

Question 19

After assessing reddened heels on a bed-bound patient with a history of a stroke,which intervention should the nurse add to the care plan?

Accepted Answer

Elevation of the feet gets the weight off the heels and will allow them to heal.All other options are not helpful to damaged skin.Brisk massage may promote damage to the skin.Alcohol can be irritating and may further damage heel skin.

Question 20

The charge nurse instructs the nursing assistants about the policy concerning call lights.The nurse teaches that patients taking which type of medication require especially prompt call light attention?

Accepted Answer

People taking diuretics need to go to the bathroom frequently,and often urgently.Prompt attention to call lights will reduce the probability of the patient getting up unassisted.Diuretics may also cause orthostatic hypotension,which increases the risk for falling.

Quiz 9: Chronic Illness and Rehabilitation