Deck 5: Chronic Illness and Older Adults

Question 1

Which patient is most likely to need long-term nursing care management?

A) 72-year-old who had a hip replacement after a fall at home
B) 64-year-old who developed sepsis after a ruptured peptic ulcer
C) 76-year-old who had a cholecystectomy and bile duct drainage
D) 63-year-old with bilateral knee osteoarthritis who weighs 350 lb (159 kg)

Answer 1

63-year-old with bilateral knee osteoarthritis who weighs 350 lb (159 kg)

Question 2

The nurse admits an acutely ill,older patient to the hospital.Which action should the nurse take first?

A) Speak slowly and loudly while facing the patient.
B) Obtain a detailed medical history from the patient.
C) Perform the physical assessment before interviewing the patient.
D) Ask a family member to go home and retrieve the patient's cane.

Answer 2

Perform the physical assessment before interviewing the patient.

Question 3

The nurse cares for an alert,homeless older adult patient who was admitted to the hospital with a chronic foot infection.Which intervention is the most appropriate for the nurse to include in the discharge plan for this patient?

A) Refer the patient to social services for further assessment.
B) Teach the patient how to assess and care for the foot infection.
C) Schedule the patient to return to outpatient services for foot care.
D) Give the patient written information about shelters and meal sites.

Answer 3

Refer the patient to social services for further assessment.

Question 4

Which nursing action will be most helpful in decreasing the risk for drug-drug interactions in an older adult?

A) Teach the patient to have all prescriptions filled at the same pharmacy.
B) Instruct the patient to avoid taking over-the-counter (OTC) medications.
C) Make a schedule for the patient as a reminder of when to take each medication.
D) Have the patient bring all medications, supplements, and herbs to each appointment.

Question 5

Which statement,if made by an older adult patient,would be of most concern to the nurse?

A) "I prefer to manage my life without much help from other people."
B) "I take three different medications for my heart and joint problems."
C) "I don't go on daily walks anymore since I had pneumonia 3 months ago."
D) "I set up my medications in a marked pillbox so I don't forget to take them."

Question 6

When caring for an older patient with hypertension who has been hospitalized after a transient ischemic (TIA),which topic is the most important for the nurse to include in the discharge teaching?

A) Effect of atherosclerosis on blood vessels
B) Mechanism of action of anticoagulant drug therapy
C) Symptoms indicating that the patient should contact the health care provider
D) Impact of the patient's family history on likelihood of developing a serious stroke

Question 7

When completing an admission assessment on an older adult,the nurse gives the patient a high fall risk score.Which action should the nurse take first?

A) Use a bed alarm system on the patient's bed.
B) Administer the prescribed PRN sedative medication.
C) Ask the health care provider to order a vest restraint.
D) Place the patient in a "geri-chair" near the nurse's station.

Question 8

An older adult patient presents with a broken arm and visible scattered bruises healing at different stages.Which action should the nurse take first?

A) Notify an elder protective services agency about the possible abuse.
B) Make a referral for a home assessment visit by the home health nurse.
C) Have the family member stay in the waiting area while the patient is assessed.
D) Ask the patient how the injury occurred and observe the family member's reaction.

Question 9

The nurse manages the care of older adults in an adult health day care center.Which
Action can the nurse delegate to unlicensed assistive personnel (UAP)?

A) Obtain information about food and medication allergies from patients.
B) Take blood pressures daily and document in individual patient records.
C) Choose social activities based on the individual patient needs and desires.
D) Teach family members how to cope with patients who are cognitively impaired.

Question 10

The nurse assesses an older patient who takes diuretics and has a possible urinary tract infection (UTI).Which action should the nurse take first?

A) Palpate over the suprapubic area.
B) Inspect for abdominal distention.
C) Question the patient about hematuria.
D) Invite the patient to use the bathroom.

Question 11

The nurse plans to complete a thorough assessment of an older patient.Which method should the nurse use to gather the most complete information?

A) Use a geriatric assessment instrument to evaluate the patient.
B) Ask the patient to write down medical problems and medications.
C) Interview both the patient and the primary caregiver for the patient.
D) Review the patient's medical record for a history of medical problems.

Question 12

The home health nurse visits an older patient with mild forgetfulness.The nurse is most concerned if which information is obtained?

A) The patient tells the nurse that a close friend recently died.
B) The patient has lost 10 pounds (4.5 kg) during the last month.
C) The patient is cared for by a daughter during the day and stays with a son at night.
D) The patient's son uses a marked pillbox to set up the patient's medications weekly.

Question 13

The family of an older patient with chronic health problems and increasing weakness is considering placement in a long-term care (LTC)facility.Which action by the nurse will be most helpful in assisting the patient to make this transition?

A) Have the family select a LTC facility that is relatively new.
B) Obtain the patient's input about the choice of a LTC facility.
C) Ask that the patient be placed in a private room at the facility.
D) Explain the reasons for the need to live in LTC to the patient.

Question 14

The nurse performs a comprehensive geriatric assessment of a patient who is being assessed for admission to an assisted living facility.Which question is the most important for the nurse to ask?

A) "Have you had any recent infections?"
B) "How frequently do you see a doctor?"
C) "Do you have a history of heart disease?"
D) "Are you able to prepare your own meals?"

Question 15

The nurse cares for an older adult patient who lives in a rural area.Which intervention should the nurse plan to implement to best meet this patient's needs?

A) Suggest that the patient move to an urban area.
B) Assess the patient for chronic diseases that are unique to rural areas.
C) Ensure transportation to appointments with the health care provider.
D) Obtain adequate medications for the patient to last for 4 to 6 months.

Question 16

An older patient complains of having "no energy" and feeling increasingly weak.The patient has had a 12-pound weight loss over the last year.Which action should the nurse take initially?

A) Ask the patient about daily dietary intake.
B) Schedule regular range-of-motion exercise.
C) Discuss long-term care placement with the patient.
D) Describe normal changes associated with aging to the patient.

Question 17

The home health nurse cares for an older adult patient who lives alone and takes several different prescribed medications for chronic health problems.Which intervention,if implemented by the nurse,would best encourage medication compliance?

A) Use a marked pillbox to set up the patient's medications.
B) Discuss the option of moving to an assisted living facility.
C) Remind the patient about the importance of taking medications.
D) Visit the patient daily to administer the prescribed medications.

Question 18

A patient who has just moved to a long-term care facility has a nursing diagnosis of relocation stress syndrome.Which action should the nurse include in the plan of care?

A) Remind the patient that making changes is usually stressful.
B) Discuss the reason for the move to the facility with the patient.
C) Restrict family visits until the patient is accustomed to the facility.
D) Have staff members write notes welcoming the patient to the facility.

Question 19

An older patient who takes multiple medications for chronic cardiac and pulmonary diseases is alert and lives with a daughter who works during the day.During a clinic visit,the patient verbalizes to the nurse that she has a strained relationship with her daughter and does not enjoy being alone all day.Which nursing diagnosis should the nurse assign as the priority for this patient?

A) Risk for injury related to drug interactions
B) Social isolation related to weakness and fatigue
C) Compromised family coping related to the patient's many care needs
D) Caregiver role strain related to need to adjust family employment schedule

Question 20

An older patient is hospitalized with pneumonia.Which intervention should the nurse implement to provide optimal care for this patient?

A) Use a standardized geriatric nursing care plan.
B) Minimize activity level during hospitalization.
C) Plan for transfer to a long-term care facility upon discharge.
D) Consider the preadmission functional abilities when setting patient goals.

Question 21

Which nursing actions will the nurse take to assess for possible malnutrition in an older adult patient ?

A) Observe for depression.
B) Review laboratory results.
C) Assess teeth and oral mucosa.
D) Ask about transportation needs.
E) Determine food likes and dislikes.