Deck 5: Chronic Illness and Older Adults

Question 1

A 78-year-old patient with multiple health problems complains of having "no energy" and feeling increasingly weak. The patient has had an 11-pound weight loss over the last year. The nurse should 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 with aging to the patient.

Answer 1

ask the patient about daily dietary intake.

Question 2

When the nurse is working in the outpatient clinic, which nursing action will be most helpful in decreasing the risk for drug-drug interactions in an older adult patient?

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 medication schedule for the patient as a reminder about when to take each medication.
D) Have the patient bring all the medications, supplements, and herbs to every health care appointment.

Answer 2

Have the patient bring all the medications, supplements, and herbs to every health care appointment.

Question 3

When caring for a patient with type 2 diabetes who has been hospitalized with severe hyperglycemia, which topic will be most important to include in discharge teaching?

A) Effect of endogenous insulin on transportation of glucose into cells
B) Function of the liver in formation of glycogen and gluconeogenesis
C) Impact of the patient's family history on likelihood of developing diabetes
D) Symptoms indicating that the patient should contact the health care provider

Answer 3

Symptoms indicating that the patient should contact the health care provider

Question 4

The nurse is planning discharge for an alert, homeless 70-year-old with a chronic foot infection. The most appropriate intervention by the nurse is to

A) teach the patient how to assess and care for the foot infection.
B) refer to social services for further assessment of patient needs.
C) schedule the patient to return to outpatient services for foot care.
D) give the patient written information about shelters and meal sites.

Question 5

When admitting a 79-year-old patient who has urinary urgency and a possible urinary tract infection (UTI), the nurse should first

A) assess the patient's orientation.
B) inspect for abdominal distention.
C) question the patient about hematuria.
D) invite the patient to use the bathroom.

Question 6

The home health nurse is caring for a 71-year-old patient who lives alone and is taking seven different prescribed medications for chronic health problems. To ensure medication compliance, which nursing intervention is best?

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 7

The nurse is planning care for an alert and active 85-year-old patient who takes multiple medications for chronic cardiac and respiratory disease and lives with a daughter who works during the day. Which nursing diagnosis is most appropriate?

A) Risk for injury related to drug-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 8

Which action will the nurse take when planning for discharge of a 68-year-old patient who will need daily assistance with activities such as shopping and transportation?

A) Write to the state Medicaid office.
B) Contact the Area Agency on Aging.
C) Provide documentation to Medicare.
D) Communicate with the patient's insurer.

Question 9

Which information obtained by the home health nurse when making a visit to an 88-year-old with mild forgetfulness is of concern?

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 10

When a hospitalized older patient is at risk of falling because of acute confusion and weakness, which action should the nurse take first?

A) Utilize 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 11

To obtain the most complete information when doing an assessment for an 81-year-old patient, the nurse will

A) interview both the patient and the primary patient caregiver.
B) use a geriatric assessment instrument to evaluate the patient.
C) review the patient's chart for the history of medical problems.
D) ask the patient to write down medical problems and medications.

Question 12

When admitting an 88-year-old patient to the hospital, the nurse should plan to

A) speak slowly and loudly while facing the patient.
B) obtain a detailed medical history from the patient.
C) interview the patient before the physical assessment.
D) determine whether the patient uses glasses or hearing aids.

Question 13

The nurse suspects that elder abuse may be occurring when a confused and agitated 76-year-old patient with a broken arm is brought to the emergency department by a family member. Which of these actions 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 14

Which nursing actions will the nurse take to assess for possible malnutrition in a 69-year-old patient (select all that apply)?

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.

Question 15

Which question will provide the most useful information when the nurse is performing a comprehensive geriatric assessment of an older adult who is being assessed for admission to an assisted-living facility?

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 16

When caring for an older adult who lives in a rural area, the nurse will plan to

A) assess the patient for chronic diseases that are unique to rural areas.
B) ensure transportation to appointments with the health care provider.
C) suggest that the patient move to an urban area for better health care.
D) obtain adequate medications for the patient to last for 4 to 6 months.

Question 17

Which information about a 77-year-old patient who is being assessed by the home health nurse is of most concern?

A) The patient organizes medications in a marked pillbox "so I don't forget them."
B) The patient uses three different medications for chronic heart and joint problems.
C) The patient says, "I don't go on my daily walks since I had pneumonia 3 months ago."
D) The patient tells the nurse, "I prefer to manage my life without much help from others."

Question 18

Which of these patients assigned to the nurse is most likely to need planning for long-term nursing management?

A) 22-year-old with appendicitis who has had an emergency appendectomy
B) 56-year-old with bilateral knee osteoarthritis who weighs 350 lbs (159 kg)
C) 34-year-old with cholecystitis who has had a laparoscopic cholecystectomy
D) 62-year-old with acute sinusitis who will require antibiotic therapy for 5 days

Question 19

When developing the plan of care for an older adult who is hospitalized for an acute illness, the nurse should

A) use a standardized geriatric nursing care plan.
B) minimize activity level during hospitalization.
C) plan for transfer to a long-term care facility after the hospitalization.
D) consider the preadmission functional abilities when setting patient goals.