Deck 5: Chronic Illness and Older Adults

Question 1

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.

Answer 1

Use a marked pillbox to set up the patient's medications.

Question 2

Which method should the nurse use to gather the most complete assessment of an older patient?

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

Answer 2

Use a geriatric assessment instrument to evaluate the patient.

Question 3

An alert older patient who takes multiple medications for chronic cardiac and pulmonary diseases 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)Social isolation related to fatigue
B)Risk for injury related to drug interactions
C)Caregiver role strain related to family employment schedule
D)Compromised family coping related to the patient's care needs

Answer 3

Risk for injury related to drug interactions

Question 4

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

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.

Question 5

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

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

Question 6

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)Ask the patient's preference for the choice of a LTC facility.
C)Explain the reasons for the need to live in LTC to the patient.
D)Request that the patient be placed in a private room at the facility.

Question 7

The nurse performs a comprehensive assessment of an older patient who is considering 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 8

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

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

Question 9

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 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 10

Which intervention should the nurse implement to provide optimal care for an older patient who is hospitalized with pneumonia?

A)Plan for transfer to a long-term care facility.
B)Minimize activity level during hospitalization.
C)Consider the preadmission functional abilities.
D)Use an approved standardized geriatric nursing care plan.

Question 11

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 12

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)Request the patient empty the bladder.

Question 13

The home health nurse visits an older patient with mild forgetfulness. Which new information is of most concern to the nurse?

A)The patient tells the nurse that a close friend recently died.
B)The patient has lost 10 lb (4.5 kg) during the past 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 14

An older patient complains of having "no energy" and feeling increasingly weak. The patient has had a 12-lb weight loss over the past 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 15

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 16

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 17

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)Make a schedule for the patient as a reminder of when to take each medication.
C)Instruct the patient to avoid taking over-the-counter (OTC) medications or supplements.
D)Ask the patient to bring all medications, supplements, and herbs to each appointment.

Question 18

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

Question 19

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 20

An older adult being admitted is assessed at high risk for falls. 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 21

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

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