Deck 41: The Older Adult Patient

Question 1

An older patient is receiving a nephrotoxic medication.Which of the following would be a priority for the nurse to monitor?

A) Electrocardiogram
B) Lung sounds
C) Blood pressure
D) Level of consciousness

Answer 1

Blood pressure

Question 2

Which of the following nonsteroidal anti-inflammatory drugs (NSAIDs)has the side effect of renal failure,HTN,heart failure,and GI bleed in the elderly population?

A) Indomethacin
B) Ketorolac
C) Aspirin greater than 325 mg
D) Naproxen

Answer 2

Naproxen

Question 3

Age-related pulmonary changes that may affect this patient include

A) increased tidal volumes.
B) weakening of intercostal muscles and the diaphragm.
C) improved cough reflex.
D) decreased sensation of the glottis.

Answer 3

weakening of intercostal muscles and the diaphragm.

Question 4

A nurse is teaching an older patient about the signs and symptoms of a myocardial infarction.Which statement by the patient would indicate that the teaching was effective?

A) "The pain in my chest may last a long time."
B) "I will feel like I have an elephant sitting on the center of my chest."
C) "The chest pain will be sharp and over the center of my chest."
D) "The pain may not be severe and may not be in my chest."

Question 5

Which medications are considered an alternative to angiotensin-converting enzyme (ACE)inhibitors in older adult hypertension patients with diabetes mellitus and heart failure (HF)?

A) Angiotensin-receptor blockers
B) Beta-blockers
C) Calcium antagonists
D) Direct renin inhibitors

Question 6

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.Dopamine 3 mcg/kg/min has been ordered for this patient.What nursing implications should be considered when administering this drug to an older patient?

A) No changes are noted in older patients with this drug.
B) Drug effect is enhanced by increased receptor site action.
C) Increased breakdown by liver hepatocytes occurs, increasing dosage requirements.
D) Drug metabolism and detoxification are slowed, increasing the risks of drug toxicity.

Question 7

Chemical changes in a drug that renders it active or inactive is known as

A) absorption.
B) metabolism.
C) excretion.
D) distribution.

Question 8

An older patient is admitted to the hospital with a hip fracture.Which of the following nursing interventions would be a priority?

A) Facilitate frequent deep breathing.
B) Administer stool softeners.
C) Perform neurologic checks.
D) Frequently offer liquids to drink.

Question 9

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.The patient awakens during the night confused and disoriented.This may be in part because of

A) impaired sensation of peripheral receptors.
B) increased nerve impulse conduction resulting in increased anxiety.
C) deficiency in the temporofrontal function of the brain.
D) inevitable dementia.

Question 10

A critically ill older adult is placed on a continuous infusion of high-dose loop diuretic for diuresis.The nurses knows to monitor for

A) hyperkalemia.
B) bradycardia.
C) metabolic acidosis.
D) hyperchloremic alkalosis.

Question 11

Which of the following can be a normal assessment finding for an older patient?

A) Asymptomatic dysrhythmias
B) Decreased urine output
C) Increased respiratory effort
D) Difficulty problem solving

Question 12

Which method is used to measure bone mineral density (BMD)and fracture prediction?

A) fracture risk assessment tool (FRAX)
B) Computed tomography
C) Dual-energy x-ray absorptiometry (DXA)
D) positron emission tomography (PET)

Question 13

Which of the following will remain unchanged in an older person when he or she exercises?

A) Cardiac output
B) Heart rate
C) Blood pressure
D) Heart rhythm

Question 14

Which of the following sounds may be difficult for an older person to hear?

A) Telephone ringing
B) Clothes dryer running
C) Car horn honking
D) Child crying

Question 15

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.When caring for this patient,the nurse will give increased attention to skin integrity because of the

A) thickening of the epidermal skin layer.
B) loss of sebaceous glands.
C) increased fragility from loss of protective subcutaneous layers.
D) decreased melanocyte production.

Question 16

An older patient is admitted to the hospital with an acute onset of mental changes and recent falls.The nurse knows that the most common cause of mental changes is

A) hypoxia.
B) infection.
C) cerebrovascular accident.
D) electrolyte imbalance.

Question 17

An older patient is started on spironolactone to control hypertension.The nurse knows to monitor for

A) hyperkalemia.
B) irregular heart rate.
C) confusion.
D) pulmonary edema.

Question 18

A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction.Age-related changes in myocardial pumping ability may be evidenced by

A) increased contractility.
B) decreased contractility.
C) decreased left ventricle afterload.
D) increased cardiac output.

Question 19

An older patient is starting a new medication that is metabolized in the liver and excreted by the kidneys.Which is the best assessment to monitor the patient's ability to tolerate the medication?

A) Liver function tests
B) Drug side effects experienced by the patient
C) Kidney function tests
D) Therapeutic drug levels

Question 20

Which of the following would be a normal assessment finding for an older patient?

A) Inability to remember what was eaten yesterday
B) An increase in resting heart rate
C) Hypoactive bowel sounds
D) Brisk papillary response to light

Question 21

A critical care nurse recognizes that the following interventions can decrease negative physical,functional,and cognitive long-term outcomes associated with critical illness.

A) Avoidance of restraints
B) Medication management to enhance orientation
C) Use of restraints
D) Use of indwelling catheters
E) Noise reduction

Question 22

The focus on the relief of suffering,in all of its dimensions,is referred to as

A) aggressive care
B) advance directives
C) hospice care
D) palliative care

Question 23

Nurses should be alert for immune deficiencies in older patients because of which of the following?

A) Nutritional deficiencies
B) Presence of chronic illnesses
C) Insertion of invasive devices
D) Decreased total lung capacity
E) Increased peristaltic action in the esophagus

Question 24

Which of the following contribute to a higher risk for myocardial ischemia in an older patient?

A) Increased diastolic filling pressures
B) Decreased intracellular free calcium
C) Thinning left ventricular wall thickness
D) Increased myocardial collagen content
E) Increased myocardial oxygen consumption

Question 25

Which of the following can contribute to an accelerated incidence of osteoporosis?

A) Immobility
B) Increase in calcium
C) Smoking
D) Decreased glucocorticoid secretion
E) Decreased intake of dietary calcium