Chapter 09 Pearson Custom For Older Adult Nursing Care By Nancy J.Brown And Linda

Chapter 09 Pearson Custom For Older Adult Nursing Care By Nancy J.Brown And Linda

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

During a physical exam, an older adult female client asks the nurse to explain what causes the large number of varicose veins in her legs. Which one of the following responses by the nurse contains accurate information?

1. “During the aging process, the veins dilate, the vein valves don’t close properly, blood is returned to the heart inefficiently, and fluid stays down in the legs, causing varicose veins and swelling to occur.”
2. “The kidneys decrease in functioning due to aging, and excess fluid is pumped into the veins, causing them to dilate and distort.”
3. “Plaque deposits build up in the veins, preventing adequate blood flow and causing the veins to swell and deform.”
4. “A sedentary lifestyle, along with the aging process, causes the veins to become inflamed which then causes them to enlarge and become distorted.”

Correct Answer: 1

Rationale 1: Correct. Varicose veins and swelling in the feet and ankles are caused by venous stasis and inefficient return of blood to the heart due to defective vein valves.

Rationale 2: The kidneys do decrease in size, but fluid is not pumped into the veins. Blood becomes stagnant in the veins.

Rationale 3: Plaque builds up in the arteries due to a different problem known as atherosclerosis.

Rationale 4: Inflammation of the veins is a different condition known as thrombophlebitis.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging in the circulatory system.

 

Question 2

Type: MCSA

After taking the blood pressure of a frail older adult client, the nurse observes petechiae in the area where the cuff was located. The nurse suspects which of the following conditions at this point?

1. Atherosclerotic damage to the capillaries in the body
2. Capillary fragility due to aging and minor trauma
3. Increased blood pressure caused by the aging process
4. Decreased cardiac output due to aging, causing insufficient blood flow

Correct Answer: 2

Rationale 1: Atherosclerosis causes plaque formation within arteries, not petechiae.

Rationale 2: Correct. With the information the nurse has at this point, capillary fragility is all the nurse can surmise. The trauma may have been caused by the blood pressure cuff being inflated too much.

Rationale 3: Capillary fragility, not increased blood pressure, is the actual cause of petechiae formation.

Rationale 4: Decreased cardiac output has signs and symptoms such as fatigue, activity intolerance, and edema, not petechiae.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging in the circulatory system.

 

Question 3

Type: MCSA

A nursing student asks the instructor to explain why the blood pressure of an older adult is typically higher than that of a younger adult. Which of the following information does the nurse educator need to include in the teaching?

1. “The blood pressure of every older adult does not increase. It is totally dependent on the individual’s lifestyle choices, the types of foods the person eats, and how much exercise they get.”
2. “Incomplete closure of venous valves or their obstruction causes a back-up of fluid in the older adult’s veins, which drives up the blood pressure.”
3. “Plaque build-up in the arteries, as well as stiffening of the arteries due to the aging process, causes the blood to be pumped under more pressure, driving up the systolic blood pressure.”
4. “Physiological changes in the body do not cause the blood pressure of older adults to increase. Higher blood pressure is strictly due to the stressors accumulated in the person’s lifetime.”

Correct Answer: 3

Rationale 1: Although not every older adult’s blood pressure increases, higher blood pressure is not caused simply by lifestyle choices. The aging process and heredity also affect the blood pressure of older adults.

Rationale 2: Blood pressure is determined by arterial, not venous, blood flow.

Rationale 3: Correct. Aging renders arteries less flexible, and plaque build-up narrows them, which causes systolic blood pressure to increase.

Rationale 4: Although stress may factor into increased blood pressure, changes in the cardiovascular system associated with the aging process predispose older adults to an increase in systolic blood pressure.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging in the circulatory system.

 

Question 4

Type: MCMA

What are some primary preventive measures that the nurse can suggest to a younger adult to promote a healthy circulatory system as one gets older? Select all that apply.

Standard Text: Select all that apply.

1. Diet high in saturated fats
2. Daily consumption of at least 10 oz. of red wine
3. Regular schedule of aerobic exercise
4. Avoidance of second-hand smoke
5. Diet rich in natural fiber

Correct Answer: 3

Rationale 1: A diet low (not high) in saturated fats is recommended to promote a healthy circulatory system later in life.

Rationale 2: Four ounces of red wine daily for a woman and 8 oz. of red wine for a man (not 10 oz.) is recommended for the antioxidant effect.

Rationale 3: Correct. Regular exercise improves fitness and diminishes effects on the cardiovascular system from aging.

Rationale 4: Smoking and exposure to second-hand smoke have a detrimental effect on the cardiovascular system, so avoiding both promotes good health.

Rationale 5: A diet full of fruits, vegetables, and whole grains promotes the health of the cardiovascular system and diminishes the effects of aging.

Global Rationale:

 

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Discuss methods of health promotion for the circulatory system.