Chapter 10 Pearson Custom For Older Adult Nursing Care By Nancy J.Brown And Linda

Chapter 10 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: MCMA

When assessing the respiratory status of older adult clients, the nurse is aware that which of the following findings involving the respiratory system are ones that are expected due to the aging process?

Standard Text: Select all that apply.

1. Hemoptysis
2. Inflexible chest wall
3. Weakened cough reflex
4. Obstructive sleep apnea
5. Inflammation of bronchioles

Correct Answer: 2,3

Rationale 1: Hemoptysis is incorrect because this is not an expected finding and would indicate pathology.

Rationale 2: Hemoptysis is incorrect because this is not an expected finding and would indicate pathology.

Rationale 3: Hemoptysis is incorrect because this is not an expected finding and would indicate pathology.

Rationale 4: Hemoptysis is incorrect because this is not an expected finding and would indicate pathology.

Rationale 5: Hemoptysis is incorrect because this is not an expected finding and would indicate pathology.

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 respiratory system.

 

Question 2

Type: MCSA

A clinic nurse is auscultating the lung sounds of a 70-year-old healthy older adult client and hears diminished sounds in both lung bases. The nurse correctly attributes this finding to what probable condition?

1. Decreased respiratory inflation associated with rigid chest wall
2. Consolidation in the lungs due to impending pneumonia
3. Weakened cough reflex associated with the aging process
4. Development of chronic obstructive pulmonary disease

Correct Answer: 1

Rationale 1: With the information given, development of a rigid chest wall is an expected change, which causes decreased inflation and decreased breath sounds in the lung bases.

Rationale 2: Consolidation in the lungs is incorrect. Without more history concerning this client, one can only assume he or she is healthy, and therefore there is not enough information to prove any pathology.

Rationale 3: Although weakened cough reflex is a normal change expected with aging, it would not be the cause of this assessment finding.

Rationale 4: Development of chronic obstructive pulmonary disease is incorrect. Without more history concerning this client, one can only assume he or she is healthy, and there is not enough information to prove any pathology.

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 respiratory system.

 

Question 3

Type: MCSA

The nurse is teaching a group of nursing assistants about the rationale for good respiratory care of older adult clients following surgery. Which information should the nurse include in the teaching?

1. “All older adults develop what is known as a barrel chest, which makes it harder to get them in a good position for coughing and deep breathing following surgery.”
2. “The older adult’s cough reflex is weakened by aging and they can’t move fluid up and out as well as younger adults, making them more prone to postoperative respiratory infections.”
3. “Older adults develop areas of empty spaces within their lungs due to natural collapse of many of the air sacs within the lungs, making them more prone to respiratory complications.”
4. “The large majority of older adults develop a problem in which they stop breathing for periods of time when they are asleep. This occurs, also, during the postoperative period in which they are sedated.”

Correct Answer: 2

Rationale 1: This is not a true statement; older adults who develop a barrel chest usually have chronic obstructive pulmonary disease (COPD).

Rationale 2: Correct. The cough reflex is decreased due to aging, and this, along with loss of cilia, makes the older adult more prone to aspiration and other respiratory complications following surgery.

Rationale 3: This is not a true statement. The presence of empty spaces in the lungs is describing what occurs with emphysema, which is not a normal expected change associated with aging.

Rationale 4: This is not a true statement. Cessation of breathing during sleep is describing what occurs with obstructive sleep apnea, which is not a normal expected change associated with aging.

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 respiratory system.

 

Question 4

Type: MCSA

An older adult client recovering from a hip replacement suddenly develops acute pain in the chest and shortness of breath and begins coughing up small amounts of blood. The nurse caring for the client immediately notifies the physician, suspecting which of the following conditions?

1. Tuberculosis
2. Atelectasis
3. Lung embolus
4. Hemoptysis

Correct Answer: 3

Rationale 1: Tuberculosis is not an acute condition and there is no history of TB given in this situation. These are signs of a pulmonary embolus.

Rationale 2: Atelectasis is a collapsed state of the lungs which would present differently. These are signs of a pulmonary embolus.

Rationale 3: Correct. Clients who have undergone orthopedic surgery are more prone to developing pulmonary emboli, which are characterized by pain in the chest, shortness of breath, cough, and hemoptysis.

Rationale 4: Hemoptysis is a sign of a pulmonary embolus, not a condition itself. These are signs of a pulmonary embolus.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts:

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