Chapter 05: Chronic Illness and Older Adults

Chapter 05: Chronic Illness and Older Adults

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. 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

 

 

ANS:  C

One of the tasks for patients with chronic illnesses is to prevent and manage a crisis. The patient needs instruction on recognition of symptoms of hypertension and TIA and appropriate actions to take if these symptoms occur. The other information may also be included in patient teaching but is not as essential in the patient’s self-management of the illness.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   60

OBJ:   Special Questions: Prioritization      TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity

 

2. 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?”

 

 

ANS:  D

The patient’s functional abilities, rather than the presence of an acute or chronic illness, are more useful in determining how well the patient might adapt to an assisted living situation. The other questions will also provide helpful information but are not as useful in providing a basis for determining patient needs or for developing interventions for the older patient.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   62

OBJ:   Special Questions: Prioritization      TOP:   Nursing Process: Assessment

MSC:  NCLEX: Health Promotion and Maintenance

 

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

 

 

ANS:  B

The patient’s age and multiple medications indicate a risk for injury caused by interactions between the multiple drugs being taken and a decreased drug metabolism rate. Problems with social isolation, caregiver role strain, or compromised family coping are not physiologic priorities. Drug–drug interactions could cause the most harm to the patient and are therefore the priority.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   73

OBJ:   Special Questions: Prioritization      TOP:   Nursing Process: Diagnosis

MSC:  NCLEX: Health Promotion and Maintenance

 

4. 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.

 

 

ANS:  B

The most complete information about the patient will be obtained through the use of an assessment instrument specific to the geriatric population, which includes information about both medical diagnoses and treatments and about functional health patterns and abilities. A review of the medical record, interviews with the patient and caregiver, and written information by the patient are all included in a comprehensive geriatric assessment.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   74

OBJ:   Special Questions: Prioritization      TOP:   Nursing Process: Assessment

MSC:  NCLEX: Health Promotion and Maintenance

 

5. 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.

 

 

ANS:  C

The plan of care for older adults should be individualized and based on the patient’s current functional abilities. A standardized geriatric nursing care plan will not address individual patient needs and strengths. A patient’s need for discharge to a long-term care facility is variable. Activity level should be designed to allow the patient to retain functional abilities while hospitalized and also to allow any additional rest needed for recovery from the acute process.

 

DIF:    Cognitive Level: Apply (application)           REF:               69

TOP:   Nursing Process: Planning               MSC:  NCLEX: Physiological Integrity