CHAPTER 24 Multisystem Problems:Caring for Frail Elders With Comorbidities

CHAPTER 24 Multisystem Problems:Caring for Frail Elders With Comorbidities

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

24.1•Which clinical manifestation would the nurse expect to find when assessing a frail older client?

1. weight gain
2. generalized weakness
3. increased endurance and energy
4. increased ability to do all activities of daily living (ADL)

Answer: 2

Rationale: Generalized weakness is the correct answer because frail elders are usually diagnosed with chronic illness, loss of organ function, or recurrent acute illnesses, which all contribute to weakness. Weight gain is incorrect because most frail elders have a loss of appetite, eat less, and lose weight, which they do not plan. Increased endurance and energy is incorrect because both endurance and energy decrease with age, chronic illnesses, loss of organ function, recurrent acute illnesses, and loss of muscle mass with loss of appetite. Increased ability to do all the activities of daily living is an incorrect answer because frail elders become more dependent and less able to do ADL for themselves as they increase in age.

Assessment

Health Promotion and Maintenance

Comprehension

24.2•An 85-year-old client is admitted to the emergency department with a major burn. Which physician order would the nurse question?

1. administer narcotics intramuscularly as needed for pain
2. insert Foley catheter for hourly output measurements
3. take vital signs every 5 to 15 minutes
4. apply topical antimicrobial ointment to wounds

Answer: 1

Rationale: Administer narcotics intramuscularly as needed for pain is the correct answer but an incorrect intervention because pain medications should be administered intravenously for better absorption and control of pain. Insert Foley catheter for hourly output measurement is incorrect but it is a correct intervention because it is used as the indicator of effective fluid resuscitation and assessment of kidney function. Take vital signs every 5 to 15 minutes is an incorrect answer but correct intervention because it is required to assess hemodynamic stability in the emergency department. Apply topical antimicrobial ointment to wounds is an incorrect answer but correct intervention because it is used to prevent or eliminate infection on the surface of the burn wound.

Diagnosis

Safe, Effective Care Environment

Application

24.3•According to the Agency for Health Care Research and Quality, which drug event committed by nurses has the highest percentage of error to the elderly?

1. inadequate monitoring
2. drug–drug interaction
3. preparation error
4. missed dose

Answer: 4

Rationale: Missed dose is the correct answer because in 7% of errors committed clients do not get the prescribed medications. Drug–drug is an incorrect answer because drug interaction occurs with 5% of drug events. Inadequate monitoring and preparation error are incorrect answers because AHCRQ states that these drug events occur in 1% of the cases.

Evaluation

Physiological Integrity

Knowledge

24.4•A nurse is caring for an elderly client who is in palliative care only. Which intervention would have the highest priority?

1. aggressive chemotherapy
2. pain management
3. invasive testing
4. aggressive invasive surgery

Answer: 2

Rationale: Palliative care provides comfort measures at the end of life. Aggressive chemotherapy, invasive testing, and aggressive invasive surgery are used when the goal is cure of the disease.

Intervention

Physiological Integrity

Analysis