A&E!!I!!Comprehensive!!Testban
k
Week!!1
Care!!of!!Older!!Adults:!!Culture,!!Spirituality,!!Communication,!Sexuality,!!Infection!!
Control
Chapter!!05:!!Chronic!!Illness!!and!!Older!!Adults!!Lewis:!!Medical-
Surgical!!Nursing,!10th!!Edition
MULTIPLE!!CHOICE
The!!nurse cares for an alert, homeless older adult patient who was admitted to the
F F F F F F F F F F F F F F
hospital with a chronic foot infection. Which intervention is the most appropriate for
F F F F F F F F F F F F F
the nurse to includein the discharge plan for this patient?
F F F F F F F F F F
a) Teach the patient how to assess and care for the foot infection.
F F F F F F F F F F F
b) Refer the patient to social services for assessment of resources.
F F F F F F F F F
c) Schedule the patient to return to outpatient services for foot care.
F F F F F F F F F F
d) Give the patient written information about shelters and meal sites.
F F F F F F F F F
ANS: B F
An interprofessional approach, including social services, is needed when caring for
F F F F F F F F F F F
homeless older adults. Even with appropriate teaching, a homeless individual may
F F F F F F F F F F F
not be able to maintainadequate foot care because of a lack of supplies or a suitable
F F F F F F F F F F F F F F F F F
place to accomplish care. Older homeless individuals are less likely to use shelters
F F F F F F F F F F F F F
or meal sites. A homeless person may fail to keep appointments for outpatient
F F F F F F F F F F F F F
services because of factors such as fear of institutionalization or lack of
F F F F F F F F F F F F
transportation.
The home health nurse cares for an older adult patient who lives alone and
F F F F F F F F F F F F F F
takes severaldifferent prescribed medications for chronic health problems.
F F F F F F F F F
Which intervention, if implemented by the nurse, would best encourage
F F F F F F F F F F
medication compliance? F
a) Use a marked pillbox to set up the patient’s medications.
F F F F F F F F F
1
, A&E!!I!!Comprehensive!!Testban
k
b) Discuss the option of moving to an assisted living facility.
F F F F F F F F F
c) Remind the patient about the importance of taking medications.
F F F F F F F F
d) Visit the patient daily to administer the prescribed medications.
F F F F F F F F
ANS: A F
Because forgetting to take medications is a common cause of medication errors in
F F F F F F F F F F F F F
older adults, the use of medication reminder devices is helpful when older adults
F F F F F F F F F F F F F
have multiple medications totake. There is no indication that the patient needs to
F F F F F F F F F F F F F F
move to assisted living or that the patient does not understand the importance of
F F F F F F F F F F F F F F
medication compliance. Home health care is not designed for the patient who needs
F F F F F F F F F F F F F
ongoing assistance with activities of daily living or instrumental ADLs.
F F F F F F F F F
The home health nurse visits an older patient with mild forgetfulness. Which new
F F F F F F F F F F F F F
informationis of most concern to the nurse? F F F F F F F
a) The patient tells the nurse that a close friend recently died.
F F F F F F F F F F
b) The patient has lost 10 lb (4.5 kg) during the past month.
F F F F F F F F F F F
c) The patient is cared for by a daughter during the day and stays with a son at
F F F F F F F F F F F F F F F F F
night.
d) The patient’s son uses a marked pillbox to set up the patient’s medications
F F F F F F F F F F F F F
weekly.
ANS: B F
A 10-pound weight loss may be an indication of elder neglect or depression and
F F F F F F F F F F F F F F
requires furtherassessment by the nurse. The use of a marked pillbox and planning
F F F F F F F F F F F F F F
by the family for 24-hour care are appropriate for this patient. It is not unusual that
F F F F F F F F F F F F F F F F
an 86-yr-old would have friends who have died.
F F F F F F F
Which statement, if made by an older adult patient, would be of most concern to the
F F F F F F F F F F F F F F F F
nurse? a. F
2
, A&E!!I!!Comprehensive!!Testban
“I prefer to manage my life without
F
k
F much help from other people.”
F F F F F F F F F
a) “I prefer to manage my life without much help from other people.”
F F F F F F F F F F F
b) “I take three different medications for my heart and joint problems.”
F F F F F F F F F F
c) “I don’t go on daily walks anymore since I had pneumonia 3 months ago.”
F F F F F F F F F F F F F
d) “I set up my medications in a marked pillbox so I don’t forget to take them.”
F F F F F F F F F F F F F F F
ANS: C F
Inactivity and immobility lead rapidly to loss of function in older adults. The nurse
F F F F F F F F F F F F F F
should develop a plan to prevent further deconditioning and restore function for the
F F F F F F F F F F F F F
patient. Self- management is appropriate for independently living older adults. On
F F F F F F F F F F F
average, an older adult takes seven different medications so the use of three
F F F F F F F F F F F F F
medications is not unusual for this patient.The use of memory devices to assist with
F F F F F F F F F F F F F F F
safe medication administration is recommended for older adults.
F F F F F F F
The nurse assesses an older patient who takes diuretics and has a possible
F F F F F F F F F F F F F
urinary tractinfection (UTI). Which action should the nurse take first?
F F F F F F F F F F
a) Palpate over the suprapubic area. F F F F
b) Inspect for abdominal distention. F F F
c) Question the patient about hematuria. F F F F
d) Request the patient empty the bladder. F F F F F
ANS: D F
Before beginning the assessment of an older patient with a UTI and on diuretics, the
F F F F F F F F F F F F F F F
nurse should have the patient empty the bladder because bladder fullness or
F F F F F F F F F F F F
discomfort will distractfrom the patient’s ability to provide accurate information.
F F F F F F F F F F F
The patient may seem disoriented ifdistracted by pain or urgency. The physical
F F F F F F F F F F F F F
assessment data are obtained after the patient is ascomfortable as possible.
F F F F F F F F F F F
Which patient is most likely to need long-term nursing care management?
F F F F F F F F F F
3
, A&E!!I!!Comprehensive!!Testban
k replacement after a fall at home
a) 72-yr-old who had a hip F F F F F F F F F F
b) 64-yr-old who developed sepsis after a ruptured peptic ulcer F F F F F F F F
c) 76-yr-old who had a cholecystectomy and bile duct drainage F F F F F F F F
d) 63-yr-old with bilateral knee osteoarthritis who weighs 350 lb (159 kg)
F F F F F F F F F F
ANS: D F
Osteoarthritis and obesity are chronic problems that will require planning for long-
F F F F F F F F F F F
term interventions such as physical therapy and nutrition counseling. The other
F F F F F F F F F F F
patients have acuteproblems that are not likely to require long-term management.
F F F F F F F F F F F
An older adult being admitted is assessed at high risk for falls. Which action
F F F F F F F F F F F F F F
should the nursetake first?
F F F F
a) Use a bed alarm system on the patient’s bed.
F F F F F F F F
b) Administer the prescribed PRN sedative medication. F F F F F
c) Ask the health care provider to order a vest restraint.
F F F F F F F F F
d) Place the patient in a “geri-chair” near the nurse’s station.
F F F F F F F F F
ANS: A F
The use of the least restrictive restraint alternative is required. Physical or chemical
F F F F F F F F F F F F F
restraintsmay be necessary, but the nurse’s first action should be an alternative such
F F F F F F F F F F F F F F
as a bed alarm.
F F F
An older adult patient presents with a broken arm and visible scattered bruises
F F F F F F F F F F F F F
healing atdifferent stages. Which action should the nurse take first?
F F F F F F F F F F
a) Notify an elder protective services agency about possible abuse.
F F F F F F F F
b) Make a referral for a home assessment visit by the home health nurse.
F F F F F F F F F F F F
c) Have the family member stay in the waiting area while the patient is assessed.
F F F F F F F F F F F F F
d) Ask the patient how the injury occurred and observe the family member’s
F F F F F F F F F F F F
4
k
Week!!1
Care!!of!!Older!!Adults:!!Culture,!!Spirituality,!!Communication,!Sexuality,!!Infection!!
Control
Chapter!!05:!!Chronic!!Illness!!and!!Older!!Adults!!Lewis:!!Medical-
Surgical!!Nursing,!10th!!Edition
MULTIPLE!!CHOICE
The!!nurse cares for an alert, homeless older adult patient who was admitted to the
F F F F F F F F F F F F F F
hospital with a chronic foot infection. Which intervention is the most appropriate for
F F F F F F F F F F F F F
the nurse to includein the discharge plan for this patient?
F F F F F F F F F F
a) Teach the patient how to assess and care for the foot infection.
F F F F F F F F F F F
b) Refer the patient to social services for assessment of resources.
F F F F F F F F F
c) Schedule the patient to return to outpatient services for foot care.
F F F F F F F F F F
d) Give the patient written information about shelters and meal sites.
F F F F F F F F F
ANS: B F
An interprofessional approach, including social services, is needed when caring for
F F F F F F F F F F F
homeless older adults. Even with appropriate teaching, a homeless individual may
F F F F F F F F F F F
not be able to maintainadequate foot care because of a lack of supplies or a suitable
F F F F F F F F F F F F F F F F F
place to accomplish care. Older homeless individuals are less likely to use shelters
F F F F F F F F F F F F F
or meal sites. A homeless person may fail to keep appointments for outpatient
F F F F F F F F F F F F F
services because of factors such as fear of institutionalization or lack of
F F F F F F F F F F F F
transportation.
The home health nurse cares for an older adult patient who lives alone and
F F F F F F F F F F F F F F
takes severaldifferent prescribed medications for chronic health problems.
F F F F F F F F F
Which intervention, if implemented by the nurse, would best encourage
F F F F F F F F F F
medication compliance? F
a) Use a marked pillbox to set up the patient’s medications.
F F F F F F F F F
1
, A&E!!I!!Comprehensive!!Testban
k
b) Discuss the option of moving to an assisted living facility.
F F F F F F F F F
c) Remind the patient about the importance of taking medications.
F F F F F F F F
d) Visit the patient daily to administer the prescribed medications.
F F F F F F F F
ANS: A F
Because forgetting to take medications is a common cause of medication errors in
F F F F F F F F F F F F F
older adults, the use of medication reminder devices is helpful when older adults
F F F F F F F F F F F F F
have multiple medications totake. There is no indication that the patient needs to
F F F F F F F F F F F F F F
move to assisted living or that the patient does not understand the importance of
F F F F F F F F F F F F F F
medication compliance. Home health care is not designed for the patient who needs
F F F F F F F F F F F F F
ongoing assistance with activities of daily living or instrumental ADLs.
F F F F F F F F F
The home health nurse visits an older patient with mild forgetfulness. Which new
F F F F F F F F F F F F F
informationis of most concern to the nurse? F F F F F F F
a) The patient tells the nurse that a close friend recently died.
F F F F F F F F F F
b) The patient has lost 10 lb (4.5 kg) during the past month.
F F F F F F F F F F F
c) The patient is cared for by a daughter during the day and stays with a son at
F F F F F F F F F F F F F F F F F
night.
d) The patient’s son uses a marked pillbox to set up the patient’s medications
F F F F F F F F F F F F F
weekly.
ANS: B F
A 10-pound weight loss may be an indication of elder neglect or depression and
F F F F F F F F F F F F F F
requires furtherassessment by the nurse. The use of a marked pillbox and planning
F F F F F F F F F F F F F F
by the family for 24-hour care are appropriate for this patient. It is not unusual that
F F F F F F F F F F F F F F F F
an 86-yr-old would have friends who have died.
F F F F F F F
Which statement, if made by an older adult patient, would be of most concern to the
F F F F F F F F F F F F F F F F
nurse? a. F
2
, A&E!!I!!Comprehensive!!Testban
“I prefer to manage my life without
F
k
F much help from other people.”
F F F F F F F F F
a) “I prefer to manage my life without much help from other people.”
F F F F F F F F F F F
b) “I take three different medications for my heart and joint problems.”
F F F F F F F F F F
c) “I don’t go on daily walks anymore since I had pneumonia 3 months ago.”
F F F F F F F F F F F F F
d) “I set up my medications in a marked pillbox so I don’t forget to take them.”
F F F F F F F F F F F F F F F
ANS: C F
Inactivity and immobility lead rapidly to loss of function in older adults. The nurse
F F F F F F F F F F F F F F
should develop a plan to prevent further deconditioning and restore function for the
F F F F F F F F F F F F F
patient. Self- management is appropriate for independently living older adults. On
F F F F F F F F F F F
average, an older adult takes seven different medications so the use of three
F F F F F F F F F F F F F
medications is not unusual for this patient.The use of memory devices to assist with
F F F F F F F F F F F F F F F
safe medication administration is recommended for older adults.
F F F F F F F
The nurse assesses an older patient who takes diuretics and has a possible
F F F F F F F F F F F F F
urinary tractinfection (UTI). Which action should the nurse take first?
F F F F F F F F F F
a) Palpate over the suprapubic area. F F F F
b) Inspect for abdominal distention. F F F
c) Question the patient about hematuria. F F F F
d) Request the patient empty the bladder. F F F F F
ANS: D F
Before beginning the assessment of an older patient with a UTI and on diuretics, the
F F F F F F F F F F F F F F F
nurse should have the patient empty the bladder because bladder fullness or
F F F F F F F F F F F F
discomfort will distractfrom the patient’s ability to provide accurate information.
F F F F F F F F F F F
The patient may seem disoriented ifdistracted by pain or urgency. The physical
F F F F F F F F F F F F F
assessment data are obtained after the patient is ascomfortable as possible.
F F F F F F F F F F F
Which patient is most likely to need long-term nursing care management?
F F F F F F F F F F
3
, A&E!!I!!Comprehensive!!Testban
k replacement after a fall at home
a) 72-yr-old who had a hip F F F F F F F F F F
b) 64-yr-old who developed sepsis after a ruptured peptic ulcer F F F F F F F F
c) 76-yr-old who had a cholecystectomy and bile duct drainage F F F F F F F F
d) 63-yr-old with bilateral knee osteoarthritis who weighs 350 lb (159 kg)
F F F F F F F F F F
ANS: D F
Osteoarthritis and obesity are chronic problems that will require planning for long-
F F F F F F F F F F F
term interventions such as physical therapy and nutrition counseling. The other
F F F F F F F F F F F
patients have acuteproblems that are not likely to require long-term management.
F F F F F F F F F F F
An older adult being admitted is assessed at high risk for falls. Which action
F F F F F F F F F F F F F F
should the nursetake first?
F F F F
a) Use a bed alarm system on the patient’s bed.
F F F F F F F F
b) Administer the prescribed PRN sedative medication. F F F F F
c) Ask the health care provider to order a vest restraint.
F F F F F F F F F
d) Place the patient in a “geri-chair” near the nurse’s station.
F F F F F F F F F
ANS: A F
The use of the least restrictive restraint alternative is required. Physical or chemical
F F F F F F F F F F F F F
restraintsmay be necessary, but the nurse’s first action should be an alternative such
F F F F F F F F F F F F F F
as a bed alarm.
F F F
An older adult patient presents with a broken arm and visible scattered bruises
F F F F F F F F F F F F F
healing atdifferent stages. Which action should the nurse take first?
F F F F F F F F F F
a) Notify an elder protective services agency about possible abuse.
F F F F F F F F
b) Make a referral for a home assessment visit by the home health nurse.
F F F F F F F F F F F F
c) Have the family member stay in the waiting area while the patient is assessed.
F F F F F F F F F F F F F
d) Ask the patient how the injury occurred and observe the family member’s
F F F F F F F F F F F F
4
