MED-SURG 2 PRACTICE QUESTIONS

MED-SURG 2 PRACTICE QUESTIONS CHAPTER 5 CHRONIC ILLNESS AND OLDER ADULTS 1. An 83-year-old woman is being discharged from the hospital following stabilization of her international normalized ratio (INR) levels (used to assess the effectiveness of warfarin therapy). She has chronic atrial fibrillation and has been on warfarin (coumadin) for several years. Discharge instructions include returning to the clinic weekly for INR testing. Which statement by the patient indicates that she may be unable to have the testing done? a. "When I have the energy, I have to take a bus to get this test done." b. "I will need to ask my son to bring me into town every week for the test." c. "Should I just keep taking the same pill every day until I can get a ride into town." d. "It is very important to have this test every week. I have several church friends who can bring me." 2. What is an important nursing measure in the rehabilitation of an older adult to prevent loss of function from inactivity and immobility? a. Using assistive devices such as walkers and canes. b. Teaching good nutrition to prevent loss of muscle mass. c. Performance of active and passive range-of-motion (ROM) exercises. d. Performance of risk appraisals and assessments related to immobility. 3. An appropriate care choice for an older adult who lives with an employed daughter but requires help with activities of daily living is: a. adult day care b. long term care c. a retirement center d. an assisted living facility 4. What is most appropriate for the nurse to do when interviewing an older patient? a. ensure all assistive devices are in place. b. interview the patient and caregiver together. c. perform the interview before administering analgesics. d. move on to the next question if the patient does not respond quickly. 5. Which assessment findings would alert the nurse to possible elder mistreatment (select all that apply)? a. agitation b. depression c. weight gain d. weight loss e. hypernatremia 6. A 70-year-old man has just been diagnosed with chronic obstructive pulmonary disease (COPD). At what point should the nurse begin to include the patient's wife in the teaching around the management of the disease? a. as soon as possible b. when the patient requests assistance from his spouse and family c. when the patient becomes unable to manage his symptoms independently d. after the patient has had the opportunity to adjust to his treatment regimen 7. The long-term care nurse is performing assessments on several of the residents. Which are the normal age-related physiological change(s) the nurse expects to note? Select all that apply. A. Increased heart rate B. Decline in visual acuity C. Decreased respiratory rate D. Decline in long term memory E. Increased susceptibility to UTI’s F. Increased incidence of awakening after sleep onset 8. The home health nurse is visiting a client for the first time. While assessing the client’s medication history, it is noted that there are 19 prescriptions and several OTC medications that the client has been taking. Which intervention should the nurse take first? A. Check for medication interactions B. Determine whether there are medication duplications C. Call the prescribing HCP and report polypharmacy D. Determine whether a family member supervises medication administration 9. The nurse is providing medication instructions to an older client who is taking digoxin (Lanoxin) daily. The nurse notes that which age-related body change could place the client at risk for digoxin toxicity? A. Decreased muscle strength and loss of bone density B. Decreased cough efficiency and decreased vital capacity C. Decreased salivation and decreased gastrointestinal mobility D. Decreased lean body mass and decreased glomerular filtration rate CHAPTER 15 – CANCER 1. A patient who is scheduled for a breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is correct? a. "Benign tumors do not cause damage to other tissues." b. "Benign tumors are likely to recur in the same location." c. "Malignant tumors may spread to other tissues or organs."