Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A nurse learns that the fastest growing subset of the older population is which group?
a. Elite old
b. Middle old
c. Old old
d. Young old
ANS: C
The old old is the fastest growing subset of the older population. This is the group comprising
those 85 to 99 years of age. The young old are between 65 and 74 years of age; the middle old
are between 75 and 84 years of age; and the elite old are over 100 years of age.
DIF: Remembering TOP: Integrated Process: Teaching/Learning
KEY: Older adults MSC: Client Needs Category: Health Promotion and Maintenance
2. A nurse working with older adults in the community plans programming to improve morale
and emotional health in this population. What activity would best meet this goal?
a. Exercise program to improve physical function
b. Financial planning seminar series for older adults
c. Social events such as dances and group dinners
d. Workshop on prevention from becoming an abuse victim
ANS: A
All activities would be beneficial for the older population in the community. However, failure
in performing one’s own activities of daily living and participating in society has direct effects
on morale and life satisfaction. Those who lose the ability to function independently often feel
worthless and empty. An exercise program designed to maintain and/or improve physical
functioning would best address this need.
DIF: Applying TOP: Integrated Process: Nursing Process: Planning
KEY: Older adult MSC: Client Needs Category: Psychosocial Integrity
3. A nurse caring for an older client on a medical-surgical unit notices the client reports frequent
constipation and only wants to eat softer foods such as rice, bread, and puddings. What
assessment would the nurse perform first?
a. Auscultate bowel sounds.
b. Check skin turgor.
c. Perform an oral assessment.
d. Weigh the client.
ANS: C
Poorly fitting dentures and other dental problems are often manifested by a preference for soft
foods and constipation from the lack of fiber. The nurse would perform an oral assessment to
determine if these problems exist. The other assessments are important, but will not yield
information specific to the client’s food preferences as they relate to constipation.
, DIF: Applying TOP: Integrated Process: Nursing Process: Assessment
KEY: Older adult, Nutrition
MSC: Client Needs Category: Physiological Integrity: Basic Care and Comfort
4. A nurse caring for an older adult has provided education on high-fiber foods. Which menu
selection by the client demonstrates a need for further review?
a. Barley soup
b. Black beans
c. White rice
d. Whole-wheat bread
ANS: C
Older adults need 35 to 50 g of fiber a day. White rice is low in fiber. Foods high in fiber
include barley, beans, and whole-wheat products.
DIF: Analyzing TOP: Integrated Process: Nursing Process: Evaluation
KEY: Older adult, Nutrition
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
5. A nurse is working with an older client admitted with mild dehydration. What teaching does
the nurse provide to best address this issue?
a. “Cut some sodium out of your diet.”
b. “Dehydration can cause incontinence.”
c. “Have something to drink every 1 to 2 hours.”
d. “Take your diuretic in the morning.”
ANS: C
Older adults often lose their sense of thirst. Plus older adults have less body water than
younger people. Since they should drink 1 to 2 L of water a day, the best remedy is to have
the older adult drink something each hour or two, whether or not he or she is thirsty. Cutting
“some” sodium from the diet will not address this issue and is vague. Although dehydration
can cause incontinence from the irritation of concentrated urine, this information will not help
prevent the problem of dehydration. Instructing the client to take a diuretic in the morning
rather than in the evening also will not directly address this issue.
DIF: Applying TOP: Integrated Process: Teaching/Learning
KEY: Older adult, Fluid and electrolyte balance
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
6. A home health care nurse is planning an exercise program with an older adult who lives at
home independently but whose mobility issues prevent much activity outside the home.
Which exercise regimen would be most beneficial to this adult?
a. Building strength and flexibility
b. Improving exercise endurance
c. Increasing aerobic capacity
d. Providing personal training
ANS: A
This older adult is mostly homebound. Exercise regimens for homebound clients include
things to increase functional fitness and ability for activities of daily living. Strength and
flexibility will help the client to be able to maintain independence longer. The other plans are
good but will not specifically maintain the client’s functional abilities.