EXAM 1 Study Guide Questions Lewis'
Medical-Surgical Nursing with Answer
. A 78-year-old female patient is admitted with nausea, vomiting, anorexia, diarrhea, and
dehydration. She has a history of diabetes and 2 years ago had a stroke with residual right-sided
weakness. Identify which characteristics of chronic illness the nurse will probably find in this
patient (select all that apply). a. Self-limiting
b. Residual disability
c. Permanent impairments
d. Infrequent complications
e. Need for long-term management
f. Nonreversible pathologic changes - <CORRECT ANSWER >>b, c, e, f. The diabetes and residual
right-sided weakness from the cerebrovascular accident (CVA) contribute to the residual
disability and permanent impairments. Diabetes requires long-term management, and both
problems contribute to nonreversible pathologic changes.
Actions aimed at early detection of disease and interventions to prevent progression of disease
are considered __________ prevention - <CORRECT ANSWER >>secondary
Following a proper diet, getting appropriate exercise, and receiving immunizations against
specific diseases are considered __________ prevention. - <CORRECT ANSWER >>primary
What is the leading cause of death in the United States?
a. Cancer
b. Diabetes
c. Coronary artery disease
d. Cerebrovascular accident
e. Chronic obstructive pulmonary disease - <CORRECT ANSWER >>c. Coronary artery disease is
the leading cause of death in the United States
,According to the Corbin and Strauss chronic illness trajectory, which statement describes a
patient with an unstable condition?
a. Life-threatening situation
b. Increasing disability and symptoms
c. Gradual return to acceptable way of life
d. Loss of control over symptoms and disease course - <CORRECT ANSWER >>d. The trajectory
defines a life-threatening situation as a crisis. Increasing disability is described as downward. A
gradual return to an acceptable way of life is a comeback.
Which statement(s) about older people are only myths and illustrate the concept of ageism
(select all that apply)?
a. You can't teach an old dog new tricks.
b. Old people are not sexually active.
c. Most old people live independently.
d. Most older adults can no longer learn new information.
e. Most older people lose interest in life and wish they would die - <CORRECT ANSWER >>a, b,
d, e. Ageism is a negative attitude based on age.
The nurse identifies the presence of age-associated memory impairment in the older adult who
states
a. "I just can't seem to remember the name of my granddaughter."
b. "I make out lists to help me remember what I need to do, but I can't seem to use them."
c. "I forgot that I went to the grocery store this morning and didn't realize it until I went again
this afternoon."
d. "I forget movie stars' names more often now, but I can remember them later after the
conversation is over." - <CORRECT ANSWER >>d. Age-associated memory impairment is
characterized by a memory lapse or benign forgetfulness that is different from a decline in
cognitive functioning. Forgetting a name, date, or recent event is not serious, but the other
examples indicate abnormal functioning.
,When working with older patients who identify with a specific ethnic group, the nurse
recognizes that health care problems may occur in these patients because they
a. live with extended families who isolate the patient.
b. live in rural areas where services are not readily available.
c. eat ethnic foods that do not provide all the essential nutrients.
d. have less income to spend for medications and health care services - <CORRECT ANSWER
>>d. Older adults with an ethnic identity often have disproportionately low incomes and may
not be able to afford Medicare deductibles or medications to treat health problems. Although
they often live in older urban neighborhoods with extended families, they are not isolated.
Ethnic diets have adequate nutrition, but health could be impaired if money is not available for
food.
What are 3 common factors known to precipitate placement in a long-term care facility? -
<CORRECT ANSWER >>rapid patient deterioration, caregiver stress and burnout, and change in
or loss of family support system. Possible factors that hasten placement decisions are
progressive dementia, urinary incontinence, or a major health event.
An 88-year-old woman is brought to the health clinic for the first time by her 64-yearold
daughter. During the initial comprehensive nursing assessment of the patient, what should the
nurse do?
a. Ask the daughter whether the patient has any urgent needs or problems.
b. Interview the patient and daughter together so that pertinent information can be confirmed.
c. Refer the patient for an interprofessional comprehensive geriatric assessment because at her
age she will have multiple needs.
d. Obtain a comprehensive health history using physical, psychologic, functional,
developmental, socioeconomic, and cultural assessments. - <CORRECT ANSWER >>d. During an
initial contact with an older adult, the nurse should perform a comprehensive nursing
assessment that includes a health history using physical, psychologic, functional,
developmental, socioeconomic, and cultural assessments
What is a mental status assessment of the older adult especially important in determining?
a. Potential for independent living
, b. Eligibility for federal health programs
c. Service and placement needs of the person
d. Whether the person should be classified as frail - <CORRECT ANSWER >>a. The results of
mental status evaluation often determine whether the patient can manage independent living,
a major issue in older adulthood. Other elements of comprehensive assessment could
determine eligibility for special problems, determination of frailty, and total service and
placement needs.
What is the most 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 - <CORRECT ANSWER
>>c. Exercise for all older adults is important to prevent deconditioning and subsequent
functional decline from many different causes
Which nursing actions would show the nurse's understanding of the concept of providing safe
care without using restraints (select all that apply)?
a. Placing patients with fall risk in low beds
b. Asking simple yes-or-no questions to clarify patient needs
c. Making hourly rounds on patients to assess for pain and toileting needs
d. Placing a disruptive patient near the nurses' station in a chair with a seat belt
e. Applying a jacket vest loosely so that the patient can turn but cannot climb out of bed -
<CORRECT ANSWER >>a, b, c. These actions are alternatives to restraints that may help reduce
falls and keep the patient safe.
When teaching a 69-year-old patient about self-care, what will promote health (select all that
apply)?
a. Proper diet
b. Immunizations
Medical-Surgical Nursing with Answer
. A 78-year-old female patient is admitted with nausea, vomiting, anorexia, diarrhea, and
dehydration. She has a history of diabetes and 2 years ago had a stroke with residual right-sided
weakness. Identify which characteristics of chronic illness the nurse will probably find in this
patient (select all that apply). a. Self-limiting
b. Residual disability
c. Permanent impairments
d. Infrequent complications
e. Need for long-term management
f. Nonreversible pathologic changes - <CORRECT ANSWER >>b, c, e, f. The diabetes and residual
right-sided weakness from the cerebrovascular accident (CVA) contribute to the residual
disability and permanent impairments. Diabetes requires long-term management, and both
problems contribute to nonreversible pathologic changes.
Actions aimed at early detection of disease and interventions to prevent progression of disease
are considered __________ prevention - <CORRECT ANSWER >>secondary
Following a proper diet, getting appropriate exercise, and receiving immunizations against
specific diseases are considered __________ prevention. - <CORRECT ANSWER >>primary
What is the leading cause of death in the United States?
a. Cancer
b. Diabetes
c. Coronary artery disease
d. Cerebrovascular accident
e. Chronic obstructive pulmonary disease - <CORRECT ANSWER >>c. Coronary artery disease is
the leading cause of death in the United States
,According to the Corbin and Strauss chronic illness trajectory, which statement describes a
patient with an unstable condition?
a. Life-threatening situation
b. Increasing disability and symptoms
c. Gradual return to acceptable way of life
d. Loss of control over symptoms and disease course - <CORRECT ANSWER >>d. The trajectory
defines a life-threatening situation as a crisis. Increasing disability is described as downward. A
gradual return to an acceptable way of life is a comeback.
Which statement(s) about older people are only myths and illustrate the concept of ageism
(select all that apply)?
a. You can't teach an old dog new tricks.
b. Old people are not sexually active.
c. Most old people live independently.
d. Most older adults can no longer learn new information.
e. Most older people lose interest in life and wish they would die - <CORRECT ANSWER >>a, b,
d, e. Ageism is a negative attitude based on age.
The nurse identifies the presence of age-associated memory impairment in the older adult who
states
a. "I just can't seem to remember the name of my granddaughter."
b. "I make out lists to help me remember what I need to do, but I can't seem to use them."
c. "I forgot that I went to the grocery store this morning and didn't realize it until I went again
this afternoon."
d. "I forget movie stars' names more often now, but I can remember them later after the
conversation is over." - <CORRECT ANSWER >>d. Age-associated memory impairment is
characterized by a memory lapse or benign forgetfulness that is different from a decline in
cognitive functioning. Forgetting a name, date, or recent event is not serious, but the other
examples indicate abnormal functioning.
,When working with older patients who identify with a specific ethnic group, the nurse
recognizes that health care problems may occur in these patients because they
a. live with extended families who isolate the patient.
b. live in rural areas where services are not readily available.
c. eat ethnic foods that do not provide all the essential nutrients.
d. have less income to spend for medications and health care services - <CORRECT ANSWER
>>d. Older adults with an ethnic identity often have disproportionately low incomes and may
not be able to afford Medicare deductibles or medications to treat health problems. Although
they often live in older urban neighborhoods with extended families, they are not isolated.
Ethnic diets have adequate nutrition, but health could be impaired if money is not available for
food.
What are 3 common factors known to precipitate placement in a long-term care facility? -
<CORRECT ANSWER >>rapid patient deterioration, caregiver stress and burnout, and change in
or loss of family support system. Possible factors that hasten placement decisions are
progressive dementia, urinary incontinence, or a major health event.
An 88-year-old woman is brought to the health clinic for the first time by her 64-yearold
daughter. During the initial comprehensive nursing assessment of the patient, what should the
nurse do?
a. Ask the daughter whether the patient has any urgent needs or problems.
b. Interview the patient and daughter together so that pertinent information can be confirmed.
c. Refer the patient for an interprofessional comprehensive geriatric assessment because at her
age she will have multiple needs.
d. Obtain a comprehensive health history using physical, psychologic, functional,
developmental, socioeconomic, and cultural assessments. - <CORRECT ANSWER >>d. During an
initial contact with an older adult, the nurse should perform a comprehensive nursing
assessment that includes a health history using physical, psychologic, functional,
developmental, socioeconomic, and cultural assessments
What is a mental status assessment of the older adult especially important in determining?
a. Potential for independent living
, b. Eligibility for federal health programs
c. Service and placement needs of the person
d. Whether the person should be classified as frail - <CORRECT ANSWER >>a. The results of
mental status evaluation often determine whether the patient can manage independent living,
a major issue in older adulthood. Other elements of comprehensive assessment could
determine eligibility for special problems, determination of frailty, and total service and
placement needs.
What is the most 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 - <CORRECT ANSWER
>>c. Exercise for all older adults is important to prevent deconditioning and subsequent
functional decline from many different causes
Which nursing actions would show the nurse's understanding of the concept of providing safe
care without using restraints (select all that apply)?
a. Placing patients with fall risk in low beds
b. Asking simple yes-or-no questions to clarify patient needs
c. Making hourly rounds on patients to assess for pain and toileting needs
d. Placing a disruptive patient near the nurses' station in a chair with a seat belt
e. Applying a jacket vest loosely so that the patient can turn but cannot climb out of bed -
<CORRECT ANSWER >>a, b, c. These actions are alternatives to restraints that may help reduce
falls and keep the patient safe.
When teaching a 69-year-old patient about self-care, what will promote health (select all that
apply)?
a. Proper diet
b. Immunizations
