NUR 243 Midterm study UPDATED
ACTUAL Questions and CORRECT
Answers
An 82-year-old woman with chronic heart failure is cared for in the home by her only child. What
problem is indicated by the caregiver's failure to provide companionship or social stimulation?
A) Neglect
B) Sexual abuse
C) Abandonment
D) Violation of personal rights - CORRECT ANSWER - A) Neglect
Ch. 5
RATIONALE: Neglect characteristics: leaving alone for long periods, failing to provide social
stimulation and/or companionship; Sexual abuse: nonconsensual sexual contact includes touching
inappropriately, forcing sexual contact; Abandonment: desertion by person who's assumed responsibility
for providing care or person w/ physical custody; Violation of personal rights: denying right to privacy or
make decisions regarding health care or living environment, forcible eviction.
A 74-year-old patient admitted with an irregular cardiac rhythm has a much lower blood level of his home
medication than expected. Which common cause of medication errors made by older adults should be
suspected?
A) Shorter drug half-life leading to medication overdose
B) Decreased use of nonprescription over-the-counter drugs
C) Improved tolerance of adverse effects of prescribed drugs
D) Lack of financial resources to obtain prescribed medications - CORRECT ANSWER - D) Lack
of financial resources to obtain prescribed medications
Ch. 5
RATIONALE: Common causes of medication errors by older adults include poor eyesight, forgetting to
take drugs, use of nonprescription over-the-counter drugs, use of medications prescribed for someone
else, lack of financial resources to obtain prescribed medication, failure to understand instructions or
importance of drug treatment, and refusal to take medication because of undesirable side effects. Drug
half-life is increased in older adults.
*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. - CORRECT ANSWER -
A) Ensure all assistive devices are in place.
Ch. 5
RATIONALE: All assistive devices, such as glasses and hearing aids, should be in place when
interviewing an older patient. It is best to interview the patient and caregiver separately to ensure a
reliable assessment related to any possible mistreatment. The patient should be free from pain during the
assessment and may need extra time to respond to questions.
*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 - CORRECT ANSWER - A, B, D, E [agitation, depression, weight loss,
hypernatremia]
Ch. 5
RATIONALE: Agitation and depression may be manifestations of psychologic abuse or neglect.
Hypernatremia may signify dehydration caused by physical neglect. Weight loss, rather than weight gain,
is another manifestation of physical neglect.
A 67-year-old woman who has a long-standing diagnosis of incontinence is in the habit of arriving 20
minutes early for church in order to ensure that she gets a seat near the end of a row and close to the exit
so that she has ready access to the restroom. Which tasks of the chronically ill is the woman
demonstrating?
(select all that apply)
A) Controlling symptoms
B) Preventing social isolation
C) Preventing and managing a crisis
D) Denying the reality of the problem
E) Adjusting to changes in the course of the disease - CORRECT ANSWER - A, C [Controlling
symptoms & Preventing and managing a crisis]
,Ch. 5
RATIONALE: The woman's efforts to ensure that she can continue in her lifestyle of church attendance
while accommodating the frequent elimination caused by her health problem are an example of
controlling her symptoms and preventing a personal crisis.
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 - CORRECT
ANSWER - A) As soon as possible
Ch. 5
RATIONALE: In the management of chronic illness, it is desirable to include family caregivers in patient
education and symptom-management efforts as early in the diagnosis as possible.
A male patient has a history of hypertension and type 1 diabetes mellitus. Because of these chronic
illnesses, the patient exercises and eats the healthy diet that his wife prepares for him. Which factors will
most likely have a positive impact on his biologic aging?
(select all that apply)
A) Exercise
B) Diabetes
C) Social support
D) Good nutrition
E) Coping resources - CORRECT ANSWER - A, C, D, E [Exercise, Social support, Good
nutrition, Coping resources]
Ch. 5
RATIONALE: Biologic aging is the progressive loss of function. Obesity, diabetes, hypertension, and
cancer are all associated with the effects of aging. Exercise, good nutrition, social support, stress
management, and coping resources are all positive factors related to the aging process.
A 60-year-old female patient has had increased evidence of dementia and physical deterioration. What
would be the best assistance to recommend to her caregiver husband who is exhausted?
, A) Long-term care
B) Adult day care
C) Home health care
D) Homemaker services - CORRECT ANSWER - B) Adult day care
Ch. 5
RATIONALE: Adult day care provides social, recreational, and health-related services in safe,
community-based environment that would keep pt. safe & decrease stress on husband. Long-term care
used when pt. has rapid deterioration, caregiver's unable to continue care, and there's alteration in or loss
of family support system. Home health care when there's supportive caregiver involvement for pt. w/
health needs. Homemaker services provide services, not pt. care.
Aging primarily affects the _________of drugs.
A) excretion
B) absorption
C) metabolism
D) distribution - CORRECT ANSWER - C) metabolism
Ch. 5
RATIONALE: Because the liver mass shrinks and hepatic blood flow and enzyme activity decrease in
older adults, metabolism of drugs drops 1/2 to 2/3 of the rate of young adults. This increases the chance of
drug toxicity and adverse drug events.
A characteristic of a chronic illness is that it:
(select all that apply)
A) has reversible pathologic changes.
B) has a consistent, predictable clinical course.
C) results in permanent deviation from normal.
D) is associated with many stable and unstable phases.
E) always starts with an acute illness and then progresses slowly. - CORRECT ANSWER - C, D
[has a consistent, predictable clinical course; results in permanent deviation from normal]
Ch. 5
RATIONALE: Characteristics of chronic illness include: permanent impairments or deviations from
normal, irreversible pathologic changes, residual disability, requirements for special rehabilitation, and
ACTUAL Questions and CORRECT
Answers
An 82-year-old woman with chronic heart failure is cared for in the home by her only child. What
problem is indicated by the caregiver's failure to provide companionship or social stimulation?
A) Neglect
B) Sexual abuse
C) Abandonment
D) Violation of personal rights - CORRECT ANSWER - A) Neglect
Ch. 5
RATIONALE: Neglect characteristics: leaving alone for long periods, failing to provide social
stimulation and/or companionship; Sexual abuse: nonconsensual sexual contact includes touching
inappropriately, forcing sexual contact; Abandonment: desertion by person who's assumed responsibility
for providing care or person w/ physical custody; Violation of personal rights: denying right to privacy or
make decisions regarding health care or living environment, forcible eviction.
A 74-year-old patient admitted with an irregular cardiac rhythm has a much lower blood level of his home
medication than expected. Which common cause of medication errors made by older adults should be
suspected?
A) Shorter drug half-life leading to medication overdose
B) Decreased use of nonprescription over-the-counter drugs
C) Improved tolerance of adverse effects of prescribed drugs
D) Lack of financial resources to obtain prescribed medications - CORRECT ANSWER - D) Lack
of financial resources to obtain prescribed medications
Ch. 5
RATIONALE: Common causes of medication errors by older adults include poor eyesight, forgetting to
take drugs, use of nonprescription over-the-counter drugs, use of medications prescribed for someone
else, lack of financial resources to obtain prescribed medication, failure to understand instructions or
importance of drug treatment, and refusal to take medication because of undesirable side effects. Drug
half-life is increased in older adults.
*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. - CORRECT ANSWER -
A) Ensure all assistive devices are in place.
Ch. 5
RATIONALE: All assistive devices, such as glasses and hearing aids, should be in place when
interviewing an older patient. It is best to interview the patient and caregiver separately to ensure a
reliable assessment related to any possible mistreatment. The patient should be free from pain during the
assessment and may need extra time to respond to questions.
*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 - CORRECT ANSWER - A, B, D, E [agitation, depression, weight loss,
hypernatremia]
Ch. 5
RATIONALE: Agitation and depression may be manifestations of psychologic abuse or neglect.
Hypernatremia may signify dehydration caused by physical neglect. Weight loss, rather than weight gain,
is another manifestation of physical neglect.
A 67-year-old woman who has a long-standing diagnosis of incontinence is in the habit of arriving 20
minutes early for church in order to ensure that she gets a seat near the end of a row and close to the exit
so that she has ready access to the restroom. Which tasks of the chronically ill is the woman
demonstrating?
(select all that apply)
A) Controlling symptoms
B) Preventing social isolation
C) Preventing and managing a crisis
D) Denying the reality of the problem
E) Adjusting to changes in the course of the disease - CORRECT ANSWER - A, C [Controlling
symptoms & Preventing and managing a crisis]
,Ch. 5
RATIONALE: The woman's efforts to ensure that she can continue in her lifestyle of church attendance
while accommodating the frequent elimination caused by her health problem are an example of
controlling her symptoms and preventing a personal crisis.
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 - CORRECT
ANSWER - A) As soon as possible
Ch. 5
RATIONALE: In the management of chronic illness, it is desirable to include family caregivers in patient
education and symptom-management efforts as early in the diagnosis as possible.
A male patient has a history of hypertension and type 1 diabetes mellitus. Because of these chronic
illnesses, the patient exercises and eats the healthy diet that his wife prepares for him. Which factors will
most likely have a positive impact on his biologic aging?
(select all that apply)
A) Exercise
B) Diabetes
C) Social support
D) Good nutrition
E) Coping resources - CORRECT ANSWER - A, C, D, E [Exercise, Social support, Good
nutrition, Coping resources]
Ch. 5
RATIONALE: Biologic aging is the progressive loss of function. Obesity, diabetes, hypertension, and
cancer are all associated with the effects of aging. Exercise, good nutrition, social support, stress
management, and coping resources are all positive factors related to the aging process.
A 60-year-old female patient has had increased evidence of dementia and physical deterioration. What
would be the best assistance to recommend to her caregiver husband who is exhausted?
, A) Long-term care
B) Adult day care
C) Home health care
D) Homemaker services - CORRECT ANSWER - B) Adult day care
Ch. 5
RATIONALE: Adult day care provides social, recreational, and health-related services in safe,
community-based environment that would keep pt. safe & decrease stress on husband. Long-term care
used when pt. has rapid deterioration, caregiver's unable to continue care, and there's alteration in or loss
of family support system. Home health care when there's supportive caregiver involvement for pt. w/
health needs. Homemaker services provide services, not pt. care.
Aging primarily affects the _________of drugs.
A) excretion
B) absorption
C) metabolism
D) distribution - CORRECT ANSWER - C) metabolism
Ch. 5
RATIONALE: Because the liver mass shrinks and hepatic blood flow and enzyme activity decrease in
older adults, metabolism of drugs drops 1/2 to 2/3 of the rate of young adults. This increases the chance of
drug toxicity and adverse drug events.
A characteristic of a chronic illness is that it:
(select all that apply)
A) has reversible pathologic changes.
B) has a consistent, predictable clinical course.
C) results in permanent deviation from normal.
D) is associated with many stable and unstable phases.
E) always starts with an acute illness and then progresses slowly. - CORRECT ANSWER - C, D
[has a consistent, predictable clinical course; results in permanent deviation from normal]
Ch. 5
RATIONALE: Characteristics of chronic illness include: permanent impairments or deviations from
normal, irreversible pathologic changes, residual disability, requirements for special rehabilitation, and
