A&E xI xComprehensive
xTestbank
Table of Contents
x x
Week 1 Care of Older Adults: Culture, Spirituality, Communication,
x x x x x x x x
Sexuality, Infection Control
x x x
Chronic xIllness xand xOlder xAdults ________________________________________________ 3
Cultural xAwareness___________________________________________________________ 10
Older xAdult 18
Communication ______________________________________________________________ 28
Patient xEducation ____________________________________________________________ 39
Infection xPrevention xand xControl________________________________________________ 51
Sexuality 69
Spiritual xHealth _____________________________________________________________78
Week 2 Critical Thinking, The Nursing Process, Loss, Death, and Grief
x x x x x x x x x x
Critical xThinking xin xNursing xPractice____________________________________________ 86
Nursing xAssessment 94
Nursing xDiagnosis __________________________________________________________ 102
Planning xNursing xCare 110
Implementing xNursing xCare 119
Evaluation _________________________________________________________________ 128
The xExperience xof xLoss, xDeath xand xGrief _______________________________________ 136
Week 3 Safety and Fall Prevention among Older Adults, Preventing
x x x x x x x x x
Complications of Immobility
x x x
Patient xSafety xand xQuality 146
Immobility 163
Activity xand xExercise 181
Week 4 Skin and Wound Care Hygiene, Introduction to Pharmacology and
x x x x x x x x x x
Medication Administration
x x
Medication xAdministration ____________________________________________________ 194
Hygiene 212
Skin xIntegrity xand xWound xCare ________________________________________________ 231
Week 5 Fluid & Electrolytes, Dehydration
x x x x x
Fluid, xElectrolyte xand xAcid-Base xBalance ________________________________________ 251
Week 6 Pain and Sleep
x x x x
1
, A&E xI xComprehensive
xTestbank
Pain xManagement 268
Sleep _____________________________________________________________________ 280
Week 7 Concepts related to Oxygenation, Circulation, and Tissue Perfusion,
x x x x x x x x x
Chronic Obstructive Pulmonary Disease
x x x x
Oxygenation _______________________________________________________________ 295
Obstructive xPulmonary xDiseases _______________________________________________ 314
Week 8 Diabetes Mellitus
x x x
Diabetes xMellitus ___________________________________________________________ 331
Week 9 Hypertension, Stroke
x x x
Hypertension _______________________________________________________________ 341
Stroke 356
Week 10 Documentation and Informatics
x x x x
Documentation and Informatics _____________________________________ 368
x x
Week 11 Nutrition, Dysphagia
x x x 382
Week 12 Care of the Surgical Patient
x x x x x x 398
Week 1 x
Care of Older Adults: Culture, Spirituality, Communication,
x x x x x x
Sexuality, Infection Control x x x
Chapter 05: Chronic Illness and Older Adults Lewis: Medical-Surgical Nursing,
x x x x x x x x x
10th Edition
x x
MULTIPLE xCHOICE
1. When xcaring xfor xan xolder xpatient xwith xhypertension xwho xhas xbeen xhospitalized xafter xa
transient xischemic x(TIA), xwhich xtopic xis xthe xmost ximportant xfor xthe xnurse xto xinclude xin xthe
x
discharge xteaching?
x
a) Effect xof xatherosclerosis xon xblood xvessels
b) Mechanism xof xaction xof xanticoagulant xdrug xtherapy
c) Symptoms xindicating xthat xthe xpatient xshould xcontact xthe xhealth xcare xprovider
d) Impact xof xthe xpatient’s xfamily xhistory xon xlikelihood xof xdeveloping xa xserious xstroke
ANS: xC
One xof xthe xtasks xfor xpatients xwith xchronic xillnesses xis xto xprevent xand xmanage xa xcrisis. xThe
xpatient
2
, A&E xI xComprehensive
xTestbank
needs xinstruction xon xrecognition xof xsymptoms xof xhypertension xand xTIA xand xappropriate
xactions xto xtake xif xthese xsymptoms xoccur. xThe xother xinformation xmay xalso xbe xincluded xin
xpatient xteaching xbut xis xnot xas xessential xin xthe xpatient’s xself-management xof xthe xillness.
2. The xnurse xperforms xa xcomprehensive xassessment xof xan xolder xpatient xwho xis
considering xadmission xto xan xassisted xliving xfacility. xWhich xquestion xis xthe xmost
x
important xfor xthe xnurse xto xask?
x
a) “Have xyou xhad xany xrecent xinfections?”
b) “How xfrequently xdo xyou xsee xa xdoctor?”
c) “Do xyou xhave xa xhistory xof xheart xdisease?”
d) “Are xyou xable xto xprepare xyour xown xmeals?”
ANS: xD
The xpatient’s xfunctional xabilities, xrather xthan xthe xpresence xof xan xacute xor xchronic xillness, xare
xmore xuseful xin xdetermining xhow xwell xthe xpatient xmight xadapt xto xan xassisted xliving xsituation.
xThe xother xquestions xwill xalso xprovide xhelpful xinformation xbut xare xnot xas xuseful xin xproviding
xa xbasis xfor xdetermining xpatient xneeds xor xfor xdeveloping xinterventions xfor xthe xolder xpatient.
3. An xalert xolder xpatient xwho xtakes xmultiple xmedications xfor xchronic xcardiac xand
xpulmonary xdiseases xlives xwith xa xdaughter xwho xworks xduring xthe xday. xDuring xa xclinic
xvisit, xthe xpatient xverbalizes xto xthe xnurse xthat xshe xhas xa xstrained xrelationship xwith xher
xdaughter xand xdoes xnot xenjoy xbeing xalone xall xday. xWhich xnursing xdiagnosis xshould xthe
xnurse xassign xas xthe xpriority xfor xthis xpatient?
a) Social xisolation xrelated xto xfatigue
b) Risk xfor xinjury xrelated xto xdrug xinteractions
c) Caregiver xrole xstrain xrelated xto xfamily xemployment xschedule
d) Compromised xfamily xcoping xrelated xto xthe xpatient’s xcare xneeds
ANS: xB
The xpatient’s xage xand xmultiple xmedications xindicate xa xrisk xfor xinjury xcaused xby xinteractions
xbetween xthe xmultiple xdrugs xbeing xtaken xand xa xdecreased xdrug xmetabolism xrate. xProblems
xwith xsocial xisolation, xcaregiver xrole xstrain, xor xcompromised xfamily xcoping xare xnot
xphysiologic xpriorities. xDrug–drug xinteractions xcould xcause xthe xmost xharm xto xthe xpatient xand
xare xtherefore xthe xpriority.
4. Which xmethod xshould xthe xnurse xuse xto xgather xthe xmost xcomplete xassessment xof xan
older xpatient?
x
a) Review xthe xpatient’s xhealth xrecord xfor xprevious xassessments.
b) Use xa xgeriatric xassessment xinstrument xto xevaluate xthe xpatient.
c) Ask xthe xpatient xto xwrite xdown xmedical xproblems xand xmedications.
d) Interview xboth xthe xpatient xand xthe xprimary xcaregiver xfor xthe xpatient.
3
, A&E xI xComprehensive
xTestbank
ANS: xB
The xmost xcomplete xinformation xabout xthe xpatient xwill xbe xobtained xthrough xthe xuse xof xan
xassessment xinstrument xspecific xto xthe xgeriatric xpopulation, xwhich xincludes xinformation xabout
xboth xmedical xdiagnoses xand xtreatments xand xabout xfunctional xhealth xpatterns xand xabilities. xA
xreview xof xthe xmedical xrecord, xinterviews xwith xthe xpatient xand xcaregiver, xand xwritten
xinformation xby xthe xpatient xare xall xincluded xin xa xcomprehensive xgeriatric xassessment.
5. Which xintervention xshould xthe xnurse ximplement xto xprovide xoptimal xcare xfor xan xolder
patient xwho xis xhospitalized xwith xpneumonia?
x
a) Plan xfor xtransfer xto xa xlong-term xcare xfacility.
b) Minimize xactivity xlevel xduring xhospitalization.
c) Consider xthe xpreadmission xfunctional xabilities.
d) Use xan xapproved xstandardized xgeriatric xnursing xcare xplan.
ANS: xC
The xplan xof xcare xfor xolder xadults xshould xbe xindividualized xand xbased xon xthe xpatient’s xcurrent
xfunctional xabilities. xA xstandardized xgeriatric xnursing xcare xplan xwill xnot xaddress xindividual
xpatient xneeds xand xstrengths. xA xpatient’s xneed xfor xdischarge xto xa xlong-term xcare xfacility xis
xvariable.
Activity xlevel xshould xbe xdesigned xto xallow xthe xpatient xto xretain xfunctional xabilities xwhile
xhospitalized xand xalso xto xallow xany xadditional xrest xneeded xfor xrecovery xfrom xthe xacute xprocess.
6. The xnurse xcares xfor xan xolder xadult xpatient xwho xlives xin xa xrural xarea. xWhich xintervention
should xthe xnurse xplan xto ximplement xto xmeet xthis xpatient’s xneeds?
x
a) Suggest xthat xthe xpatient xmove xcloser xto xhealth xcare xproviders.
b) Obtain xextra xmedications xfor xthe xpatient xto xlast xfor x4 xto x6 xmonths.
c) Ensure xtransportation xto xappointments xwith xthe xhealth xcare xprovider.
d) Assess xthe xpatient xfor xchronic xdiseases xthat xare xunique xto xrural xareas.
ANS: xC
Transportation xcan xbe xa xbarrier xto xaccessing xhealth xservices xin xrural xareas. xThe xpatient
xliving xin xa xrural xarea xmay xlose xthe xbenefits xof xa xfamiliar xsituation xand xsocial xsupport xby
xmoving xto xan xurban xarea. xThere xare xno xchronic xdiseases xunique xto xrural xareas. xBecause
xmedications xmay xchange, xthe xnurse xshould xhelp xthe xpatient xplan xfor xobtaining xmedications
xthrough xalternate xmeans xsuch xas xthe xmail xor xdelivery xservices, xnot xby xpurchasing xlarge
xquantities xof xthe xmedications.
7. Which xnursing xaction xwill xbe xmost xhelpful xin xdecreasing xthe xrisk xfor xdrug-drug
interactions xin xan xolder xadult?
x
a) Teach xthe xpatient xto xhave xall xprescriptions xfilled xat xthe xsame xpharmacy.
b) Make xa xschedule xfor xthe xpatient xas xa xreminder xof xwhen xto xtake xeach xmedication.
c) Instruct xthe xpatient xto xavoid xtaking xover-the-counter x(OTC) xmedications xor xsupplements.
d) Ask xthe xpatient xto xbring xall xmedications, xsupplements, xand xherbs xto xeach xappointment.
4
xTestbank
Table of Contents
x x
Week 1 Care of Older Adults: Culture, Spirituality, Communication,
x x x x x x x x
Sexuality, Infection Control
x x x
Chronic xIllness xand xOlder xAdults ________________________________________________ 3
Cultural xAwareness___________________________________________________________ 10
Older xAdult 18
Communication ______________________________________________________________ 28
Patient xEducation ____________________________________________________________ 39
Infection xPrevention xand xControl________________________________________________ 51
Sexuality 69
Spiritual xHealth _____________________________________________________________78
Week 2 Critical Thinking, The Nursing Process, Loss, Death, and Grief
x x x x x x x x x x
Critical xThinking xin xNursing xPractice____________________________________________ 86
Nursing xAssessment 94
Nursing xDiagnosis __________________________________________________________ 102
Planning xNursing xCare 110
Implementing xNursing xCare 119
Evaluation _________________________________________________________________ 128
The xExperience xof xLoss, xDeath xand xGrief _______________________________________ 136
Week 3 Safety and Fall Prevention among Older Adults, Preventing
x x x x x x x x x
Complications of Immobility
x x x
Patient xSafety xand xQuality 146
Immobility 163
Activity xand xExercise 181
Week 4 Skin and Wound Care Hygiene, Introduction to Pharmacology and
x x x x x x x x x x
Medication Administration
x x
Medication xAdministration ____________________________________________________ 194
Hygiene 212
Skin xIntegrity xand xWound xCare ________________________________________________ 231
Week 5 Fluid & Electrolytes, Dehydration
x x x x x
Fluid, xElectrolyte xand xAcid-Base xBalance ________________________________________ 251
Week 6 Pain and Sleep
x x x x
1
, A&E xI xComprehensive
xTestbank
Pain xManagement 268
Sleep _____________________________________________________________________ 280
Week 7 Concepts related to Oxygenation, Circulation, and Tissue Perfusion,
x x x x x x x x x
Chronic Obstructive Pulmonary Disease
x x x x
Oxygenation _______________________________________________________________ 295
Obstructive xPulmonary xDiseases _______________________________________________ 314
Week 8 Diabetes Mellitus
x x x
Diabetes xMellitus ___________________________________________________________ 331
Week 9 Hypertension, Stroke
x x x
Hypertension _______________________________________________________________ 341
Stroke 356
Week 10 Documentation and Informatics
x x x x
Documentation and Informatics _____________________________________ 368
x x
Week 11 Nutrition, Dysphagia
x x x 382
Week 12 Care of the Surgical Patient
x x x x x x 398
Week 1 x
Care of Older Adults: Culture, Spirituality, Communication,
x x x x x x
Sexuality, Infection Control x x x
Chapter 05: Chronic Illness and Older Adults Lewis: Medical-Surgical Nursing,
x x x x x x x x x
10th Edition
x x
MULTIPLE xCHOICE
1. When xcaring xfor xan xolder xpatient xwith xhypertension xwho xhas xbeen xhospitalized xafter xa
transient xischemic x(TIA), xwhich xtopic xis xthe xmost ximportant xfor xthe xnurse xto xinclude xin xthe
x
discharge xteaching?
x
a) Effect xof xatherosclerosis xon xblood xvessels
b) Mechanism xof xaction xof xanticoagulant xdrug xtherapy
c) Symptoms xindicating xthat xthe xpatient xshould xcontact xthe xhealth xcare xprovider
d) Impact xof xthe xpatient’s xfamily xhistory xon xlikelihood xof xdeveloping xa xserious xstroke
ANS: xC
One xof xthe xtasks xfor xpatients xwith xchronic xillnesses xis xto xprevent xand xmanage xa xcrisis. xThe
xpatient
2
, A&E xI xComprehensive
xTestbank
needs xinstruction xon xrecognition xof xsymptoms xof xhypertension xand xTIA xand xappropriate
xactions xto xtake xif xthese xsymptoms xoccur. xThe xother xinformation xmay xalso xbe xincluded xin
xpatient xteaching xbut xis xnot xas xessential xin xthe xpatient’s xself-management xof xthe xillness.
2. The xnurse xperforms xa xcomprehensive xassessment xof xan xolder xpatient xwho xis
considering xadmission xto xan xassisted xliving xfacility. xWhich xquestion xis xthe xmost
x
important xfor xthe xnurse xto xask?
x
a) “Have xyou xhad xany xrecent xinfections?”
b) “How xfrequently xdo xyou xsee xa xdoctor?”
c) “Do xyou xhave xa xhistory xof xheart xdisease?”
d) “Are xyou xable xto xprepare xyour xown xmeals?”
ANS: xD
The xpatient’s xfunctional xabilities, xrather xthan xthe xpresence xof xan xacute xor xchronic xillness, xare
xmore xuseful xin xdetermining xhow xwell xthe xpatient xmight xadapt xto xan xassisted xliving xsituation.
xThe xother xquestions xwill xalso xprovide xhelpful xinformation xbut xare xnot xas xuseful xin xproviding
xa xbasis xfor xdetermining xpatient xneeds xor xfor xdeveloping xinterventions xfor xthe xolder xpatient.
3. An xalert xolder xpatient xwho xtakes xmultiple xmedications xfor xchronic xcardiac xand
xpulmonary xdiseases xlives xwith xa xdaughter xwho xworks xduring xthe xday. xDuring xa xclinic
xvisit, xthe xpatient xverbalizes xto xthe xnurse xthat xshe xhas xa xstrained xrelationship xwith xher
xdaughter xand xdoes xnot xenjoy xbeing xalone xall xday. xWhich xnursing xdiagnosis xshould xthe
xnurse xassign xas xthe xpriority xfor xthis xpatient?
a) Social xisolation xrelated xto xfatigue
b) Risk xfor xinjury xrelated xto xdrug xinteractions
c) Caregiver xrole xstrain xrelated xto xfamily xemployment xschedule
d) Compromised xfamily xcoping xrelated xto xthe xpatient’s xcare xneeds
ANS: xB
The xpatient’s xage xand xmultiple xmedications xindicate xa xrisk xfor xinjury xcaused xby xinteractions
xbetween xthe xmultiple xdrugs xbeing xtaken xand xa xdecreased xdrug xmetabolism xrate. xProblems
xwith xsocial xisolation, xcaregiver xrole xstrain, xor xcompromised xfamily xcoping xare xnot
xphysiologic xpriorities. xDrug–drug xinteractions xcould xcause xthe xmost xharm xto xthe xpatient xand
xare xtherefore xthe xpriority.
4. Which xmethod xshould xthe xnurse xuse xto xgather xthe xmost xcomplete xassessment xof xan
older xpatient?
x
a) Review xthe xpatient’s xhealth xrecord xfor xprevious xassessments.
b) Use xa xgeriatric xassessment xinstrument xto xevaluate xthe xpatient.
c) Ask xthe xpatient xto xwrite xdown xmedical xproblems xand xmedications.
d) Interview xboth xthe xpatient xand xthe xprimary xcaregiver xfor xthe xpatient.
3
, A&E xI xComprehensive
xTestbank
ANS: xB
The xmost xcomplete xinformation xabout xthe xpatient xwill xbe xobtained xthrough xthe xuse xof xan
xassessment xinstrument xspecific xto xthe xgeriatric xpopulation, xwhich xincludes xinformation xabout
xboth xmedical xdiagnoses xand xtreatments xand xabout xfunctional xhealth xpatterns xand xabilities. xA
xreview xof xthe xmedical xrecord, xinterviews xwith xthe xpatient xand xcaregiver, xand xwritten
xinformation xby xthe xpatient xare xall xincluded xin xa xcomprehensive xgeriatric xassessment.
5. Which xintervention xshould xthe xnurse ximplement xto xprovide xoptimal xcare xfor xan xolder
patient xwho xis xhospitalized xwith xpneumonia?
x
a) Plan xfor xtransfer xto xa xlong-term xcare xfacility.
b) Minimize xactivity xlevel xduring xhospitalization.
c) Consider xthe xpreadmission xfunctional xabilities.
d) Use xan xapproved xstandardized xgeriatric xnursing xcare xplan.
ANS: xC
The xplan xof xcare xfor xolder xadults xshould xbe xindividualized xand xbased xon xthe xpatient’s xcurrent
xfunctional xabilities. xA xstandardized xgeriatric xnursing xcare xplan xwill xnot xaddress xindividual
xpatient xneeds xand xstrengths. xA xpatient’s xneed xfor xdischarge xto xa xlong-term xcare xfacility xis
xvariable.
Activity xlevel xshould xbe xdesigned xto xallow xthe xpatient xto xretain xfunctional xabilities xwhile
xhospitalized xand xalso xto xallow xany xadditional xrest xneeded xfor xrecovery xfrom xthe xacute xprocess.
6. The xnurse xcares xfor xan xolder xadult xpatient xwho xlives xin xa xrural xarea. xWhich xintervention
should xthe xnurse xplan xto ximplement xto xmeet xthis xpatient’s xneeds?
x
a) Suggest xthat xthe xpatient xmove xcloser xto xhealth xcare xproviders.
b) Obtain xextra xmedications xfor xthe xpatient xto xlast xfor x4 xto x6 xmonths.
c) Ensure xtransportation xto xappointments xwith xthe xhealth xcare xprovider.
d) Assess xthe xpatient xfor xchronic xdiseases xthat xare xunique xto xrural xareas.
ANS: xC
Transportation xcan xbe xa xbarrier xto xaccessing xhealth xservices xin xrural xareas. xThe xpatient
xliving xin xa xrural xarea xmay xlose xthe xbenefits xof xa xfamiliar xsituation xand xsocial xsupport xby
xmoving xto xan xurban xarea. xThere xare xno xchronic xdiseases xunique xto xrural xareas. xBecause
xmedications xmay xchange, xthe xnurse xshould xhelp xthe xpatient xplan xfor xobtaining xmedications
xthrough xalternate xmeans xsuch xas xthe xmail xor xdelivery xservices, xnot xby xpurchasing xlarge
xquantities xof xthe xmedications.
7. Which xnursing xaction xwill xbe xmost xhelpful xin xdecreasing xthe xrisk xfor xdrug-drug
interactions xin xan xolder xadult?
x
a) Teach xthe xpatient xto xhave xall xprescriptions xfilled xat xthe xsame xpharmacy.
b) Make xa xschedule xfor xthe xpatient xas xa xreminder xof xwhen xto xtake xeach xmedication.
c) Instruct xthe xpatient xto xavoid xtaking xover-the-counter x(OTC) xmedications xor xsupplements.
d) Ask xthe xpatient xto xbring xall xmedications, xsupplements, xand xherbs xto xeach xappointment.
4
