VSIM 2 Julia Morales part 1 2025 | Pre-Quiz & Detailed
Answers | The Ultimate Study Guide for Yr. (2026/2027)
PreQuiz Answers
1 Which statement below is the most important teaching point for family caregivers regarding
administering morphine sulfate to a patient in hospice care?
Time Spent - 00:00:07
Your Response:The controlled release tablets should not be crushed, dissolved, or chewed.
Rationale:Chewing, dissolving, or crushing the tablets can cause rapid release of the drug and a
potentially fatal dose of morphine. Drug abuse is not likely when a narcotic is used to treat
cancer pain in a terminally ill patient. Although hypotension may result, family members can be
taught to monitor signs and symptoms, such as dizziness, rather than checking blood pressure.
Constipation is common and should be anticipated and monitored, but the most important
teaching is about not crushing, dissolving, or chewing the drug.
Remediation:
Lippincott Advisor, morphine sulphate
2
The home health nurse should teach the patient and family about safe oxygen use in the home
environment. Which of the following are important teaching points for patients who are using an
oxygen tank with a nasal cannula at home? (Select all that apply.)
Time Spent - 00:01:01
Your Response: The patient may ambulate, eat, and talk while the oxygen is being delivered
through a nasal cannula. ,
Applying the nasal cannula too tightly can interfere with oxygen delivery.
Rationale:A nasal cannula allows a patient to ambulate, eat, and talk. Applying the cannula too
tightly can cause excess pressure on facial structures and occlude the cannula. Oxygen flow
rates can be increased to 6 L/minute with a nasal cannula, but a humidification device is
recommended with flow rates over 4 L/minute to prevent headaches and dry mucous
membranes. Oral breathers achieve the same oxygen delivery with a nasal cannula as do nasal
breathers, although complete nasal obstruction is a contraindication. An oxygen tank operates
by high pressure, and electricity is not needed for its function.
Remediation:
Lippincott Procedures, Oxygen Administration
3
, When administering drugs to older adults, what factors should the nurse consider? (Select all that
apply.)
Time Spent - 00:00:29
Your Response: The biological half-life of drugs is increased by as much as 40% in older adults. ,
Heat and massage are measures that can be used to maximize drug absorption in older adults.
Rationale:The extended half-life of drugs in older adults increases the risk of drug accumulation
in the body and, therefore, the risk of adverse reactions. Although older people have fewer
problems with drug absorption than they do with metabolism and excretion, nurses can take
measures to increase blood flow at the absorption site to maximize absorption, such as properly
used heat and massage, except when contraindicated. The risk of adverse drug reactions is
especially high in older people and may develop suddenly or may not be apparent for a
prolonged time, even developing after a drug has been discontinued. Dehydration and
immobility are more likely to decrease, not increase, drug metabolism. Drugs given
intramuscularly, subcutaneously, orally, or rectally are not absorbed as efficiently as those that
are inhaled, applied to the skin, or given intravenously.
Remediation:
Eliopoulos, Gerontological Nursing, 10th Edition, pp. 206-208
4 When caring for a patient with a terminal illness, nursing care should include what teaching about
advance directives?
Time Spent - 00:00:17
Your Response:In making a living will, a legally competent patient states which procedures he or
she does or does not want carried out.
Rationale:The Patient Self-Determination Act requires health care facilities to provide
information about patients' right to choose. The patient, while competent, can consider
whether interventions such as feeding tubes or intubation should be carried out. Signing the
document is not required, and it can be revoked either orally or in writing. The family members
do not determine when a living will goes into effect unless they were given medical power of
attorney (or designated as a health care proxy).
Remediation:
Eliopoulos, Gerontological Nursing, 10th Edition, pp. 116-117
Lippincott Procedures, Advance Directives
5
Which of the following age-related changes in the respiratory system should the nurse be aware of as
potential causes of breathing problems in an older adult? (Select all that apply)
Time Spent - 00:00:39
Your Response: Reduced numbers of cilia and hypertrophy of the bronchial mucous gland
reducing ability to expel mucus and debris. ,
Increased rigidity of the rib cage and trachea related to calcification of costal cartilage. ,
Loss of elasticity in the alveoli causing the lungs to have diminished recoil.
Answers | The Ultimate Study Guide for Yr. (2026/2027)
PreQuiz Answers
1 Which statement below is the most important teaching point for family caregivers regarding
administering morphine sulfate to a patient in hospice care?
Time Spent - 00:00:07
Your Response:The controlled release tablets should not be crushed, dissolved, or chewed.
Rationale:Chewing, dissolving, or crushing the tablets can cause rapid release of the drug and a
potentially fatal dose of morphine. Drug abuse is not likely when a narcotic is used to treat
cancer pain in a terminally ill patient. Although hypotension may result, family members can be
taught to monitor signs and symptoms, such as dizziness, rather than checking blood pressure.
Constipation is common and should be anticipated and monitored, but the most important
teaching is about not crushing, dissolving, or chewing the drug.
Remediation:
Lippincott Advisor, morphine sulphate
2
The home health nurse should teach the patient and family about safe oxygen use in the home
environment. Which of the following are important teaching points for patients who are using an
oxygen tank with a nasal cannula at home? (Select all that apply.)
Time Spent - 00:01:01
Your Response: The patient may ambulate, eat, and talk while the oxygen is being delivered
through a nasal cannula. ,
Applying the nasal cannula too tightly can interfere with oxygen delivery.
Rationale:A nasal cannula allows a patient to ambulate, eat, and talk. Applying the cannula too
tightly can cause excess pressure on facial structures and occlude the cannula. Oxygen flow
rates can be increased to 6 L/minute with a nasal cannula, but a humidification device is
recommended with flow rates over 4 L/minute to prevent headaches and dry mucous
membranes. Oral breathers achieve the same oxygen delivery with a nasal cannula as do nasal
breathers, although complete nasal obstruction is a contraindication. An oxygen tank operates
by high pressure, and electricity is not needed for its function.
Remediation:
Lippincott Procedures, Oxygen Administration
3
, When administering drugs to older adults, what factors should the nurse consider? (Select all that
apply.)
Time Spent - 00:00:29
Your Response: The biological half-life of drugs is increased by as much as 40% in older adults. ,
Heat and massage are measures that can be used to maximize drug absorption in older adults.
Rationale:The extended half-life of drugs in older adults increases the risk of drug accumulation
in the body and, therefore, the risk of adverse reactions. Although older people have fewer
problems with drug absorption than they do with metabolism and excretion, nurses can take
measures to increase blood flow at the absorption site to maximize absorption, such as properly
used heat and massage, except when contraindicated. The risk of adverse drug reactions is
especially high in older people and may develop suddenly or may not be apparent for a
prolonged time, even developing after a drug has been discontinued. Dehydration and
immobility are more likely to decrease, not increase, drug metabolism. Drugs given
intramuscularly, subcutaneously, orally, or rectally are not absorbed as efficiently as those that
are inhaled, applied to the skin, or given intravenously.
Remediation:
Eliopoulos, Gerontological Nursing, 10th Edition, pp. 206-208
4 When caring for a patient with a terminal illness, nursing care should include what teaching about
advance directives?
Time Spent - 00:00:17
Your Response:In making a living will, a legally competent patient states which procedures he or
she does or does not want carried out.
Rationale:The Patient Self-Determination Act requires health care facilities to provide
information about patients' right to choose. The patient, while competent, can consider
whether interventions such as feeding tubes or intubation should be carried out. Signing the
document is not required, and it can be revoked either orally or in writing. The family members
do not determine when a living will goes into effect unless they were given medical power of
attorney (or designated as a health care proxy).
Remediation:
Eliopoulos, Gerontological Nursing, 10th Edition, pp. 116-117
Lippincott Procedures, Advance Directives
5
Which of the following age-related changes in the respiratory system should the nurse be aware of as
potential causes of breathing problems in an older adult? (Select all that apply)
Time Spent - 00:00:39
Your Response: Reduced numbers of cilia and hypertrophy of the bronchial mucous gland
reducing ability to expel mucus and debris. ,
Increased rigidity of the rib cage and trachea related to calcification of costal cartilage. ,
Loss of elasticity in the alveoli causing the lungs to have diminished recoil.
