1. When caring for an older patient with hypertension who has been hospitalized after a transient
ischemic (TIA), which topic is the most important for
... [Show More] the nurse to include in the discharge
teaching?
a) Effect of atherosclerosis on blood vessels
b) Mechanism of action of anticoagulant drug therapy
c) Symptoms indicating that the patient should contact the health care provider
d) Impact of the patient’s family history on likelihood of developing a serious stroke
ANS: C
One of the tasks for patients with chronic illnesses is to prevent and manage a crisis. The patient
2
A&E I Comprehensive Testbank
needs instruction on recognition of symptoms of hypertension and TIA and appropriate actions to
take if these symptoms occur. The other information may also be included in patient teaching but
is not as essential in the patient’s self-management of the illness.
2. The nurse performs a comprehensive assessment of an older patient who is considering
admission to an assisted living facility. Which question is the most important for the nurse to
ask?
a) “Have you had any recent infections?”
b) “How frequently do you see a doctor?”
c) “Do you have a history of heart disease?”
d) “Are you able to prepare your own meals?”
ANS: D
The patient’s functional abilities, rather than the presence of an acute or chronic illness, are more
useful in determining how well the patient might adapt to an assisted living situation. The other
questions will also provide helpful information but are not as useful in providing a basis for
determining patient needs or for developing interventions for the older patient.
3. An alert older patient who takes multiple medications for chronic cardiac and pulmonary
diseases lives with a daughter who works during the day. During a clinic visit, the patient
verbalizes to the nurse that she has a strained relationship with her daughter and does not enjoy
being alone all day. Which nursing diagnosis should the nurse assign as the priority for this
patient?
a) Social isolation related to fatigue
b) Risk for injury related to drug interactions
c) Caregiver role strain related to family employment schedule
d) Compromised family coping related to the patient’s care needs
ANS: B
The patient’s age and multiple medications indicate a risk for injury caused by interactions
between the multiple drugs being taken and a decreased drug metabolism rate. Problems with
social isolation, caregiver role strain, or compromised family coping are not physiologic
priorities. Drug–drug interactions could cause the most harm to the patient and are therefore the
priority.
4. Which method should the nurse use to gather the most complete assessment of an older
patient?
a) Review the patient’s health record for previous assessments.
b) Use a geriatric assessment instrument to evaluate the patient.
c) Ask the patient to write down medical problems and medications.
d) Interview both the patient and the primary caregiver for the patient.
3
A&E I Comprehensive Testbank
ANS: B
The most complete information about the patient will be obtained through the use of an
assessment instrument specific to the geriatric population, which includes information about both
medical diagnoses and treatments and about functional health patterns and abilities. A review of
the medical record, interviews with the patient and caregiver, and written information by the
patient are all included in a comprehensive geriatric assessment.
5. Which intervention should the nurse implement to provide optimal care for an older patient
who is hospitalized with pneumonia?
a) Plan for transfer to a long-term care facility.
b) Minimize activity level during hospitalization.
c) Consider the preadmission functional abilities.
d) Use an approved standardized geriatric nursing care plan.
ANS: C
The plan of care for older adults should be individualized and based on the patient’s current
functional abilities. A standardized geriatric nursing care plan will not address individual patient
needs and strengths. A patient’s need for discharge to a long-term care facility is variable.
Activity level should be designed to allow the patient to retain functional abilities while
hospitalized and also to allow any additional rest needed for recovery from the acute process.
6. The nurse cares for an older adult patient who lives in a rural area. Which intervention should
the nurse plan to implement to meet this patient’s needs?
a) Suggest that the patient move closer to health care providers.
b) Obtain extra medications for the patient to last for 4 to 6 months.
c) Ensure transportation to appointments with the health care provider.
d) Assess the patient for chronic diseases that are unique to rural areas.
ANS: C
Transportation can be a barrier to accessing health services in rural areas. The patient living in a
rural area may lose the benefits of a familiar situation and social support by moving to an urban
area. There are no chronic diseases unique to rural areas. Because medications may change, the
nurse should help the patient plan for obtaining medications through alternate means such as the
mail or delivery services, not by purchasing large quantities of the medications.
7. Which nursing action will be most helpful in decreasing the risk for drug-drug interactions in
an older adult?
a) Teach the patient to have all prescriptions filled at the same pharmacy.
b) Make a schedule for the patient as a reminder of when to take each medication.
c) Instruct the patient to avoid taking over-the-counter (OTC) medications or supplements.
d) Ask the patient to bring all medications, supplements, and herbs to each appointment.
4
A&E I Comprehensive Testbank
ANS: D
The most information about drug use and possible interactions is obtained when the patient
brings all prescribed medications, OTC medications, and supplements to every health care
appointment. The patient should discuss the use of any OTC medications with the health care
provider and obtain all prescribed medications from the same pharmacy, but use of supplements
and herbal medications also need to be considered in order to prevent drug–drug interactions.
Use of a medication schedule will help the patient take medications as scheduled, but will not
prevent drug–drug interactions.
8. A patient who has just moved to a long-term care facility has a nursing diagnosis of relocation
stress syndrome. Which action should the nurse include in the plan of care?
a) Remind the patient that making changes is usually stressful.
b) Discuss the reason for the move to the facility with the patient.
c) Restrict family visits until the patient is accustomed to the facility.
d) Have staff members write notes welcoming the patient to the facility.
ANS: D
TestBankWorld.org
Having staff members write notes will make the patient feel more welcome and comfortable at
the long-term care facility. Discussing the reason for the move and reminding the patient that
change is usually stressful will not decrease the patient’s stress about the move. Family member
visits will decrease the patient’s sense of stress about the relocation.
9. An older patient complains of having “no energy” and feeling increasingly weak. The patient
has had a 12-lb weight loss over the past year. Which action should the nurse take initially?
a) Ask the patient about daily dietary intake.
b) Schedule regular range-of-motion exercise.
c) Discuss long-term care placement with the patient.
d) Describe normal changes associated with aging to the patient.
ANS: A
In a frail older patient, nutrition is frequently compromised, and the nurse’s initial action should
be to assess the patient’s nutritional status. Active range of motion may be helpful in improving
the patient’s strength and endurance, but nutritional assessment is the priority because the patient
has had a significant weight loss. The patient may be a candidate for long-term care placement,
but more assessment is needed before this can be determined. The patient’s assessment data are
not consistent with normal changes associated with aging.
10. The nurse is admitting an acutely ill, older patient to the hospital. Which action should the
nurse take?
a) Speak slowly and loudly while facing the patient.
b) Obtain a detailed medical history from the patient.
5
A&E I Comprehensive Testbank
c) Perform the physical assessment before interviewing the patient.
d) Ask a family member to go home and retrieve the patient’s cane.
ANS: C
When a patient is acutely ill, the physical assessment should be accomplished first to detect any
physiologic changes that require immediate action. Not all older patients have hearing deficits,
and it is insensitive of the nurse to speak loudly and slowly to all older patients. To avoid tiring
the patient, much of the medical history can be obtained from medical records. After the initial
physical assessment to determine the patient’s current condition, then the nurse could ask
someone to obtain any assistive devices for the patient if applicable. [Show Less]