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 Question 11 The nurse manages an acute care unit that is beginning to provide care for more and more older adults after surgery. The nurse manager would encourage nurses to add which interventions to the plan of care for these patients? 1. Use of restraints to prevent falls and disruption of invasive lines 2. Early return to ambulation and self-care activities 3. Get patients out of bed to a chair for most of the day 4. Keep patients on bedrest until strength returns Question 12 An older adult patient tells the nurse that he is “tired” of having his medication doses changed so many times and wants to find a doctor who “knows what he’s doing.” How should the nurse respond to this patient? 1. “Have you thought about cutting pills or add pills together to get the correct dose?” 2. “If you seriously want to change providers know some of the other doctors in the building are taking new patients.” 3. “Frequent dose changes are necessary until the correct dose for you is determined.” 4. “I know what you mean. It is annoying, but it is necessary.” Question 13 The primary nurse reports to the team caring for an older adult that the patient has a low Braden Scale score. The nurse would instruct the team to start interventions to prevent which complication? 1. Skin breakdown 2. Dehydration 3. Falls 4. Drug–food interactions Question 14 The nurse is admitting an older adult female who uses two canes for ambulation. The patient is attended by her daughter who quietly reorients her mother several times during the assessment process. The daughter reports that her mother was a smoker for many years, but has not smoked for the last 5 years. The patient wears incontinence underwear and has problems with constipation. The nurse would evaluate which of these findings as key risk factors from the Hendrich II Fall Risk Model? 1. The patient is female. 2. The patient has a history of using tobacco. 3. The patient wears incontinence underwear. 4. The patient requires frequent reorientation. 5. The patient uses a cane. Question 15 The daughter of an older adult calls the emergency department (ED) triage nurse and reports that her mother hit her head “very hard” while getting into the car about 10 minutes ago. There is no bleeding. The daughter asks what she should watch for in her mother. How should the nurse respond? 1. “As long as she does not develop a severe headache she is probably okay. Be sure to bring her to the ED if that happens.” 2. “As long as your mother does not begin vomiting she is probably not severely injured. If she does begin to vomit, bring her in immediately.” 3. “Watch her for the next hour or two. If she seems okay after that she is not likely to have a severe injury. Bring her in to the ED if you are concerned.” 4. “In older adults the changes are very subtle and can develop over several hours or even days. Bring her to the ED if you have any concerns.”   Question 16 An older adult is admitted to the emergency department (ED) after being the restrained front seat passenger in a motor vehicle accident. The nurse assessing this patient should consider that which physiologic response to hypovolemia is not as likely in an older adult? 1. Decreased blood pressure 2. Tachycardia 3. Decreased cardiac output by hemodynamic monitor 4. Decreased urine output 5. Question 17 The nurse has assessed that an older adult patient is at risk for impaired skin integrity. Which interventions are indicated? 1. Secure IV catheters with paper tape. 2. Apply transparent film dressings to pressure prone areas. 3. Pull the patient up in bed every hour. 4. Keep the patient warm. 5. Monitor IV sites for infiltration. Question 18 An older adult patient’s testing reveals decreased absorption of calcium, which is a common age-related change. The nurse would consider which nursing diagnosis when creating a care plan for this patient? 1. Impaired Swallowing 2. Risk for Constipation 3. Risk for Incontinence 4. Activity Intolerance Question 19 The nurse has received emergency admission orders for an older adult patient who was severely injured in a fall. The nurse would question the use of which medication in this patient? 1. Digoxin 0.125 mg po daily 2. Diazepam 5 mg po every 6 hours prn agitation 3. Morphine sulfate 2 mg IV every hour prn severe pain 4. Furosemide 20 mg po daily Question 20 Results of the CAM-ICU testing reveal that an older adult hospitalized in the intensive care unit has delirium. Which nursing interventions should be instituted? 1. Increase environmental stimuli in the patient’s room. 2. Limit visiting hours. 3. Sedate the patient until ready for discharge from the intensive care unit. 4. Manage the patient’s pain effectively.

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