SOLVED

Chapter 3 Question 1 A nurse is assessing an 85-year-old patient who presented to the emergency department with a complaint of “not feeling like myself.” What should the nurse consider during this assessment? 1. Aging causes sudden loss of function in organ systems. 2. In older adults diseases often present with uncharacteristic symptoms. 3. Many older adults do not participate in activities to support wellness. 4. Since the majority of 85-year-old patients live in an institutional setting they are exposed to more communicable diseases. Question 2 An older adult has been prescribed medication to control hypertension. Today she says, “I took this same medication years ago, but I’m having more side effects this time.” What should the nurse consider before replying? 1. Many antihypertensive medications have similar names so the patient could have confused the drugs. 2. Older women often decrease oral fluid intake, which would change response to the drug. 3. The older pancreas cannot supply enzymes to metabolize the drugs as early in the digestive system. 4. Changes in the blood–brain barrier may make older patients more sensitive to some side effects. Question 3 An older adult being treated for a burn on her lower leg and foot is surprised at its severity. She says, “It really didn’t hurt very badly when I did it.” What should the nurse consider before responding? 1. Patients can block out portions of painful stimuli if it is overwhelming. 2. Aging can decrease touch sensitivity to the feet and lower legs. 3. Poor circulation has probably resulted in death of the nerve endings in the patient’s legs. 4. Burns on the legs often appear very severe because the skin is so thin. Question 4 An older adult says, “I cannot believe that I have had a heart attack. I thought I had stomach flu and a backache.” What nursing response is indicated? 1. “I am also surprised that you had a heart attack. Your symptoms did not sound that severe.” 2. “Usually a patient has chest and arm pain with a heart attack.” 3. “The symptoms of heart attack change as people age and may include back pain or stomach problems.” 4. “It is rare but a backache and a stomach ache can occur as a signal of a heart attack.” Question 5 An older patient says, “I seem to get chest colds so often now.” How should the nurse respond to this report? 1. “How often do you wash your hands?” 2. “Risk for colds and infections increase as we age.” 3. “Do other people you are around have frequent colds?” 4. “Maybe you should consider taking antibiotics during the winter.” Question 6 An older adult patient remarks that he has been experiencing constipation, which has never been a problem for him before now. What questions should the nurse ask? 1. “Do you have a list of your medications?” 2. “How many fluids do you drink each day?” 3. “Do you get enough rest at night?” 4. “What kinds of fruits and vegetables do you eat daily?” 5. “How often do you have a bowel movement?” Question 7 The nurse suspects urinary tract infection in an older adult patient who has sudden onset of incontinence. Which symptoms, atypical in a younger adult, would the nurse assess for in this patient? 1. Confusion 2. Vomiting 3. Chills 4. Flank pain 5. Fever   Question 8 A 70-year-old patient had a pneumonia vaccination 10 years ago. Which information should the nurse provide about this vaccination? 1. ”A booster vaccination is warranted.” 2. “As long as your kidney function is good you do not need a second immunization.” 3. “You will never need another pneumonia vaccination.” 4. ”You should plan to get a pneumonia vaccination every year after September.” Question 9 After being medicated for postoperative pain an older patient becomes agitated and combative. Since this behavior has not been previously demonstrated the nurse conducts additional assessment for which most likely condition? 1. Depression 2. Delirium 3. Drug toxicity 4. Dementia Question 10 An older adult with osteoarthritis has been told that he cannot have his painful knee replaced because of his cardiac status. The patient is having progressive difficulty with normal self-care activities. The nurse should monitor this patient for which condition? 1. Depression 2. Noncompliance 3. Dementia 4. Delirium