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Nursing for Wellness in Older Adults 8th Edition Test Bank

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1. A 75-year-old man has iron deficiency anemia, for which he takes iron three times a day. You ask him about his eating habits to determine whether he may be sufficiently absorbing the iron supplemen... ts. Which of the following statements by him indicates a need for further teaching? A) ìI drink orange juice with breakfast.î B) C) ìI limit my intake of fiber in my meals.î D) ìI eat cereal for breakfast.î 2. A healthy 70-year-old man has been having trouble sleeping at night. In addition, he has been having difficulties with gastroesophageal reflux. He buys generic Benadryl to help him sleep and buys generic Tagamet for his reflux. After 7 days of taking these over-the-counter medications, he exhibits signs of confusion and disorientation. His wife calls the primary care facility to speak with the nurse. What should the nurse suspect first? A) The older adult has an electrolyte imbalance, leading to delirium. B) The older adult is having transient ischemic attacks. C) The older adult has an overwhelming infection. D) 3. An older adult, age 72, with type 2 diabetes is recovering from a myocardial infarction and is admitted to a long-term care facility. He takes an oral hypoglycemic agent, a beta-blocker, and furosemide, and administers nitroglycerin tablets as needed. His medical history states he has drunk a pint of whiskey per day for the past few years. Which of the following should be a priority for his admitting nurse? A) Assess and observe him for depression. B) C) Observe him for changes in his mental status. D) Evaluate his blood work for changes in electrolytes. 4. An older adult wants to take ginkgo biloba to help improve his memory. He takes valsartan (Diovan) and hydrochlorothiazide for hypertension. He also takes an aspirin a day because he heard it was ìgood for his heart.î Which of the following statements best reflects the advice his nurse should give him? A) ìGinkgo biloba may cause postprandial hypotension in older adults.î B) ìGinkgo biloba has the potential to interact with hydrochlorothiazide.î C) ìGinkgo biloba can interact with Diovan, reducing its effectiveness.î D) 5. Which of the following questions best links medical assessment with the overall assessment of an older adult? A) ìDo you have any difficulty taking your pills at any time?î B) ìWhat did your health care practitioner tell you about the medications?î C) D) ìWhat do you do to help you sleep when you have a problem falling asleep?î 6. A nurse who works in an acute care for elders (ACE) unit recognizes the unique pharmacokinetics and pharmacodynamics that often occur in older adults. Which of the following factors should the nurse take into account when administering medications to older adults on the unit? A) Older adults tend to achieve clearance of medication faster than do younger patients. B) Drug metabolism shifts from the liver to the kidneys as individuals age. C) Older adults tend to need either higher doses or more frequent doses of a drug to achieve therapeutic effect. D) 7. A gerontological nurse is conducting a medication assessment of a new patient on a subacute medicine unit. Which of the patient's statements should signal to the nurse a need for patient education? A) ìOverall, I much prefer to prevent getting sick than having to rely on different drugs to stay healthy.î B) ìI've made a reminder system for myself so that I don't miss any of my pills during the day.î C) ìMy family doctor has me on so many different pills now, so I want to talk with her about whether they're all necessary.î D) 8. A medical nurse is aware that older adults tend to have a significantly decreased rate of hepatic blood flow compared with younger adults. What effect is this likely to have on pharmacokinetics and pharmacodynamics in an older adult? A) B) Elimination half-time is likely to be faster. C) The kidneys will likely compensate for decreased hepatic capacity. D) Multiple bioactive substances will be needed for therapeutic effect. 9. A nurse is conducting a medication assessment of an older adult client who will soon be receiving home care. Which of the following questions should the nurse include in this assessment? Select all that apply. A) B) ìWhat is your typical diet?î C) D) E) 10. Having completed a medication assessment and physical assessment of a new client, a home care nurse is now creating nursing diagnoses and choosing interventions appropriate to these diagnoses. What factor should the nurse prioritize in this process? A) The need to maintain the client's autonomy. B) The nurse's responsibility to teach the patient and minimize liability. C) D) The importance of fostering patient compliance. 1. The nurse is responsible for assessing an older adult in an acute care setting. Which of the following statements most accurately captures the complexity involved in assessing the older adult? A) Older adults manifest fewer symptoms of illness than do younger patients. B) C) Care must be taken to avoid assessing normal, age-related changes. D) Older adults experience fewer acute health problems but more chronic illnesses than do younger patients. 2. An 82-year-old man is getting advice from a family member on how to drive safely. What piece of advice should the older adult follow? A) ìAvoid modifying your vehicle with devices that were not supplied by the manufacturer.î B) ìRealize that normal, age-related changes should not affect your ability to drive safely.î C) D) ìYou should transition from driving to using public transportation as soon as possible.î 3. The nurse is conducting a functional assessment of a resident who has recently moved to the assisted-living facility. Which of the following statements best describes functional assessment? A) It excludes information on the resident's medical diagnoses and health problems. B) C) It is an alternative to assessing the resident's activities of daily living (ADLs). D) It prioritizes the resident's ability to perform roles in relationships and in society. 4. As part of a functional assessment, the nurse is assessing an older adult's activities of daily living (ADLs) and instrumental activities of daily living (IADLs). What piece of assessment data would most likely be considered an IADL rather than an ADL? A) The older adult is able to ambulate to and from the bathroom at home. B) The older adult can feed herself independently. C) The older adult can dress in the morning without assistance. D) 5. The nurse is employed in a Medicare- and Medicaid-funded nursing home. Which of these statements is true of the functional assessments the nurse is likely to perform? A) The nurse will address core activities of daily living (ADLs) but not more complex instrumental activities of daily living (IADLs). B) C) The nurse will utilize various functional assessment models. D) The main goal of functional assessments will be to ensure older adult safety. 6. A nurse who provides care in a nursing home has completed the admission assessment of an 84-year-old man who has just moved from an assisted living facility. The nurse would document a deficit in the resident's activities of daily living (ADLs) in light of what assessment finding? A) The man experiences chronic pain as a result of rheumatoid arthritis. B) The man is able to ambulate with a wheeled walker for 60 ft but then requires a rest break. C) D) The man is unable to explain the rationale for each of the medications that he receives. 7. A 79-year-old woman has been admitted to a nursing home primarily because her diagnosis of Alzheimer disease has progressed from the mild stage to the moderate stage. How should the nurse proceed with functional assessment in light of the woman's cognitive deficits? A) Obtain assessment data from the woman's family members and friends. B) C) Perform assessment passively by observing and recording the woman's behavior and actions over the next several days. D) Document the fact that it is not possible to accurately gauge the woman's activities of daily living. 8. A nurse who works in an acute care for elders (ACE) unit has observed that a female patient on the unit frequently stumbles when she ambulates with her walker. How should the nurse best follow up this observation? A) Provide a wheelchair for the patient to use for the duration of her hospital stay. B) Ask the patient to remain in her bed or in a chair as much as possible and teach her about falls risks. C) Place a chair in the hallway so the patient can take a rest break when she feels unsteady on her feet. D) 9. Staff members at a nursing home have been reminded by management of their responsibility to utilize the Minimum Data Set (MDS) for Resident Assessment and Care Screening. When should the MDS be used? A) B) Once per week for the first month after admission and once per month after that C) Whenever a registered nurse or physician documents a significant change in a resident's level of function D) Daily, as part of routine assessment in the facility 10. Assessment of an older adult's activities of daily living (ADLs) addresses parameters such as mobility, dressing, and elimination. In addition to such functional parameters, assessment of ADLs should also address A) pain and range of motion. B) C) previous medical history. D) integumentary assessment. [Show More]

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