A&E I Comprehensive Testbank

A&E I Comprehensive Testbank Table of Contents Week 1 Care of Older Adults: Culture, Spirituality, Communication, Sexuality, Infection Control Chronic Illness and Older Adults__________________________________________________3 Cultural Awareness____________________________________________________________10 Older Adult__________________________________________________________________18 Communication_______________________________________________________________28 Patient Education_____________________________________________________________39 Infection Prevention and Control_________________________________________________51 Sexuality____________________________________________________________________69 Spiritual Health______________________________________________________________78 Week 2 Critical Thinking, The Nursing Process, Loss, Death, and Grief Critical Thinking in Nursing Practice_____________________________________________86 Nursing Assessment___________________________________________________________94 Nursing Diagnosis___________________________________________________________102 Planning Nursing Care________________________________________________________110 Implementing Nursing Care____________________________________________________119 Evaluation__________________________________________________________________128 The Experience of Loss, Death and Grief__________________________________________136 Week 3 Safety and Fall Prevention among Older Adults, Preventing Complications of Immobility Patient Safety and Quality_____________________________________________________146 Immobility__________________________________________________________________163 Activity and Exercise__________________________________________________________181 Week 4 Skin and Wound Care Hygiene, Introduction to Pharmacology and Medication Administration Medication Administration_____________________________________________________194 Hygiene____________________________________________________________________212 Skin Integrity and Wound Care__________________________________________________231 Week 5 Fluid & Electrolytes, Dehydration Fluid, Electrolyte and Acid-Base Balance_________________________________________251 Week 6 Pain and Sleep 1 A&E I Comprehensive Testbank Pain Management____________________________________________________________268 Sleep______________________________________________________________________280 Week 7 Concepts related to Oxygenation, Circulation, and Tissue Perfusion, Chronic Obstructive Pulmonary Disease Oxygenation________________________________________________________________295 Obstructive Pulmonary Diseases________________________________________________314 Week 8 Diabetes Mellitus Diabetes Mellitus____________________________________________________________331 Week 9 Hypertension, Stroke Hypertension________________________________________________________________341 Stroke_____________________________________________________________________356 Week 10 Documentation and Informatics Documentation and Informatics______________________________________368 Week 11 Nutrition, Dysphagia_____________________________________382 Week 12 Care of the Surgical Patient________________________________398 Week 1 Care of Older Adults: Culture, Spirituality, Communication, Sexuality, Infection Control Chapter 05: Chronic Illness and Older Adults Lewis: Medical-Surgical Nursing, 10th Edition MULTIPLE CHOICE 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 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