Chapter 07
Lewis: Medical-Surgical Nursing in Canada
MULTIPLE CHOICE
1. Findings from a health history indicate that the client takes daily supplements of the
antioxidants beta carotene, vitamin C, and vitamin E. This health practice reflects which of the
following theories of biological aging?
a. Free radicals
b. Crosslinking
c. Somatic mutation
d. Telomere-telomerase depletion
ANS: A
Free radicals are natural by-products of many normal cellular processes and are also created
under the influence of environmental factors such as smog, tobacco smoke, and radiation.
Numerous natural protective mechanisms are in place to prevent oxidative damage. Recent
research has focused on the roles of various antioxidants, including vitamins C and E, in
slowing down the oxidative process and, ultimately, the aging process. The somatic mutation
theory focuses on spontaneous mutations. The crosslinking theory is based upon lipids,
proteins, CHO, and nucleic acid reactions. The telomere-telomerase depletion theory focuses
on the loss of telomeres, repeated sequences at the ends of DNA.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
N R I G B.C M
U S status
2. The nurse is assessing the nutritional N Tof an O
older-adult client using the SCALES
acronym. Which of the following should the nurse assess when completing the “S”?
a. Serum potassium level
b. Sadness or mood change
c. Social support
d. Sexual intimacy
ANS: B
The acronym SCALES can be used to remind the nurses to assess important nutritional
indicators. In the case of the “S,” the nurse is to assess sadness or mood changes.
DIF: Cognitive Level: Application TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
3. The nurse is planning care for an alert and active older-adult client who takes multiple
medications for chronic cardiac and respiratory disease and lives with a daughter who works
during the day. Which nursing diagnosis is most appropriate?
a. Risk for injury as evidenced by exposure to toxic chemical (drug-drug interactions)
b. Social isolation related to social behavior incongruent with norms (weakness and
fatigue)
c. Disabled family coping related to differing coping styles between support person
and client
d. Caregiver role strain related to increase in care needs
, ANS: A
The client’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. The client data
do not indicate problems with social isolation, caregiver role strain, or compromised family
coping.
DIF: Cognitive Level: Application TOP: Nursing Process: Diagnosis
MSC: NCLEX: Health Promotion and Maintenance
4. Which of the following actions would enable the nurse to obtain the most complete
information when doing an assessment with an older-adult client?
a. Interview both the client and the primary client caregiver.
b. Use a geriatric assessment instrument to evaluate the client.
c. Review the client’s chart for the history of medical problems.
d. Ask the client to write down medical problems and medications.
ANS: B
The most complete information about the client 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 chart, interviews of the client and caregiver, and written information by the
client will all be included in a comprehensive geriatric assessment.
DIF: Cognitive Level: Application TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
5. Which of the following actions should the nurse consider when developing the plan of care for
NURS
an older adult who is hospitalized forIan
NGacute
TB.C OM
illness?
a. Use a standardized geriatric nursing care plan.
b. Minimize activity level during hospitalization.
c. Plan for transfer to a long-term care facility after the hospitalization.
d. Consider preadmission functional abilities when setting client goals.
ANS: D
The plan of care for older adults should be individualized and based on the client’s current
functional abilities. A standardized geriatric nursing care plan will not address individual
client needs and strengths. A client’s need for discharge to a long-term care facility is
variable. Activity level should be designed to allow the client to retain functional abilities
while hospitalized and also to allow any additional rest needed for recovery from the acute
process.
DIF: Cognitive Level: Application TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
6. The nurse is caring for clients in a geriatric family practice clinic with a primary health care
provider. Which of the following actions should the nurse do when caring for older adults
who live in rural areas?
a. Assess the client for chronic diseases that are unique to rural areas.
b. Ensure transportation to appointments with the health care provider.
c. Schedule appointments for the client in an urban area for better health care.
d. Obtain adequate medications for the client to last for 4–6 months.
Lewis: Medical-Surgical Nursing in Canada
MULTIPLE CHOICE
1. Findings from a health history indicate that the client takes daily supplements of the
antioxidants beta carotene, vitamin C, and vitamin E. This health practice reflects which of the
following theories of biological aging?
a. Free radicals
b. Crosslinking
c. Somatic mutation
d. Telomere-telomerase depletion
ANS: A
Free radicals are natural by-products of many normal cellular processes and are also created
under the influence of environmental factors such as smog, tobacco smoke, and radiation.
Numerous natural protective mechanisms are in place to prevent oxidative damage. Recent
research has focused on the roles of various antioxidants, including vitamins C and E, in
slowing down the oxidative process and, ultimately, the aging process. The somatic mutation
theory focuses on spontaneous mutations. The crosslinking theory is based upon lipids,
proteins, CHO, and nucleic acid reactions. The telomere-telomerase depletion theory focuses
on the loss of telomeres, repeated sequences at the ends of DNA.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
N R I G B.C M
U S status
2. The nurse is assessing the nutritional N Tof an O
older-adult client using the SCALES
acronym. Which of the following should the nurse assess when completing the “S”?
a. Serum potassium level
b. Sadness or mood change
c. Social support
d. Sexual intimacy
ANS: B
The acronym SCALES can be used to remind the nurses to assess important nutritional
indicators. In the case of the “S,” the nurse is to assess sadness or mood changes.
DIF: Cognitive Level: Application TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
3. The nurse is planning care for an alert and active older-adult client who takes multiple
medications for chronic cardiac and respiratory disease and lives with a daughter who works
during the day. Which nursing diagnosis is most appropriate?
a. Risk for injury as evidenced by exposure to toxic chemical (drug-drug interactions)
b. Social isolation related to social behavior incongruent with norms (weakness and
fatigue)
c. Disabled family coping related to differing coping styles between support person
and client
d. Caregiver role strain related to increase in care needs
, ANS: A
The client’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. The client data
do not indicate problems with social isolation, caregiver role strain, or compromised family
coping.
DIF: Cognitive Level: Application TOP: Nursing Process: Diagnosis
MSC: NCLEX: Health Promotion and Maintenance
4. Which of the following actions would enable the nurse to obtain the most complete
information when doing an assessment with an older-adult client?
a. Interview both the client and the primary client caregiver.
b. Use a geriatric assessment instrument to evaluate the client.
c. Review the client’s chart for the history of medical problems.
d. Ask the client to write down medical problems and medications.
ANS: B
The most complete information about the client 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 chart, interviews of the client and caregiver, and written information by the
client will all be included in a comprehensive geriatric assessment.
DIF: Cognitive Level: Application TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
5. Which of the following actions should the nurse consider when developing the plan of care for
NURS
an older adult who is hospitalized forIan
NGacute
TB.C OM
illness?
a. Use a standardized geriatric nursing care plan.
b. Minimize activity level during hospitalization.
c. Plan for transfer to a long-term care facility after the hospitalization.
d. Consider preadmission functional abilities when setting client goals.
ANS: D
The plan of care for older adults should be individualized and based on the client’s current
functional abilities. A standardized geriatric nursing care plan will not address individual
client needs and strengths. A client’s need for discharge to a long-term care facility is
variable. Activity level should be designed to allow the client to retain functional abilities
while hospitalized and also to allow any additional rest needed for recovery from the acute
process.
DIF: Cognitive Level: Application TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
6. The nurse is caring for clients in a geriatric family practice clinic with a primary health care
provider. Which of the following actions should the nurse do when caring for older adults
who live in rural areas?
a. Assess the client for chronic diseases that are unique to rural areas.
b. Ensure transportation to appointments with the health care provider.
c. Schedule appointments for the client in an urban area for better health care.
d. Obtain adequate medications for the client to last for 4–6 months.
