Chapter 05: Chronic Illness and Older
Adults
Test Bank for Lewis Medical Surgical Nursing 11th Edition by
Harding
MULTIPLE CHOICE
1. The nurse plans to complete a thorough assessment of an older patient. Which
method should the nurse use to gather the most complete information?
a. Use a geriatric assessment instrument to evaluate the patient.
b. Ask the patient to write down medical problems and medications.
c. Interview both the patient and the primary caregiver for the patient.
d. Review the patients medical record for a history of medical problems.
ANS: A
The most complete information about the patient 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 medical record, interviews with the
patient and caregiver, and written information by the patient are all included in a
comprehensive geriatric assessment.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and
Maintenance
2. An older patient who takes multiple medications for chronic cardiac and pulmonary
diseases is alert and 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. Risk for injury related to drug interactions
b. Social isolation related to weakness and fatigue
c. Compromised family coping related to the patients many care needs
d. Caregiver role strain related to need to adjust family employment schedule
ANS: A
The patients 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 is therefore the priority.
, DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Diagnosis MSC: NCLEX: Health Promotion and
Maintenance
3. The nurse performs a comprehensive geriatric assessment of a patient who is being
assessed for 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 patients 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.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and
Maintenance
4. 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 patients 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 needs instruction on recognition of symptoms of hypertension
and TIA and appropriate actions to take if these symptoms occur. The other
information also may be included in patient teaching but is not as essential in the
patients self-management of the illness.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
5. An older patient is hospitalized with pneumonia. Which intervention should the nurse
implement to provide optimal care for this patient?
a. Use a standardized geriatric nursing care plan.
b. Minimize activity level during hospitalization.
c. Plan for transfer to a long-term care facility upon discharge.
d. Consider the preadmission functional abilities when setting patient goals.
Adults
Test Bank for Lewis Medical Surgical Nursing 11th Edition by
Harding
MULTIPLE CHOICE
1. The nurse plans to complete a thorough assessment of an older patient. Which
method should the nurse use to gather the most complete information?
a. Use a geriatric assessment instrument to evaluate the patient.
b. Ask the patient to write down medical problems and medications.
c. Interview both the patient and the primary caregiver for the patient.
d. Review the patients medical record for a history of medical problems.
ANS: A
The most complete information about the patient 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 medical record, interviews with the
patient and caregiver, and written information by the patient are all included in a
comprehensive geriatric assessment.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and
Maintenance
2. An older patient who takes multiple medications for chronic cardiac and pulmonary
diseases is alert and 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. Risk for injury related to drug interactions
b. Social isolation related to weakness and fatigue
c. Compromised family coping related to the patients many care needs
d. Caregiver role strain related to need to adjust family employment schedule
ANS: A
The patients 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 is therefore the priority.
, DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Diagnosis MSC: NCLEX: Health Promotion and
Maintenance
3. The nurse performs a comprehensive geriatric assessment of a patient who is being
assessed for 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 patients 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.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and
Maintenance
4. 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 patients 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 needs instruction on recognition of symptoms of hypertension
and TIA and appropriate actions to take if these symptoms occur. The other
information also may be included in patient teaching but is not as essential in the
patients self-management of the illness.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
5. An older patient is hospitalized with pneumonia. Which intervention should the nurse
implement to provide optimal care for this patient?
a. Use a standardized geriatric nursing care plan.
b. Minimize activity level during hospitalization.
c. Plan for transfer to a long-term care facility upon discharge.
d. Consider the preadmission functional abilities when setting patient goals.
