A&E 1 COMPREHENSIVE TEST BANK AE 1 Comprehensive Test
Bank EXAM 2024-2025 QUESTIONS AND ANSWERS 100 % PASS
SOLUTION A+ GRADE
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. Which nursing action will be most helpful in decreasing the risk for drug-drug interactions in an
older adult?
a) Teach the patient to have all prescriptions filled at the same pharmacy.
b) Make a schedule for the patient as a reminder of when to take each medication.
c) Instruct the patient to avoid taking over-the-counter (OTC) medications or
supplements.
d) Ask the patient to bring all medications, supplements, and herbs to each
appointment.
ANS: D
The most information about drug use and possible interactions is obtained when the patient
brings all prescribed medications, OTC medications, and supplements to every health care
appointment. The patient should discuss the use of any OTC medications with the health care
provider and obtain all prescribed medications from the same pharmacy, but use of
supplements and herbal medications also need to be considered in order to prevent drug–drug
interactions.
Use of a medication schedule will help the patient take medications as scheduled, but will not
prevent drug–drug interactions.
2. A patient who has just moved to a long-term care facility has a nursing diagnosis of
relocation stress syndrome. Which action should the nurse include in the plan of care?
a) Remind the patient that making changes is usually stressful.
b) Discuss the reason for the move to the facility with the patient.
c) Restrict family visits until the patient is accustomed to the facility.
d) Have staff members write notes welcoming the patient to the facility.
ANS: D
TestBankWorld.org
Having staff members write notes will make the patient feel more welcome and comfortable at
the long-term care facility. Discussing the reason for the move and reminding the patient that
change is usually stressful will not decrease the patient’s stress about the move. Family
member visits will decrease the patient’s sense of stress about the relocation.
3. An older patient complains of having “no energy” and feeling increasingly weak. The
patient has had a 12-lb weight loss over the past year. Which action should the nurse take
initially?
a) Ask the patient about daily dietary intake.
, b) Schedule regular range-of-motion exercise.
c) Discuss long-term care placement with the patient.
d) Describe normal changes associated with aging to the patient.
ANS: A
In a frail older patient, nutrition is frequently compromised, and the nurse’s initial action should
be to assess the patient’s nutritional status. Active range of motion may be helpful in improving
the patient’s strength and endurance, but nutritional assessment is the priority because the
patient has had a significant weight loss. The patient may be a candidate for long-term care
placement, but more assessment is needed before this can be determined. The patient’s
assessment data are not consistent with normal changes associated with aging.
4. The nurse is admitting an acutely ill, older patient to the hospital. Which action should
the nurse take?
a) Speak slowly and loudly while facing the patient.
b) Obtain a detailed medical history from the patient.
c) Perform the physical assessment before interviewing the patient.
d) Ask a family member to go home and retrieve the patient’s cane.
ANS: C
When a patient is acutely ill, the physical assessment should be accomplished first to detect any
physiologic changes that require immediate action. Not all older patients have hearing deficits,
and it is insensitive of the nurse to speak loudly and slowly to all older patients. To avoid tiring
the patient, much of the medical history can be obtained from medical records. After the initial
physical assessment to determine the patient’s current condition, then the nurse could ask
someone to obtain any assistive devices for the patient if applicable.
5. 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.
6. The home health nurse visits an older patient with mild forgetfulness. Which new
information is of most concern to the nurse?
a) The patient tells the nurse that a close friend recently died.
b) The patient has lost 10 lb (4.5 kg) during the past month.
c) The patient is cared for by a daughter during the day and stays with a son at
night.
d) The patient’s son uses a marked pillbox to set up the patient’s medications
weekly.
ANS: B
,A 10-pound weight loss may be an indication of elder neglect or depression and requires further
assessment by the nurse. The use of a marked pillbox and planning by the family for 24-hour care
are appropriate for this patient. It is not unusual that an 86-yr-old would have friends who have
died.
7. 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.
ANS: B
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.
8. Which intervention should the nurse implement to provide optimal care for an older
patient who is hospitalized with pneumonia?
a) Plan for transfer to a long-term care facility.
b) Minimize activity level during hospitalization.
c) Consider the preadmission functional abilities.
d) Use an approved standardized geriatric nursing care plan.
ANS: C
The plan of care for older adults should be individualized and based on the patient’s current
functional abilities. A standardized geriatric nursing care plan will not address individual
patient needs and strengths. A patient’s need for discharge to a long-term care facility is
variable.
Activity level should be designed to allow the patient to retain functional abilities while
hospitalized and also to allow any additional rest needed for recovery from the acute process.
9. The nurse cares for an older adult patient who lives in a rural area. Which intervention
should the nurse plan to implement to meet this patient’s needs?
a) Suggest that the patient move closer to health care providers.
b) Obtain extra medications for the patient to last for 4 to 6 months.
c) Ensure transportation to appointments with the health care provider.
d) Assess the patient for chronic diseases that are unique to rural areas.
ANS: C
Transportation can be a barrier to accessing health services in rural areas. The patient living in
a rural area may lose the benefits of a familiar situation and social support by moving to an
urban area. There are no chronic diseases unique to rural areas. Because medications may
change, the nurse should help the patient plan for obtaining medications through alternate
means such as the mail or delivery services, not by purchasing large quantities of the
medications.
, 10. 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
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.
11. The nurse cares for an alert, homeless older adult patient who was admitted to the
hospital with a chronic foot infection. Which intervention is the most appropriate for the nurse to
include in the discharge plan for this patient?
a) Teach the patient how to assess and care for the foot infection.
b) Refer the patient to social services for assessment of resources.
c) Schedule the patient to return to outpatient services for foot care.
d) Give the patient written information about shelters and meal sites.
ANS: B
An interprofessional approach, including social services, is needed when caring for homeless
older adults. Even with appropriate teaching, a homeless individual may not be able to
maintain adequate foot care because of a lack of supplies or a suitable place to accomplish
care. Older homeless individuals are less likely to use shelters or meal sites. A homeless person
may fail to keep appointments for outpatient services because of factors such as fear of
institutionalization or lack of transportation.
12. The home health nurse cares for an older adult patient who lives alone and takes several
different prescribed medications for chronic health problems. Which intervention, if
implemented by the nurse, would best encourage medication compliance?
a) Use a marked pillbox to set up the patient’s medications.
b) Discuss the option of moving to an assisted living facility.
c) Remind the patient about the importance of taking medications.
d) Visit the patient daily to administer the prescribed medications.
ANS: A
Because forgetting to take medications is a common cause of medication errors in older adults,
the use of medication reminder devices is helpful when older adults have multiple medications
to take. There is no indication that the patient needs to move to assisted living or that the
patient does not understand the importance of medication compliance. Home health care is not
designed for the patient who needs ongoing assistance with activities of daily living or
instrumental ADLs.
Bank EXAM 2024-2025 QUESTIONS AND ANSWERS 100 % PASS
SOLUTION A+ GRADE
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. Which nursing action will be most helpful in decreasing the risk for drug-drug interactions in an
older adult?
a) Teach the patient to have all prescriptions filled at the same pharmacy.
b) Make a schedule for the patient as a reminder of when to take each medication.
c) Instruct the patient to avoid taking over-the-counter (OTC) medications or
supplements.
d) Ask the patient to bring all medications, supplements, and herbs to each
appointment.
ANS: D
The most information about drug use and possible interactions is obtained when the patient
brings all prescribed medications, OTC medications, and supplements to every health care
appointment. The patient should discuss the use of any OTC medications with the health care
provider and obtain all prescribed medications from the same pharmacy, but use of
supplements and herbal medications also need to be considered in order to prevent drug–drug
interactions.
Use of a medication schedule will help the patient take medications as scheduled, but will not
prevent drug–drug interactions.
2. A patient who has just moved to a long-term care facility has a nursing diagnosis of
relocation stress syndrome. Which action should the nurse include in the plan of care?
a) Remind the patient that making changes is usually stressful.
b) Discuss the reason for the move to the facility with the patient.
c) Restrict family visits until the patient is accustomed to the facility.
d) Have staff members write notes welcoming the patient to the facility.
ANS: D
TestBankWorld.org
Having staff members write notes will make the patient feel more welcome and comfortable at
the long-term care facility. Discussing the reason for the move and reminding the patient that
change is usually stressful will not decrease the patient’s stress about the move. Family
member visits will decrease the patient’s sense of stress about the relocation.
3. An older patient complains of having “no energy” and feeling increasingly weak. The
patient has had a 12-lb weight loss over the past year. Which action should the nurse take
initially?
a) Ask the patient about daily dietary intake.
, b) Schedule regular range-of-motion exercise.
c) Discuss long-term care placement with the patient.
d) Describe normal changes associated with aging to the patient.
ANS: A
In a frail older patient, nutrition is frequently compromised, and the nurse’s initial action should
be to assess the patient’s nutritional status. Active range of motion may be helpful in improving
the patient’s strength and endurance, but nutritional assessment is the priority because the
patient has had a significant weight loss. The patient may be a candidate for long-term care
placement, but more assessment is needed before this can be determined. The patient’s
assessment data are not consistent with normal changes associated with aging.
4. The nurse is admitting an acutely ill, older patient to the hospital. Which action should
the nurse take?
a) Speak slowly and loudly while facing the patient.
b) Obtain a detailed medical history from the patient.
c) Perform the physical assessment before interviewing the patient.
d) Ask a family member to go home and retrieve the patient’s cane.
ANS: C
When a patient is acutely ill, the physical assessment should be accomplished first to detect any
physiologic changes that require immediate action. Not all older patients have hearing deficits,
and it is insensitive of the nurse to speak loudly and slowly to all older patients. To avoid tiring
the patient, much of the medical history can be obtained from medical records. After the initial
physical assessment to determine the patient’s current condition, then the nurse could ask
someone to obtain any assistive devices for the patient if applicable.
5. 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.
6. The home health nurse visits an older patient with mild forgetfulness. Which new
information is of most concern to the nurse?
a) The patient tells the nurse that a close friend recently died.
b) The patient has lost 10 lb (4.5 kg) during the past month.
c) The patient is cared for by a daughter during the day and stays with a son at
night.
d) The patient’s son uses a marked pillbox to set up the patient’s medications
weekly.
ANS: B
,A 10-pound weight loss may be an indication of elder neglect or depression and requires further
assessment by the nurse. The use of a marked pillbox and planning by the family for 24-hour care
are appropriate for this patient. It is not unusual that an 86-yr-old would have friends who have
died.
7. 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.
ANS: B
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.
8. Which intervention should the nurse implement to provide optimal care for an older
patient who is hospitalized with pneumonia?
a) Plan for transfer to a long-term care facility.
b) Minimize activity level during hospitalization.
c) Consider the preadmission functional abilities.
d) Use an approved standardized geriatric nursing care plan.
ANS: C
The plan of care for older adults should be individualized and based on the patient’s current
functional abilities. A standardized geriatric nursing care plan will not address individual
patient needs and strengths. A patient’s need for discharge to a long-term care facility is
variable.
Activity level should be designed to allow the patient to retain functional abilities while
hospitalized and also to allow any additional rest needed for recovery from the acute process.
9. The nurse cares for an older adult patient who lives in a rural area. Which intervention
should the nurse plan to implement to meet this patient’s needs?
a) Suggest that the patient move closer to health care providers.
b) Obtain extra medications for the patient to last for 4 to 6 months.
c) Ensure transportation to appointments with the health care provider.
d) Assess the patient for chronic diseases that are unique to rural areas.
ANS: C
Transportation can be a barrier to accessing health services in rural areas. The patient living in
a rural area may lose the benefits of a familiar situation and social support by moving to an
urban area. There are no chronic diseases unique to rural areas. Because medications may
change, the nurse should help the patient plan for obtaining medications through alternate
means such as the mail or delivery services, not by purchasing large quantities of the
medications.
, 10. 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
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.
11. The nurse cares for an alert, homeless older adult patient who was admitted to the
hospital with a chronic foot infection. Which intervention is the most appropriate for the nurse to
include in the discharge plan for this patient?
a) Teach the patient how to assess and care for the foot infection.
b) Refer the patient to social services for assessment of resources.
c) Schedule the patient to return to outpatient services for foot care.
d) Give the patient written information about shelters and meal sites.
ANS: B
An interprofessional approach, including social services, is needed when caring for homeless
older adults. Even with appropriate teaching, a homeless individual may not be able to
maintain adequate foot care because of a lack of supplies or a suitable place to accomplish
care. Older homeless individuals are less likely to use shelters or meal sites. A homeless person
may fail to keep appointments for outpatient services because of factors such as fear of
institutionalization or lack of transportation.
12. The home health nurse cares for an older adult patient who lives alone and takes several
different prescribed medications for chronic health problems. Which intervention, if
implemented by the nurse, would best encourage medication compliance?
a) Use a marked pillbox to set up the patient’s medications.
b) Discuss the option of moving to an assisted living facility.
c) Remind the patient about the importance of taking medications.
d) Visit the patient daily to administer the prescribed medications.
ANS: A
Because forgetting to take medications is a common cause of medication errors in older adults,
the use of medication reminder devices is helpful when older adults have multiple medications
to take. There is no indication that the patient needs to move to assisted living or that the
patient does not understand the importance of medication compliance. Home health care is not
designed for the patient who needs ongoing assistance with activities of daily living or
instrumental ADLs.
