Lewis's Medical Surgical Nursing Test Bank 11th Edition [Harding]
Chapter 5 - Chronic Illness and Older Adults
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.
Answer: A
Explanation: A comprehensive geriatric assessment instrument is specifically designed to
evaluate both medical diagnoses and functional health patterns, providing the most complete
information. While reviewing records and interviewing the patient and caregiver are
components, the structured instrument ensures all critical areas are assessed systematically.
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
Answer: A
Explanation: The patient's age and polypharmacy create a high risk for injury due to potential
drug interactions and altered drug metabolism. While psychosocial issues are present, the
physiologic risk of injury is the priority as it could cause the most immediate harm.
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?
Answer: D
,Explanation: Functional abilities, such as the capacity to perform instrumental activities of
daily living like meal preparation, are the most critical factors in determining suitability and
needed support in an assisted living environment.
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
Answer: C
Explanation: A key task in chronic illness management is preventing and managing crises.
Teaching the patient to recognize and respond to symptoms of hypertension or recurrent TIA
empowers self-management and promotes timely intervention.
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.
Answer: D
Explanation: Care for older adults should be individualized. Using preadmission functional
status as a baseline helps set realistic, patient-centered goals and promotes the recovery of
prior independence, rather than applying a standardized plan or unnecessarily limiting
activity.
6. The nurse cares for an older adult patient who lives in a rural area. Which
intervention should the nurse plan to implement to best meet this patient's
needs?
A. Suggest that the patient move to an urban area.
B. Assess the patient for chronic diseases that are unique to rural areas.
C. Ensure transportation to appointments with the health care provider.
D. Obtain adequate medications for the patient to last for 4 to 6 months.
Answer: C
, Explanation: Transportation is a significant barrier to healthcare access in rural areas.
Ensuring the patient can get to appointments addresses a primary obstacle to receiving
continuous care.
7. 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. Instruct the patient to avoid taking over-the-counter (OTC) medications.
C. Make a schedule for the patient as a reminder of when to take each medication.
D. Have the patient bring all medications, supplements, and herbs to each
appointment.
Answer: D
Explanation: Bringing all medications, including prescriptions, OTC drugs, and supplements,
to every appointment allows the healthcare provider to conduct a comprehensive review and
identify potential interactions, which is the most effective strategy for prevention.
8. 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.
Answer: D
Explanation: A welcoming gesture from staff can help the patient feel accepted and reduce
feelings of stress and isolation associated with relocation. Family visits should be
encouraged, not restricted, as they provide social support.
9. An older patient complains of having no energy and feeling increasingly weak.
The patient has had a 12-pound weight loss over the last 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.
Answer: A
Chapter 5 - Chronic Illness and Older Adults
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.
Answer: A
Explanation: A comprehensive geriatric assessment instrument is specifically designed to
evaluate both medical diagnoses and functional health patterns, providing the most complete
information. While reviewing records and interviewing the patient and caregiver are
components, the structured instrument ensures all critical areas are assessed systematically.
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
Answer: A
Explanation: The patient's age and polypharmacy create a high risk for injury due to potential
drug interactions and altered drug metabolism. While psychosocial issues are present, the
physiologic risk of injury is the priority as it could cause the most immediate harm.
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?
Answer: D
,Explanation: Functional abilities, such as the capacity to perform instrumental activities of
daily living like meal preparation, are the most critical factors in determining suitability and
needed support in an assisted living environment.
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
Answer: C
Explanation: A key task in chronic illness management is preventing and managing crises.
Teaching the patient to recognize and respond to symptoms of hypertension or recurrent TIA
empowers self-management and promotes timely intervention.
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.
Answer: D
Explanation: Care for older adults should be individualized. Using preadmission functional
status as a baseline helps set realistic, patient-centered goals and promotes the recovery of
prior independence, rather than applying a standardized plan or unnecessarily limiting
activity.
6. The nurse cares for an older adult patient who lives in a rural area. Which
intervention should the nurse plan to implement to best meet this patient's
needs?
A. Suggest that the patient move to an urban area.
B. Assess the patient for chronic diseases that are unique to rural areas.
C. Ensure transportation to appointments with the health care provider.
D. Obtain adequate medications for the patient to last for 4 to 6 months.
Answer: C
, Explanation: Transportation is a significant barrier to healthcare access in rural areas.
Ensuring the patient can get to appointments addresses a primary obstacle to receiving
continuous care.
7. 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. Instruct the patient to avoid taking over-the-counter (OTC) medications.
C. Make a schedule for the patient as a reminder of when to take each medication.
D. Have the patient bring all medications, supplements, and herbs to each
appointment.
Answer: D
Explanation: Bringing all medications, including prescriptions, OTC drugs, and supplements,
to every appointment allows the healthcare provider to conduct a comprehensive review and
identify potential interactions, which is the most effective strategy for prevention.
8. 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.
Answer: D
Explanation: A welcoming gesture from staff can help the patient feel accepted and reduce
feelings of stress and isolation associated with relocation. Family visits should be
encouraged, not restricted, as they provide social support.
9. An older patient complains of having no energy and feeling increasingly weak.
The patient has had a 12-pound weight loss over the last 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.
Answer: A
