C HAPTER 40: C OMMON P HYSICAL C ARE
P ROBLEMS OF THE O LDER A DULT
Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th
Edition
MULTIPLE CHOICE
1. An older adult patient on bed rest has been eating poorl y. The patient is
exhibiting abdominal distention and cramping and is passing small
amounts of liquid stool. The nurse assesses these signs as an indication of:
a. constipation.
b. fecal impaction.
c. diarrhea.
d. GI tract infection.
ANS: B
Abdominal distention, cramping, and passage of small amounts of
liquid stool are signs and symptoms of fecal impaction. The risk
factors that contribute to this are bed rest, not eating a norma l diet, and
the use of pain medication.
DIF: Cognitive Level: Anal ysis REF: p. 820 OBJ:
Theory #5 TOP: Fecal Impaction KEY: Nursing Process
Step: Assessment MSC: NCLEX: Physiological Integrit y:
Physiological Adaptation
,2. When performing a digital rectal examination to determine the presence of
fecal impaction, the nurse must be alert for:
a. increasing blood pressure.
b. increasing respiratory rate.
c. reflexing incontinence.
d. decreasing heart rate.
ANS: D
The stimulation of the rectum by digital examinati on may stimulate the
vagus nerve, which then slows the heart rate. This is potentially
hazardous, so it is done cautiousl y and onl y when allowed by agency
policy.
DIF: Cognitive Level: Application REF: p. 820 OBJ:
Theory #2 TOP: Fecal Impaction KEY: Nursing Process
Step: Implementation MSC: NCLEX: Physiological
Integrit y: Reduction of Risk
3. The nurse, in reviewing with an older adult patient the nutritional changes
that would be most beneficial, would suggest:
a. reducing sugar intake.
b. increasing fat intake.
c. increasing intake of oils.
d. decreasing intake of roughage.
ANS: A
, Dietary recommendations for the older adult include decreasing sugar
and fat intake. Roughage should be increased to maintain proper bowel
elimination.
DIF: Cognitive Level: Compr ehension REF: p. 820
OBJ: Theory #6 TOP: Nutrition KEY: Nursing
Process Step: Implementation MSC: NCLEX:
Physiological Integrity: Physiological Adaptation
4. The nurse stresses taking vitamins and minerals to older adult
postmenopausal patients. To reduce the risk of osteoporosis, women
should increase their intake of:
a. iron.
b. magnesium.
c. calcium.
d. selenium.
ANS: C
Osteoporosis is the loss of calcium from bone. Calcium intake for
postmenopausal and perimenopausal women should be increased to
1000 to 15,000 mg/day, up from 800 mg/day for the general population.
DIF: Cognitive Level: Comprehension REF: p. 821|Table
40-3 OBJ: Theory #5 TOP: Nutrition KEY: Nursing
Process Step: Implementation MSC: NCLEX: Health
Promotion and Maintenance: Prevent ion and Earl y Detection of
Disease
P ROBLEMS OF THE O LDER A DULT
Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th
Edition
MULTIPLE CHOICE
1. An older adult patient on bed rest has been eating poorl y. The patient is
exhibiting abdominal distention and cramping and is passing small
amounts of liquid stool. The nurse assesses these signs as an indication of:
a. constipation.
b. fecal impaction.
c. diarrhea.
d. GI tract infection.
ANS: B
Abdominal distention, cramping, and passage of small amounts of
liquid stool are signs and symptoms of fecal impaction. The risk
factors that contribute to this are bed rest, not eating a norma l diet, and
the use of pain medication.
DIF: Cognitive Level: Anal ysis REF: p. 820 OBJ:
Theory #5 TOP: Fecal Impaction KEY: Nursing Process
Step: Assessment MSC: NCLEX: Physiological Integrit y:
Physiological Adaptation
,2. When performing a digital rectal examination to determine the presence of
fecal impaction, the nurse must be alert for:
a. increasing blood pressure.
b. increasing respiratory rate.
c. reflexing incontinence.
d. decreasing heart rate.
ANS: D
The stimulation of the rectum by digital examinati on may stimulate the
vagus nerve, which then slows the heart rate. This is potentially
hazardous, so it is done cautiousl y and onl y when allowed by agency
policy.
DIF: Cognitive Level: Application REF: p. 820 OBJ:
Theory #2 TOP: Fecal Impaction KEY: Nursing Process
Step: Implementation MSC: NCLEX: Physiological
Integrit y: Reduction of Risk
3. The nurse, in reviewing with an older adult patient the nutritional changes
that would be most beneficial, would suggest:
a. reducing sugar intake.
b. increasing fat intake.
c. increasing intake of oils.
d. decreasing intake of roughage.
ANS: A
, Dietary recommendations for the older adult include decreasing sugar
and fat intake. Roughage should be increased to maintain proper bowel
elimination.
DIF: Cognitive Level: Compr ehension REF: p. 820
OBJ: Theory #6 TOP: Nutrition KEY: Nursing
Process Step: Implementation MSC: NCLEX:
Physiological Integrity: Physiological Adaptation
4. The nurse stresses taking vitamins and minerals to older adult
postmenopausal patients. To reduce the risk of osteoporosis, women
should increase their intake of:
a. iron.
b. magnesium.
c. calcium.
d. selenium.
ANS: C
Osteoporosis is the loss of calcium from bone. Calcium intake for
postmenopausal and perimenopausal women should be increased to
1000 to 15,000 mg/day, up from 800 mg/day for the general population.
DIF: Cognitive Level: Comprehension REF: p. 821|Table
40-3 OBJ: Theory #5 TOP: Nutrition KEY: Nursing
Process Step: Implementation MSC: NCLEX: Health
Promotion and Maintenance: Prevent ion and Earl y Detection of
Disease
