Deck 10: Chronic Disease in Late Life

Question 1

You are caring for a client with a newly diagnosed chronic illness.In answering her questions,your most accurate response will include phrasing to the effect that:

A) the most prevalent form of disease in older adults at this time is acute illness.
B) although chronic illness lasts a long time,the effect on the family is minimal,primarily affecting only the client.
C) chronic illness is lifelong,and coping can be influenced by perceived uncertainty.
D) the client's acquisition of knowledge of the disease will guarantee successful coping with phases of the illness.

Answer 1

chronic illness is lifelong,and coping can be influenced by perceived uncertainty.

Question 2

You are developing a class on stroke prevention for a local senior citizens center.What would be an important focus when teaching stroke prevention directed at modifiable risk factors?

A) Smoking cessation
B) Blood glucose control
C) Annual physical examination
D) Annual influenza immunization

Answer 2

Smoking cessation

Question 3

An 86-year-old woman is diagnosed with diverticulosis on her routine colonoscopy.She asks you how she got this problem.You base your answer on the knowledge that the risk factors for diverticulosis include:

A) increased intake of dairy products.
B) overuse of laxatives.
C) infection with the bacterium Helicobacter pylori.
D) a diet low in fiber.

Answer 3

a diet low in fiber.

Question 4

What is written in measurable terms on the care plan of your elderly client who has heart failure?

A) He will ambulate 20 feet twice daily without complaints of shortness of breath and maintaining pulse less than 110 beats per minute.
B) He will keep his oxygen on longer during the day.
C) He will be more compliant with his diuretic therapy.
D) He will decrease his fluid intake.

Question 5

An elderly man has been admitted to the hospital for prostate surgery.He has a history of hypertension for which he is on medication.He also reports a recent fall at home.The nurse should perform which assessment?

A) Check blood pressure every 2 hours.
B) Check orthostatic blood pressures.
C) Check serum creatinine levels.
D) Check serum sodium levels.

Question 6

You are conducting a blood pressure screening at a local senior center.A 90-year-old client of the center has a blood pressure reading of 150/88.He reports no other symptoms,and no acute medical illness.You should instruct him to:

A) not worry because this reading is consistent with his age.
B) go to the emergency department for immediate evaluation.
C) contact his primary care provider for evaluation.
D) return to your next screening in 6 weeks.

Question 7

A client is diagnosed with diverticular disease from a routine colonoscopy.She meets with the registered dietitian for diet teaching.What would indicate that she needs additional teaching:

A) "I need to increase my fiber intake."
B) "I need to avoid eating for 3 to 4 hours before I go to bed."
C) "I need to drink at least 6 to 8 glasses of water every day."
D) "I should avoid drinking too much coffee."

Question 8

A 79-year-old male client with chronic obstructive pulmonary disease (COPD)is seen in the respiratory clinic.What intervention is most important when developing his plan of care to address the long-term goal of promoting healthy respiratory aging?

A) Annual tuberculosis (TB)skin testing
B) Teaching the patient to use alternative modalities such as meditation in order to relax
C) Annual influenza immunization
D) Consuming a high-protein,high-calorie diet

Question 9

As the nurse plans to instruct a chronically ill older adult about the changes needed to maintain his health,what statement is most appropriate to consider in establishing goals for behavior change?

A) Management of the client's chronic disease rests on the client and caregiver; goals should be set in collaboration.
B) The client will be able to make needed changes in his life if the nurse provides accurate written instructions.
C) Psychological functioning is usually impaired only to a small extent in a client with chronic illness.
D) The client's values,culture,and beliefs have little to do with the types of changes he will be able to make.

Question 10

Type 2 diabetes mellitus is often difficult to diagnoses in older adults because:

A) presenting symptoms occur very quickly.
B) it rarely occurs in older adults.
C) the classic symptoms may not be present in older adults.
D) there are no recognizable symptoms; it is a "silent killer."

Question 11

The major difference between a transient ischemic attack (TIA)and a cerebrovascular accident (CVA)is that:

A) TIA symptoms begin to resolve within minutes and are completely resolved within 24 hours.
B) TIA symptoms always precede an ischemic CVA.
C) TIA symptoms begin to resolve within minutes but are not completely resolved for 48 to 72 hours.
D) TIA symptoms do not usually involve motor functions.

Question 12

You are assisting your elderly client with chronic obstructive pulmonary disease (COPD)in self-care activities.Which direction provided by you will best help her achieve the goal of being able to perform self-care activities?

A) Bathe and eat slowly,allowing rest periods.
B) Attempt to walk short distances without oxygen.
C) Perform all activities of daily living at one time,and then rest.
D) Bathe right after eating,and then rest.

Question 13

Treatment of a cerebrovascular accident (CVA)with thrombolytic therapy:

A) is used for both thrombotic and hemorrhagic CVAs.
B) is indicated if the first symptoms of the CVA have occurred within 6 hours or less.
C) is given to dissolve the clot and reestablish circulation to the affected part of the brain.
D) is not associated with serious complications.

Question 14

An older adult with pneumonia often:

A) presents with an elevated temperature.
B) is not treated with antibiotics.
C) presents with a change in functional status and mental status.
D) presents with a markedly elevated white blood cell (WBC)count.

Question 15

A 77-year-old patient had an acute myocardial infarction and subsequently coronary artery bypass graft (CABG)surgery.The interprofessional team recommends that the patient attend a cardiac rehabilitation program.He tells the nurse,"I don't see why I can't go home.I will go to my gym every day.I don't see what the difference is between that and the rehab." The nurse bases her response on the knowledge that:

A) cardiac rehabilitation programs typically begin with light activity and progress in intensity with the supervision of a nurse or physical therapist.
B) cardiac rehabilitation programs are only useful for individuals who are typically sedentary and would not exercise otherwise.
C) cardiac rehabilitation programs are only offered in long-term care settings.
D) cardiac rehabilitation programs are more effective in men than in women.

Question 16

A 77-year-old client is newly diagnosed with type 2 diabetes mellitus.What is a priority goal for her?

A) To have an eye examination by an ophthalmologist yearly
B) To have routine foot examinations by a podiatrist
C) To maintain proper control of her blood sugar
D) To be knowledgeable about the signs and symptoms of kidney failure