Deck 9: Health Care Delivery Settings and Older Adults

Question 1

The nurse best addresses the possible intrinsic factors that contribute to falls experienced by older adult patients in an acute care setting by:

A)encouraging patients to wear their glasses.
B)keeping a low-level light on in the room at night.
C)keeping the patient's bed low to the floor.
D)assessing the room for clutter on the floor.

Answer 1

encouraging patients to wear their glasses.

Question 2

The nurse is caring for a confused patient.Which action by the nurse shows the best understanding of managing the cascading effects of iatrogenic illnesses in this population cohort?

A)Reorienting the patient to person,place,and time frequently
B)Offering the patient liquids each time there is patient-nurse contact
C)Repositioning the patient every 2 hours
D)Using restraints to ensure patient safety only as a last resort

Answer 2

Using restraints to ensure patient safety only as a last resort

Question 3

Which action does the nurse delegate to the unlicensed assistive personnel (UAP)pertaining to pressure ulcer prevention?

A)Assessing the patient's skin daily
B)Keeping the patient's skin clean and dry
C)Obtaining a special overlay mattress
D)Monitoring the patient's nutritional status

Answer 3

Keeping the patient's skin clean and dry

Question 4

What action by the nurse best shows an understanding of the effects of acute hospitalization on the functional abilities of the older patient?

A)Setting goals that support a short hospitalization.
B)Attempting to adapt nursing care to individual needs
C)Administering a systematic functional assessment
D)Assessing for a decline from original baseline function

Question 5

An older patient has fallen twice in the hospital in the last 2 days.What action by the nurse is best?

A)Request restraint orders from the provider.
B)Assess the patient for undiagnosed illness.
C)Remind the patient to call for help getting up.
D)Have a family member stay with the patient.

Question 6

The nurse in an acute care facility is caring for a patient recovering from a cerebral vascular accident that has resulted in a mild loss of muscle function in his right arm and leg.The nurse is best addressing the patient's need via the functional model of care when:

A)assessing the patient's right-sided muscle strength daily.
B)reaffirming to the patient that physical therapy will improve his muscle strength.
C)instructing the patient's family on how to properly assist the patient in walking.
D)placing the telephone where the patient can reach it with his left hand.

Question 7

The nurse is planning the discharge of a 70-year-old patient who lives alone and is recovering from a fractured ankle.What action by the nurse shows an understanding of factors affecting the patient's ultimate return to preinjury function?

A)Encourages the patient to comply with recommendations made by the physical therapist
B)Arranges for the patient's meals to be delivered daily for several weeks after discharge
C)Assesses the barriers to self-ambulation that exist in the patient's home
D)Educates the patient on the importance of a diet that promotes both bone and muscle healing

Question 8

A nurse is caring for an older patient in the intensive care unit.The patient has a sudden onset of confusion.What action by the nurse is best?

A)Request a sedative from the provider.
B)Attempt to reorient the patient.
C)Perform a sepsis screening.
D)Review lab work for today.

Question 9

Which individual would the nurse refer to the local Area Agency on Aging?

A)One who needs housekeeping services
B)One who needs help with preparing taxes
C)One who needs nutritious meals
D)One who needs long-term care placement

Question 10

Which statement by a resident best indicates that the resident's psychosocial needs are being met?

A)"I'm really enjoying the opportunity to select my own mealtimes."
B)"I miss being at home,but I understand why I must live here."
C)"I appreciate being placed on the waiting list for a private room because I prefer living alone."
D)"I'm an independent person who has always made my own decisions,and I will for as long as I can."

Question 11

The nurse is caring for an older adult patient who was admitted with a stage 3 pressure ulcer on the left heel and who also has a history of Parkinson disease and chronic renal failure.To minimize the patient's risk of developing an iatrogenic illness,the nurse:

A)uses sterile technique when changing the heel's dressings.
B)reviews all the patient's medications for possible adverse reactions.
C)instructs the patient to call for assistance when needing to go to the bathroom.
D)assists the patient in choosing the appropriate foods from the daily menu.

Question 12

What action by the nurse is most important for preventing hospital-acquired infections in the older population?

A)Appropriate hand hygiene
B)Rapid isolation for infection
C)Strict sterile procedures
D)Ensuring patient nutrition

Question 13

The nursing faculty explains to students the definition of "homebound." Which is the best explanation of this situation?

A)A person uses a wheelchair for all mobility.
B)A person desires services provided at home.
C)Leaving home requires great effort.
D)No local agency is available to provide service.

Question 14

A patient is on hospice care.Which situation would result in an acute hospitalization?

A)Progression of disease
B)Intractable pain
C)New pressure ulcer
D)Bladder infection

Question 15

A 70-year-old patient covered by Medicare is being admitted for stabilization of type 2 diabetes.When asked by the family why their parent's care is being co-managed by a geriatric nurse practitioner and a physician,the best explanation is that:

A)the geriatric nurse practitioner is specially trained to work with older patients.
B)research has shown that this care model often results in shorter hospital stays.
C)the physician and nurse practitioner will focus on different needs.
D)Medicare encourages this team concept of patient care.

Question 16

The nurse at an assisted living facility is caring for a 73-year-old cognitively impaired patient who has recently been admitted.The nurse creates a care plan that strives to help maintain the patient's independence by including:

A)sufficient time for the patient to complete self-care.
B)encouraging the patient to make decisions regarding self-care.
C)regular assessment of the patient's ability to provide self-care.
D)regular cueing by staff to direct patient self-care.

Question 17

An 80-year-old patient with visual and hearing deficits is admitted for hip replacement surgery.The patient has begun to show mild confusion and has become resistant to care and treatment.To minimize this problem,the nurse initially edits the patient's care plan to include:

A)frequent reorientation to people in the patient's environment.
B)putting on the patient's glasses and hearing aid as a part of activities of daily living (ADLs).
C)assigning the same staff to provide patient care whenever possible.
D)minimizing the number of off-unit trips for the patient.

Question 18

The nurse on a medical acute care unit is preparing for the admission of an 84-year-old patient with several diagnosed chronic illnesses.The nurse begins the plan of care for this patient based on the understanding that the older adult is likely to:

A)develop hospital-induced delirium.
B)require special attention related to sensory deficits.
C)need a social services consult before discharge.
D)present with a need for a high level of nursing care.

Question 19

The nurse is going to educate an older patient newly diagnosed with type 2 diabetes on how to test serum glucose levels appropriately.The nurse shows an understanding of the adaptation of teaching techniques for this age group by:

A)providing both written and verbal instructions on the skill.
B)asking the patient if he has any hearing or vision deficits.
C)restating the important points several times.
D)asking the patient to describe the proper technique in his own words.

Question 20

The nurse caring for an older patient is concerned when the patient begins experiencing mild confusion.The nurse notes that the vital signs are all within normal limits for this patient.To best assess related symptoms,the nurse initially:

A)asks the patient to "Squeeze my hand as hard as you can."
B)reviews documentation about how the patient has been eating.
C)reviews the patient's medication for possible adverse reactions.
D)asks the patient's daughter if her mother has been confused before.

Question 21

What actions by the nursing staff in a long-term care facility display an awareness of resident rights? (Select all that apply. )

A)Getting informed consent for the use of an antipsychotic medication
B)Reminding the unhappy resident and family about grievance processes
C)Ensuring that all residents are asked if they wish to vote in an election
D)Giving residents information on the ombudsman's name and address
E)Assessing residents for their ability to safely administer their medications

Question 22

The nurse explains to the student the benefits of home health care.Which are benefits typically associated with this care? (Select all that apply. )

A)Less exposure to iatrogenic risks
B)Less chance of becoming confused
C)Better management of chronic conditions
D)Better reimbursement from Medicare
E)Patient remains in control of environment

Question 23

A nurse is caring for a confused and frail patient.Which interventions will best minimize the patient's risk of injury related to the geriatric triad? (Select all that apply. )

A)Respond to the patient's call bell promptly.
B)Ensure the bed alarm is on at all times.
C)Remain with the patient when eating.
D)Assess elimination needs every 2 hours while the patient is awake.
E)Offer the patient fluids during each visit.