Chapter 12- The Critically Ill Older Patient My Nursing Test Banks

 

1.

The nurse is working with a patient in the ICU who has presbycusis. Which of the following would the nurse likely find with this client? Select all that apply.

A)

Impairment of discrimination ability

B)

Dementia

C)

A gray shadow in the center of the visual area

D)

Balance problems during transfer

2.

An elderly patient is recovering in the ICU after surgery. When the nurse notices that the patient has not touched his food, she asks him why he is not eating. He complains that the food is too bland and that his mouth is dry. Which of the following interventions should the nurse make to help the patient enjoy his meal? Select all that apply.

A)

Use liberal seasonings in his food.

B)

Vary his position in the bed.

C)

Measure his creatinine clearance.

D)

Offer him sugar-free candies before his meal.

3.

A nurse is bathing an elderly patient in the ICU. The patient has fine wrinkling, looseness, and sagging in her skin. Which of the following should the nurse do to best care for the patients skin? Select all that apply.

A)

Scrub the patients skin vigorously with a loofah to exfoliate.

B)

Lather the patient with plenty of soap.

C)

Immerse the patient for 10 minutes daily.

D)

Use an emollient after bathing.

4.

An elderly patient in the ICU has been on bed rest for the past 48 hours, has had decreased intake of food and fluids, and is taking multiple medications. Which of the following conditions is the patient especially prone to, given her situation? Select all that apply.

A)

Constipation

B)

Dehydration

C)

Muscle atrophy

D)

Decreased glomerular filtration rate

E)

Malignant lesions

F)

Presbycusis

5.

An elderly patient in the ICU broke her foot when she attempted to stand on it after having been on bed rest for 2 weeks. The nurse, who was assisting the patient as she stood, was surprised at how easily the woman sustained the injury. Which of the following factors most likely predisposed this patient to the injury she sustained?

A)

Lack of balance

B)

Mental confusion

C)

Decreased bone mineral density

D)

Pernicious anemia

6.

An elderly patient in the ICU presents with atrial tachycardia. The nurse also observes that the patient appears anorexic. Which of the following conditions would best explain these symptoms?

A)

Diabetes mellitus

B)

Arthritis

C)

Pernicious anemia

D)

Hyperthyroidism

7.

An older adult patient in the ICU has diabetes. Which intervention could the nurse perform that would best prevent complications related to this disease?

A)

Have the patient rise from his bed and bear weight.

B)

Offer the patient sugar-free candy.

C)

Bathe the patients feet daily and apply emollient.

D)

Reposition the patient often in bed.

8.

An elderly patient in the ICU has hyperthyroidism. As the nurse is talking with her, she suddenly becomes confused and starts babbling incoherently. The nurse takes her vital signs and finds tachycardia, a temperature of 98 F, and an elevated blood pressure reading. Which of the following is the most reliable indication that the patient has an infection?

A)

Delirium

B)

Temperature

C)

Blood pressure

D)

Tachycardia

9.

An older patient in the ICU has been determined to have early dementia. As the nurse is taking her vital signs, the patient expresses frustration that she cannot remember what happened earlier in the day. What can the nurse do to help calm the patient?

A)

Perform the Mini-Cog on the patient.

B)

Remind the patient of what actually happened earlier in the day.

C)

Ask the patient to recount some memories from her childhood.

D)

Offer the patient sugar-free candy.

10.

An elderly patient in the ICU is taking erythromycin to treat a bacterial infection. The patient is diabetic and has been on bed rest for 3 days. She has hypoglycemia and nausea. After being on erythromycin for 24 hours, the patient is still showing signs of infection, including fever and delirium. What is the most likely reason for the medication not taking effect?

A)

Lack of movement due to bed rest

B)

Delayed stomach emptying time

C)

Drug interaction between erythromycin and insulin

D)

Drug resistance

11.

An older patient is admitted to the CCU after a motor vehicle crash. What normal physiological change of aging will most affect the patients ability to adjust to the CCU milieu?

A)

Onset of dementia

B)

Impaired hearing

C)

Altered stress response

D)

Increased lung compliance

12.

The nurse is caring for an elderly patient in the CCU who has very wrinkled skin, very uneven skin tone, and several irregularly shaped white blotches on the skin. What is probably the cause of these skin changes?

A)

Adverse reaction or allergy to a medication

B)

Secondary to stress of CCU admission

C)

Overexposure to sunlight

D)

Individual variation in skin tone

13.

An elderly patient is admitted to the CCU with a critical illness. To support the developmental goals and tasks of this patient, what is an appropriate intervention?

A)

Restrict visiting to very immediate family members to prevent fatigue.

B)

Contact the social worker to help place pets in the animal shelter.

C)

Call the patient by a nickname such as Grandma or Grandpa.

D)

Ask the patient about his life accomplishments and feelings of satisfaction.

14.

An elderly patient with presbycusis is being cared for in the CCU after major surgery. Which alteration in nursing approach will best facilitate this patients care?

A)

Keep the light on in the room at all times.

B)

Increase the dose of sedation at night.

C)

Introduce yourself each time you enter the room.

D)

Speak clearly and face the patient when talking.

15.

An elderly patient with presbyopia is being discharged from the CCU after an invasive cardiac procedure. The nurse is giving discharge instructions to him that include instructions on medications. What accommodation should the nurse plan to use while teaching this patient?

A)

Speak loudly, clearly, and directly to the patient.

B)

Give all instructions to the family only.

C)

Teach the patient to get out of bed slowly.

D)

Use a larger font for all printed materials.

16.

An elderly patient is being cared for in the CCU after a surgical procedure. The nurse finds snoring, frequent awakening, nocturnal sweating, and awakening with anxiety. The family states that the patient had these behaviors at home before the surgery. What is the most appropriate nursing action?

A)

Continue routine assessment, as these behaviors indicate normal aging changes.

B)

Make a referral for sleep disorder evaluation, as these behaviors are abnormal.

C)

Tell the family to discuss these behaviors with the physician after discharge from the CCU.

D)

Increase bedtime sedation to ensure that the patient gets adequate rest.

17.

The nurse is caring for an elderly patient in the CCU. Which intervention indicates understanding of the normal aging changes in the skin for this patient?

A)

Use very hot water and strong soap for bathing.

B)

Increase the frequency of turning and repositioning.

C)

Bathe every other day and avoid use of lotions.

D)

Ask the patients preference for time of bath.

18.

An elderly patient in the CCU is getting out of bed for the first time after being on bed rest for several days. What is the highest-priority nursing intervention?

A)

Provide adequate physical help so that the patient does minimal weight bearing.

B)

Ensure that the patients call light is always within reach.

C)

Apply a vest restraint while the patient is up to prevent falling.

D)

Have the patient sit on the side of the bed for a few minutes before standing.

19.

The nurse is caring for an elderly patient with pneumonia. What normal aging change increases the patients risk for the development of pneumonia?

A)

Decreased compliance

B)

Reduced functional epithelial cells

C)

Increased functional reserve capacity

D)

Damage from smoking

20.

The nurse is caring for an elderly patient who is receiving a number of medications. Taking into consideration normal aging, what should the nurse monitor most carefully?

A)

Vital signs

B)

Creatinine clearance

C)

Muscle strength

D)

Cardiac function

21.

The nurse is caring for a critically ill elderly patient. The patient is confused and agitated. The family states that the patient had not exhibited confusion at home. What is the most important nursing action?

A)

Apply restraints to prevent patient injury.

B)

Sedate the patient to prevent injury.

C)

Assess vital signs and laboratory results for abnormal values.

D)

Apply oxygen by nonrebreather mask at 10 L/min.

22.

An elderly patient is exhibiting inability to remember locations and routines, does not recognize close family members, and expresses constant anger, with frequent physical attacks on others. The family states that the patient has had worsening behavior for several months. The patient was clean and well-dressed on admission. There are no bruises or lesions on the arms or head. What is probably causing this behavior?

A)

Dementia

B)

Delirium

C)

Elder abuse

D)

Personality disorder

23.

The nurse is caring for an elderly patient. As visiting hours approach, the patient becomes increasingly anxious and states she is worried that her son will be angry with her for being sick and in the CCU. What is the most appropriate nursing intervention?

A)

Assess the patient for possible abuse.

B)

Assure the patient that her son loves her.

C)

Tell the son that his mother thinks he is angry with her.

D)

Give the son extra time to visit his mother.

24.

The nurse notices that a physicians order for a medication for an elderly patient seems very low. What is the best nursing action?

A)

Verify that the low dose is deliberate to compensate for aging.

B)

Ask the pharmacist for a rationale for the dose.

C)

Refuse to administer the medication as the dose is too low.

D)

Ask the physician to increase the dose of the medication.

Answer Key

1.

A, D

2.

A, D

3.

C, D

4.

A, B, C

5.

C

6.

D

7.

C

8.

A

9.

C

10.

B

11.

C

12.

C

13.

D

14.

D

15.

D

16.

B

17.

B

18.

D

19.

B

20.

B

21.

C

22.

B

23.

A

24.

A

Page 1

Leave a Reply