Toward Healthy Aging 7th Edition Ebersole Hess Touhy Jett Test Bank
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Below you will find some free nursing test bank questions from this test bank:
Ebersole: Toward Healthy Aging, 7th Edition
Chapter 7: Managing Basic Physiological Needs
- It is 3:00 AM. You are the night shift charge nurse on the east wing of a hospital. You are busy verifying that yesterday’s orders were correctly transcribed when an elderly female patient who has ambulated to the desk calls your name. She seems upset when she says, “I can’t sleep. I haven’t gotten more than two consecutive hours’ sleep since I was admitted the other day.” Your response is:
|a.||“That’s very unusual, older people tend to sleep a lot more.”|
|b.||“I will call the doctor and have him order some sleeping pills for you.”|
|c.||“Just be glad you aren’t the patient in the next room. She was just diagnosed with cancer. Now that’s something to lose sleep over!”|
|d.||“Let’s get some warm milk and talk about it.”|
Nonpharmacological sleep interventions should be attempted first with older adults. Total sleep time tends to decrease with age. Nonpharmacological sleep interventions should be attempted first. Transient sleep disorders do not require medications. Option C is not a therapeutic response to the patient, and it breaks confidentiality of the other patients.
DIF: Cognitive level: Application REF: 135-136
- An older adult has Alzheimer’s disease. His wife says he gets up at night and wanders around the house. What suggestion given by the nurse would be most appropriate?
|a.||“Ask your physician to prescribe strong sedatives.”|
|b.||“Increase his daily activity by taking him on frequent walks.”|
|c.||“Try using a restraint jacket at night.”|
|d.||“He needs his rest, so make sure he takes a nap during the day.”|
Increasing activity during the day will tire the patient and assist him in sleeping. It will also relieve daytime boredom, which may be a cause of the restlessness. It is not prudent to administer strong sedatives to an older adult with dementia. The use of the lowest dose of the mildest drug is recommended for chronic sleep problems. Restraints are not indicated. Restraint use is not a benign intervention and has the potential for causing harm to this patient. Napping during the day can lead to sleep disruption.
DIF: Cognitive level: Application REF: 138
- In implementing your nursing care plan for your client with constipation, what will you include in your plan?
|c.||Increased fiber in the diet|
Including adequate amounts of fiber in the diet is an important intervention in preventing and treating constipation in older adults. Adequate exercise is an important intervention that stimulates colon motility and bowel evacuation. Aluminum-containing antacids tend to cause constipation.
DIF: Cognitive level: Knowledge REF: 123
- What client statement might encourage you to add the nursing diagnosis of constipation to the client’s care plan?
|a.||“I only have a bowel movement every 2 days.”|
|b.||“I have to have my morning cup of coffee before I can move my bowels.”|
|c.||“If I don’t eat enough prunes or other fruit, I sometimes have trouble.”|
|d.||“I had a bowel movement 3 days ago, but it wasn’t much, and it was very hard.”|
Constipation occurs when there are fewer than three bowel movements per week, hard stools, and difficulty with evacuation. Option B is a habit that establishes a regular routine for bowel evacuation. The inclusion of adequate amounts of fiber in the diet is very important for older adults.
DIF: Cognitive level: Application REF: 121
- In evaluating interventions for your client’s problem of constipation, what best indicates progress toward resolution of the problem?
|a.||Small, liquid bowel movements once to twice per day|
|b.||Moderate discomfort with every-other-day evacuation|
|c.||Fluid intake of 1 L/day with a low-residue diet|
|d.||Normal bowel movements 1 to 3 days apart|
Normal bowel movements three times per week is an appropriate resolution of the problem of constipation. Liquid bowel movements one to two times per day is not a normal bowel regimen. It is not normal to have pain from evacuation. The appropriate diet for an individual with constipation is a liberal fluid intake and high fiber, which is not low residue.
DIF: Cognitive level: Analysis REF: 123
- When beginning an exercise program, an elderly client should first be assessed. What is important to include in the initial assessment for older adults of all ages?
|a.||Exercise tolerance testing (ETT)|
|c.||Medical history and physical examination|
|d.||Pulmonary function tests (PFTs)|
An assessment should be initiated before an older adult begins a program of exercise. This assessment should include a history and physical examination. There is no indication that the individual has either cardiac or respiratory compromise. If it were indicated, then additional assessments may be warranted.
DIF: Cognitive level: Knowledge REF: 144-146
- A 77-year-old woman reports that she has difficulty sleeping. The nurse asks her for
a history of her sleep problems. What instruction should the nurse include in suggestions to improve her sleep?
|a.||Take several daytime naps if you cannot sleep at night.|
|b.||Try a glass of wine at bedtime.|
|c.||Include 10 minutes of moderately strenuous exercise before going to bed.|
|d.||Use the bed only for sleep or sex.|
Improved sleep hygiene should improve the client’s sleep. The bed should only be used for sleep and sex. Other activities in bed can add to the difficulty with sleeping. Daytime napping may interfere with the ability to sleep at night. Alcohol has been found to disrupt REM sleep. The hour before going to bed should be a time where the individual refrains from strenuous activities, calms herself, and prepares for the onset of sleep.
DIF: Cognitive level: Application REF: 139-142
- Older adults with sleep apnea:
|a.||experience excessive deep sleep.|
|b.||are often slim and underweight.|
|c.||have an increased risk for sudden death and stroke.|
|d.||experience excessive tension in the muscles of the throat and soft palate.|
Older adults with sleep apnea are subject to hypopnea and hypoxemia. These conditions put the individual at greater risk for increased morbidity and mortality. Individuals with sleep apnea have fragmented sleep and tend to be obese. The muscles in the throat and soft palate are relaxed, causing obstruction.
DIF: Cognitive level: Analysis REF: 136-137
- You are a nurse on the Acute Care for the Elderly unit in a large academic medical center. One of the performance improvement projects of your unit is to implement a protocol to decrease the use of indwelling urinary catheters. The major reason for the choice of this project is that:
|a.||urinary catheters are very costly.|
|b.||long-term catheter use increases the risk of urinary tract infections.|
|c.||long-term catheter use causes pain in older adults.|
|d.||intermittent catheterization is very time consuming.|
Long-term catheter use increases the risk of urinary tract infections leading to urosepsis. There is no evidence that the project is based on a financial issue. Unless there are complications from insertion or other conditions specific to an individual, urinary catheters do not routinely cause pain. There is no indication that intermittent catheterization is more time consuming than properly caring for an indwelling catheter.
DIF: Cognitive level: Knowledge REF: 134-135
- A 78-year-old client in your home care agency has a history of congestive heart failure and arthritis. She lives alone in a two-story home; the bathroom is on the first level, and her bedroom is on the second level. She reports that she has something “very upsetting” to tell you, and reports that she has been wetting the bed at night. What type of incontinence does she most likely have?
The client has a history of arthritis, her bathroom is far from her bedroom, and the incontinent episodes are at night. With functional incontinence, the lower urinary tract is intact, but the individual is limited by environmental factors.
DIF: Cognitive level: Application REF: 126-128