Week 1 

Care of Older Adults: Culture, Spirituality, Communication,

Sexuality, Infection Control 

Chapter 05: Chronic Illness and Older Adults Lewis: Medical-Surgical Nursing, 10th Edition  


1. When caring for an older patient with hypertension who has been hospitalized after a transient

ischemic (TIA), which topic is the most important for the nurse to include in the discharge


a) Effect of atherosclerosis on blood vessels 

b) Mechanism of action of anticoagulant drug therapy 

c) Symptoms indicating that the patient should contact the health care provider 

d) Impact of the patient’s family history on likelihood of developing a serious stroke  


One of the tasks for patients with chronic illnesses is to prevent and manage a crisis. The patient needs instruction on recognition of symptoms of hypertension and TIA and appropriate actions to

take if these symptoms occur. The other information may also be included in patient teaching but

is not as essential in the patient’s self-management of the illness.  

2. The nurse performs a comprehensive assessment of an older patient who is considering

admission to an assisted living facility. Which question is the most important for the nurse to


a) “Have you had any recent infections?” 

b) “How frequently do you see a doctor?” 

c) “Do you have a history of heart disease?” 

d) “Are you able to prepare your own meals?”  


The patient’s functional abilities, rather than the presence of an acute or chronic illness, are more

useful in determining how well the patient might adapt to an assisted living situation. The other

questions will also provide helpful information but are not as useful in providing a basis for

determining patient needs or for developing interventions for the older patient.  

3. An alert older patient who takes multiple medications for chronic cardiac and pulmonary

diseases lives with a daughter who works during the day. During a clinic visit, the patient

verbalizes to the nurse that she has a strained relationship with her daughter and does not enjoy

being alone all day. Which nursing diagnosis should the nurse assign as the priority for this


a) Social isolation related to fatigue 

b) Risk for injury related to drug interactions

c) Caregiver role strain related to family employment schedule

d) Compromised family coping related to the patient’s care needs  


The patient’s age and multiple medications indicate a risk for injury caused by interactions

between the multiple drugs being taken and a decreased drug metabolism rate. Problems with

social isolation, caregiver role strain, or compromised family coping are not physiologic

priorities. Drug–drug interactions could cause the most harm to the patient and are therefore the


4. Which method should the nurse use to gather the most complete assessment of an older


a) Review the patient’s health record for previous assessments. 

b) Use a geriatric assessment instrument to evaluate the patient. 

c) Ask the patient to write down medical problems and medications. 

d) Interview both the patient and the primary caregiver for the patient.  

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