Test Bank Nursing for Wellness in Older Adults 9th Edition Carol A Miller All Chapters

a. Arrange admission to a rehabilitation center. b. Plan care for a nearly dependent person. c. Plan care for a nearly independent person. d. Tells the family the patient is cognitively impaired. ANS: B Eighteen measures are accounted for in the FIM with scores ranging from 1 (dependent) to 7 (independent). A score of 20 indicates near total dependence. The FIM does not measure cognitive status. DIF: Applying (Application) REF: N/A OBJ: 16-3 TOP: Nursing Process: Assessment MSC: Physiologic Integrity MULTIPLE RESPONSE 1. Adherence to prescribed health care treatments by a patient with a chronic disease is best facilitated when the nurse does which of the following? (Select all that apply.) a. Provides the patient with information regarding his disease b. Assesses the patients ability to understand his disease c. Defines health and wellness for the patient d. Helps the patient identify barriers to his personal wellness e. Coordinates support services to facilitate the patients discharge ANS: A, B, D, E The five As of a patients self-management of care includes assess, advise, agree, assist, and arrange. DIF: Remembering (Knowledge) REF: MCS: 284 OBJ: 16-3 TOP: Nursing Process: Implementation MSC: Physiologic Integrity 2. The student learning about chronic disease and illness in the older population learns which facts about this situation? (Select all that apply.) a. One in two adults, or more than 133,000 Americans, has a chronic condition. b. Chronic disease is the leading cause of death in those over 65. c. About 75% of medical costs each year are spent on managing chronic disease. d. Formerly acute conditions are now manageable chronic diseases.. e. The focus of Americas health care services is now on chronic illness ANS: A, B, C, D One in two adults has a chronic illness, and these problems are the leading cause of death in those over 65 and the largest cost to our health care system. One reason for this is that formerly acute, possibly fatal, conditions are now manageable as chronic conditions. Americas health care system continues to be focused on acute care. DIF: Remembering (Knowledge) REF: MCS: 282 OBJ: 16-1 TOP: Teaching-Learning MSC: Physiologic Integrity 3. The nurse understands what about the Americans with Disabilities Act? (Select all that apply.) a. It outlaws discrimination on the job because of disabilities. b. It requires state governments to fund disability services. c. It prohibits discrimination in government services to the disabled. d. It requires all buildings to be retrofitted to allow access. e. It provides funding for barrier-free buildings and parks. ANS: A, C The ADA outlawed discrimination on the basis of disability in employment, in programs and services provided by state and local governments, and in the provision of goods and services provided by private companies and commercial facilities. It does not mandate government payment for disability services, require buildings to be retrofitted, or provide funding for barrier- free facilities. Chapter 28 Caring for Older Adults Experiencing Pain MULTIPLE CHOICE 1. When planning care for the older adult experiencing pain, the nurse bases interventions on the realization that: a. generally pain control is less effective than it is for younger adults. b. this cohort is less pain sensitive than younger adults. c. older adults are more likely to verbally express pain than younger adults. d. pain is undertreated in this cohort compared to younger adults. ANS: D Pain is underrecognized, highly prevalent, and undertreated among older adults. DIF: Remembering (Knowledge) REF: MCS: 256 OBJ: 14-4 TOP: Nursing Process: Analysis MSC: Physiologic Integrity 2. An older patient is observed grimacing whenever walking and getting in and out of bed. When assessed, the patient regularly denies having any pain. To best provide the patient with effective pain control, the nurse initially: a. discusses the effects of untreated pain on the patients general wellness. b. offers the patient a prescribed prn analgesic. c. asks the patient why he is denying the presence of pain. d. documents the symptoms that the patient is exhibiting. ANS: A Older adult patients actually underreport pain and are therefore at risk for undertreatment of pain, which may cause unnecessary suffering, exacerbation of the underlying disease, and reduction in activities of daily living (ADLs) and quality of life. Without this information the patient is unlikely to take the prn medication. Why questions are not therapeutic, as they place people on the defensive. The symptoms should be documented, but this should not be the only action. DIF: Applying (Application) REF: N/A OBJ: 14-2 TOP: Teaching-Learning MSC: Physiologic Integrity 3. The nurse caring for an older adult patient experiencing carpal tunnel syndrome anticipates the patient will best achieve pain control when prescribed a(n): a. narcotic (e.g., fentanyl). b. opioid (e.g., oxycodone). c. tricyclic antidepressant (e.g., amitriptyline [Elavil]). d. nonpharmacologic strategy (e.g., wrist bracing). ANS: C Neuropathic pain results from a pathophysiologic process involving the peripheral or central nervous system. These types of pain respond to unconventional analgesic drugs, such as tricyclic antidepressants. Carpal tunnel syndrome is caused by nerve injury. DIF: Analyzing (Analysis) REF: N/A OBJ: 14-8 4. When planning care for the older adult patient with a history of persistent pain, the nurse acknowledges the effects of the mind-body connection by including: a. regular pain assessments. b. prompt response to reports of pain. c. pain consults. d. relaxation techniques. ANS: D