NUR 243 Midterm Exam Study Questions
and Correct Answers
An 82-year-old woman with chronic heart failure is cared for in the home by her only
child. What problem is indicated by the caregiver's failure to provide companionship or
social stimulation?
A) Neglect
B) Sexual abuse
C) Abandonment
D) Violation of personal rights ✅A) Neglect
Ch. 5
RATIONALE: Neglect characteristics: leaving alone for long periods, failing to provide
social stimulation and/or companionship; Sexual abuse: nonconsensual sexual contact
includes touching inappropriately, forcing sexual contact; Abandonment: desertion by
person who's assumed responsibility for providing care or person w/ physical custody;
Violation of personal rights: denying right to privacy or make decisions regarding health
care or living environment, forcible eviction.
A 74-year-old patient admitted with an irregular cardiac rhythm has a much lower blood
level of his home medication than expected. Which common cause of medication errors
made by older adults should be suspected?
A) Shorter drug half-life leading to medication overdose
B) Decreased use of nonprescription over-the-counter drugs
C) Improved tolerance of adverse effects of prescribed drugs
D) Lack of financial resources to obtain prescribed medications ✅D) Lack of financial
resources to obtain prescribed medications
Ch. 5
RATIONALE: Common causes of medication errors by older adults include poor
eyesight, forgetting to take drugs, use of nonprescription over-the-counter drugs, use of
medications prescribed for someone else, lack of financial resources to obtain
prescribed medication, failure to understand instructions or importance of drug
treatment, and refusal to take medication because of undesirable side effects. Drug
half-life is increased in older adults.
*What is most appropriate for the nurse to do when interviewing an older patient?
A) Ensure all assistive devices are in place.
B) Interview the patient and caregiver together.
C) Perform the interview before administering analgesics.
D) Move on to the next question if the patient does not respond quickly. ✅A) Ensure all
assistive devices are in place.
Ch. 5
RATIONALE: All assistive devices, such as glasses and hearing aids, should be in
place when interviewing an older patient. It is best to interview the patient and caregiver
,separately to ensure a reliable assessment related to any possible mistreatment. The
patient should be free from pain during the assessment and may need extra time to
respond to questions.
*Which assessment findings would alert the nurse to possible elder mistreatment?
(select all that apply)
A) Agitation
B) Depression
C) Weight gain
D) Weight loss
E) Hypernatremia ✅A, B, D, E [agitation, depression, weight loss, hypernatremia]
Ch. 5
RATIONALE: Agitation and depression may be manifestations of psychologic abuse or
neglect. Hypernatremia may signify dehydration caused by physical neglect. Weight
loss, rather than weight gain, is another manifestation of physical neglect.
A 67-year-old woman who has a long-standing diagnosis of incontinence is in the habit
of arriving 20 minutes early for church in order to ensure that she gets a seat near the
end of a row and close to the exit so that she has ready access to the restroom. Which
tasks of the chronically ill is the woman demonstrating?
(select all that apply)
A) Controlling symptoms
B) Preventing social isolation
C) Preventing and managing a crisis
D) Denying the reality of the problem
E) Adjusting to changes in the course of the disease ✅A, C [Controlling symptoms &
Preventing and managing a crisis]
Ch. 5
RATIONALE: The woman's efforts to ensure that she can continue in her lifestyle of
church attendance while accommodating the frequent elimination caused by her health
problem are an example of controlling her symptoms and preventing a personal crisis.
A 70-year-old man has just been diagnosed with chronic obstructive pulmonary disease
(COPD). At what point should the nurse begin to include the patient's wife in the
teaching around the management of the disease?
A) As soon as possible
B) When the patient requests assistance from his spouse and family
C) When the patient becomes unable to manage his symptoms independently
D) After the patient has had the opportunity to adjust to his treatment regimen ✅A) As
soon as possible
Ch. 5
RATIONALE: In the management of chronic illness, it is desirable to include family
caregivers in patient education and symptom-management efforts as early in the
diagnosis as possible.
,A male patient has a history of hypertension and type 1 diabetes mellitus. Because of
these chronic illnesses, the patient exercises and eats the healthy diet that his wife
prepares for him. Which factors will most likely have a positive impact on his biologic
aging?
(select all that apply)
A) Exercise
B) Diabetes
C) Social support
D) Good nutrition
E) Coping resources ✅A, C, D, E [Exercise, Social support, Good nutrition, Coping
resources]
Ch. 5
RATIONALE: Biologic aging is the progressive loss of function. Obesity, diabetes,
hypertension, and cancer are all associated with the effects of aging. Exercise, good
nutrition, social support, stress management, and coping resources are all positive
factors related to the aging process.
A 60-year-old female patient has had increased evidence of dementia and physical
deterioration. What would be the best assistance to recommend to her caregiver
husband who is exhausted?
A) Long-term care
B) Adult day care
C) Home health care
D) Homemaker services ✅B) Adult day care
Ch. 5
RATIONALE: Adult day care provides social, recreational, and health-related services in
safe, community-based environment that would keep pt. Safe & decrease stress on
husband. Long-term care used when pt. Has rapid deterioration, caregiver's unable to
continue care, and there's alteration in or loss of family support system. Home health
care when there's supportive caregiver involvement for pt. W/ health needs.
Homemaker services provide services, not pt. Care.
Aging primarily affects the _________of drugs.
A) excretion
B) absorption
C) metabolism
D) distribution ✅C) metabolism
Ch. 5
RATIONALE: Because the liver mass shrinks and hepatic blood flow and enzyme
activity decrease in older adults, metabolism of drugs drops 1/2 to 2/3 of the rate of
young adults. This increases the chance of drug toxicity and adverse drug events.
A characteristic of a chronic illness is that it:
(select all that apply)
A) has reversible pathologic changes.
B) has a consistent, predictable clinical course.
, C) results in permanent deviation from normal.
D) is associated with many stable and unstable phases.
E) always starts with an acute illness and then progresses slowly. ✅C, D [has a
consistent, predictable clinical course; results in permanent deviation from normal]
Ch. 5
RATIONALE: Characteristics of chronic illness include: permanent impairments or
deviations from normal, irreversible pathologic changes, residual disability,
requirements for special rehabilitation, and need for long-term medical and/or nursing
management. Chronic illness may have stable and unstable periods.
Ageism is characterized by:
A) Denial of negative stereotypes regarding aging.
B) Positive attitudes toward the elderly based on age.
C) Negative attitudes toward the elderly based on age.
D) Negative attitudes toward the elderly based on physical disability. ✅C) Negative
attitudes towards the elderly based on age.
Ch. 5
RATIONALE: Ageism is a negative attitude based on age.
A patient arrives at the ambulatory surgery center for a scheduled laparoscopy
procedure in outpatient surgery. Which information is of most concern to the nurse.
A. The patient is planning to drive home after surgery
B. The patient had a sip of water 4 hours before arriving
C. The patient's insurance does not cover outpatient surgery
D. The patient has not had surgery using general anesthesia before ✅A. The patient is
planning to drive home after surgery.
Ch. 17
Rationale: the patient should not drive home and will need assistance with
transportation and home care.
A patient who has never had any prior surgeries tells the nurse doing the preoperative
assessment about an allergy to bananas and avocados. Which action is most important
for the nurse to take.
A. Notify the dietitian about the food allergies
B. Alert the surgery center about a possible latex allergy
C. Reassure the patient that all allergies are noted on the medical record
D. Ask whether the patient uses antihistamines to reduce allergic reactions. ✅B. Alert
the surgery center about a possible latex allergy.
Ch. 17
Rationale: Certain food allergies (eggs, avocados, bananas, chestnuts, potatoes,
peaches) are related to latex allergies.
A patient undergoing an emergency appendectomy has been using St. John's wort to
prevent depression. Which complication would the nurse expect in the postanesthesia
care unit?
A. Increased pain
