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Geri Exam #1
Exam of 54 pages for the course ISC2 CC at ISC2 CC (Geri Exam #1)
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Geri Exam #1A diabetic is struggling with the carbohydrate-controlled diet as a result of having a large
extended family with many get-togethers. What action by the nurse is best?
a) Remind the patient of the consequences of poor control of diabetes.
b) Tell the patient that once a month he or she can eat as desired.
c) Help the patient make priorities so some favorite foods can be eaten.
d) Tell the patient to increase the insulin dose on get-together days. - ANS-ANS: C
Nurses working with patients who have dietary issues need to understand the social,
emotional, cultural, and religious ties their patients have to food, or the interventions will
not be successful. While normally maintaining a diabetic diet the patient can be assisted
to prioritize foods that are must haves and determine how to work them into the diet.
A patient is being discharged on total parenteral nutrition (TPN). What topics do the
patient and family need to be taught? (Select all that apply.)
a) How to work the enteral feeding pump
b) Care of a central venous catheter
c) How to crush and give medications
d) Proper use of an intravenous (IV) pump
e) Actions to take if the IV becomes occluded - ANS-ANS: B, D, E
TPN is administered via a large central IV line using an IV pump. The family needs to
know how to use the pump, how to care for the catheter, and what to do if the IV line
becomes occluded. An enteral pump is not used. Meds are not crushed and given
through the TPN line.
A patient smokes. What advice does the nurse give this patient for safety?
a. Do not smoke inside the house
b. Install working smoke detectors
c. Only smoke during the daytime
d. Install carbon monoxide detectors - ANS-ANS: A
Smoking has been related to house fires for many years. The nurse can provide many
suggestions, but not smoking inside at all is the safest option. Smoke detectors work
after a fire has started. Smoking during the daytime does not eliminate the possibility of
falling asleep while working. Carbon monoxide detectors are important but not related to
fire.
,A patient wants to know what no sugar added on a food label means. What explanation
is best?
a) The food has no calories.
b) No sugar was added during processing.
c) The food naturally has no sugar.
d) The food has 23% less sugar than normal. - ANS-ANS: B
No sugar added means that no sugar is added during processing (or packaging) and no
ingredients are added that contain sugar. It does not mean that the food has no calories
or that the food itself does not naturally contain sugar. A product with 23% less sugar
than the original counterpart is labeled low sugar.
An older adult is worried about potassium intake. What does the nurse teach this
patient?
a) Unless you take a diuretic, don't worry about potassium.
b) You should take a daily potassium supplement.
c) You should try to get all your potassium through food.
d) Potassium is not a nutrient people generally worry about. - ANS-ANS: C
The guidelines for nutrition and older individuals state that potassium intake (4700
mg/day) should be ingested through food. Some people do need a supplement, for
instance, those on potassium-wasting diuretics. Potassium is a vital nutrient, important
in electrical conduction and muscle function.
An older adult patient has been prescribed a specialized enteral formula after an
extensive surgical procedure. The nurse anticipates and addresses a concern of many
patients in this age cohort when assuring the patient that:
a) her family can easily manage the formula after she is discharged.
b) Medicare will cover the expense of the treatment.
c) the treatment will be discontinued as soon as she is able to eat sufficiently.
d) this is the most effective form of nutrition for her at this time. - ANS-ANS: B
Specialized enteral formulas are considerably more expensive than standard formulas
and should be used only when clearly indicated. The cost of such a treatment would be
of great concern to this cohort. The special feeding will be discontinued as soon as
possible, this is the best way to give this patient nutrition at this time, and the family can
manage the feedings, but the bigger concern is cost.
,An older adult patient with a history of a myocardial infarction tells the nurse that he
takes his daily dose of prescribed aspirin with breakfast each morning. The nurses
response is:
a) Food interferes with the drugs absorption, so take it between meals.
b) Taking aspirin with food increases your likelihood of stomach upset.
c) Taking the drug with food is likely to alter the taste of the food.
d) Eating as you take the aspirin is likely to result in constipation. - ANS-ANS: A
The absorption of aspirin occurs in the stomach and so is greatly altered by the
presence of food.
An older woman asks the nurse why she suddenly has a deficiency in B vitamins as her
eating and cooking habits have not changed. What response by the nurse is best?
a) Something has to be different now.
b) You cant absorb B vitamins like before.
c) Your need for B vitamins has increased.
d) The guidelines have been increased. - ANS-ANS: B
Age-related gastrointestinal changes include a decrease in intestinal pH, which lowers
the ability of the gastrointestinal tract to absorb B vitamins.
Based on recent surveys identifying nutritional information concerning the daily diet of
older adults in America, the nurse suggests:
a) substituting carbohydrates with lean protein sources.
b) adding calories through the addition of fruits and vegetables.
c) introducing a protein at each meal.
d) relying on foods that are both easy to chew and easy to digest. - ANS-ANS: B
Government-sponsored surveys have indicated that the average diet of the older adult
lacks in calories, especially in the form of fruits and vegetables. The recommendations
do not include substituting protein for carbohydrates, adding protein at each meal, and
relying solely on foods that are easy to chew and digest, although these suggestions
might be appropriate for individual patients.
Ch. 1
4. Based on current data, when presenting an older adults discharge teaching plan, the
nurse includes the patients:
, a.nonrelated caretaker.
b.paid caregiver.
c.family member.
d.intuitional representative. - ANS-ANS: C
Less than 4% of older adults live in a formal health care environment. The majority of
the geriatric population lives at home or with family members.
ch. 1
A nurse is caring for an older patient in the emergency department. What information
about the patient will be most helpful in creating a plan of care?
a) Baseline physical and cognitive functioning
b) Living conditions and family support
c) Medications and current medical problems
d) Results of the Mini-Mental State Examination - ANS-ANS: A
The nurse is encouraged to view older patients as individuals and consider their
baseline physical and cognitive functional status as a standard by which to compare the
patient's current status. The other information is also important, but the basis of
individualized care begins with the patient's strengths and weaknesses.
ch. 1
A nurse is preparing to complete a health assessment and history on an older patient.
Which statement reflects an understanding of the general health status of this
population?
a) "I'll need to document the medications the patient is currently prescribed."
b) "I would like to understand how supportive the patient's family members are."
c) " Most older patients are being treated for a variety of chronic health
d) "It will be interesting to see whether this patient sees herself as being healthy." -
ANS-ANS: D
It is a misconception that old age is synonymous with disease and illness. In fact, older
adults already tend to view their personal health positively despite the presence of
chronic illness, disease, and impairment. The nurse should always determine the
patient's sense of wellness and independence when conducting a health and history
assessment. An assessment of medication use and family support is important for any
patient. Many older adults do have chronic health conditions, but their perception is
more important than a singl
ch. 1
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