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Pearson Custom for Nursing Older Adult Nursing Care 1st Edition Brown Eby Test Bank

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Pearson Custom for Nursing Older Adult Nursing Care 1st Edition Brown Eby Test Bank

ISBN-13: 978-1256612339

ISBN-10: 1256612332

 

Description

Pearson Custom for Nursing Older Adult Nursing Care 1st Edition Brown Eby Test Bank

ISBN-13: 978-1256612339

ISBN-10: 1256612332

 

 

 

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Free Nursing Test Questions:

Brown Older Adult Nursing Care, 1/E
Chapter 12

Question 1

Type: MCSA

When an older adult client with dementia begins to have trouble balancing his checkbook and finding the right words to say when talking, the nurse is aware that what part of the client’s brain is being affected by the dementia?

  1. Frontal lobe
  2. Parietal lobe
  3. Temporal lobe
  4. Occipital lobe

Correct Answer: 1

Rationale 1: Correct. The frontal lobe is responsible for voluntary motor control, emotion, judgment, complex thinking, speech, and personality.

Rationale 2: The parietal lobe is actually responsible for determining right from left position in the environment.

Rationale 3: The temporal lobe is actually responsible for senses of smell, taste, and hearing; understanding the spoken and written word; and long-term memory.

Rationale 4: The occipital lobe is actually responsible for receiving and processing visual images.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging in the nervous system.

 

Question 2

Type: MCSA

What is one common change in the nervous system of the older adult client that the nurse needs to be aware of which puts the client at greater risk of injury?

  1. Hypersensitive reactions
  2. Decreased sensation
  3. Increased sensation
  4. Intensified hemiplegia

Correct Answer: 2

Rationale 1: The reaction time of older adults actually slows due to the aging process.

Rationale 2: Correct. The older adult begins to experience decreased sensation with aging which, for example, causes the older adult not to feel pain as readily as a younger adult. Therefore, the older adult may sustain injury without realizing it.

Rationale 3: The older adult actually experiences decreased, not increased, sensation with aging.

Rationale 4: Hemiplegia is not an expected change in the nervous system associated with aging.

Global Rationale:

 

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging in the nervous system.

 

Question 3

Type: MCSA

What age-related change in the nervous system of the older adult does the nurse know predisposes the older adult client to slowed thinking processes, slowed decision making, and decreased memory?

  1. Decreased sensation
  2. A deficiency of dopamine
  3. Slowed nerve transmission
  4. Decreased reflexes

Correct Answer: 3

Rationale 1: Decreased sensation causes lack of awareness of an injury; slowed nerve transmission causes changes in speed of mental processing.

Rationale 2: A deficiency of dopamine is not an expected change in the nervous system of the older adult. Instead, it occurs in Parkinson’s disease.

Rationale 3: Correct. Slowed nerve transmission in the nervous system of an older adult predisposes the adult to slowed thinking, slower decision making, and decreased memory as well as a slower response time and inaccuracy in giving information.

Rationale 4: Slowed nerve transmission causes a slowing of mental processes; decreased reflexes predispose the older adult to injury due to slowed reaction time.

Global Rationale:

 

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging in the nervous system.

 

Question 4

Type: MCMA

A nurse working in an assisted living facility is planning activities for the older adult clients with the planned outcome of promoting the clients’ brain health. What type of activities should the nurse plan to assist in meeting this outcome?

Standard Text: Select all that apply.

  1. Social isolation
  2. Playing strategy games
  3. Watching television
  4. Talking with others
  5. Tai chi

Correct Answer: 2,4,5

Rationale 1: Socially isolating activities are not stimulating and do not improve brain health.

Rationale 2: Correct. Playing strategy games is an example of an activity which stimulates nerve cells in the brain and prevents damage from lipofuscin deposits.

Rationale 3: Television watching is not stimulating and does not improve brain health.

Rationale 4: Correct. Talking with others is an example of an activity which stimulates nerve cells in the brain and prevents damage from lipofuscin deposits.

Rationale 5: Correct. Engaging in exercises to improve balance, such as tai chi, is an example of an activity which stimulates nerve cells in the brain and prevents damage from lipofuscin deposits.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Discuss methods of health promotion for the nervous system.

 

Question 5

Type: MCMA

An older adult client is being discharged from an acute care medical facility following a mild stroke. The family is concerned about the client having additional strokes at home. The nurse tells the family about some assessments they can do at home if they suspect another stroke. What information does the nurse need to include in the teaching?

Standard Text: Select all that apply.

  1. Have the client smile and look for symmetry on the client’s face.
  2. Have the client speak a simple sentence and check clarity of speech.
  3. Ask the client to perform basic math calculations and check accuracy.
  4. Have the client raise both arms and check for drifting of arm downward.
  5. Ask the client to balance on one foot for two minutes and assess unsteadiness.

Correct Answer: 1,2,4

Rationale 1: Correct. A simple assessment for strokes which a family can do at home includes asking the client to follow three commands, one of which is to smile. The family should look for lopsidedness of the smile.

Rationale 2: Correct. A simple assessment for strokes which a family can do at home includes asking the client to follow three commands, one of which is to speak a simple sentence. The family should check for slurring of speech.

Rationale 3: The assessment does not include asking the client to perform basic math calculations and check accuracy.

Rationale 4: Correct. A simple assessment for strokes which a family can do at home includes asking the client to follow three commands, one of which is to raise both arms overhead. The family should look for downward drifting of an arm.

Rationale 5: The assessment does not include asking the client to balance on one foot for two minutes in order to assess unsteadiness.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts:

Learning Outcome: Discuss methods of health promotion for the nervous system.

 

Question 6

Type: MCSA

In working with an older adult client in a rehabilitation facility following a stroke, the nurse must keep in mind that the goal of tertiary prevention is what?

  1. Prompt identification of neurological disorder
  2. Ascertaining what deficits the client may have
  3. Focusing on the maintenance of whatever skills the client still possesses
  4. Improvement of function, mobility, and psychosocial adjustment

Correct Answer: 1

Rationale 1: Prompt identification of a neurological disorder is a goal of secondary, not tertiary, prevention.

Rationale 2: Ascertaining what deficits the client may have actually focuses on what the client cannot do. Tertiary prevention focuses on improving the skills the client still has.

Rationale 3: Tertiary prevention focuses on improving, not maintaining, the skills the client has.

Rationale 4: Improvement of function, mobility and psychosocial adjustment includes all parts of the goal of tertiary prevention.

Global Rationale:

 

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts:

Learning Outcome: Discuss methods of health promotion for the nervous system.

 

Question 7

Type: MCSA

An older adult male client is admitted to the long-term care facility with advanced Parkinson’s disease. The nurse going to assess this client would expect to see which of the following signs and symptoms?

  1. Tremors, slurred speech, drooling, slow body movement
  2. Numbness in a limb, aphasia, visual disturbance, weakness
  3. Seeing double, severe headache, vomiting, difficulty walking
  4. Hemiplegia, blackened vision in both eyes, slurred speech, tremors

Correct Answer: 1

Rationale 1: Correct. Tremors, slurred speech, drooling, and slow body movement are all signs/symptoms of Parkinson’s disease.

Rationale 2: Numbness, aphasia, visual disturbance, and weakness are signs/symptoms of a transient ischemic attack, not of Parkinson’s disease.

Rationale 3: Seeing double, severe headache, vomiting, and difficulty walking describe someone having a stroke, not Parkinson’s disease.

Rationale 4: Hemiplegia, blackened vision in both eyes, slurred speech, and tremors are a combination of manifestations seen in stroke and in Parkinson’s disease.

Global Rationale:

 

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts:

Learning Outcome: Discuss common nervous system disorders that occur with aging.

 

Question 8

Type: MCMA

An older adult client is admitted to an acute care hospital post CVA (cerebrovascular accident or stroke). He is currently unresponsive except to pain. What nursing interventions would be appropriate for this client at this time?

Standard Text: Select all that apply.

  1. Maintain a patent airway.
  2. Turn and position client every 4 hours.
  3. Provide active range-of-motion exercises.
  4. Monitor vital signs frequently.
  5. Assess neurological signs frequently.

Correct Answer: 1,4,5

Rationale 1: Correct. Maintaining an airway is a priority nursing action for a client who just had a stroke.

Rationale 2: The nurse would have the client turned and repositioned every 2, not every 4, hours.

Rationale 3: The client is nonresponsive except to pain, and would need passive (not active) range-of-motion exercises done for him.

Rationale 4: Correct. The nurse must monitor vital signs frequently until stable.

Rationale 5: Correct. The nurse must monitor neurological signs frequently until stable.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts:

Learning Outcome: Use the nursing process to guide you in caring for a client with a nervous system disorder.

 

Question 9

Type: MCSA

An older adult client in a long-term care facility had a bad stroke a few weeks ago. Which following sign/symptom would suggest to the assessing nurse that the client suffered damage to the right hemisphere of the brain from the stroke?

  1. Right-sided weakness
  2. An awareness of deficits/losses
  3. Inability to recognize familiar objects
  4. Client neglect of the affected side of the body

Correct Answer: 4

Rationale 1: Right-sided weakness is a sign of damage to the left, not the right, hemisphere of the brain.

Rationale 2: Awareness of deficits/losses is a sign of damage to the left, not the right, hemisphere of the brain.

Rationale 3: The inability to recognize familiar objects is a sign of damage to the left, not the right, hemisphere of the brain.

Rationale 4: Correct. A sign of damage to the right hemisphere of the brain is neglect of the left side of the body, which is the affected side.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts:

Learning Outcome: Discuss common nervous system disorders that occur with aging.

 

Question 10

Type: MCSA

An older adult client is brought to the emergency room by his son who reported that the client “passed out” in the front yard while mowing the lawn. The client is awake now. He has spontaneous eye response and is able to follow commands (e.g., hold arm out for blood pressure to be taken). He is able to talk with the nurse but does not remember what day it is or why his son brought him to the emergency room. The nurse, using the Glasgow Coma Scale, would give this client which of the following scores?

  1. 15
  2. 14
  3. 12
  4. 10

Correct Answer: 2

Rationale 1: The client is awake (has spontaneous eye response, +4), has motor response to a verbal command (+6), but is disoriented (+4) = total of 14.

Rationale 2: Correct. The client is awake (+4); can follow verbal commands (+6), but is disoriented (+4) = total of 14.

Rationale 3: The client is awake (has spontaneous eye response, +4), has motor response to a verbal command (+6), but is disoriented (+4) = total of 14.

Rationale 4: The client is awake (has spontaneous eye response, +4), has motor response to a verbal command (+6), but is disoriented (+4) = total of 14.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts:

Learning Outcome: Describe the appropriate assessment techniques for the nervous system.

 

Question 11

Type: MCSA

When using the Glasgow Coma Scale with older adult clients exhibiting neurological signs/symptoms, the nurse is aware that the scale gives a quantifiable score in which three areas?

  1. Best eye, motor, and verbal response
  2. Best eye, facial, and auditory response
  3. Best motor, nerve, and facial response
  4. Best verbal, auditory, and nerve response

Correct Answer: 1

Rationale 1: Correct. The Glasgow Coma Scale is designed to give a quantifiable score up to 15 for the Best Eye Response, the Best Motor Response, and the Best Verbal Response. The scale is used to measure level of consciousness of clients.

Rationale 2: Best eye, best motor, and best verbal response (not facial and auditory) are the categories of response in the Glasgow Coma Scale.

Rationale 3: Best eye, best motor, and best verbal response (not nerve and facial) are the categories of response in the Glasgow Coma Scale.

Rationale 4: Best eye, best motor, and best verbal response (not verbal, auditory, and nerve) are the categories of response in the Glasgow Coma Scale.

Global Rationale:

 

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts:

Learning Outcome: Describe the appropriate assessment techniques for the nervous system.

 

Question 12

Type: MCSA

An older adult client fell in the bathtub and hit his head. He was rushed to the emergency room by his family. How often should the nurse assess this client neurologically?

  1. Once per shift
  2. Every 2 hours
  3. Every 15 minutes until stable
  4. Every 60 minutes unless sleeping

Correct Answer: 3

Rationale 1: The client should be assessed neurologically every 15 minutes until stable, not every shift.

Rationale 2: The client should actually be assessed neurologically every 15 minutes, not every two hours, until stable.

Rationale 3: Correct. An older adult client who may have suffered a closed head injury needs to have a neurological assessment done every 15 minutes until stable.

Rationale 4: The client should be assessed neurologically every 15 minutes, not every 60 minutes, until stable.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts:

Learning Outcome: Describe the appropriate assessment techniques for the nervous system.

 

Question 13

Type: MCSA

An older adult client has a nursing diagnosis of Impaired Verbal Communication related to a stroke. Which of the following nursing actions would not be appropriate for the nurse to implement to facilitate this client’s communication?

  1. Speak slowly and clearly.
  2. Keep encouraging an aphasic client to speak.
  3. Let the client know if speech is not understood.
  4. Ask one question at a time.

Correct Answer: 2

Rationale 1: Speaking slowly and clearly is an appropriate action for the nurse to takeRemember, this statement is not the correct answer.

Rationale 2: Correct. Encouraging an aphasic client to speak is not an appropriate action for the nurse to take. Encouraging him to speak will only frustrate him. The nurse should encourage other forms of communication for the aphasic client. The nurse can encourage him to write things on a board, use gestures, draw pictures, or even point to pictures in order to stimulate undamaged areas of his brain.

Rationale 3: Letting the client know if speech is not understood is an appropriate action for the nurse to takeRemember, this statement is not the correct answer.

Rationale 4: Asking one question at a time is an appropriate action for the nurse to takeRemember, this statement is not the correct answer.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts:

Learning Outcome: Use the nursing process to guide you in caring for a client with a nervous system disorder.

 

Question 14

Type: MCSA

In obtaining a history from an older adult client with a neurological impairment, what is an important factor for the nurse to consider?

  1. The client should be the primary source of the history.
  2. The client’s level of consciousness is assessed after obtaining the history.
  3. If the client’s responses are not normal, continue to ask more in-depth questions.
  4. Any history of mental illness should not be probed due to privacy considerations.

Correct Answer: 3

Rationale 1: If the client has an altered level of consciousness, he or she may not be the most accurate source of history. The family may need to fill in gaps within the client’s past.

Rationale 2: The client’s level of consciousness should be the first thing to assessRemember, the nurse can evaluate whether or not the family needs to be consulted as well.

Rationale 3: Correct. The nurse needs to evaluate further and report any abnormal findings to the registered nurse.

Rationale 4: A mental illness history may be very pertinent to the client’s current condition.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Use the nursing process to guide you in caring for a client with a nervous system disorder.

 

Question 15

Type: MCSA

When the nurse is determining expected outcomes in planning care for older adult clients with neurological disorders, it is very important for the nurse to consider which one of the following factors?

  1. The client needs to be compared to other clients with the same diagnosis.
  2. The focus of the planning needs to be on long-range outcomes for the client.
  3. The client should be the one to decide his functional potential and work toward that.
  4. In planning outcomes a reasonable time frame needs to be established.

Correct Answer: 4

Rationale 1: The client truly needs to be seen as an individual with their own potential, not compared to others.

Rationale 2: The focus for a client with a neurological disorder needs to be on short-term, attainable outcomes.

Rationale 3: The nurse, not the client, needs to assess the client’s functional potential and plan care for the client’s deficits.

Rationale 4: Correct. The nurse needs to be aware that progress with a client with a neurological disorder takes time and must be accomplished in small steps.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Use the nursing process to guide you in caring for a client with a nervous system disorder.

 

 

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