During an assessment the nurse determines that an older patient dying from a terminal illness is experiencing common fears. What fears did this nurse assess in the patient? Standard Text: Select all that apply.
1. Dying alone
2. Loss of consciousness
3. Loss of bladder control
4. Leaving loved ones behind
5. Becoming a burden to others
Question 2A client is seen for a routine physical examination. During the examination, she reports increasing discomfort in her feet. A review of the medical record reveals a history of diabetic neuropathy. The physician prescribes a tricyclic antidepressant.
When providing education to the client about the medication, the client states she is not mentally ill. Further questioning reveals she has a friend with depression who takes the same medication. What response by the nurse is indicated at this time?
A) If you feel there has been a mistake, you may speak with your physician.
B) Pain and depression often manifest together.
C) Although this is not a pain reliever, it has been shown to relieve discomfort.
D) This medication may help to reduce the anxiety caused by your chronic pain.
Question 3An older patient with terminal cancer is considering hospice care but is concerned that Medicare will stop payments if the care is provided for longer than 6 months.
What can the nurse respond to this patient? Standard Text: Select all that apply. 1. Medicare does not limit the hospice benefit.
2. Medicare regulations discourage a longer use of the benefit.
3. Hospice costs more than traditional hospital or long-term care.
4. Patient may enroll when the life expectancy is 6 months or less.
5. Hospice supports the family for 6 months after the patient's death.
Question 4The nurse is performing the shift assessment on the client. During the assessment the nurse notes the client is demonstrating myoclonic jerking movements. The nurse completes the assessment and finds nothing else abnormal.
A review of the medication record reveals the client has been taking morphine to manage cancer-related pain. The client has a variable dosage of morphine IV ordered. What action is indicated at this time?
A) The nurse will need to contact the physician.
B) Document the findings and continue to observe the client.
C) Reduce the dosage administered to the lowest amount ordered.
D) Order lab testing to determine toxicity levels.
Question 5The daughter of an older patient who is a resident of a nursing home suspects the patient is a victim of abuse. What should the nurse suggest that the daughter do about this situation? Standard Text: Select all that apply.
1. Visit the facility at varied times.
2. Do nothing until evidence is obtained.
3. Realize that the patient can be confused.
4. Participate in the resident's council.
5. Actively participate in care plan meetings.
Question 6The nurse is caring for a hospitalized client. Morphine has been prescribed by the physician to manage pain. The client has received morphine IV over the past 24 hours. The client has been experiencing nausea and vomiting.
Which actions will best manage the client's concerns at this time?
A) The use of morphine should be suspended and another opioid analgesic employed.
B) The client will be unlikely to handle any opioid analgesic administration and another type of medication will need to be tried.
C) When morphine is not tolerated, Meperidine may be implemented without nausea and vomiting.
D) An anti-emetic can be used for a few days and gradually withdrawn.
Question 7An older patient with a black eye is diagnosed with a broken arm that is reported as being caused by falling on a shovel while clearing snow from a walkway. Why should the nurse suspect physical abuse with this patient?
1. The patient is confused.
2. The patient is 65 years old.
3. The patient is African American.
4. The patient's testing results are inconsistent with the history given.
Question 8Morphine sulfate has been prescribed for a client experiencing acute pain Which of the following instructions should be included in the teaching provided by the nurse?
A) Begin taking a bulking agent.
B) Reduce water intake.
C) If constipation occurs, contact your physician to obtain a stool softener.
D) Increase intake of fresh fruits.
Question 9The nurse is concerned that an older patient is at risk for abuse because the patient lives with an adult son who is an alcoholic. Which theory of elder mistreatment is this nurse basing this concern for the patient?
1. Isolation
2. Situational
3. Psychopathology
4. Transgenerational
Question 10A client who has chronic pain has been prescribed a low dose of oral morphine. The client voices concern about feeling sleepy when taking the medication. What response by the nurse is indicated?
A) Feeling sleepy is an unfortunate problem with morphine.
B) Lowering the dose may reduce these feelings.
C) Once you develop a tolerance to the medications, this will improve.
D) Unfortunately you will need to change medications.
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