A nurse is providing care for an 82-year-old woman on the palliative care unit of a hospital. The woman has a long-standing diagnosis of diabetes that has manifested in serious cardiac problems and she is not expected to survive the weekend.
How can the nurse best understand this course of events in light of the chronic care that the patient has long received? A) Death represents the ultimate failure of the provision of care.
B) Dying in comfort and dignity is the final component of high-quality chronic care.
C) The period of death represents the transition from chronic care to acute care.
D) Holistic, chronic care requires that the nurse limit care to psychosocial interventions.
Question 2The nurse at a long-term care facility is teaching unlicensed care providers about some of the factors that characterize adverse drug reactions in the elderly residents. Which teaching points are valid? (Select all that apply.)
A) Even when a resident stops taking a drug, a reaction can take place after the fact..
B) Even when a resident has been taking a drug for a long time, a drug reaction can still occur..
C) Most 'drug reactions' are in fact age-related changes that are mistakenly attributed to medications..
D) Older adults often have signs and symptoms of adverse reactions that are very different from those of younger adults..
E) While older adults are prone to adverse reactions, these reactions tend to resolve more quickly than in younger people..
Question 3A nurse has responded to a patient's call light and found her to being experiencing a nosebleed. What is the first action that the nurse should perform in the treatment of epistaxis?
A) Position the patient supine and apply an ice pack to the bridge of her nose.
B) Insert rolled 22 gauzes coated with water-soluble lubricant into each nostril.
C) Have the patient sit in a high Fowler's position and apply direct pressure to her nose.
D) Instruct the patient to look up at the ceiling and to exhale through her mouth.
Question 4The nurse caring for older patients in an acute care facility is aware of the changes in drug metabolism that can occur in older adults. Which statement explains the most important factor that affects pharmacokinetics in older patients?
A) Changes in gastrointestinal (GI) motility increase the absorption time for many drugs.
B) Drug distribution is unpredictable due to metabolic and body-composition factors.
C) Preexisting chronic conditions complicate the distribution and metabolism of drugs.
D) Decreased renal and liver function contributes to an increased half-life for many drugs.
Question 5The nurse is assisting the physician in removing a small sample of tissue from the patient's cervix to have it evaluated. This procedure is called a cervical _______________.
Fill in the blank(s) with correct word
Question 6Despite the fact that the patient is now receiving palliative care because of the progression of her congestive heart failure (CHF), a nurse views the care that was provided for the patient as a success.
Which of the following aspects of the patient's situation would most likely lead the nurse to this conclusion? A) The client was able to live independently and care for herself until very late in the progression of her disease.
B) The client maintained an acceptable cardiac output for the majority of the time that she lived with CHF.
C) The client was able to teach other older adults about the experience of living with CHF and the way it affected her life.
D) The client remained largely pain-free from the time of diagnosis until the present.
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