chapter 16

The nurse has identified the diagnosis of Ineffective Airway Clearance for an older patient with pneumonia. Which intervention should the nurse include when planning care for this patient? 1. Chest percussion 2. Limiting fluid intake 3. Smoking cessation education 4. Administering the pneumococcal vaccine

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The nurse is reviewing new medication orders for an older patient with asthma. Which medication should the nurse question before providing it to the patient? 1. Aspirin 2. Antibiotic 3. Anticoagulant 4. Calcium channel blocker

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What should the nurse keep in mind when teaching an older patient about smoking cessation? 1. Most people quit smoking several times before they are successful. 2. Bupropion (Zyban) taken orally is safe for patients with seizure disorders. 3. A piece of nicotine gum should be chewed for 5 minutes of every waking hour. 4. There is no adverse risk if the patient chooses to smoke while wearing a nicotine patch.

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Which change in the respiratory system of an older patient does the nurse recognize as an expected finding with aging? 1. Decrease in vital capacity 2. Increase in alveolar surface area 3. Decrease in stiffness of the chest wall 4. Increase in the amount of oxygen carried in the blood

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An older patient asks the nurse what can be done to prevent a respiratory infection during the winter months. How should the nurse respond to this patient? Standard Text: Select all that apply. 1. Stay active with daily exercise. 2. Dont smoke and avoid secondhand smoke. 3. Wash the hands often and get a flu vaccination. 4. Eat a healthy diet and maintain a normal weight. 5. Visit with a variety of people to build up immunity.

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The nurse is preparing to use a peak flow meter for an older patient with asthma. For which reasons will the nurse use this device? Standard Text: Select all that apply. 1. Evaluate effects of stress. 2. Measure response to medications. 3. Recognize the need for emergency care. 4. Determine if medications need changed. 5. Establish the presence of medication side effects.

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An older patient is prescribed an inhaled corticosteroid as part of treatment for asthma. What will the nurse instruct the patient about the use of this medication? Standard Text: Select all that apply. 1. It can cause oral thrush or candidiasis. 2. Use a spacer when taking this medication. 3. It has no effect on any other health problems. 4. Rinse the mouth and spit after using this medication. 5. It is the most effective anti-inflammatory treatment for asthma.

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What manifestations will the nurse assess in an older patient with active tuberculosis? Standard Text: Select all that apply. 1. Weight loss 2. Night sweats 3. Ankle edema 4. Bloody sputum 5. Loss of appetite

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What steps will the nurse follow when administering a two-step purified protein derivative (PPD) tuberculin skin test to an older patient? Standard Text: Select all that apply. 1. Repeat the PPD test in 1 to 2 weeks. 2. Measure the area of injection in 48 hours. 3. Measure the area of injection in 72 hours. 4. Administer 5 units of the BCG vaccination serum. 5. Administer an injection of 0.1 mL of 5 TU intradermally

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The nurse has instructed an older patient on ways to prevent the development of pneumonia. Which patient statement indicates further instruction is needed? 1. I will get the influenza vaccine every year. 2. I will get the pneumococcal vaccine every fall. 3. I cant get the influenza vaccine due to my allergy to eggs. 4. I will get the pneumococcal vaccine as soon as I recover from this pneumonia.

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What will the nurse keep in mind when planning care for an older patient diagnosed with asthma? 1. Asthma is not diagnosed as a new condition in older patients. 2. Asthma is treated with the same types of medications in older patients as in younger patients. 3. Older patients will have fewer side effects and drug interactions from asthma medications than younger patients. 4. Asthma can be differentiated from chronic obstructive pulmonary disease (COPD) by changes seen on a series of chest x-rays.

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When assessing an older patient with chronic obstructive lung disease (COPD) the nurse sees calluses on both of the patients elbows. What does this finding indicate to the nurse? 1. The patient lifts weights. 2. Use of the tripod position. 3. An allergy to a medication. 4. The patient falls frequently

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Why will the nurse plan interventions to reduce an older patients risk of developing a pulmonary disease? 1. There is an increase in alveolar diameter. 2. The older patient has decreased production of antibodies. 3. The older patient has an improved response to immunizations. 4. The cilia of an older patient is more effective in removing debris from the airway.

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The nurse is caring for an older patient with chronic obstructive pulmonary disease (COPD) who is having difficulty clearing secretions from the respiratory tract. Which actions can the nurse take to help this patient? Standard Text: Select all that apply. 1. Restrict oral fluids. 2. Use postural drainage. 3. Apply chest percussion. 4. Teach controlled coughing. 5. Perform tracheal suctioning.

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What will the nurse instruct an older patient with asthma to do to control house dust? Standard Text: Select all that apply. 1. Wash the hands frequently. 2. Remove carpets from the bedroom. 3. Reduce indoor humidity to less than 50%. 4. Stay out of a room that is being vacuumed. 5. Do not sleep or lie on upholstered furniture.

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When should the nurse instruct an older patient with asthma to use a peak flow meter? Standard Text: Select all that apply. 1. After eating dinner in the evening 2. If feeling like cold symptoms are occurring 3. When wheezing or tightness in the chest occurs 4. In the morning after awakening and between noon and 2 p.m. 5. Every day for the first 2 weeks when medication treatment changes

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Which manifestations should the nurse investigate as indicating possible pneumonia in an older patient? Standard Text: Select all that apply. 1. Fever 2. Dyspnea 3. Tachycardia 4. Behavior changes 5. Substernal chest pain

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An older patient is prescribed isoniazid (INH) for 6 months. What should the nurse instruct the patient about this medication? 1. Avoid vitamin supplements. 2. Use alcohol in small amounts. 3. Report yellow eyes or skin immediately. 4. Expect the finger and toe tingling to occur.

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An older patient with chronic obstructive pulmonary disease (COPD) develops a dysrhythmia. Which health problem should the nurse consider is occurring with this patient? 1. Anemia 2. Asthma 3. Cor pulmonale 4. Left ventricular hypertrophy

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An older patient with asthma is prescribed rescue inhalers. What should the nurse instruct the patient about this medication? Standard Text: Select all that apply. 1. Refrigerate unused canisters. 2. Place the canisters near the bed. 3. Label the canisters with bright red tape. 4. Obtain a prescription for extra canisters. 5. Keep several inhalers in different areas in the home.

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An older patient who is having difficulty breathing and is wheezing is scheduled for a test to differentiate the health problem as being asthma or chronic obstructive pulmonary disease (COPD). For which diagnostic test should the nurse prepare the patient? 1. Chest x-ray 2. Electrocardiogram 3. Complete blood count 4. Pulmonary function tests

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The nurse is preparing a care plan for an older patient with asthma. The patient is receiving oxygen and has a respiratory rate of 28, heart rate of 86, and blood pressure of 108/52. Which nursing diagnosis would be the priority for this patient? 1. Risk for Injury 2. Risk for Infection 3. Activity Intolerance 4. Ineffective Peripheral Tissue Perfusion

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What should the nurse instruct an older patient who is newly diagnosed with tuberculosis? 1. In the early stage, it causes weight gain and shortness of breath. 2. It is caused by a virus related to human immunodeficiency virus (HIV). 3. It can be spread by persons who have positive skin tests and no symptoms. 4. It presents a higher risk for patients who take immunosuppressant medications.

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Which manifestation of chronic obstructive pulmonary disease (COPD) that occurs early in the disease will the nurse assess in an older patient? 1. Dysrhythmias 2. Cyanotic nail beds 3. Clubbing of the fingers 4. Cough in the morning producing clear sputum

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Which nursing diagnosis would the nurse select for an older patient with asthma that has a respiratory rate of 28 and audible wheezes on inspiration? 1. Activity Intolerance 2. Altered Tissue Perfusion 3. Ineffective Airway Clearance 4. Ineffective Breathing Pattern with tachypnea and wheezing.

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