Seven tasks required for daily living with chronic illness have been identified. From Table 5-4, select at least one of these tasks that would specifically apply to the following common chronic conditions in older adults.
- A. Diabetes mellitus
- B. Visual impairment
- C. Heart disease
- D. Hearing impairment
Correct Answer: A
Rationale: Each chronic condition requires specific daily living tasks: Diabetes involves monitoring blood sugar; visual impairment may require adaptive techniques; heart disease necessitates lifestyle modifications; hearing impairment might involve using assistive devices.
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Paralytic ileus may occur as a postoperative complication. Which of the following patients would you be most concerned about the development of paralytic ileus?
- A. Kim, a 27-year-old postlaparoscopic appendectomy.
- B. Joyce, a 39-year-old post–open right hemicolectomy.
- C. Nancy, a 56-year-old postmediastinoscopy.
- D. John, a 47-year-old post–total joint replacement.
Correct Answer: B
Rationale: Paralytic ileus is more common after abdominal surgeries, particularly those involving bowel manipulation, such as an open right hemicolectomy. Joyce is at the highest risk due to the nature of her surgery.
Which of the following would you include as risk factors for the development of skin cancer when assessing the integumentary system?
- A. Advancing age
- B. Positive family history
- C. Dark pigmentation
- D. White collar job
Correct Answer: B
Rationale: Advancing age by itself is not a risk factor. If that person has been exposed to a lot of sun there may be increased risk, but that information is not given here. There is a known genetic risk, with some cancers being seen to be present in families with low risk factors. Those with dark pigmentation develop skin cancer, but at a lower rate than those with low amounts of pigmentation. White collar jobs, which occur in offices and inside buildings, are a low risk for skin cancer.
What are clinical manifestations of insomnia (select all that apply)?
- A. Narcolepsy
- B. Fragmented sleep
- C. Long sleep latency
- D. Morning headache
Correct Answer: B
Rationale: The correct answers are B, C, and F. Fragmented sleep, long sleep latency, and difficulty concentrating are common symptoms of insomnia. Narcolepsy (A) is unrelated, morning headache (D) can occur but is less common, and daytime sleepiness (E) is more typical of sleep apnea.
Which task is appropriate to delegate to the nursing assistant?
- A. Chest compressions
- B. Bag-valve mask ventilation
- C. Assisting with oral intubation
- D. Placing the defibrillator pads
Correct Answer: A
Rationale: Chest compressions are a physical task that can be delegated to a nursing assistant under supervision.
What is the purpose and advantage of methadone maintenance therapy?
- A. Increased alertness
- B. Lower immune response
- C. Faster metabolism
- D. Enhanced digestion
Correct Answer: C
Rationale: The correct answer is C because it is the most appropriate response based on physiological and medical principles.
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