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You care for a resident in a long-term facility. She receives a phone call informing her that her older sister has died. Which of the following interventions will be most helpful for her at this time?
- A. Give her the number of a support group.
- B. Contact the facility's chaplain.
- C. Sit quietly with her.
- D. Tell her that grieving is a process with several stages.
Correct Answer: C
Rationale: Sitting quietly provides immediate emotional support and presence, which is most helpful during acute grief.
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Anticoagulant drugs (sometimes called 'blood thinners') are broken down (metabolized) in the liver. Which of the following might be an outcome if a patient has undiagnosed liver disease but is started on anticoagulants?
- A. There will be an increase in bleeding tendencies.
- B. The drugs will be ineffective, leading to an increase in clotting tendencies.
- C. The drugs will be excreted from the body unchanged.
- D. The drugs will cause more harm to the liver, possibly leading to liver failure.
Correct Answer: A
Rationale: Undiagnosed liver disease impairs anticoagulant metabolism, leading to drug accumulation and increased bleeding risk due to prolonged effects.
Which of the following are interventions that address the issues of osteoporosis and the risk for broken bones?
- A. Make sure stairs are well lighted and that handrails are present.
- B. Suggest the patient lift light weights and wear ankle weights on his or her daily walk.
- C. Tell the patient which foods are high in potassium.
- D. Suggest the patient use an emergency help signaling device.
Correct Answer: A,B
Rationale: Proper lighting and handrails prevent falls, while weight-bearing exercises strengthen bones, reducing osteoporosis-related fracture risk.
Unless indicated by unexpected events, documentation in a long-term care facility is usually done once per week.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: Documentation occurs daily or per shift to ensure accurate and timely records of care.
Many older patients experience a decline in renal function as they age. What effect does renal decline have on medications?
- A. Decline in renal function has very little effect on medications unless the patient goes into acute renal failure.
- B. Decline in renal function can cause excessive amounts of a drug to be left circulating in the blood.
- C. Decline in renal function can cause an increase in dilute urine elimination, thereby flushing out too much medication too quickly.
- D. Decline in renal function does not really affect medications because most drugs are rendered inactive by the liver.
Correct Answer: B
Rationale: Reduced renal function impairs drug excretion, leading to accumulation in the blood, which can cause toxicity or prolonged effects.
Older adults often have trouble with constipation. What is the physiological reason for constipation that is associated with old age?
- A. Changes in appetite
- B. Decreased peristalsis
- C. Insufficient fiber in the diet
- D. Using supplements such as Ensure
Correct Answer: B
Rationale: Decreased peristalsis, a common age-related change, slows intestinal motility, leading to constipation.