An older adult patient is being assessed for possible alcohol ...

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An older adult patient is being assessed for possible alcohol abuse. To best assess the patient's risk potential, the nurse asks
 
  a. Have you ever experienced a memory loss as a result of consuming alcohol?
  b. Would you drink to relax after a particu-larly stressful day?
  c. Do you ever drink when you are alone?
  d. How many alcoholic drinks do you con-sume each week?

Question 2

An older patient admitted to the hospital with symptoms strongly suggestive of tuberculosis (TB) has a negative Mantoux test. The nurse correctly anticipates that
 
  a. the purified protein derivative (PPD) test will be administered.
  b. a chest x-ray will be ordered to detect possible infiltration.
  c. therapy consisting of a combination of bactericidal drugs will be initiated.
  d. the skin test will be repeated to achieve a booster effect.

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Answer to Question 1

D
The nurse should start the assessment for alcohol abuse by inquiring as to the number of drinks the patient consumes each week. The other questions can be part of an abuse assessment, but it is easiest to start with a simple, quantitative question to open the discussion.

Answer to Question 2

D
Tuberculin skin testing in older patients is an unreliable indicator of TB because they are more likely to have false-negative results because of reduced immune system activity. If skin testing is used, it is recommended that the standard 5 tuberculin unit (TU) Mantoux test be given and then repeated to create a booster effect. The PPD is not recommended. The skin test is followed up with a chest x-ray. Drug therapy should not begin until the patient has a diagnosis.

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TYSM

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Gracias!