aging MT

Promotion of wellness and quality of life throughout the life span

1. A gerontological nurse is a guest speaker at a local community college career day. During the discussion, the nurse describes gerontological nursing roles and responsibilities, emphasizing that gerontological nurses emphasize which aspect in contrast to geriatric nurses?

Self-care

1. A gerontological nurse is a single parent who often works overtime and who rarely gets sufficient sleep. This nurse should prioritize which action?

Integration and quality of life

1. A gerontological nurse is conducting an in-service program for a group of nurses working at a long-term care facility. After describing the holistic model of gerontological care, the nurse determines that the class has been successful when the group define health as

Evidence-based practice

1. A gerontological nurse is providing care to a large older adult population with diverse problems. To effectively care for the clinical complexities of these clients and ensure best practices, the nurse would rely on which information as the foundation?

The client lacks the requisites to meet his or her needs independently.

1. A gerontological nurse is providing care to an older adult client. Which situation best indicates to the nurse that intervention is required?

"I am wondering what feelings you may be having now around being at this stage of your life."

1. A nurse who provides care on the palliative unit of a large teaching hospital has been working with an older adult client who is dying. The client was diagnosed with lung cancer and liver metastases. The nurse has generated good rapport with both the client and family. Which statement by the nurse would best exemplify a holistic approach to this client?

Assess the son and daughter-in-law's knowledge and skill level.

1. An adult son is taking his father home to live with him after being discharged from the skilled care unit. The son and his wife are familiar with caring for older adults as they have already cared for the wife's father before he passed away. What should the gerontological nurse first do to prepare this family for discharge?

Contemplation

A 69-year-old cigarette smoker asks the nurse questions about the potential benefits of quitting smoking, a subject avoided in past interactions. The nurse asks the client, "Would you like to quit smoking?," to which the client replies, "I will give it some serious thought." What stage of the Stages of Change model is the client demonstrating?

Fluid volume deficit

A 70-year-old client with urosepsis is admitted to a nursing unit. The labs include elevated sodium, blood urea nitrogen, hematocrit, and albumin. Which of the following nursing diagnoses is priority for this client?

Use an assessment tool that is specifically designed for use with cognitively impaired clients.

A 79-year-old client has been admitted to a long-term care facility because of the progression of Alzheimer disease from mild to the moderate stage. How should the nurse proceed with functional assessment?

"Gradually increase the amount of fiber in your daily diet"

A client has been asked to keep a food journal to address ongoing issues with constipation. The client brings the journal to a follow-up appointment. When reviewing the journal, the nurse notes that the client has a bagel and coffee for breakfast, macaroni and cheese for lunch, and soup and salad for supper during a typical 24-hour period. Which dietary change would the nurse most likely suggest?

"What are some goals that you have for maximizing your level of wellness?"

A diabetes nurse is providing care for a 73-year-old client who is a regular client of the hospital's out-client diabetes clinic. What assessment question most clearly addresses this client's potential for optimal function?

An exercise program for older adults who live in the community

A gerontological nurse who works in a public health setting has limited funding for initiatives. Which of the following prevention and health promotion initiatives is most likely to result in significant benefits for the older adults who participate?

Gerontological nursing

A graduate nurse expresses an interest in focusing future study to healthy aging. Toward which of the following fields should the experienced nurse steer the graduate nurse?

Healthy People 2020

A graduate nurse expresses an interest in focusing future study to healthy aging. Toward which of the following resources should the experienced nurse steer the graduate nurse?

The replacement of participants' unhealthy behaviors with healthy behaviors

A group of community health nurses is using the Stages of Change model as the foundation of a new health promotion campaign for older adults. What goal for the participants are the nurses likely to promote when working with older adults in the program?

Decreased serum cholesterol

A health-conscious resident of an assisted living facility is promoting the value of fiber to a fellow resident. In addition to improving bowel activity, which additional benefit would be most appropriate for the health-conscious resident to cite?

The client's home has large south-facing windows with blinds.

A home care nurse assesses the home environment of an older adult client. Which of the following environmental conditions positively affects the functioning and quality of life for the client?

Increased use of assisted living facilities by older adults

A nurse administrator is involved in strategic planning for a large long-term care facility that has locations in numerous regions of the country. What trend should the nurse administrator anticipate?

Low albumin and red blood cells

A nurse admits a 90-year-old client to the hospital with a diagnosis of failure to thrive. Which of the following laboratory data should the nurse expect?

A homemaker born in 1957

A nurse assesses a community of older adults. Which of the following persons is at highest risk for a shortened life expectancy?

Lung sounds

A nurse assesses an older adult in the assisted living facility who has presbyphagia. Which of the following systems should the nurse auscultate?

"Have you been losing weight?"

A nurse assesses older adults at a senior center. One older adult, age 78, has a body mass index (BMI) of 15. Which response by the nurse is appropriate?

An 83-year-old single woman

A nurse assesses the risk of the members of the community. Which of the following are most likely to be living at or below the poverty line?

Diuretics

A nurse at a rehabilitation unit assesses an 86-year-old woman with a BMI of 30 and a history of heart failure, whose oral intake is declining. Which of the following risk factors is related to this older adult's decline in appetite?

Health promotion

A nurse at the aging center organizes exercise classes including tai chi. Which of the following principles is the nurse incorporating?

Explore the client's abilities and strengths.

A nurse cares for an 81-year-old client whose current hospital admission has been prompted by an exacerbation of chronic renal failure. Which of the following actions by the nurse will best emphasize the goal of client wellness?

The client is able to wash self but requires assistance entering and leaving the bathtub.

A nurse completes the admission assessment of an 84-year-old client to the long-term care facility. Which assessment finding would direct the nurse to document a deficit in the client's ADLs?

Client's ability to perform self-care tasks with a focus on rehabilitation.

A nurse conducts a functional assessment of a client who has moved to the assisted living facility. Which of the following statements best describes this functional assessment?

"Overall, you don't need to take in as many calories as you used to."

A nurse counsels an older adult regarding nutritional requirements. Which of the following teaching points is priority when discussing age-related changes in nutritional requirements?

I am concerned about your safety, as well as the safety of others.

A nurse discusses driving with an older adult who continues to drive, but is probably unsafe on the road. Which statement made by the nurse is most appropriate?

The client pockets food in the affected cheek during meals.

A nurse evaluates the plan of care for a client who experienced an ischemic stroke. Which of the following assessment findings should signal the nurse to the possibility that the client has developed dysphagia?

"You have to remember that there's a huge economic disparity among older adults."

A nurse hears a colleague make the statement, "Most older adults have nothing to worry about financially." Which of the following responses is most appropriate?

"I know it's hard to get outside in the winter, so let's try to identify some ways of getting more exercise indoors during your usual activities."

A nurse helps older adults increase healthy behaviors by restructuring. Which of the following communication techniques should the nurse use to help the older adult overcome barriers?

A 50-year-old who balances the care of an 82-year-old parent and a 20-year-old child

A nurse identifies those who are at risk for familial stress. Which of the following persons exemplifies the sandwich generation?

The nurse will identify changes in the older adult's function over time.

A nurse in a Medicare- and Medicaid-funded nursing home performs assessments and develops care plans. Which of these statements is true of the functional assessments the nurse is likely to perform?

"Healthy maturity is characterized by wisdom."

A nurse interviews a centenarian gathering data for a large study. In the interview, the centenarian defines aging as not growing older, but growing wiser. Which of the following is the best response to this definition by the nurse?

Subjective aging

A nurse interviews a centenarian gathering data for a large study. In the interview, the centenarian says, "You're only as old as you feel, some days I feel like 'I'm 50.'" To which definition of aging does this response correspond?

Assisted living arrangements have become increasingly common.

A nurse is conducting a study on the needs and living situations of older adults in the community. Which of the following statements should the nurse take into account?

We need to teach the older adult how he can keep living a fruitful life in spite of his diagnosis."

A nurse is discussing an older adult's recent diagnosis of rheumatoid arthritis with a colleague. Which of the nurse's statements reflects an accurate view of the relationship between aging and wellness?

Identifying and treating a client's vascular dementia

A nurse is explaining to a new colleague the similarities and differences between gerontology and geriatrics. Which of the following situations would most likely be addressed by a geriatrician rather than a gerontologist?

Signs and symptoms of illness are often obscure and less predictable among older adults.

A nurse is responsible for assessing an older adult in an acute care setting. Which of the following statements most accurately captures the complexity involved in assessing the older adult?

"Do you feel like you actively engage with life?"

A nurse is teaching an older person about the concept of successful aging. Which of the nurse's questions addresses an important contributor to successful aging?

"I can see why we would want to promote timely discharge back to the community following hospitalization."

A nurse is teaching nursing students about the importance of health promotion among older adults. Which of the following statements by a student indicates a need for further teaching?

Promote oral care for residents multiple times each day.

A nurse manager of the long-term care facility develops plans to reduce nutritional deficits. Which of the following interventions is appropriate to include in the plan?

-Meals in the common room - Oral care before each meal -Eight-ounce bottle of water between each meal

A nurse plans care for a client who states that food is no longer appealing. The nurse notes a dry mouth and teeth in poor condition. Which interventions should the nurse include in the plan of care? (Select all that apply.)

Provide 55% of calories from complex carbohydrates.

A nurse plans the diet for an older adult with congestive heart failure. Which of these nursing interventions would be most successful to encourage optimal nutrition?

If older adults need a medication to promote bowel regularity, a bulk-forming agent is needed daily

A nurse teaches a health education class for older adults about constipation. Which of the following points should the nurse stress?

Baked chicken, carrots, and angel food cake

A nurse teaches an older adult about changes to nutritional requirements. Which of the following meal choices would give evidence that the older adult understands the teaching?

A holistic approach to caring for older adults can foster their well-being at every stage of life.

A nurse who provides care to many older adults recognizes the importance of implementing a wellness approach to care. What principle underlies this approach to the health care of older adults?

"How can we help older adults maintain wellness as they age?"

A nurse who works with older adults is teaching a colleague about the similarities and differences between gerontology and geriatrics. Which of the following questions best conveys the focus of gerontology?

Unintentional weight loss

A nurse working for human services visits a long-term care facility. Which resident assessment finding indicates poor quality care?

Ensure that the woman's mobility is assessed and the appropriate assistive device is provided.

A nurse working in an acute care for elders unit observes that a client on the unit frequently stumbles when ambulating with a walker. Which action by the nurse is best?

Risk-reduction interventions

A nurse works with a program that performs interviews, blood work, and digital rectal examinations aimed at identifying older men with BPH. The program also facilitates bathroom alterations in older adults' homes to ensure men with BPH have easy access to a toilet. Which of the following components of health promotion has yet to be implemented in the program?

Health promotion is essential for older adults because they have complex health care needs.

A rural community nurse sets up a monthly disease screening service. Local news coverage chooses not to cover this event. Which of the following justifications best supports the screenings?

Diuretic

After reviewing a client's list if medications the nurse asks if the client ever experiences a dry mouth. Which medication on the list caused the nurse to ask the client this question?

"You can consider timing your medications to avoid their interfering with safe driving."

An 82-year-old client is getting advice from a family member on how to drive safely. What piece of advice should the older adult follow?

Ageism

An 85-year-old client takes meals on wheels around the community. The client states, "All those old people really need me, you know how older people are. They can't get out, and are a burden to their family, and I just want to help." Most of the people on the client's delivery route are in their 60s. Which of the following characterizes this scenario?

Slow peristalsis

An 88-year-old client is prone to chronic constipation and ask the nurse why. The nurse should explain what age-related physiological change?

"With age, reduced pancreatic secretions can affect the digestion of fatty foods."

An older adult client reports that he often experiences "indigestion" after each fatty food. He states that this never used to happen to him when he was younger and asks the nurse why this is now the case. What is the nurse's best response?

Review the client's medication list.

An older adult develops diarrhea. Which of the following is the priority intervention for the nurse?

Age attribution

An older adult has recently begun to display unprecedented lapses in short-term memory. The nurse overhears a colleague reassuring the person by saying, "Try not to worry; it's just a part of growing older." The nurse recognizes that this is an example of what phenomenon?

"Slower emptying of your stomach may be the cause."

An older adult states, "I just feel so full so fast, I can't eat any more." Which of the following responses is most appropriate?

Ability to draw up insulin

An older adult with a history of arthritis is diagnosed with type 1 diabetes mellitus while hospitalized. What is the nurse's priority holistic concern to address at discharge?

Thicken liquids

An older client has esophageal dysphagia. What intervention should the nurse plan for this client?

The older adult is able to clean and maintain her own apartment.

As part of a functional assessment, a nurse is assessing an older adult's ADLs and instrumental activities of daily living (IADLs). What piece of assessment data would most likely be considered an IADL rather than an ADL?

Mental status

Assessment of an older adult's ADLs addresses parameters such as mobility, dressing, and elimination. In addition to these, which of the following categories should the functional assessment also include?

Increased nursing education and clinical experience specific to working with older adults

Despite the fact that older adults are proportionately the highest users of health care services, many nurses harbor misconceptions and deficits in practice related to gerontological nursing. What is the most likely solution to this problem?

Check with the health care provider to identify any supplements that may produce adverse interactions with prescribed medication

During a home visit, the nurse notes that an older adult client has a tray of many types of vitamins, minerals, and herbal supplements on the kitchen counter. The client was recently discharged from the hospital after having an acute myocardial infarction. Which instruction would be the most appropriate for the nurse to make about the client's supplements?

"My over-the-counter beta-carotene pill is appropriate for long-term use."

Older adults need increased intake of foods with a high nutritional value and a concomitant decrease in the intake of foods containing little or no nutrients.

promoting clients' optimal function.

The gerontological nurse best demonstrates the role of healer by:

talk with the client about plans to meet self-care needs

The nurse is concerned about an older client returning home alone after recovering from hip replacement surgery. What should the nurse do to support this client's needs?

Serum albumin level 2.8 g/dl (28 g/L)

The nurse is concerned that an older adult client is experiencing undiagnosed malnutrition. What information may cause the nurse to make this clinical determination?

Swabbed the lower back molars with lemon-glycerin swabs

The nurse observes the unlicensed assistive personnel provide mouth care to an older client. For which observation should the nurse intervene?

Ampicillin

The nurse suspects that an older adult's diarrhea is related to medications. Which medication should the nurse consider as causing this client's problem?

The symptoms of the disease appear at the same time that it is detectable by screening.

Which of the following circumstances would be most likely to render a screening program unnecessary?

Leading a flexibility and mobility class among older adults

Which of the following interventions most closely aligns with the practices of health promotion?

-"In the United States, 20% of the older adults who need care are in a nursing home. - "People consider themselves old when they are old enough to apply for Medicare."

Which of the following statements, made by a new nurse, are myths and need correcting? (Select all that apply.)