cpt 18 prepu
After reviewing a client's list of 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? a. Diuretic b. Oral hypoglycemic agent c. Anticoagulant d. Vasodilator
a
An older adult client has a history of a deep vein thrombosis. The client should be taught to avoid excessive intake of which vitamin or nutrient? a. Vitamin K b. Calcium c. Vitamin D d. Potassium
a
An older adult reports that the dentures are rubbing against the gums and causing discomfort. The client is not wearing the dentures at all now and states it will be too expensive to buy another set. What is the nurse's best response? a. "Sometimes dentures can be lined to ensure a proper fit." b. "You should clean your dentures thoroughly to help them fit better." c. "Not wearing your dentures poses a choking hazard." d. "You should eat soups and soft foods since you are not able to chew."
a
The nurse is caring for a client 1 month after a cerebrovascular accident. Which assessment will the nurse perform first? a. gag reflex b. appetite c. weight d. bowel sounds
a
The nurse is concerned that an older adult client is experiencing undiagnosed malnutrition. What information may cause the nurse to make this clinical determination? a. serum albumin level 2.8 g/dL (28 g/L) b. serum calcium level 9 mg/dL (2.25 mmol/L) c. hemoglobin level 13 g/dL (130 g/L) d. hematocrit level 37% (0.37)
a
An older adult client has just been fitted with new dentures. What should the nurse emphasize when teaching about the care of the dentures? Select all that apply. a. Soak the dentures in water b. Schedule dental exams every 2 months c. Clean the gums before applying the dentures d. Clean the dentures every day e. Remove the dentures each night
a c d e
A 78-year-old client reports heartburn on a regular basis after eating. Which topic will the nurse include in the teaching plan? a. Lay down after meals. b. Eat smaller meals. c. Include a glass of wine with dinner. d. Drink milk with meals.
b
A 78-year-old client states eating 3 full servings of fruits and vegetables per day. What is the nurse's best response? a. "The majority of this intake should be green vegetables." b. "You should incorporate at least 2 more servings into your diet." c. "Avoid eating too much broccoli due to the risk of high calcium consumption." d. "Substitute 1 or 2 of those servings with yogurt or gelatin dessert."
b
A client reports nausea and vomiting after taking naproxen at home. Which intervention will the nurse recommend first when administering this to the client while an inpatient? a. Direct the client to take the medication with a full glass of water. b. Place the client in an upright position for at least 10 minutes. c. Teach the client to take the medication with food or milk. d. Provide an antacid for the client to take with the medication.
b
The health care provider suggests that the client increase intake of insoluble fiber. What item should the nurse suggest that this older adult client ingest every day? a. oatmeal b. fresh vegetables c. gluten-free bread d. apples
b
The nurse evaluates a 90-year-old client's concern about an inability to taste food anymore and determines the need for education. Which of the following topics would be important to include in the education plan? a. Cancer b. Accessory structures c. Digestion d. Bowel elimination
b
The nurse is caring for a client who is diagnosed with xerostomia related to age-related decline in saliva production. Which intervention will the nurse implement for this client? a. Drink carbonated beverages. b. Suck on hard candy during the day. c. Avoid fluids at mealtime. d. Sip cold water throughout the day.
b
The nurse is preparing to facilitate a referral for an older adult client with dysphagia. To which member of the multidisciplinary team will the nurse place the referral? a. Registered dietician b. Speech-language therapist c. Geriatric nurse specialist d. Rehabilitation therapist
b
The nurse is providing discharge instructions for a client diagnosed with oropharyngeal dysphagia. Which instruction will the nurse include? a. Flex your head backward at 100 degrees to open the trachea. b. Eat in an upright position to improve swallowing. c. Watch TV at mealtime to divert your attention. d. Eat a sweet first to increase salivation and moisten food.
b
The unlicensed assistive personnel (UAP) notices that an older adult client's oral intake has been poor since being admitted to the care area. The UAP reports this finding to the nurse, but says, "I am not concerned since older people do not need to eat much anyway." Which response by the nurse would be appropriate? a. "Actually, that is a myth; older adults have increased caloric and nutritional needs." b. "Even though older adults may not need quite as many calories, they need as many nutrients as you or I." c. "You are right, but it is still important that we provide vitamin supplements especially when a client is recovering from an illness." d. "Older adults, who are sick, require more calories than younger people do during their recovery."
b
fter teaching an unlicensed assistive personnel (UAP) about how to feed an older adult client with dysphagia, the nurse determines that the teaching was successful when the UAP identifies which action as appropriate? a. Offering thinned liquids at frequent intervals b. Make sure the client is sitting upright whenever consuming food or fluid c. Cutting solid food into large pieces as much as possible d. Allowing the client to store small amounts of food in the cheek
b
The nurse is educating an older adult client about nutritional needs. The client asks, "What should I include in my diet to keep my mind healthy?" Which statements will the nurse include in the response? Select all that apply. a. "Fiber is critical for maintaining clear thinking, and preventing dysfunction in cognition and memory." b. "The Mediterranean-style diet is considered the 'gold standard' for healthy aging, including preventing brain atrophy, or deterioration." c. "Increasing plant-based and unprocessed foods is important for reducing risk for neurodegenerative diseases such as Alzheimer and Parkinson disease." d. "Folate is important for cognitive function, but supplements should be used with caution as they may mask vitamin B12 insufficiency." e. "Potassium is considered a 'nutrient of public health concern' because of its critical roles in cognitive function."
b c d
An 80-year-old client who has just spent 2 days at the beach with the family is demonstrating confusion and has concentrated urine. Which action will the nurse take? a. Administer a mini-mental exam. b. Apply a cooling blanket. c. Administer fluids. d. Obtain a urinalysis.
c
An adult child caring for an older adult parent calls the nurse, stating concern about the parent's chronic bad breath and stubborn plaque on the teeth. Which teeth-cleaning measure should the nurse recommend for this older adult? a. "Lemon-glycerin swabs should be used to clean around the gumline." b. "An alcohol-based mouthwash will kill bacteria causing the odor." c. "An manual toothbrush is most effective when giving oral hygiene." d. "Use a soft swab to clean the teeth as well as gums."
c
An older adult client reports having a dry mouth after being diagnosed with thrush. Which recommendation will the nurse make to this client? a. Drink decaffeinated coffee. b. Eat foods that increase salivation. c. Rinse your mouth with warm saltwater. d. Include salty foods in your meals.
c
During a home visit, the nurse observes an older client place prepared food on a plate for dinner. Which observation indicates that additional teaching is required? a. small red potato 25% of the plate, spinach 50%, lamb burger 25% b. green beans 50% of the plate, pork chop 25%, pasta 25% c. beef steak 50% of the plate, green beans 25%, potato 25% d. summer squash 50% of the plate, chicken 25%, rice 25%
c
During an examination, the nurse determines that an older adult client has a weak gag reflex. Which nursing intervention will the nurse include in the plan of care for this client? a. Include thin liquids, such as apple juice, in the meal plan. b. Position client in the supine position after eating. c. Elevate the head of bed for 30 minutes after eating. d. Combine food and fluids during meals.
c
The nurse is assessing an older adult client's food journal after receiving education to help the client to gain weight. When reviewing the client's entries, what information demonstrates the client has implemented the teaching provided? a. Breakfast, lunch and dinner noted. b. Lunch and dinner noted. c. Five to six small meals per day noted. d. Breakfast, dinner and bedtime snack noted.
c
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? a. codeine b. prednisone c. ampicillin d. propranolol
c
A 79-year-old client asks the nurse what to eat to prevent chronic constipation. The nurse knows that which of the following is important to include in the client's teaching plan? a. Include 20 to 25 grams of fiber every day b. Include 20 to 30 grams of fiber every day c. Include 25 to 30 grams of fiber every day d. Include 25 to 35 grams of fiber every day
d
A nurse is assessing an older adult client who has been admitted to the long-term care facility. Which finding would the nurse interpret as a potential pathological process rather than a normal age-related change? a. hardened, brittle tooth enamel b. diminished saliva c. retraction of the gum's pulp d. red and swollen gums
d
An older adult client with controlled chronic illnesses has no interest in eating and is losing weight. What should the nurse assess first? a. dentition b. finances c. ability to swallow d. reason for no interest in eating
d
The nurse is caring for an unresponsive client who wears partial dentures. Which action will the nurse take to provide oral care for this client? a. Provide oral care using lemon-glycerin swabs. b. Brush teeth and dentures while in the mouth on a daily basis. c. Remove dentures and place in drawer while the client is responsive. d. Remove dentures, brush teeth and dentures daily.
d
The nurse is teaching a class to older adults about oral health practices. What health promotion activity should the nurse recommend? a. Visit a dentist every six months to check dentures b. Schedule visits to a dentist solely on the basis of tooth pain c. Visit a dentist every three months after the age of 80 d. Visit a dentist every six months to detect oral diseases
d
The nurse observes the unlicensed assistive personnel provide mouth care to an older client. For which observation should the nurse intervene? a. Dampened the toothbrush with a small amount of water b. Diluted mouthwash with water before providing c. Applied a small amount of toothpaste onto a toothbrush d. Swabbed the lower back molars with lemon-glycerin swabs
d
