Exam 3 Practice Questions

To best help manage health care costs in older adults, the nurse entrepreneur would do which of the following? A. Create a telehealth system where nurses could check on patients daily B. Provide local transportation services for older people to keep appointments C. Create educational videos in multiple languages seen in the community D. Build a nurse-run clinic to serve the homeless and underinsured population

A. Create a telehealth system where nurses could check on patients daily

An older patient diagnosed with severe osteoarthritis has recently moved in with his son because of a history of falls. The son describes how he and his family have eagerly assumed responsibility for meeting all Dads needs. The nurse is most concerned that this environment will result in the patient: A. Developing a sense of powerlessness and possibly a loss of hope B. Becoming unnecessarily physically and emotionally dependent C. Losing his will to get better and become independent again D. Becoming resentful and argumentative with his sons family

A. Developing a sense of powerlessness and possibly a loss of hope With no control over the meeting of his own needs, the patient may develop a sense of powerlessness, which can result in a loss of hope.

The nurse is planning to teach an older patient about diverticulitis. What topic does the nurse include? A. Dietary fiber and fluids will reduce the symptoms B. It is unusual to see diverticula in older persons C. Abdominal cramping and severe diarrhea should be reported D. Diverticulosis rarely reoccurs once it has been treated

A. Dietary fiber and fluids will reduce the symptoms Teaching should include the need to eat high-fiber foods and the importance of achieving and maintaining adequate fluid status. Patients should be encouraged to consume up to 2000 mL of fluids each day, unless contraindicated by cardiac status. Older people have diverticulitis commonly. Abdominal cramping and diarrhea are expected findings. Diverticulitis usually reoccurs

When preparing to discharge an older patient with mild dysphagia, the nurse suggests that the patient can minimize symptoms by: A. Eating small meals every 2 to 3 hours B. Cutting a sandwich into bite-sized pieces C. Eating less but choosing nutrient-dense foods D. Drinking thin liquids instead of eating solids

A. Eating small meals every 2 to 3 hours small, frequent meals, pureed or soft foods, and high-protein, high-calorie foods are helpful Thin liquids are often harder to swallow than thickened ones

Nurses should evaluate health programs based on what data? A. Effect on QOL B. Cost-benefit ratio of service C. Adherence statistics D. Ease of following through

A. Effect on QOL Quality of life

The nurse impacts the trajectory of a patients type 2 insulin-dependent diabetes best by: A. Evaluating the patient's ability to administer insulin appropriately B. Providing the patient with a written copy of the treatment plan C. Explaining to the patient the importance of serum glucose control D. Providing the patient with research-based nursing care

A. Evaluating the patient's ability to administer insulin appropriately

A student learning about the early AIDS epidemic wonders why the patients were stigmatized. What response by the nurse was best? A. Fear of the unknown etiology B. Expense required government assistance C. Patients being ashamed of their illness D. Younger patients not having accomplishments

A. Fear of the unknown etiology

The family of a patient who has type 2 diabetes calls the clinic to report a very small sore on the patients foot. What action by the nurse is best? A. Have the patient come to the clinic today B. Have the family wash and bandage it C. Tell the patient to check for a fever D. Have the patient go to the emergency room

A. Have the patient come to the clinic today Any ulcer or sore on a foot requires medical attention

An older patient is admitted with possible chronic renal failure (CRF). Which lab value does the nurse notify the physician about as a priority? a.Increased calcium level b.Increased red blood cells c.Decreased BUN level d.Decreased creatinine clearance level

ANS: D The diagnosis of CRF is usually made based on a decrease in creatinine clearance, an elevation of BUN level, and a decrease in red blood cells. The other findings can be documented.

A male patient reports difficulty starting a urine stream and a weak urine flow. When prompted to seek medical attention, the patient asks why, as its obviously benign prostatic hypertrophy. What response by the nurse is best? a.You never know; it could be cancer. b.You should have any change checked out. c.Only the physician can make a diagnosis, d.BPH and prostate cancer have similar symptoms.

ANS: D The patient should have these new symptoms checked out. Although only the provider can make the diagnosis, the best answer is to explain that symptoms of BPH and cancer are similar. The other options do not give useful information.

An older patient has moved into an adult childs home after an extended stay at a rehabilitation facility. The patient complains the child is now the boss and the child complains about caregiving duties. What action by the nurse is best? A. Help the older patient find another place to live B. Suggest that it is time for assisted living C. Mediate a family meeting to discuss roles D. Listen empathetically but let them work it out

C. Mediate a family meeting to discuss roles

The nurse observes signs that a patient being assessed may have an under-active thyroid. The data supporting this suspicion includes: A. Heat intolerance, low-grade fever, and patchy hair loss B. Polycythemia, tachycardia, and oral candidiasis C. Muscle cramps, fatigue, and cold intolerance D. Increased blood pressure, postural hypotension, and blurred vision

C. Muscle cramps, fatigue, and cold intolerance Older patients are seen with complaints of fatigue, cold intolerance, weight gain, muscle cramps paresthesias, and confusion, which are symptoms of hypothyroidism.

The patient complains of feeling the need to urinate and fullness and tenderness in the bladder area. The patient is restless and diaphoretic. The initial nursing intervention would be to: A. Help the patient into a warm tub bath to stimulate voiding B. Catheterize the patient C. Palpate the bladder fundus D. Place heated towels over the bladder area

C. Palpate the bladder fundus Palpation to assess distention would be the initial intervention before trying to remedy the urinary retention

The nurse explains that a diet low in dietary fiber results in a small stool that: A. Moves rapidly through the intestines B. Becomes excessively dry C. Overstimulates the defecation reflex D. Contributes to frequent bowel movements

B. Becomes excessively dry Small stools move slowly because of the understimulation of peristalsis. The stool becomes dry and leads to infrequent defecation and constipation

The nurse explains that the slowed speed of nerve impulses will cause the older adult to: A. Get a scrambled message in the brain B. Take longer to complete an activity C. Become confused D. Forget how to complete the activity

B. Take longer to complete an activity Slowed transmission causes the older adult to take more time to complete an activity because the message must travel from the source to the brain and then from the brain to the parts of the body involved in completing the activity

An older patient has been diagnosed with metabolic syndrome. What action by the nurse takes priority? A. Educate the patient on medications B. Teach lifestyle changes the patient can manage C. Encourage 60 minutes of aerobic activity daily D. Instruct the patient on a low-fat diet

B. Teach lifestyle changes the patient can manage Lifestyle changes are the mainstay of treatment for this disorder.

The nurse knows difficulty in bowel and bladder elimination occur in the older adult as a result of _______ (SATA) A. Daily use of senna for defecation B. Inability to get to adequate water C. Fear of pain with defecation D. Total privacy during elimination E. Use of a bedpan for elimination

A, B, C, E A. Daily use of senna for defecation B. Inability to get to adequate water C. Fear of pain with defecation E. Use of a bedpan for elimination A lack of privacy may be a hindrance to elimination

The nurse outlines age-related changes that promote constipation in the older adult, which include _______ (SATA) A. Diminished abdominal muscle tone B. Reduced activity level C. Inadequate fluid intake D. Increased dietary fiber E. Dependence on laxatives

A, B, C, E A. Diminished abdominal muscle tone B. Reduced activity level C. Inadequate fluid intake E. Dependence on laxatives Increased dietary fiber and bulk help prevent constipation

An older adult patient reports losing urine when she bends over or gets out of a chair. What type of incontinence does the nurse plan interventions for? a.Overflow b.Urge c.Functional d.Stress

ANS: D Stress incontinence is commonly seen in older women who involuntarily lose urine as the result of a sudden increase in intraabdominal pressure. Overflow incontinence consists of frequent involuntary losses of small amounts of urine. Functional incontinence is manifested by loss of large volumes of urine because of a lack of awareness of the need to void or a mobility problem. Urge incontinence is accompanied by a sudden urge to void.

The nurse is aware that an adult has the urge to urinate when the bladder has approximately _______ mL of urine in it

300 mL

A type 2 diabetic patient is admitted to the hospital with a gastrointestinal illness and a blood glucose of 480 mg/dL. After stabilizing the patient, what action by the nurse is best? A. Educate the patient on safe food handling B. Ask if the patient took the diabetic medication C. Teach the patient ways to avoid dehydration D. Delegate frequent blood sugars to the aide.

A frequent cause of hyperglycemia requiring hospitalization in diabetics is poor sick day management. The type 2 diabetic still makes insulin and so needs antihyperglycemic drugs even when ill

The nurse encourages fluid intake for the older adult to prevent constipation. If fluid intake is inadequate, constipation occurs because ________ (SATA) A. Fluid will be withdrawn from the stool B. The stool becomes hard and dry C. Less mucus is formed in the colon D. Lumen of bowel constricts because of smaller bulk E. Peristalsis slows

A, B, C A. Fluid will be withdrawn from the stool B. The stool becomes hard and dry C. Less mucus is formed in the colon Inadequate fluid intake causes fluid to be withdrawn from the stool for the bodys fluid needs, making the stool dry and hard. There is less mucus in the bowel from age-related changes and diminished mucus production because of decreased fluid. Slowed peristalsis is not related to fluid intake. Lumen of the bowel does not constrict because of smaller bulk.

When preparing a patient teaching session on retinopathy, the nurse should include which interventions when discussing treatments for slowing the progression of the disease? (SATA) A. Glucose control B. Blood pressure control C. Laser therapy D. Cornea transplant

A, B, C A. Glucose control B. Blood pressure control C. Laser therapy Better control of glucose, blood pressure, and cholesterol can assist in halting the progression of retinopathy. Laser therapy is also a treatment.

The nurse assesses a risk for constipation related to pain because of the presence of conditions such as _________ (SATA) A. Hemorrhoids B. Anal fissures C. Reduction of bowel mucus D. Diminished abdominal muscle tone E. Slowed peristalsis

A, B, C A. Hemorrhoids B. Anal fissures C. Reduction of bowel mucus Diminished tone and slowed peristalsis do not contribute to pain

The nurse teaches an older patient safety rules for exercising. What do these rules include? (SATA) A. Carry medical identification B. Check blood glucose before exercising C. Drink plenty of water D. Have quick-acting glucose E. Knowing signs of hyperglycemia

A, B, C, D A. Carry medical identification B. Check blood glucose before exercising C. Drink plenty of water D. Have quick-acting glucose Patient is more likely to experience hypoglycemia

The nurse is alerted to the possibility of a fecal impaction when the older adult patient complains of _____ (SATA) A. Cramping B. Rectal pain C. Abdominal distention D. Anorexia E. Passing large amounts of liquid stool

A, B, C, D A. Cramping B. Rectal pain C. Abdominal distention D. Anorexia Passing large amounts of liquid stools is not a sign of fecal impaction. All other options are indications of fecal impaction.

The nurse takes into consideration that the lessened stamina of the older adult is related to an altered oxygen exchange resulting from _________ (SATA) A. Flattened diaphragm B. Loss of elasticity in the lung C. Nutritional deficiencies D. Decrease in size of chest cavity E. Fragility of capillaries

A, B, C, D A. Flattened diaphragm B. Loss of elasticity in the lung C. Nutritional deficiencies D. Decrease in size of chest cavity Fragility of capillaries does not interfere with gas exchange

The children of an older man believe he is too old to drive a car. Which assessment information about the man warrants further investigation by the nurse to determine his fitness to drive a car safely? (SATA) A. Increased rate of tripping on curbs B. Increased frequency of getting lost C. Multiple bruises on lower extremities D. Restricts reading to a well-lit sunroom E. Socializes with a partners bridge group F. Cooks gourmet meals for entertainment

A, B, C, D A. Increased rate of tripping on curbs B. Increased frequency of getting lost C. Multiple bruises on lower extremities D. Restricts reading to a well-lit sunroom

When teaching an older patient about diet therapy, the nurse plans to assess for barriers to adherence, including which factors? (SATA) A. Lifelong habits B. Cultural influences C. Finances D. Dependency E. Inability to learn

A, B, C, D A. Lifelong habits B. Cultural influences C. Finances D. Dependency

The student learning about chronic disease and illness in the older population learns which facts about this situation? (SATA) A. One in two adults, or more than 133,000 Americans, has a chronic condition B. Chronic disease is the leading cause of death in those over 65 C. About 75% of medical costs each year are spent on managing chronic disease D. Formerly acute conditions are now manageable chronic diseases E. The focus of Americas health care services is now on chronic illness

A, B, C, D A. One in two adults, or more than 133,000 Americans, has a chronic condition B. Chronic disease is the leading cause of death in those over 65 C. About 75% of medical costs each year are spent on managing chronic disease D. Formerly acute conditions are now manageable chronic diseases

The home health nurse points out the benefits of regular exercise, which include _________ (SATA) A. Maintenance of joint mobility B. Enhancement of muscle tone C. Promotion of sense of general well-being D. Guarantee of weight loss E. Promotion of regular elimination

A, B, C, E A. Maintenance of joint mobility B. Enhancement of muscle tone C. Promotion of sense of general well-being E. Promotion of regular elimination Regular exercise does not guarantee weight loss.

Because of a knowledge of age-related changes in the gastrointestinal system, the nurse encourages regular screenings for which of the following? (Select all that apply) A. Osteoporosis B. Vitamin B deficiency C. Pernicious anemia D. Enlarged liver E. Iron deficiency anemia

A, B, C, E A. Osteoporosis B. Vitamin B deficiency C. Pernicious anemia E. Iron deficiency anemia By the age of 60, a persons gastric secretions decrease to 70% to 80% of those of the average adult. A decrease in pepsin may hinder protein digestion, whereas a decrease in hydrochloric acid and intrinsic factor may lead to malabsorption of iron, vitamin B12, calcium, and folic acid.

The long-term goals for rehabilitation are _______________ (SATA) A. Prevention of further disability B. Modifying the impact of the disability on lifestyle C. Supporting adaptation to a changed lifestyle D. Focusing on a complete return to the former level of activity E. Reestablishing the patient's control of her or his life

A, B, C, E A. Prevention of further disability B. Modifying the impact of the disability on lifestyle C. Supporting adaptation to a changed lifestyle E. Reestablishing the patient's control of her or his life Rehab is focused on attaining the best possible recovery with adjustment to a change in lifestyle

The nurse is aware that the broad general causes of bowel incontinence are ________ (SATA) A. inability to recognize defecation urge related to mental impairment B. Inability to respond to defecation urge related to immobility C. Inflammatory bowel disease D. Increased fiber in the diet E. Unexpected defecation when passing gas

A, B, C, E A. inability to recognize defecation urge related to mental impairment B. Inability to respond to defecation urge related to immobility C. Inflammatory bowel disease E. Unexpected defecation when passing gas Fiber provides bulk to waste. All other options are causes of incontinence

The nurse is assessing an older patient with elevated plasma triglyceride levels. What other assessment finding leads the nurse to suspect metabolic syndrome? (SATA) A. BP of 148/90 mm Hg B. A fasting blood glucose of 109 mg/dL C. Reports of frequent urination D. Weight measurement of 50 inches E. HDL Level of 52 mg/dL

A, B, D, E A. BP of 148/90 mm Hg B. A fasting blood glucose of 109 mg/dL D. Weight measurement of 50 inches E. HDL Level of 52 mg/dL Clinical criteria for metabolic syndrome includes: -Increased waist circumference -BP greater than 129/84 mm Hg or taking hypertension medication -Plasma triglyceride levels over 149 mg/dL or taking triglyceride medication -High-density lipid levels less than 40 mg/dL in men or less than 50 mg/dL in women or taking hDL-C Medications -Fasting glucose greater than 99 mg/dL (including patients with diabetes)

When planning an exercise program for a person with activity intolerance, the nurse would consider __________ (SATA) A. Identification of factors that contribute to activity intolerance B. Arranging activities that progress from mild to more demanding C. Rapid pacing activities to build up stamina D. Individualizing the plan to include activities that the patient particularly likes E. Including the patient in the planning phase

A, B, D, E A. Identification of factors that contribute to activity intolerance B. Arranging activities that progress from mild to more demanding D. Individualizing the plan to include activities that the patient particularly likes E. Including the patient in the planning phase Rapid pacing of activities will only result in continued activity intolerance. Pacing should be slowly increased to build stamina

The overall goals in caring for a patient with impaired physical mobility are ___________(SATA) A. Increasing the patients participation in physical activities B. Preserving the patients anatomical position and function of joints C. Increasing the patients former level of mobility D. Avoiding unnecessary restraints E. Using assistive devices to maintain mobility

A, B, D, E A. Increasing the patients participation in physical activities B. Preserving the patients anatomical position and function of joints D. Avoiding unnecessary restraints E. Using assistive devices to maintain mobility Increasing the former level of mobility is unrealistic

The nurse explains that normal bowel stimulation patterns for elimination of each person are influenced by _______ (SATA) A. Level of activity B. Diet C. Medication D. Fluid intake E. Lifestyle

A, B, D, E A. Level of activity B. Diet D. Fluid intake E. Lifestyle Medications frequently disrupt normal bowel elimination patterns

When assessing the patient's vision, the nurse should understand that older adults may report common aging changes, including which of the following? (Select all that apply) A. My eyelids droop so unattractively B. The whites on my eyes seem a bit yellow C. The vision in my right eye seems blurry D. I've started to use OTC eye moisturizing drops E. I have noticed the night driving has become more difficult

A, B, D, E A. My eyelids droop so unattractively B. The whites on my eyes seem a bit yellow D. I've started to use OTC eye moisturizing drops E. I have noticed the night driving has become more difficult The eyelids lose tone and become lax, which may result in ptosis of the eyelids, redundancy of the skin of the eyelids, and malposition of the eyelids. The conjunctiva thins and yellows in appearance. In addition, this membrane may become dry because of the diminished quantity and quality of tear production. Peripheral vision decreases, night vision diminishes, and sensitivity to glare increases

Adherence to prescribed health care treatments by a patient with a chronic disease is best facilitated when the nurse does which of the following? (SATA) A. Provides the patient with information regarding his disease B. Assesses the patient's ability to understand his disease C. Defines health and wellness for the patient D. Helps the patient identify barriers to his personal wellness E. Coordinates support services to facilitate the patients discharge

A, B, D, E A. Provides the patient with information regarding his disease B. Assesses the patient's ability to understand his disease D. Helps the patient identify barriers to his personal wellness E. Coordinates support services to facilitate the patients discharge The five A's of a patients self-management of care includes assess, advise, agree, assist, and arrange

A nurse is assessing a patient who reports a moderate tinnitus. The nurse should assess the patient for which of the following? (SATA) A. Use of Ibuprofen (Motrin) B. History of excessive cerumen C. Drinking carbonated beverages D. History of frequent headaches E. Presence of hypertension

A, B, D, E A. Use of Ibuprofen (Motrin) B. History of excessive cerumen D. History of frequent headaches E. Presence of hypertension Beverages with caffeine are assessed; the patient may be drinking decaffeinated cola products. The other assessments are appropriate

The nurse is assessing patients diagnosed with chronic disease processes for the probability of hospitalization because of the exacerbation of related symptoms. The nurse recognizes that the patient with the highest probability is a(n): A. 72-year-old male with congestive heart failure (CHF) B. 82-year-old male with type 2 diabetes C. 72-year-old female with chronic bronchitis D. 82-year-old female with osteoporosis

A. 72-year-old male with congestive heart failure (CHF) Most common reasons for hospitalization in older patients are heart disease, cancer, pneumonia, and stroke.

The nurse understands what about the Americans with Disabilities Act? (SATA) A. It outlaws discrimination on the job because of disabilities B. It requires state governments to fund disability services C. It prohibits discrimination in government services to the disabled D. It requires all buildings to be retrofitted to allow access E. It provides funding for barrier-free buildings and parks

A, C A. It outlaws discrimination on the job because of disabilities C. It prohibits discrimination in government services to the disabled The ADA outlawed discrimination on the basis of disability in employment, in programs and services provided by state and local governments, and in the provision of goods and services provided by private companies and commercial facilities. It does not mandate government payment for disability services, require buildings to be retrofitted, or provide funding for barrier-free facilities

An older adult patient is being evaluated for a possible duodenal ulcer (DU). Which of the following assessments supports the diagnoses? (Select all that apply) A. Passing a moderate amount of dark reddish-brown stool B. Reporting a stabbing pain in the epigastric region C. Asking for some crackers to stop my stomach cramps D. Reporting the need to take antacid tablets most days E. Having a rigid abdomen about 2 hours after eating

A, C, D A. Passing a moderate amount of dark reddish-brown stool C. Asking for some crackers to stop my stomach cramps D. Reporting the need to take antacid tablets most days Typically the symptoms of DU are patterned by periods of exacerbation and remission and follow a pain-food-relief pattern The pain begins 2 to 4 hours after meals, is immediately relieved by food or antacids, is located in the mid epigastrium and may be described as a burning or cramplike pain. On physical examination, the only abnormality is possibly a tender epigastrium. A rigid abdomen could indicate a perforation of the ulcer. Stabbing epigastric pain is not a manifestation.

An older adult diagnosed with Menire disease is prescribed Meclizine (Antivert) and hydrochlorothiazide (HCTZ). The nurses educational instructions include which of the following? (SATA) A. The need to avoid alcoholic beverages B. Instructions to take the medication with food C. Symptoms of electrolyte imbalances D. That drowsiness is a common side effect E. Stopping the medication if chest pain occurs

A, C, D A. The need to avoid alcoholic beverages C. Symptoms of electrolyte imbalances D. That drowsiness is a common side effect Meclizine may cause drowsiness. A patient on a diuretic such as hydrochlorothiazide (HCTZ) needs to be monitored for evidence of fluid or electrolyte imbalances

The nurse knows the goals of rehabilitative nursing include helping the patient to _______ (SATA) A. Minimize the impact of disability B. Return to maximum level of function C. Increase level of independence D. Adjust to change in lifestyle E. Increase control of their life

A, C, D, E A. Minimize the impact of disability C. Increase level of independence D. Adjust to change in lifestyle E. Increase control of their life

An 82-year-old patient with a history of chronic heart and respiratory problems asks the nurse, What can I do to help my hemorrhoids from acting up? Which of the following responses made by the nurse are appropriate? (SATA) A. Ask if he experiences constipation with any regularity B. Encourage him to increase his fluid intake to 2000 mL daily C. Suggest he eat more whole grains and fresh fruits D. Discuss how he should include a walk into his daily routine E. Ask if he has a history of rectal bleeding

A, C, D, E A. Ask if he experiences constipation with any regularity C. Suggest he eat more whole grains and fresh fruits D. Discuss how he should include a walk into his daily routine E. Ask if he has a history of rectal bleeding Nursing management of an older patient with hemorrhoids includes the prevention and elimination of constipation. -High-fiber, high-roughage foods, including indigestible fiber like whole grains, legumes, and fresh fruits and vegetables -Adequate intake off luids -Consume up to 2000 mL of fluids each day unless contraindicated (like if they have heart disease) -Encourage light exercise on a regular basis and review the importance of a regular toileting routine

Which of the following are appropriate steps to take when removing cerumen from an older persons ear? (SATA) A. Instill a softening agent first B. Use hot water and hydrogen peroxide C. Use a waterpik inserted just inside the meatus D. Have the patient lead backward E. Drain water by having the patient lean forward toward the affected side

A, C, E A. Instill a softening agent first C. Use a waterpik inserted just inside the meatus E. Drain water by having the patient lean forward toward the affected side The nurse instills a softening agent and uses warm (not hot) water mixed with hydrogen peroxide or saline to irrigate the ear. A Waterpik or other irrigating equipment is used and is inserted just inside the meatus so the tip is still visible. Tip the patients head toward the side being irrigated. When draining, patient can lean forward and toward the affected side

What assessment findings support a diagnosis of hyperthyroidism in the older adult? (SATA) A. Tremors B. Heat intolerance C. Tachycardia D. Palpable goiter E. Atrial fibrillation

A, D, E A. Tremors D. Palpable goiter E. Atrial fibrillation Classic geriatric presentation of hyperthryoidism includes tachycardia, fatigue, tremors, and nervousness

The rehabilitation nurse demonstrates a positive attitude toward care planning by ______ (SATA) A. Acknowledging the impact of a traumatic amputation on therapy B. Encouraging the residents input on the care plan C. Inviting the resident and family member to attend the care plan meetings D. Making a list of questions for the resident to ask at the care plan meeting E. Helping the resident to perform all activities of daily living (ADLs)

A. Acknowledging the impact of a traumatic amputation on therapy B. Encouraging the residents input on the care plan C. Inviting the resident and family member to attend the care plan meetings Making a list of questions for the resident and performing all ADLs does not promote positive attitude or allow patient to pose his or her own questions

A patient has been admitted to the post-anesthesia care unit after a trabeculectomy. What assessment takes priority? A. Airway B. Pain C. Eye patch D. Blood pressure

A. Airway Airway always comes first

The nurse is teaching a newly diagnosed diabetic patient about Metformin. What information does the nurse include? (SATA) A. Alcohol intake should be limited and taken with food B. Overweight patients sometimes poorly tolerate metformin C. Oral hypoglycemic agents can increase the risk of hyperglycemia D. Metformin has been the cause of anorexia in older patients E. Oral hypogylcemic agents affect vitamin D absorption

A. Alcohol intake should be limited and taken with food D. Metformin has been the cause of anorexia in older patients

The nurse directs an 80-year-old recovering from a fractured pelvis to participate in several isometric exercises to maintain muscle strength, such as: A. Alternately tightening and relaxing the abdominal muscles B. Lifting the body up off the bed using an overhead trapeze C. Pushing against the bed to lift the buttocks off the bed a few inches D. Pressing the sole of the foot against a footboard

A. Alternately tightening and relaxing the abdominal muscles Alternately tightening and relaxing muscles maintains strength in muscles, such as the abdominals, gluteal muscles, and quadriceps. Other options are isotonic exercises that involve joint movement.

The daughter of a dependent older patient reports to the nurse that the patient requires regular soapsud enemas to manage chronic constipation. The nurse responds that: A. An alternative management technique should be discussed B. Enemas are generally the most effective interventions for the older adult C. Chronic constipation is best managed with oral medications D. Her mother's diet is the most likely cause of the constipation

A. An alternative management technique should be discussed Soapsud enemas lead to mucosal irritation and should not be used. Alternative methods to managing constipation include dietary changes and medications when needed.

An older adult reports chronic constipation. When asked why this problem has gotten worse with age, the nurse responds: A. As we age, our bodies require more fiber to bring about healthy bowel function B. We need to discuss the proper use of laxatives to minimize constipation C. It's possible that you have lost the ability to feel when you need to move your bowels D. Aging brings about decreased gastric motility that often results in constipation

A. As we age, our bodies require more fiber to bring about healthy bowel function Most widespread cause of constipation in older adults is diet. Diets need to include 20 to 30 mg of fiber a day and plenty of water. Laxatives should only be used as a last resort.

An older adult has chronic fatigue from several illnesses. The patient is frustrated at this symptom. What action by the nurse is best? A. Ask the patient to prioritize activities B. Have the patient keep a fatigue diary C. Encourage the patient to rest in the day D. Instruct the patient on good sleep hygiene

A. Ask the patient to prioritize activities

A nurse is working with a patient who was diagnosed with type 2 diabetes 4 months ago. The patients blood sugars have stayed under control. What action by the nurse is best? A. Ask the patient what barriers to wellness still exist B. Remind the patient about the A1C in 2 months C. Review side effects of medications with the patient D. Ask the patient how she or he feels about diabetes

A. Ask the patient what barriers to wellness still exist

The nurse is preparing to provide an older, newly diagnosed diabetic patient with information regarding type 2 diabetes. The nurse initially: A. Asks if the patient prefers a video or a pamphlet B. Invites the patients spouse to be present during the instruction C. Selects a quiet, well-lighted space for the class D. Ensures that the patient is pain-free and comfortably seated

A. Asks if the patient prefers a video or a pamphlet Knowing the patients preferred learning style facilitates education

A patient with glaucoma is on timolol (Timoptic). The patient also takes metoprolol (Toprol) for hypertension. The patient reports to the clinic nurse that the eyedrops make me dizzy. What assessment by the nurse is most appropriate? A. Assess the patients eyedrop instillation technique B. Determine how long the patient has been on the drops C. Assess the patients gait and balance while walking D. Ask the patient if breakfast is eaten prior to applying the eyedrops

A. Assess the patients eyedrop instillation technique The patient should be using punctual occlusion (closing the lacrimal duct) when instilling these eyedrops to avoid a cumulative, systemic effect from the combination of both beta-blockers.

A patient had a chemical splash into the eye at work. What action by the occupational health nurse takes priority? A. Begin flushing the patients eyes with cool water B. Call emergency medical services C. Ask about the patients tetanus status D. Tape the eye closed to prevent injury

A. Begin flushing the patients eyes with cool water The nurse should begin flushing the eye immediately. While the eye is being irrigated, the nurse can call 9-1-1 and inquire about the patient's last tetanus shot. The eye should not be taped shut.

A patient in a nursing home is confused, nonverbal, but pleasant. The nurse notes the patient has suddenly become agitated and is screaming and scratching at the eyes. While the nurse is examining the patient, the patient vomits. What action by the nurse is best? A. Consult the provider about an ophthalmologic exam B. Sedate the patient so she won't injure herself C. Place mitts on the patient's hands to avoid scratches D. Give the patient a prn medication for pain

A. Consult the provider about an ophthalmologic exam Patient could be having an episode of acute angle closure glaucoma, manifested by severe pain, nausea and vomiting, and visual disturbances.

An older patient with presbycusis has been advised to purchase a hearing aid and asks about its function and use. Which information is most accurate to give the patient about the function of hearing aids? A. Hearing aids amplify sound but do not improve the ability to hear B. Hearing aids improve the ability to hear by intensifying the duration of sound waves C. Hearing aids control the input of sound waves to eliminate extraneous noise D. Hearing aids intensify sound waves and improve the ability to hear

A. Hearing aids amplify sound but do not improve the ability to hear

A 73-year-old patient has been diagnosed with congested heart failure (CHF). The nurse provides the greatest support for this patient's positive view of self-wellness by presenting information regarding: A. how to minimize the exacerbation of symptoms B. Locally available supportive services C. The importance of adherence to medical treatment D. The need to report symptoms promptly

A. How to minimize the exacerbation of symptom Many older adults now seek education about health promotion and management of their illness. The nurse can support older adults by teaching self-care management in these areas

A 66-year-old patient has been diagnosed with type 2 diabetes mellitus and related vision loss. Which statement demonstrates the ability to manage her condition? A. I schedule my yearly eye examination for the week of my birthday B. When I notice haloes around lights, I'll know I'm developing a problem with retinopathy C. My sister had diabetic retinopathy, and the vessels in her eyes were scarred D. I understand that the eye problems need to be diagnosed with an ophthalmoscopic exam

A. I schedule my yearly eye examination for the week of my birthday Patients with diabetes should have a yearly exam by an opthalmologist. Scheduling the exam for the week of her birthday will keep the patient from forgetting to do so.

The nurse explains that the focus of aerobic exercises such as walking and biking is to: A. Improve cardiovascular function B. Build muscle mass C. Improve dexterity D. Enhance balance

A. Improve cardiovascular function Aerobic exercises such as walking and biking are focused on improving cardiovascular function

The nurse feels most confident that an older patient is prepared to assume self-management of new type 2 insulin-dependent diabetes when the patient: A. Is heard asking her son to check the insulins expiration date B. Is able to identify the symptoms of hypoglycemia C. Asks why she needs to test her glucose levels so frequently D. Inquires why she needs to have an A1C test every 3 months

A. Is heard asking her son to check the insulins expiration date

An older patient has osteoporosis and is reluctant to exercise because I already have a bone problem, so how will it help? What response by the nurse is best? A. It can improve posture, balance, and reduce falls B. It will give you heart-healthy benefits C. Exercise will make you feel younger D. If you join a gym, you can socialize with new people

A. It can improve posture, balance, and reduce falls Exercise not only improves bone health but improves posture, balance, and reduces falls

An older patient with hepatitis has pruritus. What advise does the nurse provide this patient? A. Keep your fingernails cut short B. Use diphenhydramine (Benadryl) C. Hot soapy showers will help D. Butter is a good home remedy for itching

A. Keep your fingernails cut short Pruritus is intense itching. The patients nails should be kept short to avoid injury to the skin and possible infection. Diphenhydramine is not recommended in older patients Tepid (lukewarm) water with little soap is best

The nurse recognizes the cardinal sign of stress incontinence when the patient says: A. Lifting my grandchild makes me wet my pants B. I frequently wet myself because i just cant get to the bathroom in time C. My arthritis makes me so clumsy that I cant get my pants down in time D. Every time i have a urinary infection, I experience incontinence

A. Lifting my grandchild makes me wet my pants Stress incontinence occurs when intra-abdominal pressure increases and forces urine through a weakened urinary sphincter. Lifting, sneezing, coughing, and laughing can cause stress incontinence

An older patient is having a colostomy as part of surgery for colon cancer. What assessment by the nurse is most important in this patient? A. Manual dexterity B. Body image C. Fear of dying D. Fluid volume status

A. Manual dexterity Older adult with diminished manual dexterity may need assistance with ostomy care.

The home health nurse recognizes that the 75-year-old male patient has made an adjustment to reduced stamina when he: A. Moved his home office to a downstairs location B. Used public transportation rather than driving his own car C. Tilled the garden plot with a motor-driven tiller D. Went to a senior center twice in 1 week to play dominoes

A. Moved his home office to a downstairs location Moving the office to avoid climbing stairs is related to reduced stamina

An 80-year-old patient has nausea and vomiting related to a gastrointestinal disorder. The nursing intervention most likely to help the patient is to: A. Offer sips of soda every 15 minutes until more is tolerated B. Encourage the patient to lie in a prone position while nauseated C. Encourage the intake of high-calorie foods such as milkshakes D. Keep the patient on a nothing-by-mouth (NPO) order until the nausea subsides

A. Offer sips of soda every 15 minutes until more is tolerated Nursing interventions for nausea and vomiting include many self-help measures, including drinking clear liquids, progressing from eating bland foods to solid foods, and small frequent feedings. If vomiting occurs, fluid replacement should be a priority. Sips of fluids every 15 minutes until more can be tolerated may decrease episodes of dehydration. Patient should avoid non-clear liquids such as milkshakes

An older patient has been admitted to the nursing unit after a car crash and surgery. When does the nurse begin planning for rehabilitation? A. On admission B. When the patient is awake C. When the patient is stable D. When the family requests it

A. On admission Planning for rehabilitation, like discharge planning, begins on admission

A nurse is reviewing possible first-line medications for a new, older type 2 diabetic. What contraindication does the nurse identify for metformin (Glucophage)? A. Patient drinks 3 to 4 alcoholic drinks/day B. Patients parents both took insulin C. Creatinine 0.9 mg/dL D. Potassium 3.8 mEq/dL

A. Patient drinks 3 to 4 alcoholic drinks/day Patients with hepatic or renal dysfunction should not take metformin.

The skin care for an older adult with diarrhea should include _______ (SATA) A. Perineal care immediately after the diarrhea episode B. Application of lotion to the buttocks C. Maintenance of dry linens D. Patting the anal area dry rather than wiping E. Leaving excoriated areas open to the air

A. Perineal care immediately after the diarrhea episode C. Maintenance of dry linens D. Patting the anal area dry rather than wiping E. Leaving excoriated areas open to the air Lotion will not protect the skin from urine and stool. Barrier cream must be used.

A patient is admitted with infectious diarrhea. What action by the nurse is best? A. Place the patient in contact precautions B. Place the patient on droplet precautions C. Use standard precautions to care for the patient D. Prepare staff to take prophylactic antibiotics

A. Place the patient in contact precautions Contact precautions should not be used when caring for a patient with infectious diarrhea. The other options are not warranted.

The nurse assessing patients for diabetes looks for the classic signs, including which of the following? (SATA) A. Polyuria B. Polycythemia C. Polydipsia D. Polyphagia E. Polyandrony

A. Polyuria C. Polydipsia D. Polyphagia The classic signs of diabetes are polyuria, polydipsia, and polyphagia

A 96-year-old patient reports symptoms of xerostomia. The nurse attempts to minimize the effects of this condition by: A. Providing appropriate fluids with the patients meals B. Cutting the patients meat into small bite-sized pieces C. Elevating the head of the patients bed at mealtimes D. Assisting the patient with oral care before each meal

A. Providing appropriate fluids with the patients meals Xerstomia (dry mouth)

Persons with normal age-related sensory changes are likely to have the most difficulty distinguishing which of the following? A. Spoken pairs of phrases like shes praised and fees raised B. Orange towel hanging on a biege wall C. Go and to in lowercase letters in fine print D. Spoken word pairs like cupful and capful

A. Spoken pairs of phrases like shes praised and fees raised A person with presbycusis has trouble hearing the higher frequencies, where most of the differences between consonant sounds occur.

A patient has been admitted with new atrial fibrillation. What additional diagnostic testing does the nurse anticipate? A. Thyroid hormones B. Platelet count C. Urinalysis D. Blood glucose

A. Thyroid hormones Hyperthyroidism is often seen with atrial fibrillation.

When assessing the patient for urinary incontinence, which patient symptom best supports the nursing diagnosis of overflow incontinence? a.I have small accidents ever since I developed a cystocele. b.It burns so badly after I urinate that I hold it as long as I can. c.I cant make it to the toilet when I feel the need to urinate. d.I lose small amounts of urine when I sneeze or laugh hard.

ANS: A Typically, individuals with overflow incontinence complain of frequent losses of small volumes of urine, which are commonly a result of cystoceles. Burning indicates a urinary tract infection. Not making it to the bathroom is generally functional incontinence. Losing control of the bladder with sneezing or laughing is a manifestation of stress incontinence.

A patient asks how elevating the legs at night will decrease nocturia. What is the nurses best response? a.All that fluid gets into circulation before you go to bed. b.Decreased swelling makes it easier to ambulate at night. c.it wont help; thats an old wives tale you heard. d.This measure helps dehydrate you before bedtime.

ANS: A Elevating the legs returns dependent fluid into circulation so the kidneys can excrete it sooner. Without elevating the legs, that fluid movement does not happen until the patient goes to bed, contributing to nocturia. The other answers are incorrect.

An 87-year-old patient has suddenly become incontinent. What should the nurses first action be? a.Review the patients record for medications that may be causing urinary incontinence. b.Seek an order for an indwelling urinary catheter to prevent skin breakdown. c.Limit the patients fluid intake to reduce the feeling of having to void so often. d.Teach the patient to void every 2 hours when awake during the day or night.

ANS: A Medication is a common cause of incontinence and should always be suspected as a potential cause of new incontinence. A catheter is not needed. Limiting fluids leads to dehydration. Voiding every 2 hours at night will disrupt sleep.

A patient treats chronic kidney failure with peritoneal dialysis. The patient notes the fluid draining out of the abdomen is cloudy and foul smelling. What action by the nurse is best? a.Assess the patient for other signs of infection. b.Document the findings in the patients chart. c.Call the rapid response team immediately. d.Request a prescription for an antibiotic.

ANS: A One of the complications of peritoneal dialysis is infection in the peritoneal space, or peritonitis. The nurse should fully assess the patient for infection and notify the provider. Documentation should occur, but the nurse needs to take action first. The rapid response team is not needed. Antibiotics will probably be used to treat the infection.

A patient has a history of smoking and now has painless hematuria. After a workup, the patient is told the diagnosis of bladder cancer. What action by the nurse is most important? a.Allow the patient to verbalize feelings. b.Educate the patient on care of an ileal conduit. c.Teach the patient how to manage nausea. d.Offer a social work referral to complete a living will.

ANS: A The first intervention the nurse should provide is to be present for the patient and allow the expression of feelings. It is too early to teach, the patient may or may not have an ileal conduit, and the patient may not be ready to complete a living will or other advance directive.

A patient is scheduled to have surgery for prostate cancer in a few weeks. What action by the nurse is most important? a.Discuss options and their effect on sexuality. b.Ensure the patient has advance directives. c.Offer the patient a tour of the operating room. d.Determine if the patient prefers outpatient surgery.

ANS: A Treatment for prostate cancer can affect sexual functioning, so the nurse ensures the patient knows the risks and benefits of his choices. The other options are not necessary, although any patient with a serious illness should have advance directives.

A patient in a long-term care facility has incontinence. What assessment by the nurse is most important before designing interventions for this problem? a.Cognitive status b.Ambulatory status c.Cardiovascular status d.History of childbirth

ANS: A Treatment options differ between cognitively impaired and intact individuals. If the person is not intact, he or she has to rely on caregivers to maintain appropriate bladder function. The other assessments can be worked into the treatment plan.

A patient has a glomerular filtration rate (GFR) of 19 mL/min/1.73m2. What assessment findings correlate with this condition? (Select all that apply.) a.Fatigue b.Weakness c.Edema d.No specific symptoms e.Headaches

ANS: A, B, C This patient is in stage 4 of chronic kidney disease. Expected assessment findings include weakness, edema, fatigue, hypertension, heart failure, impaired cognition and immune function, dry skin and pruritus, anorexia, nausea, malnutrition, increased bleeding, anemia, peripheral neuropathy, and an overall decreased quality of life. In stages 1 and 2, patients are asymptomatic. Headache is not a finding.

A nurse is assessing an older patient for the possible cause of his acute urinary incontinence. Which actions by the nurse are most important? (Select all that apply.) a.Asking when his last normal bowel movement was b.Monitoring his intake and output c.Determining if he has been screened for prostatic hypertrophy d.Asking him if he awakens during the night to urinate e.Measuring his abdominal girth

ANS: A, C, D Constipation or fecal impaction as well as an enlarged prostate gland (causing frequent nighttime urination) are commonly overlooked causes of incontinence. Intake and output and abdominal girth are not related to possible causes of incontinence.

When preparing educational information regarding benign prostatic hyperplasia (BPH) for a group of older male patients, the nurse includes which of the following? (Select all that apply.) a.Eighty percent of males experience the symptoms by age 80. b.Diabetes mellitus is a risk factor. c.It is only as the prostate enlarges that symptoms occur. d.The resulting urinary retention can cause urinary tract infections. e.Symptoms are a result of urethral obstruction.

ANS: A, C, D, E Approximately 80% of men may be diagnosed with BPH by the age of 80. In early prostatic enlargement, the patient may be asymptomatic because the muscles may initially compensate for increased urethral resistance. As the prostate gland enlarges, the patient begins to manifest symptoms of an obstructive process. The symptoms may include hesitancy, a decrease in the force of the urinary stream, terminal dribbling, a sensation of a full bladder after voiding, and urinary retention. Urethral obstruction may cause urinary stasis, UTIs, hydronephrosis, and renal calculi. Diabetes is not a risk factor.

An older adult patient is hospitalized for after an automobile crash. The nurse recognizes symptoms suggestive of an upper urinary tract (UTI) infection when the patient: a.voids 100 mL of urine over a 3-hour period of time. b.is not able to state where he is or what day it is. c.has an elevated red blood cell (RBC) count. d.reports burning when he urinates.

ANS: B For many older adults, the presentation of a UTI is confusion or another change in mental status. Burning on urination would signify a lower urinary tract infection. The other two assessments are unrelated.

What information does the nurse share with the student about normal age-related changes in the kidneys? a.Renal mass increases. b.The glomerular filtration rate decreases. c.Poor renal function occurs after age 65. d.There are no real age-related changes.

ANS: B Older adults have a decreased glomerular filtration rate, decreased renal mass, but renal function can remain good up to the ninth decade.

A patient being treated for prostate cancer calls the clinic to report severe back pain. What action by the nurse is best? a.Advise the patient to take his pain medication. b.Tell the patient to come in to the clinic today. c.Make an appointment for the patient next week. d.Encourage the patient to rest and use moist heat.

ANS: B Prostate cancer can metastasize to the bones including the spine. If this happens, spinal cord compression can occur. The patient is advised to come into the clinic today for evaluation. The other options are not appropriate.

The nurse working in the gerontology clinic understands which facts related to incontinence? (Select all that apply.) a.It is a normal age-related change. b.It is an independent predictor of nursing home admission. c.It contributes to falls and injuries. d.It can disrupt sleep. e.It can lead to urinary tract infections.

ANS: B, C, D, E Urinary incontinence is not a normal age-related development, although people commonly believe this is true. The other statements are correct.

A male patient has benign prostatic enlargement. He is at risk for what type of acute kidney injury? a.Prerenal b.Intrarenal c.Postrenal d.Combined form

ANS: C BPH would place this patient at risk for postrenal failure. Prerenal failure is often the result of decreased cardiac output or acute fluid volume loss. Intrarenal failure consists of damage to the actual nephrocytes.

When caring for older adults, the nurse expects to encounter the normal urinary age-related outcome of: a.urinary incontinence. b.low-grade bladder infection. c.nocturia. d.urinary residual volume.

ANS: C With age, increased urine formation at night leads to nocturia. The other findings are not age-related changes.

An older adult patients urinary incontinence is being addressed by prompted voiding. The nurse instructs all ancillary staff to do which of the following? (Select all that apply.) a.Provide only minimal fluids after 7 PM. b.Keep the patient on the toilet until voiding occurs. c.Allow the patient to void at times other than those scheduled. d.Offer toileting during the night only when the patient is awake. e.Encourage the patient to toilet himself.

ANS: C, D The goal is to increase a patients awareness of the need to void and, it is hoped, to increase the frequency of self-initiated toileting. Patients are approached on a regular schedule, asked if they are wet or dry, and then prompted to toilet. A patient should never be forced to toilet or reprimanded for failing to toilet appropriately. Self-initiated toileting should not be discouraged. To relieve the stress that can occur because of sleep disruption for both caregiver and patient, toileting protocols can be modified during the nighttime hours.

An older adult woman has a resistant strain of pneumonia. To best minimize her risk of developing acute renal failure, the nurse: a.monitors the patients serum blood urea nitrogen (BUN) levels via diagnostic laboratory work. b.helps the patient select low-sodium foods from her daily menu. c.measures and records the patients urinary output. d.chooses an analgesic other than ibuprofen (Motrin).

ANS: D Patients with pneumonia often have mild to moderate pain. Nonsteroidal antiinflammatory drug (NSAIDs) are common analgesics; however, they can cause acute kidney injury. Using another class of drug for pain relief will help protect the patients kidneys. The patient may be at risk of acute kidney injury because of dehydration or the nephrotoxic effects of certain antibiotics.

The nurse is admitting an older patient with benign prostate hyperplasia (BPH). The nurses priority questioning focuses on: a.family history of prostate disorders. b.onset of symptoms. c.psychosocial impact of the diagnosis. d.typical urinary voiding patterns.

ANS: D The purpose of the nursing assessment for an individual with BPH is to determine the extent of prostate enlargement and its effect on function so that appropriate nursing interventions can be planned and implemented. The primary assessment focuses on the patients current voiding patterns.

An older cognitively impaired adult patient is being discharged to a daughters home. The nurse knows continued success of the patients bladder training for urinary incontinence primarily rests on the: a.patients ability to follow instructions. b.severity of the impairment of the urinary sphincter. c.patients ability to sense the need to urinate. d.daughters ability to support the training.

ANS: D Treating urinary incontinence in individuals with cognitive impairment requires the use of other behavioral techniques that depend on the caregiver rather than the patient. The success of the techniques in large part depends on the availability and motivation of the caregiver. The other actions are not as important for the cognitively impaired persons success.

Which population groups are most at risk for developing macular degeneration? (SATA) A. African american B. Asian american C. Caucasian D. Hispanic

B, C B. Asian american C. Caucasian Individuals who are Caucasian or Asian American are most at risk for developing macular degeneration than are African Americans or Hispanics

The nurse lists factors that the patient should consider when planning an exercise program, which are _________ (SATA) A. Purchasing weights B. Wearing clothing appropriate to the type of exercise C. Considering membership in a health club D. Establishing realistic goals E. Committing time for consistent regular exercise

B, C, D, E B. Wearing clothing appropriate to the type of exercise C. Considering membership in a health club D. Establishing realistic goals E. Committing time for consistent regular exercise

A 70-year-old patient has lost 25 pounds since being diagnosed with hepatitis A. To best manage the patient's anorexia, what does the nurse suggest? (Select all that apply) A. A protein powder supplement added to liquids B. Several meals eaten during the day C. Megavitamins that include iron and folic acid D. A dietary assessment to identify favorite foods E. A high-carbohydrate, low-fat diet

B, E B. Several meals eaten during the day E. A high-carbohydrate, low-fat diet Several small feedings throughout the day will help alleviate the effect of anorexia. A patient with hepatitis best tolerates a high-carbohydrate, low-fat diet.

Which of the following interventions should the nurse use when communicating with a hearing impaired older patient A. Stand besides the patients chair when speaking B. Always clearly identify yourself and others with you c. Exaggerate your voice, depending on the cause of the hearing loss D. Select colors for paint, furniture, and pictures with rich intensity

B. Always clearly identify yourself and others with you Always speak promptly, and clearly identify yourself and others who are with you. State when you are leaving to ensure that the person is aware of your departure. Get down to persons level, and face him or her when speaking. Speak normally but not from a distance; do not raise or lower your voice, and continue to use gestures if doing so is natural.

The nurse recognizes that an older adult on both antihypertensive and antidepressant drug therapies has a specific need for: A. Regular blood pressure monitoring B. An effective history focusing on sexual function C. An increase in daily fluid intake D. Frequent assessment of emotional stability

B. An effective history focusing on sexual function Drugs such as oral contraceptives, hormone replacement, antihypertensives, antidepressants, or sedatives can cause a sexual arousal disorder as a side effect

An older man who has tinnitus complains to the nurse that it is very annoying. Which should the nurse implement to alleviate the stress he is experiencing from tinnitus? A. Irrigate the bilateral eustachian tubes B. Assess for modifiable risk factors C. Propose a hearing aid and a masker D. Use white noise to override the tinnitus.

B. Assess for modifiable risk factors -Smoking cigarettes -Consuming caffeine -Drinking alcohol -Experiencing fatigue -Taking medications that carry a high risk

When working with older adults with chronic illness and exacerbations, what action by the nurse is most appropriate? A. Continually assess the patients for adherence to the regime B. Assess the patients for ways they can remain in control C. Teach the patients about the illness trajectory D. Routinely review all medications the patients are taking

B. Assess the patients for ways they can remain in control

Because isometric and isotonic exercises can cause the patient to perform an accidental Valsalva maneuver, the nurse coaches the patient to: A. Hold the breath during an exercise cycle B. Breathe through the mouth C. Breathe deeply and rhythmically during an exercise cycle D. Breathe in through the nose and out through the mouth

B. Breathe through the mouth Breathing through the mouth makes it impossible to hold the breath, and bearing down cannot be performed. Valsalva manuever increases BP and may cause cardiac overload

The most detrimental illness or condition that an older adult with deafness that occurred at birth can experience is which one of the following? A. Aphasia B. Cataracts C. Glaucoma D. Osteoarthritis

B. Cataracts Cataracts can have a potentially devastating impact on the life of an individual with prelingual deafness because sign language is the primary source for communication.

A patient has pernicious anemia. What action by the patient and family indicates teaching for this condition has been effective? A. Proper administration of oral vitamin B12 B. Correct technique for intramuscular (IM) injections C. Choosing aspirin over ibuprofen (Motrin) for pain D. Preparing a low-carbohydrate meal

B. Correct technique for intramuscular (IM) injections Pernicious anemia is typically treated with IM injections of Vitamin B12. Oral preparations are not absorbed in the gastrointestinal tract. Aspirin or ibuprofen are not related, nor is a low carbohydrate diet.

An older adults chart documents that she has been diagnosed with macular disequilibrium. Based on an understanding of this condition and the resulting vertigo, the nurse suggests that the patient: A. Turn her head very slowly when looking from right to left B. Dangle her legs at the bedside before getting out of bed C. Use the wall for stabilization when ambulating in the hallway D. Be careful to be seated when flexing or hyperextending her neck

B. Dangle her legs at the bedside before getting out of bed Macular disequilibrium is vertigo precipitated by a change of head position in relation to the direction of gravitational force (severe dizziness when rising from bed). Dangling at the bedside and changing positions slowly will decrease the chance of injury.

The nurse recognizes a need to make a focused bowel assessment when the 80-year-old resident complains of: A. The inability to have a bowel movement every day B. Feeling pressure and fullness in the rectum but is unable to defecate C. Having had one loose stool after breakfast D. Ingestion and flatulence

B. Feeling pressure and fullness in the rectum but is unable to defecate Feelings of pressure and fullness without being able to defecate may indicate a fecal impaction or rectal cancer. One loose stool does not represent diarrhea.

A patient has type 2 diabetes. The family reports the patient has become very forgetful. What response by the nurse is best? A. We should assess her for Alzheimer disease B. Forgetfulness is a common sign in diabetes C. Have her blood sugars been under good control? D. Does she recognize you and know your names?

B. Forgetfulness is a common sign in diabetes Many diabetics report depression and memory problems, so the nurse explains this fact. Forgetfulness does not necessarily indicate dementia. Asking about blood glucose is appropriate, but not related. Not recognizing family is not the same as forgetfulness

A nurse is assessing quality of life (QOL) in older individuals with chronic illnesses who attend a community center. What information is most important to assess? A. How many days were lost to exacerbations in the last year B. How good each individual perceives his or her QOL to be C. how burdensome the patients treatment regime is daily D. How often the patient needs to see a health care provider

B. How good each individual perceives his or her QOL to be QOL is individualized for each patient, and each person is the only one who can rate his or her QOL.

To assist an 85-year-old older adult with weak abdominal muscles to defecate, the nurse would: A. Encourage the use of a bedpan before getting up in the morning B. Place a footstool under the feet of the patient when seated on the toilet C. Insert a finger in the patients rectum to stimulate the urge to defecate D. Instruct the patient to do isometric exercises to strengthen the abdominal muscles

B. Place a footstool under the feet of the patient when seated on the toilet Placement of a stool under the patients feet increases intra-abdominal pressure and encourages bearing down (Valsalva manuever) to accomplish defecation

A nurse assesses a newly admitted patient to a nursing home using the Functional Independence Measure (FIM) and rates the patient at 20. What action by the nurse is best? A. Arrange admission to a rehabilitation center B. Plan care for a nearly dependent person C. Plan care for a nearly independent person D. Tells the family the patient is cognitively impaired

B. Plan care for a nearly dependent person 18 Measures are accounted for in the FIM with scores ranging from 1 (dependent) to 7 /(independen). A score of 20 indicates near total dependence

The care plan that is custodial in its focus is characterized by: A. Attention to high-level wellness B. Plans for physiologic and safety concerns C. Aggressive rehabilitation goals D. Patient participation in his or her own care

B. Plans for physiologic and safety concerns Low expectations and little focus for improvement, a rather negative outlook, represent the character of the custodial care plan. The goals will be those of physiologic care and safety

To encourage a normal daily bowel movement, the nurse can aid the older adult by: A. Decreasing fluid intake B. Providing a warm beverage at breakfast C. Medicating with a mild laxative at bedtime D. Providing a warm shower each morning

B. Providing a warm beverage at breakfast Warm beverages at breakfast frequently stimulate the urge to defecate

Aware that older adult patients often present with nonclassic symptoms of type 2 diabetes mellitus, the nurse is particularly suspicious of a patient reporting: A. Bouts of diarrhea alternating with periods of constipation B. Recent problems reading and an infected sore on the toe that will not heal C. Periods of depression and severe indigestion after eating D. Dizziness when getting up too quickly and a red rash on the hands

B. Recent problems reading and an infected sore on the toe that will not heal Often a newly diagnosed older individual will describe symptoms of fatigue, blurred vision, weight change (Gain or loss), and infections

An older adult patient reports burning and itching eyes. On assessment, the nurse notes swelling of the eyelid margins bilaterally. What additional data are necessary to confirm the nurses suspicion of blepharitis? A. The patient reports visual disturbances such as rainbow halos B. The eyelids are reddened from seborrhea C. The patient is being treated with anticoagulants D. Small corneal hemorrhages are present

B. The eyelids are reddened from seborrhea Blepharitis is a chronic inflammation of the eyelid margins that is commonly found in older adults. It can be caused by seborrheic dermatitis or infection. The symptoms include red, swollen eyelids, matting and crusting along the base of the eyelash at the margins, small ulcerations along the lid margins, and complaints of irritation, itching, burning, tearing, and photophobia

A 68-year-old patient is reporting symptoms that suggest a peptic ulcer. The nurse asks the patient if: A. The pain exacerbates when he eats fatty food B. There is a family history of peptic ulcers C. He smokes either cigars or cigarettes D. He uses acetaminophen (Tylenol) for minor pain

B. There is a family history of peptic ulcers Both genetic and environmental factors have been proposed as the cause of peptic ulcers because both gastric ulcers and duodenal ulcers tend to occur in families.

An older adult patient reports ringing in the ears. What additional data should the nurse gather to help determine the cause of the patients problem? A. History of ear surgery B. Use of prescription medications C. Exercise and sleep patterns D. Nutritional status, especially protein intake

B. Use of prescription medications Tinnitus can be a result of damage to inner structures caused by the toxic effect of certain drugs. The other assessment findings are not as important for this problem

The nurse is teaching older adults about maintaining health and wellness. Which recommendation should the nurse include in the teaching to maintain optimal vision? A. Take 50,000 units of vitamin A daily B. Wear sunglasses that block sun rays C. Read in good light to avoid eye strain D. Visit the ophthalmologist every 5 years

B. Wear sunglasses that block sun rays

The nurse recognized which of the following as symptoms of wet age-related macular degeneration (AMD)? (SATA) A. Rarely causes severe visual impairment B. Yellow deposits under the retina C. Decrease in central vision D. Visual distortion

C, D C. Decrease in central vision D. Visual distortion Patients suffering from wet AMD experience a decrease in central vision and visual distortion. Wet AMD leads to blindness. With distortion, edges or lines become wavy. Dry AMD rarely causes severe visual impairment, and yellow deposits under retina are a classic sign

The home health nurse instructs the 75-year-old woman that daily exercise of a minimum of ________ minutes daily is a beneficial as a longer period of extreme exercise on an irregular basis A. 15 B. 20 C. 30 D. 45

C. 30 Moderate exercise for a period of 30 minutes daily is enough to keep joints mobile and maintain strength

What assessment findings support an older patients diagnosis of hypothyroidism? A. A 2-cm wound noted on medial aspect of left foot B. An apical rate: 98/min C. A patient report that I always wear a sweater D. A weight loss of 10 pounds over 6 weeks

C. A patient report that I always wear a sweater Older patients are seen with complaints of fatigue, cold intolerance, weight gain, muscle cramps, paresthesias, and confusion.

The nurse would be especially observant for the indication of constipation in the patient who is taking: A. Antibiotics for an upper respiratory infection B. Hormones for postmenopausal symptoms C. Iron supplements for anemia D. Non-steroidal inhalants for chronic obstructive pulmonary disease (COPD)

C. Iron supplements for anemia Iron supplements increase the risk of constipation

Which documentation demonstrates that the nurse effectively assessed an older adult diabetic patients cardiac status? A. Radial pulse: 88 and regular B. Carotid pulses equal and strong C. BP 126/78 recumbent and 122/78 sitting D. Nail beds pale in color

C. BP 126/78 recumbent and 122/78 sitting To assess circulation, take apical pulse, noting rate and rhythm; check pedal pulses bilaterally; and note the presence of hair on the lower extremities. Take BP measurements with patient in recumbent and sitting positions, note any dizziness associated with change of position, and assess the respiratory rate, depth, and chest sounds

An older patient has been admitted with nausea and vomiting. What assessment takes priority? A. respiratory system B. Urine output C. Blood pressure and pulse D. Skin integrity

C. Blood pressure and pulse Concern in this older patient is dehydration, so assessment of cardiovascular status comes first. Urine output reflects cardiac output but it does not reflect as up-to-date information as do vital signs.

The fiercely independent 90 year old woman who is recovering from a stroke frequently ambulates without the use of her walker because she says it is ugly and cumbersome. The nurses most effective intervention would be to: A. Allow her to ambulate independently B. Place a gait belt around her and ambulate when she does C. Bring her walker to her and remind her that the walker is for her safety D. Instruct her to use a wheelchair for mobility

C. Bring her walker to her and remind her that the walker is for her safety

A home health care nurse is conducting a functional assessment on an older woman who lives alone. What assessment question is likely to get the best information? A. How do you manage all your medications? B. Who shops and cleans your house for you? C. Can you show me how you prepare a meal? D. What parts of your body cant you wash?

C. Can you show me how you prepare a meal?

Balance training will help the older adult recovering from a prolonged period of immobility related to a broken hip to: A. Increase peripheral circulation B. Increase strength C. Decrease the incidence of falls D. Eliminate the need for ambulatory assistive devices

C. Decrease the incidence of falls

A patient had cataract surgery without a lens implant. What teaching point is most important? A. Keep your follow-up appointment with the surgeon B. Instill your eyedrops just like we have practiced C. Do not drive and be careful going up or down stairs D. Take acetaminophen (Tylenol) for pain

C. Do not drive and be careful going up or down stairs If cataract surgery was performed without a lens implant, the patient will wear glasses or contact lenses but will have a decrease in depth perception.

Which of the following is used to treat the most common cause of impairment to an older persons hearing? A. Hearing aids B. Cochlear implants C. Ear canal irrigation D. Sign language

C. Ear canal irrigation Most common cause impairing the hearing of older persons is cerumen impaction

The nurse plans to help reduce episodes of bowel incontinence by a proactive program of: A. Encouraging intake of foods that cause mild constipation B. Using appropriate disposable garments, pads, and bed covering C. Establishing a toileting schedule D. Coaching the patient in Kegel exercises

C. Establishing a toileting schedule Establishing a toileting schedule that follows the preincontinent state can train the patients bowel and caregivers so that incontinence is reduced

The nurse plans the care of an older female resident of a nursing home who has experienced a sudden deterioration in visual acuity. Which intervention should the nurse complete first? A. Prevent behavioral and social decline B. Tell her to hold onto the rails during ambulation C. Examine her mood and functional status D. Use problem solving involving the resident

C. Examine her mood and functional status Most important intervention for the nurse to compelte first is to assess the impact of the visual impairment on the residents quality of life, mood, and functional ability

Your 88-year-old patient is hospitalized for a retinal detachment. He is on bed rest, and both eyes are covered with patches. Which nursing diagnosis takes priority at this time? A. Self-esteem disturbance related to decreased independence B. High risk for altered thought processes related to visual impairment C. High risk for injury related to altered sensory perception D. Impaired social interaction related to visual deficit

C. High risk for injury related to altered sensory perception

An older patient has developed moderate muscle weakness on the left side as a result of cerebral vascular accident (CVA, stroke). The nurse determines the patient possesses the healthiest view of self-wellness when heard stating: A. Ill certainly miss hiking, but I guess I'll find something else to do outdoors B. I was getting too old to safely practice karate C. I've decided to take up oil painting because its difficult for me to knit D. It was getting difficult to work int he garden anyway

C. I've decided to take up oil painting because its difficult for me to knit

A patient has Menire disease. What statement by the patient indicates a good ability to manage the condition? A. Because its from dehydration, I can increase salt in my food B. There are no medications, so I just have to learn to live with it C. If I get dizzy I should lie down immediately and hold my head still D. Because I have asthma, I cannot take any medications for Mnire disease

C. If I get dizzy I should lie down immediately and hold my head still If the patient gets dizzy, he or she should lie down and hold the head still. A low-salt diet may help with fluid retention in the ear. There are several medications for Menire disease, but because of the anticholinergic properties of some of them, people with asthma, glaucoma, or BPH should be monitored closely

The nurse recognizes a need for instruction about prevention of constipation when the patient says: A. I eat bran flakes or oatmeal every day to add bulk to my diet B. Since I started eating three servings of fruit a day, i havent been constipated C. Im never constipated. I take a gentle laxative every night D. My daily walks have kept my bowels working regularly

C. Im never constipated. I take a gentle laxative every night Long-term laxative use may cause the body to become so dependent on laxatives that the patient is unable to have a normal elimination pattern without medication

To best assist an older adult patient to cope with a new diagnosis of chronic renal failure, the nurse: A. Asks the patient to describe her usual coping strategies B. Provides the patient with descriptions of new coping strategies C. Initiates discussions with the patient to explain the disease D. Offers to arrange a meeting with another patient with the diagnosis

C. Initiates discussions with the patient to explain the disease

A 77-year-old patient who is quiet and withdrawn may have a hearing deficit related to impacted cerumen. During the nursing assessment, the nurse confirms supporting evidence of the condition when nothing: A. Frothy drainage from the patients ears B. Patient reports of dizziness C. Patient reports of a feeling of fullness in the ears D. Gray, metallic-appearing tympanic membrane

C. Patient reports of a feeling of fullness in the ears Patients with cerumen buildup may complain of ear fullness, itching, and difficulty hearing. The patient will not have frothy drainage, dizziness, or metallic-appearing tympanic membrane from cerumen

The nurse tells the older adult that a food with the double action of providing fiber and being a natural laxative is: A. Oatmeal B. Pineapple C. Prunes D. Raw apple

C. Prunes Although all the options add fiber and bulk to the diet, only prunes provide a laxative effect

The nurse explains that the urge to defecate (defecation reflex) can be destroyed by: A. Frequent episodes of diarrhea B. Long-term use of vitamin A and Vitamin B complex C. Repeatedly ignoring the urge D. Excessive fiber and bulk in diet

C. Repeatedly ignoring the urge Ignoring the urge to defecate repeatedly suppresses the urge and may destroy it completely

When the older adult confides to the home health nurse that he wants to build muscle mass so that he can look good at the apartment pool, the nurse recommends ______ exercise A. aerobic B. Stretching C. Resistance D. Tai chai

C. Resistance Resistance exercises using weights, elastic bands, and exercise balls can build muscle mass

A nurse is preparing to administer metoprolol (Toprol) to an older male patient. What action by the nurse is best regarding endocrine disorders? A. Administer the medication as ordered B. Check the patients ID using two sources C. Say, Many men experience ED with this drug D. Tell the patient to discuss the side effects with his provider

C. Say, Many men experience ED with this drug

An older adult patient has recently diagnosed gastritis. What statement made by this patient indicates the need for further teaching? A. The abdominal pain is caused by acidity B. I should avoid taking aspirin C. Smoking has little effect on my stomach problem D. I could develop pernicious anemia

C. Smoking has little effect on my stomach problem Acute gastritis causes transient inflammation, hemorrhages, and erosion into the gastric mucosal lining. Frequently associated with alcoholism, aspirin, or NSAID ingestion, smoking, and severely stressful conditions such as burns, trauma, CNS damage, chemotherapy, and radiotherapy.

The nurse takes into consideration that the arthritic patient may be less likely to exercise because: A. Fragility of the bones puts the patient at risk for fractures B. Numbness in the feet and legs puts the patient at risk for a fall C. Stiffened ligaments and tendons put the patient at risk for reduced flexibility D. Moving heavy edematous limbs puts the patient at risk for fatigue

C. Stiffened ligaments and tendons put the patient at risk for reduced flexibility Arthritis limits joint movement; in turn, this reduces tendon and ligament flexibility, making them stiff and limiting mobility

The home health nurse suggests that the patient perform a frequent series of Kegel exercises to reduce incontinence by: A. Increasing the tone of the bladder B. Reducing urinary retention C. Strengthening the urinary sphincter D. Sensitizing biofeedback

C. Strengthening the urinary sphincter Helps strengthen the pelvic floor and help hold back the flow of urine

When the 65-year-old patient who is a type 1 diabetic informs the home health nurse that he now exercises for 1 hour a day at a club, the nurse cautions him to be sure to: A. Drink plenty of fluids B. Wearing clothing that allows ventilation C. Take hard candy to the gym when he exercises D. Give himself less insulin than is prescribed

C. Take hard candy to the gym when he exercises Exercise lowers the blood sugar level. A type 1 diabetic could become hypoglycemic and need a ready source of glucose, such as in hard candy

The nurse cancels the outing to the park for a group of older adults in a long-term care facility on a(n): A. 75 degree sunny day in Texas B. A 70 degree cloudy day in Oregon C. 80 degree sunny day in Florida D. 75 degree ozone alert day in California

D. 75 degree ozone alert day in California Ozone alerts are given to warn of excessive air pollution and to limit exposure to the outside environment

An older patient had a stroke several months ago. The patient begins to exhibit dysphagia. What action by the nurse is best? A. Consult with a speech-language therapist B. Discuss the need for enteral feedings C. Provide the patient swallowing exercises D. Arrange for a physical exam

D. Arrange for a physical exam This patient has started exhibiting difficulty swallowing months after a stroke, so the stroke is probably not the cause. Difficulty swallowing is a sign of esophageal cancer, however, so nurse should arrange for patient to have physical exam.

The nurse is caring for an older patient who recently immigrated to the US from Asia. To best address the patient's apparent resistance to the medical and nursing plan of care, the nurse: A. Discusses the patients behavior with Asian staff members B. Researches the patient's cultural views on health care C. Requests a cultural consultation from social services D. Asks family members to discuss the patient's views on health care

D. Asks family members to discuss the patient's views on health care

The nurse uses special caution when performing a rectal digital examination on a patient with: A. Chronic obstructive pulmonary disease (COPD) B. Diabetes C. Parkinson disease D. Congestive heart failure

D. Congestive heart failure Persons with a cardiac history may experience vagal stimulation and have a sudden drop in heart rate, resulting in syncope

A 74-year-old adult is experiencing dumping syndrome after gastric resection surgery. The nurse caring for the patient instructs the patient to: A. Stop smoking B. Abstain from beverages that contain caffeine C. Eat three low-carbohydrate meals daily D. Drink only between meals

D. Drink only between meals The institution of small, frequent meals that are low in carbohydrates will diminish the incidence of these symptoms. Resting after eating and drinking fluids between (rather than during) meals will also help alleviate symptoms. Smoking and caffeine are not related, and eating only three meals a day is not warranted

The nurse assesses constipation in the patient who passes: A. Firm stool without difficulty every 3 days B. Hard stool without difficulty every 2 days C. Soft brown stool with difficulty every 2 days D. Hard dry stool with difficulty every 3 days

D. Hard dry stool with difficulty every 3 days Constipation is defined as a hard, dry stool that is difficult to pass

The nurse is preparing an older widowed patient with several chronic illnesses for discharge to home. The nurse addresses the primary nursing outcome for this patient when: A. Assuring the patient that social services will arrange for help with medical expenses B. Arranging for in-home assistance in areas of activities of daily living (ADLs) and nursing care as needed C. Educating the patient regarding the safety risks caused by these conditions D. Identifying barriers to ensure adherence to the prescribed drug therapies

D. Identifying barriers to ensure adherence to the prescribed drug therapies

When the patient tells the home health nurse that he has begun to take psyllium (Metamucil), the nurse cautions him that to avoid fecal impaction with this drug, he should: A. Eat several servings of fresh fruit and vegetables a day B. Avoid citrus fruit juices C. Reduce intake of carbonated drinks D. Increase his fluid intake to 3000 mL a day

D. Increase his fluid intake to 3000 mL a day Increased fluid intake is essential to dissolve the fiber in this drug completely; otherwise, fecal impaction can occur

Which of the following diseases affects the eyesight of an older adult by damaging the central part of the retina? A. Glaucoma B. Presbyopia C. Cataract D. Macular degeneration

D. Macular degeneration Macular degeneration is a disease characterized by damage to the central part of the retina that leaves the outer edges of the visual field intact. Presbyopia = a gradual decline in the flexibility of the lens, makes close-up focusing more difficult and is a common age-related change but not a disease Glaucoma = disease marked by increased pressure within the eye that potentially leads to optic nerve damage (most common cause of blindness in those 65 years + ) A cataract is a disease marked by clouding and blurring of the lens

The nurse recognizes the patient who is exhibiting signs of diarrhea and will need enhanced skin care precautions as the patient who has: A. One unformed stool after a bolus of tube feeding B. An unformed stool followed by a formed stool 3 hours later C. Cramping and nausea followed by an unformed stool D. No abdominal discomfort but has had three unformed stools in 8 hours

D. No abdominal discomfort but has had three unformed stools in 8 hours Frequent passage of unformed stool with or without other symptoms should call for a heightened level of skin care

The older woman who has diminished dexterity would find the activity of ______ the most frustrating and difficult A. Working a crossword puzzle B. Playing a round of golf C. Playing the piano D. Painting with watercolors

D. Painting with watercolors Fine motor skills are lost, which make painting with watercolors very difficult for a person with diminished dexterity

A patient is admitted with copious diarrhea. The patient is dizzy when standing, and skin assessment reveals abrasions around the perianal area. What assessment finding demonstrates that goals for the priority nursing diagnosis have been met? A. Perianal skin abrasions are smaller in size B. Patient does not fall while hospitalized C. Patient sits up without dizziness D. Patient is able to tolerate oral fluids

D. Patient is able to tolerate oral fluids The priority diagnosis for this patient is decreased cardiac output or fluid volume deficit, either of which is evaluated with the lack of dizziness. Falling indicates dehydration or weakness, both brought about by the cardiac output situation. Skin integrity is important but not the priority. Being able to tolerate fluids indicates treatment is going well. However, the priority diagnosis relates to cardiac output and fluid volume

An older adult complains about experiencing dry eyes daily. Which of the following should the nurse assess to help determine the cause of the patients complaint? A. Vitamin B deficiency B. Use of humidifier at home C. History of diabetes mellitus D. Prescription antihistamine use

D. Prescription antihistamine use Medications can cause dry eye, especially antihistamines, diuretics, beta-blockers, and some sleeping pills. Humidifier should help with dry eyes

The nurse caring for an older adult with type 2 diabetes mellitus places importance on assessing the patient for: A. Painful nodules on the fingers and toes B. Reddened rash and brittle nails on the hands C. Heartburn and flatus after meals D. Skin temperature and hair growth pattern on the legs

D. Skin temperature and hair growth pattern on the legs Insulin resistance causes increased production of inflammatory cytokines correlating with the development of type 2 diabetes mellitus and atherosclerotic vascular disease

The preferred way for the nurse to communicate with a 72-year-old hearing impaired patient is to: A. Speak loudly into the patients unaffected ear B. Exaggerate the form of each word C. Provide all communication in written form D. Speak clearly and directly, facing the person

D. Speak clearly and directly, facing the person Interventions for the patient with a hearing impairment focus on aural rehabilitation and facilitation of communication. Patients should be spoken to using a clear voice and face to face, which gives the patient an unobstructed view of the speakers face and lips. The other techniques are not as helpful.

The nurse suggests to the 70-year-old woman who has painful arthritic joints that a beneficial exercise for her because of disability would be: A. Training with hand weights B. Walking on a treadmill C. Low-impact aerobics D. Swimming

D. Swimming Swimming is a pleasurable aerobic exercise for many seniors, and water excerises can help individuals with sore joints because the water provides support and eases movement

An older patient is being taught about oral gingivitis. The nurse has included instruction about maintaining an oral hygiene program, signs and symptoms of oral infection, and the importance of maintaining regular professional dental care. What important teaching has been missed? A. Information about when to have teeth removed and dentures made B. The necessity of using a hard-bristled toothbrush to maintain cleanliness C. The importance of avoiding meat and caffeine-containing products D. The importance of adequate nutrition for maintaining oral health

D. The importance of adequate nutrition for maintaining oral health Nursing management of an older patient with gingivitis or periodontitis includes promotion of regular oral hygiene, regular preventive dental care, and maintenance of nutritional status.

Which assessment findings support the suspicion that an older patient has osteoporosis? A. The patients reports an allergy to dairy products B. A lactase enzyme is a part of the patients drug regime C. Bones in one of the patients lower legs are shorter than in the other D. The patient is inch shorter than at his or her previous physical

D. The patient is inch shorter than at his or her previous physical Dorsal kyphosis, chronic back pain, and loss of height are common signs of primary osteoporosis in older persons.

The nurse caring for an older adult diagnosed with hyperplastic polyps instructs him that: A. This type of polyp is rarely malignant and usually does not require treatment B. Follow-up colonoscopies should be performed every 3 to 4 years after diagnosis C. Stool should be guaiac tested every week for 1 year after diagnosis D. The presence of blood in the stool requires a repeat sigmoidoscopy examination

D. The presence of blood in the stool requires a repeat sigmoidoscopy examination this type of polyp is rarely cancerous and rarely causes symptoms; however, they occasionally bleed, leaving bright red blood in the stool. A colonoscopy every 3 to 4 years is not indicated nor is testing the stool for blood for 1 year

An older adult patient reports episodes of fecal incontinence. The nurse provides appropriate emotional support when assuring the patient that: A. It is a common problem that occurs in response to normal aging B. The incontinence is rarely a result of a serious problem C. Disposable absorbent underwear will help manage the problem D. The problem generally responds well to bowel control programs

D. The problem generally responds well to bowel control programs Reassure older patients that control and retraining are achievable because many older adults believe that fecal incontinence is the first step on the road to permanent institutionalization. It is not a normal response to aging.

A medical illustration shows a man with the blunt end of a tuning fork pressed to the center of his forehead. The man is being tested for which of the following? A. Sensorineural hearing loss B. Presbycusis C. Tinnitus D. Unilateral conductive hearing loss

D. Unilateral conductive hearing loss Webers test, in which a vibrating tuning fork is placed on the center of the forehead, detects the differences in hearing between one ear and the other caused by poor sound conduction. Patient is asked to describe the sensation felt when the tuning fork is activated and then placed on the forehead. -If hearing is intact, then he or she will feel vibrations conducted through the bones of the skull from the tuning fork -Used to detect conductive hearing loss

An alert, independent, 89-year-old male resident with congestive heart failure has been on Lasix for a week. Over the past 2 days he has been frequently incontinent and does not make it to the bathroom in time. His urine is now dark amber with a strong ammonia smell. He tells the nurse that he is having spasms in his lower abdomen. The nursing diagnosis that most applies to this resident is: A. Impaired urinary elimination B. Functional urinary incontinence C. Stress urinary incontinence D. Urge urinary incontinence

D. Urge urinary incontinence Urge urinary incontinence occurs with the physiologic changes of aging. The use of diuretics, increased bladder stimulation from urinary tract infections, and involuntary bladder spasms cause the older adult to have a feeling of urgency and result in incontinence

What dietary suggestion does the nurse give the older patient to manage age-related changes in taste? A. Add more salt to foods B. Use a salt substitute C. Add sugar when possible D. Use a variety of herbs

D. Use a variety of herbs Older adults experience a decrease in taste discrimination. Various herbs can be used to spice up foods. More salt should not be added, as older adults generally should eat low-salt diets. Salt substitutes often contain potassium, a problem for older adults who have an age-related decrease in kidney function and the ability to excrete potassium.

The nurse teaching a 79-year-old with type 2 diabetes about the importance of regular exercise suggests that the patient: A. Swim 10 laps in the community center pool 3x a week B. Enroll in a daily lunch time aerobics class at the senior center C. Lift 5 pound weights in a routine of 10 repetitions in each arm D. Walk on the treadmill each morning for 30 minutes

D. Walk on the treadmill each morning for 30 minutes Greatest benefit from morning exercise because that is the time of greatest insulin resistance

The morning of her scheduled cataract extraction and intraocular lens placement of the right eye, an older adult patient expresses concern that she will not remember her instructions for home care. Which statement is the best response to the patients concern? A. Is your family going to be here while you're in surgery? B. Are you anxious about the surgery? C. I'll reinforce the important points D. We will provide you with written instructions

D. We will provide you with written instructions