Exam 3 Practice Questions: GERO

A nurse is making a home visit to a client who has AD. The client's partner states that the client is often disoriented to time and place, is unsteady, and has a history of wandering. Which of the following safety measures should the nurse review with the partner? (Select all that apply) a. remove floor rugs b. have door locks that can be easily opened c. provide increased lighting in stairwells d. install handrails in the bathroom e. place the mattress on the floor

a. remove floor rugs c. provide increased lighting in stairwells d. install handrails in the bathroom e. place the mattress on the floor

A nurse is providing care for a client who had a vertebroplasty of the thoracic spine. Which of the following actions should the nurse take? a. apply heat to the puncture site b. place the client in the supine position c. turn the client very 1 hr d. ambulate the client within the first hour of the procedure

b. place the client in the supine position

A nurse is providing information to a client who has osteoarthritis of the hip and knee. Which of the following information should the nurse include in the information? (Select all that apply) a. apply heat to joints to alleviate pain b. ice inflamed joints for 30 min following activity c. reduce the amount of exercise performed on days with increased pain d. prop the knees with a pillow while in bed e. active range of motion is more effective than passive range of motion

a. apply heat to joints to alleviate pain c. reduce the amount of exercise performed on days with increased pain e. active range of motion is more effective than passive range of motion -limit ice to 20 mins to prevent injury -avoid propping up knees because it keeps them in a flexed position

A nurse is providing dietary teaching about calcium-rich foods to a client who has osteoporosis. Which of the following foods should the nurse include in the instructions? a. white bread b. kale c. apples d. brown rice

b. kale *green leafy vegetables

Which of the following characteristics of RA are unlike those of OA? a. Myalgia and stiffness c. Crepitus and instability b. Joint pain that is curable d. Systemic and symmetrical

d. Systemic and symmetrical

At 10 PM, an older male resident attempts to climb over the bedrails. Which intervention should the nurse implement first? a. Talk to the resident about his behavior. b. Call the physician, and ask for a sedative. c. Apply a vest restraint on the resident. d. Get a companion to keep him in the bed.

a. Talk to the resident about his behavior. *least restrictive intervention first

An older adult comes to the clinic accompanied by his daughter who reports he is having a sudden decrease in cognitive function. Which of the following could be causes for this event? (Select all that apply.) a. Urinary tract infection b. Eye infection c. Change of residence d. Muscle atrophy

a. Urinary tract infection b. Eye infection c. Change of residence

A nurse is caring for a client who has Alzheimer's disease. A family member asks the nurse about risk factors for the disease. Which of the following should be included in the nurse's response? (Select all that apply) a. exposure to metal waste products b. long-term estrogen therapy c. sustained used of Vit E d. previous head injury e. history of herpes infection

a. exposure to metal waste products d. previous head injury e. history of herpes infection

The classic signs of OA include (Select all that apply.) a. palpable crepitus. b. joint pain and stiffness. c. generalized fatigue and malaise. d. activity leading to pain, which is relieved by rest. e. stiffening lasting more than 20 to 30 minutes after rest.

a. palpable crepitus. b. joint pain and stiffness. d. activity leading to pain, which is relieved by rest. *Incorrect answers: c. generalized fatigue and malaise. (RA) e. stiffening lasting more than 20 to 30 minutes after rest. (RA)

A terminally ill patient asks the nurse what hospice care entails. How should the nurse answer? "Hospice care: a. provides holistic care aimed at promoting comfort." b. must be provided in the home by a family member." c. works best for those who need help with pain management." d. focuses on treating the disease process as quickly as possible."

a. provides holistic care aimed at promoting comfort."

A nurse working in an outpatient clinic is assessing a client who has RA. The client reports increased joint tenderness and swelling. Which of the following findings should the nurse expect? (Select all that apply) a. recent influenza b. decreased ROM c. hypersalivation d. increased BP e. pain at rest

a. recent influenza b. decreased ROM e. pain at rest -recent illness can be an exacerbating factor -clients have xerostomia, not hypersalivation

Which of the following is a true statement about joints in older adults? a. Osteoarthritis is an inflammatory joint disorder. b. Surgical joint replacement can cure osteoarthritis. c. Joint damage in osteoarthritis is reversed with medication. d. Very old patients should avoid joint replacement surgery.

b. Surgical joint replacement can cure osteoarthritis. (only cure for disease) -OA is a degenerative joint disease, whereas rheumatoid arthritis (RA) is an inflammatory process. -Medications are used to control the pain of OA. The joint damage cannot be reversed except through joint replacement surgery. -Surgical joint replacements are recommended even for those who are very old.

Which of the following statements is true about conservators? a. A conservatorship entails control over property, whereas a guardianship entails control over the person. b. The most legally restricting way individuals and property can be handled are through conservatorships and guardianships. c. Conservators cannot be members of the conservatee's (patient's) family. d. Because a conservatorship is the least restrictive alternative, a court hearing is not required.

b. The most legally restricting way individuals and property can be handled are through conservatorships and guardianships. Guardian = responsible for another person in all aspects of life Conservator = control of finances/ property/ assets *requires to be appointed by courts

Which of the following statements is true about end-of-life care? a. The physician is the ultimate authority in the decision to use or not to use life-sustaining medical treatment. b. The proxy appointed in a living will cannot speak for the testator in health care matters other than terminal illness. c. A patient with dementia cannot be capable of making personal wishes known about life-sustaining treatment. d. The American Nurses Association encourages nurses to participate in assisted suicide.

b. The proxy appointed in a living will cannot speak for the testator in health care matters other than terminal illness. ?? According to the Patient Self-Determination Act, the adult patient has the ultimate authority to accept or forgo treatment. By contrast, the health care advocate designated by a durable power of attorney for health care can speak for the patient in other health care matters.

A nurse is admitting an adult client who has suspected osteoporosis. Which of the following findings are risk factors for osteoporosis? (Select all that apply) a. history of consuming one glass of wine daily b. loss in height of 2 in (5.1 cm) c. BMI of 18 d. kyphotic curve at upper thoracic spine e. history of lactose intolerance

b. loss in height of 2 in (5.1 cm) c. BMI of 18 d. kyphotic curve at upper thoracic spine e. history of lactose intolerance -if consuming more than 3 glasses of alcohol daily, that is a risk factor -low BMI indicates low bone mass

A nurse is caring for a client who has AD and falls frequently. Which of the following actions should the nurse take first to keep the client safe? a. keep the call light near the client b. place the client in a room close to the nurses's station c. encourage the client to ask for assistance d. remind the client to walk with someone for support

b. place the client in a room close to the nurses's station *priority action = all the rest of actions, client may forget to do since they have AD (even use call light)

The nurse prepares an older man who has OA for discharge. Which instruction does the nurse include in patient teaching to maintain safety for this man? a. Take ibuprofen (Motrin) rather than opioid analgesics. b. Increase rest periods to slow disease progression. c. Report joint instability to the health care provider. d. Avoid stretching the affected joint during exercise.

c. Report joint instability to the health care provider. -NSAIDs poor analgesic choices for older adults -increased rest leads to stiffness -stretching helps maintain joint flexibility and ROM

The community health nurse is preparing for an educational session on AD for a group of seniors. Which modifiable risk factors should the nurse include? (Select all that apply.) a. Family history b. Sex c. Smoking d. Obesity

c. Smoking d. Obesity *modifiable risk factors -Increasing evidence strongly points to the potential risk roles of vascular risk factors (VRFs) and disorders (e.g., midlife obesity, dyslipidemia, hypertension, cigarette smoking, obstructive sleep apnea, diabetes, cerebrovascular lesions) and the potential protective roles of psychosocial factors (e.g., higher education, regular exercise, healthy diet, intellectually challenging leisure activities, socially active and integrated lifestyle) in the pathogenesis and clinical manifestations of dementia (especially AD and vascular cognitive impairment).

A nurse is about to perform postmortem care of a client. The family wishes to view the body. Which of the following actions should the nurse take? (Select all that apply) a. remove the dentures from the body b. make sure the body is lying completely flat c. apply fresh linens and place a clean gown on the body d. remove all equipment from the bedside e. dim the lights in the room

c. apply fresh linens and place a clean gown on the body d. remove all equipment from the bedside e. dim the lights in the room -don't lie body completely flat, prop head on pillow to prevent discoloration of face -dim lights to create calm environment for family

The gerontological nurse determines that teaching an older adult about a diet for osteoporosis has been successful when the older adult selects which of the following meals as having the highest amount of calcium? A. Ham and Swiss cheese sandwich on whole wheat bread, steamed broccoli, and an apple. B. Sardine (three ounces) sandwich on whole wheat bread, one cup of fruit yogurt, and one cup of skim milk. C. Chicken stir-fry with 1 cup each of bok choy, onions, and snap peas, and one cup of steamed rice. D. Two-egg omelet with two ounces of American cheese, one slice of whole-wheat toast, and one-half grapefruit.

B. Sardine (three ounces) sandwich on whole wheat bread, one cup of fruit yogurt, and one cup of skim milk. *two dairy products, bread, and sardines (all high in calcium)

The husband is visiting his wife who is in a subacute care facility undergoing rehabilitation for physical weakness resulting from a stroke. The gerontological nurse finds the man lying in bed with his wife, caressing her. The gerontological nurse considers the developmental needs of the older adult by: A. Telling the husband that his behavior could upset or harm his wife. B. Asking the husband to leave because his behavior is not acceptable. C. Closing the door and ensuring that the couple is not disturbed for as long as possible. D. Informing the client and her husband that behavior appropriate in the home is not appropriate in a health care facility

C. Closing the door and ensuring that the couple is not disturbed for as long as possible.

A nurse is consoling the partner of a client who just died after a long battle with liver cancer. The grieving partner states, "I hate them for leaving me". Which of the following statements should the nurse make to facilitate mourning? (Select all that apply) a. "Would you like me to contact the chaplain to come and speak with you?" b. "You will feel better soon. You have been expecting this for awhile" c. "Let's talk about your children and how they are going to react" d. "You know, it is quite normal to feel anger toward your loved one at this time" e. "Tell me more about how you are feeling"

a. "Would you like me to contact the chaplain to come and speak with you?" d. "You know, it is quite normal to feel anger toward your loved one at this time" e. "Tell me more about how you are feeling" -don't change the subject to talk about children

A nurse is teaching a client who has a new diagnosis of RA. Which of the following statements should the nurse include in the teaching? a. "You can experience morning stiffness when you get out of bed" b. "You can experience abdominal pain" c. "You can experience weight gain" d. "You can experience low blood sugar"

a. "You can experience morning stiffness when you get out of bed"

A nurse is performing health screenings at a health fair. Which of the following clients have a risk factor for osteoporosis? (Select all that apply) a. 40 yo client who has been taking prednisone for 4 months b. 30 yo client who jogs 3 miles daily c. 45 yo client who takes phenytoin for seizures d. 65 yo client with a sedentary lifestyle e. 70 yo client who has smoked for 50 years

a. 40 yo client who has been taking prednisone for 4 months c. 45 yo client who takes phenytoin for seizures d. 65 yo client with a sedentary lifestyle e. 70 yo client who has smoked for 50 years *both steroids and phenytoin are medications that increase risk for osteoporosis

While awaiting the imminent death of her sister, an older woman makes arrangements to bury her sister in the survivor's home state because she cannot reach the other family members. Which step should the nurse implement? a. Ask questions, including questions about the location of her sister's family. b. Instruct this woman that this is not her decision to make. c. Try to contact the family to inform them of the decision. d. Question her about holding behaviors that she will want.

a. Ask questions, including questions about the location of her sister's family. -In a countercoping intervention, the nurse assists the older adult to cope with the loss by collecting information and encouraging her to avoid acting on impulse. The older adult can arrive at a hasty decision when not effectively coping with grief; therefore the nurse acts to help restore some control for the bereaved and helps avoid a decision that might be regretted later.

Which medication administered for delirium under a controlled environment can reduce the duration and severity of delirium for high-risk patients? a. Haloperidol (Haldol) c. Fluphenazine (Prolixin) b. Thioridazine (Mellaril) d. Chlorpromazine (Thorazine)

a. Haloperidol (Haldol) Haloperidol administered in low doses can help reduce the severity and duration of delirium for high-risk patients after hip surgery; however, haloperidol therapy does not reduce the incidence of delirium in this group. In addition, atypical antipsychotic medications can al

The older adult wants to appoint an attorney-in-fact with DPA for a specific period around a forthcoming surgery. Which should the nurse implement? a. Help the patient find a qualified attorney. b. Explain the legal rights and responsibilities of an attorney-in-fact with a DPA. c. Suggest using a guardian for the surgical period. d. Offer to act as the patient's guardian during surgery.

a. Help the patient find a qualified attorney. The nurse provides safe, effective, and comprehensive care but should not provide legal advice to an older adult; rather, the nurse should refer the patient to experts in the law and can assist the older adult with finding a suitable attorney.

Which disease has become known as the "great imitator?" a. Human immunodeficiency virus (HIV) b. Acquired immunodeficiency syndrome (AIDS) c. Alzheimer disease d. Schizophrenia

a. Human immunodeficiency virus (HIV) -The compromised immune system of an older individual makes him or her more susceptible to HIV or AIDS than a younger person. AIDS in older adults has been called the "great imitator"; many of the symptoms, such as fatigue, weakness, weight loss, and anorexia, are common to other disease conditions and may be attributed to normal aging.

The nurse working in a long-term care facility completes her morning assessment on a new postoperative patient and notes a change in cognitive status from the previous day? The nurse recognizes which of the following as a precipitating factor for delirium? (Select all that apply.) a. Major medical treatment b. Poor sleep habits c. Admission to long-term care d. Pharmacological agents

a. Major medical treatment c. Admission to long-term care d. Pharmacological agents *also changes in surroundings. -poor sleep habits not a contributing factor in of itself

Which is a healthy practice recommended for a person at risk for OA? a. Milk and orange juice at breakfast; cheese pizza at lunch; spaghetti served with spinach covered with melted cheese for dinner; and ice cream for dessert b. Long-term estrogen administration as adjunct therapy c. Alendronate (Fosamax) taken with a snack just before bedtime d. Coffee, raisin bran and milk, and sausage at breakfast; a can of cola and a hot dog on a high-fiber bun at lunch; cocktails before dinner; steak with brown rice, celery, and red wine for dinner

a. Milk and orange juice at breakfast; cheese pizza at lunch; spaghetti served with spinach covered with melted cheese for dinner; and ice cream for dessert *lots of calcium! -Alendronate (Fosamax) must be taken with a full glass of water on an empty stomach after awakening. -Alcohol and high amounts of protein and salt inhibit calcium uptake, whereas caffeine, excess fiber, and phosphorus (in the cola) promote calcium excretion.

Which assessment is typical for a patient with OA? a. Narrow joint spaces with crepitus b. Effects in symmetrical joints c. Morning stiffness for at least an hour d. Swelling from excess synovial fluid

a. Narrow joint spaces with crepitus -symmetrical joints, swelling = RA -morning stiffness of 1 hour or more = polymyaligia rheumatica

Which assessment parameter should the nurse use to differentiate between delirium and depression in an older adult? a. Orientation c. Course over the morning hours b. Activity d. Psychomotor activity

a. Orientation -in delirium, orientation is usually impaired, and in depression, orientation is normal.

An older woman has a wound infection 5 days after a below-the-knee amputation brought about by diabetes mellitus. Which of the following is the nurse's priority intervention to prevent cognitive dysfunction and postoperative complications in this older adult? a. Remove invasive devices as soon as possible. b. Minimize the administration of opioid analgesics. c. Allow for self-care and independent activities. d. Administer short-acting benzodiazepines as needed.

a. Remove invasive devices as soon as possible. *To help prevent cognitive dysfunction, postoperative complications, and an increased risk of morbidity and mortality, the nurse recognizes that the risk factors this older adult has for delirium include stressors, infection, and surgery; therefore to prevent cognitive decline and additional postoperative complications, the nurse promptly removes invasive devices such as intravenous infusions, urinary catheters, and wound drains. Removing these devices not only reduces the risk of infection, thromboembolic events, blood loss, injury, and fluid imbalance, but they also serve to promote mobility, promote a sense of control for the patient, and reduce the types of situations that can frighten the patient or that the patient can misinterpret.

Which of the following are risk factors for the development of osteoporosis? (Select all that apply.) a. Smoking b. Being obese c. Advancing age d. Sedentary lifestyle e. High alcohol consumption

a. Smoking c. Advancing age d. Sedentary lifestyle e. High alcohol consumption

When differentiating the characteristics of depression, delirium, and dementia, the nurse recognized which of the following as an indicator of delirium? a. Sudden onset c. Insidious b. Recent loss d. Life change

a. Sudden onset

Which of the following approaches to bathing is beneficial for a patient with dementia? a. Wash the patient's hair first. b, Bathe the legs before the arms and trunk. c. Ask the patient when the best time is to bathe. d. Use a team approach so that bathing is done quickly.

b, Bathe the legs before the arms and trunk. -Begin bathing the least sensitive area first: the legs and feet followed by the arms and trunk. Washing the hair is last or done separately. Tell the person it is time to get freshened up; do not ask, "Do you want a bath?" because the answer may be no.

A nurse working in a gerontology clinic sees older adult women on a long-term basis. An assessment finding that alerts the nurse to the presence of osteoporosis in a client is: a. The presence of bowed legs b. A measurable loss of height c. The development of unstable, wide gait ambulation d. A poor appetite and aversion to dairy products

b. A measurable loss of height *red flag for development of osteoporosis- 3 inches or more

Which of the following should the nurse use to assess a nonverbal older adult for delirium? a. Cranial nerves XI and XII b. Confusion Assessment Method c. MMSE-2 d. Controlled Word Association Test

b. Confusion Assessment Method

An older patient who has end-stage pulmonary disease decides to accept care from the palliative care nurse. This older adult will most likely benefit from the palliative care nurse in which patient needs of Weisman's six needs for the dying? a. Closure b. Control c. Composure d. Cohesiveness

b. Control -The dying patient is most likely to benefit from the care of the palliative care nurse by affording the patient as much control as possible, providing effective nursing care for symptom control and by providing continuity of care as the palliative care team directs total patient care. In providing control, the nurse asks the patient to determine activities and how time is spent.

A patient loses her husband because of a sudden myocardial infarction, and she blames herself for not recognizing the warning signs. Which patient outcome associated with her loss should the nurse use to plan care? a. Meets her daily responsibilities b. Expresses feelings of guilt, fear, anger, or sadness c. Assesses the causes of the dysfunctional grieving processes d. Identifies problems connected to anticipatory grief

b. Expresses feelings of guilt, fear, anger, or sadness -The nurse plans care that will help this patient resolve her grief and will work to accomplish this by determining a suitable patient outcome—the ability of the patient to express feelings of guilt, fear, anger, or sadness within 3 months. Being able to express herself in this manner is part of the work of grief.

Which is the fundamental difference between Medicare Part A and Medicare Part B? a. Hospice care b. Health care setting c. Home care services d. Invasive procedures

b. Health care setting Part A covers acute, inpatient care and some specialized care. Part B covers some costs of outpatient and ambulatory services.

An older woman is recovering from a bowel resection in the intensive care unit but remains intubated and on a mechanical ventilator. Which of the following should the nurse implement to help prevent delirium in this woman? a. Assess cognition with MMSE-2. b. Provide uninterrupted periods of rest and sleep. c. Maintain adequate sedation and pain management. d. Cover the patient's eyes with protective ophthalmic ointment.

b. Provide uninterrupted periods of rest and sleep. *Providing uninterrupted periods of rest and sleep is a challenge for the nurse in intensive care. Because of the nature of the patients' illnesses, nurses administer medications and treatments and perform invasive procedures on a 24-hour basis, leaving patients little time for rest. Many patients become delirious in the intensive care unit because the noise, activity, brightness, and disturbance tend to persist around the clock, which contribute to delirium.

The spouse of an older adult with a terminal illness tells the nurse that the couple has sold a number of their belongings and moved into a retirement facility. What description of grief best describes this situation? a. Acute b. Shadow c. Anticipatory d. Disenfranchised

c. Anticipatory -The nurse observes this grief in preparation for potential loss, such as selling of a home and belongings and moving in anticipation of the loss of a spouse.

An older man is being abused by his daughter, a single working mother of four children, with whom he lives. The nurse investigates and learns that the abuse is due to situational stress. Which of the following interventions should the nurse implement to address the short-term crisis? a. Immediately remove him from his daughter's home. b. Encourage the daughter to work with social services. c. Arrange respite care or day care for the patient. d. Place the patient in a long-term care facility.

c. Arrange respite care or day care for the patient. -By relieving the daughter of some responsibilities, respite care is likely to be beneficial for the older adult and his daughter; it can help reduce tension. -Unlike children, abused older adults cannot be removed from their situations without their permission. Helping the daughter manage the situational stress would be more effective.

Which of the following statements is true about RA? a. Strikes unilaterally. b. Affects more men than women. c. Can affect body systems other than the joints. d. Glucosamine can be helpful for patients in the first 2 years of RA.

c. Can affect body systems other than the joints. -Women are affected more often than men. -RA strikes the same parts of the body on both sides and affects joints in a symmetrical pattern.

A definitive diagnosis of Alzheimer disease (AD) can be made by detecting or using which one of the following methods? a. Clinical observation of dementia b. Inability to speak with relevance c. Development of neurofibrillary tangles d. Computed axial tomographic (CAT) scan

c. Development of neurofibrillary tangles -inability to speak w/ relevance = dementia (would have to rule out other cases of dementia) -CAT scan helpful for stroke

The community health nurse delivers a program to middle-aged adults about retirement planning and wants to them to choose the year of their retirement. Which is the most important area on which the participants should focus to ease the transition to retirement? a. Kind of legacy they want to leave behind b. Type of setting for their personal residence c. Location of convenient health care services d. Ability to maintain a stable standard of living

d. Ability to maintain a stable standard of living

After the older adult dies, the brother who has a history of alcohol abuse upsets the family by going on a drinking binge instead of attending the funeral. Which of the following is the best description of the brother's behavior? a. Personality disorder b. Disrespectful attitude c. Disenfranchised grief d. Chronic grief

c. Disenfranchised grief -When a family is in discord, a grieving member can be unable to or consider him or herself permitted to express grief by socially acceptable means. The brother's behavior is most likely a grief reaction, although it could be indicative of a personality disorder. The brother can feel that the most respectful thing he can do for the family members is to stay out of their way. The brother has suffered an acute loss.

The son of an older adult couple ends his life suddenly and violently. The husband proceeds with living as usual. After 1 year, the wife remains in seclusion and is hospitalized for dehydration. Which steps should the nurse implement to help improve the wife's mental health and wellness? a. Encourage additional fluids and social activity. b. Instruct the husband to display empathy for her. c. Establish a trusting, caring relationship with her. d. Ask social services for a survivor's support group.

c. Establish a trusting, caring relationship with her. *first step to determine her needs (likely experiencing chronic grief)

The nurse recognizes which of the following displays may indicate hyperactive delirium? a. Lethargy b. Withdrawn behavior c. Nonpurposeful repetitive movements d. Decreased psychoactive activity

c. Nonpurposeful repetitive movements Lethargy and withdrawn behavior = hypoactive delirium

Which of the following is a true statement about osteoporosis? a. Osteoporosis is indicative of an underlying health problem. b. The most common site for osteoporosis fractures is in long bones. c. African-American women have the highest risk for osteoporosis. d. A high risk of death follows an osteoporosis-related fracture.

d. A high risk of death follows an osteoporosis-related fracture. -One-third of all persons who have an osteoporosis-related fracture die within 1 year. -The risk of osteoporosis is much lower for African-American women than it is for those of other races.

The wife of an older man who has diabetes mellitus brings him to primary care. He has severe bilateral infections forming black rings around each ankle. He tells the nurse it is caused by tight shoes. Which intervention should the nurse implement first to investigate this individual's health care regimen? a. Examine his health insurance coverage. b. Question the man without the wife present. c. Consult with social services about neglect. d. Analyze his glycosylated hemoglobin level.

d. Analyze his glycosylated hemoglobin level. *Priority framework: assess potential immediate physiological needs first, then assess potential of neglect

A health care provider asks the nurse about an older man's durable power of attorney (DPA) because consent is needed for a medically necessary invasive procedure. The patient has end-stage disease, is intubated, and is on mechanical ventilation. Which steps should the nurse implement? a. Refer to the patient's advance directive for a name. b. Assist with obtaining informed consent from the patient. c. Use the oral trail-making test to measure cognitive function. d. Apply the Confusion Assessment Method for critical care.

d. Apply the Confusion Assessment Method for critical care. The health care provider assumes the intubated older adult lacks the cognitive skill to give consent for treatment. Before the search begins for the DPA and to help determine the patient's cognitive status, the nurse assesses the patient for delirium using the Confusion Assessment Method for the intensive care unit. As the patient's advocate, the nurse implements this valid and reliable tool because the nurse wants to give the patient every opportunity to participate in the plan of care and make his own determinations.

Which of the following approaches to hygienic care is beneficial for a patient with dementia? a. Schedule the patient's full shower at 7 AM, three mornings every week. b. Have a team give the bath with each member washing a different body area. c. Wash the perineal region first to remove potentially infectious material. d. Explain each step as you go, and keep the patient covered as much as possible while bathing.

d. Explain each step as you go, and keep the patient covered as much as possible while bathing.

Which is the most important element for older adults to have for enhancing the transition into retirement? a. Good health c. 401k retirement plan b. Private pension d. Preretirement planning

d. Preretirement planning (good health would be nice, but planning more important)

Which of the following statements is true about loss in older adulthood? a. A person experiences each stage of grief once, and then grieving is resolved. b. Antianxiety agents are frequently recommended for reducing the pain of grief. c. The loss response model is concerned with the effect of loss on an individual. d. Referring to the deceased in the past tense can acknowledge the death's reality.

d. Referring to the deceased in the past tense can acknowledge the death's reality. The widow may say, for example, that her husband "just loved to garden" rather than "just loves to garden."

After living with OA for 2 years, an older woman's bone density scan shows no improvement, despite consistent bisphosphonate therapy. Which intervention should the nurse implement to reduce bone loss for this older adult? a. Add tai chi or yoga exercises. b. Instruct her to drink fortified milk. c. Increase weight-bearing exercises. d. Review her daily nutritional habits.

d. Review her daily nutritional habits. *assess first, then recommend Reviewing the older adult's nutritional habits can reveal clues about potential dietary contributors to bone loss from excessive sodium, alcohol, caffeine, or carbonated beverage intake. In addition, the nurse also confirms that the patient avoids smoking and a sedentary lifestyle that contribute to bone loss.

Managed care systems are most effective for an older adult who does which of the following? a. Avoids using the system until it is really needed in an emergency. b. Avoids seeing generalists and seeks health care only from specialists. c. Uses high-tech treatments to reduce expenses over the long term. d. Seeks regular primary care and preventive strategies to maintain health.

d. Seeks regular primary care and preventive strategies to maintain health.

The actions of the family members of an older adult who just died are chaotic, and they are unable to decide on a funeral home. Which recommendation should the nurse implement? a. Help them make a list of the problems. b. Provide a list of preferred funeral homes. c. Allow them privacy to work it out alone. d. Suggest they call someone who can help.

d. Suggest they call someone who can help. -To facilitate the family with decision making, the nurse asks one family member to consider calling another person who will likely help the family face the reality of the death.

Which of the following interventions is recommended for an older adult in the final stages of dying? a. Apply an electric blanket to keep the patient warm. b. Lower the head of the bed, and turn the head to the side. c. Decrease the number of visitors. d. Support the preservation of energy.

d. Support the preservation of energy. -Conserving energy should be a focus in the care of a patient in the final stage of dying. Completing only the necessary activities of daily living (ADLs) would be an example.

Which of the following statements is true about cognitive impairments in older adults? a. Loss or interruption of sleep can lead to delirium. b. Confusion is a normal and unavoidable consequence of aging. c. Older patients who are agitated often have a lower cognitive status than those who are quietly sitting. d. The Mini-Mental State Examination-2nd edition (MMSE-2) should be administered on admission to detect delirium.

d. The Mini-Mental State Examination-2nd edition (MMSE-2) should be administered on admission to detect delirium. *The loss or interruption of sleep, in of itself, does not often lead to delirium. It can potentiate delirium in the presence of other factors.

A nurse is caring for a client who has a terminal illness. Death is expected within 24 hours. The client's family is at the bedside and asks the nurse what to expect at this time. Which of the following findings should the nurse include? a. regular breathing patterns b. warm extremities c. increased urine output d. decreased muscle tone

d. decreased muscle tone