Geriatric EXAM 2
An older adult reflects, "Why should I go to the gym, I'm going to get fat anyway." Which response by the nurse is most appropriate?
"Age-related changes are inevitable; however, most problems affecting older adults are related to risk factors, so it's important to do what you can to maintain a high level of functioning."
An older adult expresses frustration about limitations of aging. Which of the following statements by the nurse promotes wellness?
"Do you have some words of wisdom to share about that valuable experience?"
A group of nurses is involved in the planning and implementation of a health promotion campaign aimed at older adults. Which of the following questions is the best guide to such a campaign?
"How can we help older adults maintain wellness as they age?"
A nurse teaches an older adult client about the use of the telehealth equipment to monitor congestive heart failure. Which of the following statements by the client shows understanding?
"I need to step on this scale and use this automatic cuff each day."
A nurse speaks at a staff development in-service. Which of the following statements by a nurse participant shows the need for education?
"It's inaccurate to link the prevalence of particular diseases with particular minority groups."?????
A 93-year-old asks the nurse, "I sure would like to live to get that 100 year birthday card from the president." Which of the following responses by the nurse is best?
"Keeping fit and dealing with stress in a positive way helps your chances of living to be 100."
A client in the skilled nursing facility refuses rehabilitation services 5 out of 7 days. An administrator tells the client that they will be transferred to the intermediate care unit. The client states, "Medicare is paying my bill; you can't transfer me." Which of the following is the best response by the nurse administrator?
"Medicare will only pay as long as you continue to make progress toward your goals."
A nurse assesses an older adult's abstract thinking ability. Which of the following questions is most appropriate?
"What do a dog and a cat have in common?"
An older adult is brought to the community clinic by an adult child with the concern of increasingly frequent lapses in memory. Which assessment question is most likely to identify potential risk factors for impaired cognitive functioning?
"What medications are you currently taking?"
A nurse performs a psychosocial assessment on an older adult in the hospital. Which of the following statements may suggest low self-esteem?
"When I was younger, I worked around the clock and now I can't even make it to the toilet."
A nurse assesses an older adult's insight regarding the care plan. What question may the nurse ask to gauge the client's insight?
"Why do you think that your doctor admitted you to the hospital?"
An 82-year-old client is getting advice from a family member on how to drive safely. What piece of advice should the older adult follow?
"You can consider timing your medications to avoid their interfering with safe driving."
An 81-year-old adult suffered an ischemic stroke 6 days ago. The client has failed to regain consciousness since the event. The care team has approached the client's family to obtain their views on inserting a feeding tube. Which of the following documents will allow the family to make a decision on the parent's behalf?
A durable power of attorney for health care
A nurse who provides care to many older adults recognizes the importance of implementing a wellness approach to care. What principle underlies this approach to the health care of older adults?
A holistic approach to caring for older adults can foster their well-being at every stage of life.
A nurse assesses a 66-year-old woman who strained a muscle. The client attends the gym daily, and states, "I injured my muscle grouting the floor tile getting ready for the bridge class I teach." Which of the following categorizes this client's aging?
Active
A gerontological nurse is aware that quality of life is an important consideration when assessing the functioning of older adults. What measure should the nurse use when appraising older adults' quality of life?
Active life expectancy
A nurse in the long-term care facility plans care to improve quality of life. Which of the following actions is most likely to enhance the older adult's connectedness?
Advocating for a husband and wife to remain in the same room of a long-term care facility, as is their preference
An older adult has recently begun to display unprecedented lapses in short-term memory. The nurse overhears a colleague reassuring the person by saying, "Try not to worry; it's just a part of growing older." The nurse recognizes that this is an example of what phenomenon?
Age attribution??????
A nurse is teaching a colleague about the difference between age-related changes and risk factors. Which of the following examples should the nurse use when discussing age-related changes?
An older adult with decreased bowel motility
A nurse addresses the social supports available for an older adult client. Which of the following should the nurse include in the plan?
Ask the client direct questions about the barriers to the use of social supports.
A nurse assesses an 82-year-old client who has a history of coronary artery bypass surgery and heart failure. In the interview, the family expresses concern because the client's "ability to figure out what is going on" has deteriorated. However, the client remains wise and continues to give solid life advice. Which theory explains this phenomenon?
Cognitive abilities may be impaired by the client's cardiovascular disease.
A nurse is leading a word-quiz game with a group of nursing home residents because the nurse knows this activity will assist the residents in maintaining:
Crystallized intelligence
An older woman of Filipino heritage has been having rectal bleeding for several months. Her physician has told the woman and her daughters that she has advanced colon cancer. Her daughters want to obtain hospice services but the client is reluctant and does not want to discuss what she feels is "beyond her control." Which of the following concerns is this client most likely experiencing?
Cultural taboo to discuss death
A nurse reviews the medication list of an older adult. Which of the following age-related changes leads to a slower drug clearance?
Decrease in hepatic blood flow
A resident of a nursing home has accused several members of the care staff of stealing jewelry from the overbed table despite the fact that the facility's policy requires residents to keep such valuables in a lock box. The nurse has responded empathically to the accusations and has explained why this is impossible, to no avail. Which of the following conditions is the client experiencing?
Delusions
A nurse in a long-term care facility organizes a "Healthy Aging" class for residents. Which activity should be prioritized during these classes?
Discuss coping strategies helpful in adjusting to challenges of aging.
A nurse at the aging center organizes exercise classes including tai chi. Which of the following principles is the nurse incorporating?
Health promotion
A 69-year-old has recently been diagnosed with mild cognitive impairment and has asked the nurse to help her remember things better. Which of the following nursing diagnoses is appropriate for this older adult?
Health-seeking behaviors
A nurse manager develops policies to promote a sense of control for older adults in the assisted living facility. Which of the following policies should be included?
Hold resident council meetings twice monthly and invite all residents to attend.
A gerontological nurse has been providing ongoing care for an older adult who has a diagnosis of dementia. What goal should the nurse prioritize when conducting ongoing assessment of this client?
Identifying factors affecting the client's functioning and quality of life
Despite the fact that older adults are proportionately the highest users of health care services, many nurses harbor misconceptions and deficits in practice related to gerontological nursing. What is the most likely solution to this problem?
Increased nursing education and clinical experience specific to working with older adults
Which of the following are examples of appropriate communication techniques for dealing effectively with people with dementia?
Maintain good eye contact and use a relaxed and smiling approach.
In which of the following situations would a living will provide clear direction to the care and treatment of the individual involved?
Mr. Jimenez, age 84, has suffered a severe hemorrhagic stroke and is unconscious and unlikely to survive.
A 69-year-old woman is saddened by her recent diagnosis of type 2 diabetes, which is a stressor that will make numerous demands on her life in the coming years. Which of the following actions demonstrates a problem-focused approach to this stressor?
Obtaining diabetic cookbooks and learning to change her cooking habits
Which of the following characteristics of older adults is explained by the subculture theory?
Older adults may interact much more with other older adults than with members of other age groups.
A nurse is teaching an older adult about possible involvement in Programs of All-inclusive Care for the Elderly (PACE). Which of the following statements by the older adult shows understanding?
PACE programs provide several social and medical services on a managed care basis.
An older woman returns to her hospital room after abdominal surgery. As the nurse completes her assessment, the client asks the nurse to pin her "prayer cloth" to her pillow. Which of the following interventions is priority?
Pin the prayer cloth to her pillow since it is an essential part of her spiritual health.
A nurse plans discharge for an older woman from China who is living with her son. Which of the following should be included in this plan to indicate that the nurse understands cultural influences?
Review the discharge plans with the client and her son.
Following knee replacement surgery 10 days earlier, a 79-year-old woman has been diagnosed with an infection in the knee. A sample of synovial fluid has been cultured in order to determine the causative microorganism and to select an appropriate antibiotic. This course of events characterizes what major health belief system?
Scientific paradigm
A nurse in a community setting plans wellness outcomes with a 68-year-old female client who desires to participate in a half-marathon run. Which of the following outcomes should the nurse document?
The client will participate in the half marathon that is scheduled in 6 months.???
A nurse in a Medicare- and Medicaid-funded nursing home performs assessments and develops care plans. Which of these statements is true of the functional assessments the nurse is likely to perform?
The nurse will identify changes in the older adult's function over time.?????