Gero Unit Exam 3

Recognizing the high incidence of breast cancer among older adult women, a public health nurse is including the topic in a health promotion teaching session at a senior center. Which statement would the nurse most likely include in the teaching session about their risk of developing breast cancer?

"Breast cancer is one type of cancer that appears to be heavily influenced by heredity."

An 75-year-old client who fell at home is brought to the emergency department by emergency medical responders. On arrival, which action would be the priority?

Assess the clients vital signs

A gerontological nurse is conducting a presentation about cancer and older adults for a group of older adults at a local senior center. The nurse is describing the relationship between cancer and aging. Which information would the nurse most likely include?

Age is considered the most significant risk factor for cancer.

The family of a 78-year-old client is shocked by the recent diagnosis of pancreatic cancer, citing the client's lifelong commitment to a healthy diet, consistent exercise, and avoidance of environmental risk factors. Which factor would the nurse most likely identify as contributing to this client's diagnosis?

Age-related changes to the immune system may have compromised the body's ability to recognize cancerous cells.

The nurse plans care for a client who has had gradual vision loss. Which of the following should the nurse include in the care plan?

A clock that chimes the hour in the client's living room

A nurse is reviewing the medical records of several older adult clients. Which factor would the nurse most likely identify as challenging older adults' emotional homeostasis? Select all that apply.

Increased vulnerability to crime and abuse Altered function or body image Sensory deficits Greater awareness of own mortality

A nurse is assessing an older adult's mental health. During the assessment, which factor would the nurse need to keep in mind about the development of mental illness in this group despite the advantages of experience?

The many losses and challenges of late life may exceed the physical, emotional, and social resources of some persons.

At the beginning of shift, a nurse has entered the room of a 78-year-old client who is in the late stages of liver failure. The client's son, who has interacted with the nurse appropriately in the past, states, "If you all wouldn't have botched the treatment when the problem first started, he wouldn't be lying here dying." The nurse interprets the son's statement as reflecting which situation?

The son is demonstrating a common manifestation of anger about the death of a loved one by directing it elsewhere.

A gerontological nurse is preparing a presentation for a group of older adults at a local senior center. The topic is the "Aging of the Endocrine System." Which information would the nurse most likely include in the presentation?

The thyroid, pancreas, and adrenal glands are at risk for problems in older adults.

A nurse is providing care to an older adult client diagnosed with cancer who is receiving radiation and chemotherapy. The nurse closely monitors the client for which reason?

They are more vulnerable to dehydration and infections.

The nurse at the ophthalmology office is teaching an older adult client newly diagnosed with cataracts. The nurse determines that the teaching was successful when the client states the need to avoid which situation?

Bright sunlight

An 81-year-old client with a history of depression has been admitted to hospital for the treatment of diverticulitis. Which intervention would the nurse most likely implement to foster the client's mental health?

Encouraging the client to actively engage in decision-making about routine and care.

A nurse is providing care to an older adult client with dementia. Which intervention would the nurse identify as the priority?

Ensuring client safety

A 70-year-old resident of a long-term care facility is in the advanced stages of Alzheimer's disease. Consequently, the resident frequently wanders throughout and, on more than one occasion, outside the facility. Due to cognitive deficits, the client is not responsive to teaching and redirection. Which action by the staff would be most appropriate response to the resident's behavior?

Provide a controlled and safe place within which the resident can wander freely around.

A nurse manager is working with a staff nurse to initiate discharge planning for an older adult who has had surgery. The nurse asks the nurse manager, "Why are we doing discharge planning so early in the client's course of care?" Which reason would the nurse most likely cite? Select all that apply.

Reduce the risk of rehospitalization Minimize stress to the client and their caregivers Prevent complications

A nurse who works with seriously ill older adult clients tells a colleague, "I'm worried about my own health because I think I carry a gene for a fatal disease." The nurse asks the colleague for advice. Which suggestion would be most appropriate for the colleague to make to promote the nurse's own mental health and the mental health of the clients cared for by the nurse?

"Come to grips with your own mortality.

A gerontological nurse is participating at a community health fair and is providing information to older adults about ways to promote healthy sensory function. Which suggestion would the nurse most likely make?

"Even if you have good vision, it's important to get an eye examination every year."

A gerontological nurse is conducting a health promotion program for a group of older adults about activities specific to the integumentary system. The nurse determines that the teaching was successful based on which statement?

"I'm aware that irregularly shaped moles can be associated with melanoma."

The homecare nurse performs visits to a 74-year-old client with numerous health problems. The nurse has noted the presence of an irregular-shaped, growing lesion of irregular color on the client's scalp but the client is resistant to visiting the primary health care provider. Which response by the nurse would be most appropriate?

"If this is skin cancer, the sooner you have it diagnosed, the better the chance of a favorable outcome."

Three gerontological nurses have announced their intention to open a long-term care facility in their community, something that a colleague has disparaged as "making money from older adults' frailty." Which response by the nurses to their colleague's criticism would be most appropriate?

"It can actually be in the best interests of residents for experts in care, like nurses, to be in charge of directing care."

A home care nurse makes regular visits to the home of a client with type 2 diabetes. The client asks about ways that exercise might be able to control his type 2 diabetes. Which response would be most appropriate by the nurse?

"It's important to have an exercise plan that is appropriate for you, because you don't want to bring on hypoglycemia by exercising too hard."

An older adult client says, "I don't need my medicine for hypertension. It makes me feel weak and I think it sometimes makes me impotent." When the client's spouse tries to remind the client to take the drug, the client becomes enraged. Which action would be most appropriate for the nurse to do?

Allow the client to vent these frustrations.

A gerontological nurse is conducting a program for staff nurses at a long-term care facility about older adults and sensory function. When discussing this topic, which information would the nurse most likely include? Select all that apply.

"Sensory deficits are a threat not only to quality of life but to safety as well." "Sensory losses commonly lead to impaired communication." "Sensory deficits make it difficult to interpret the older adult's physical environment." "Sensory deficits have a negative effect on older adults' social relationships."

A nurse working in a long-term care facility asks the gerontological nurse, "What can I do to help best assist an older resident with mental health issues?" Which response by the gerontological nurse would be most appropriate?

"Strengthen the client's capacity to manage the condition by promoting the client's health."

An older adult client has recently been diagnosed with rheumatoid arthritis that is having a significant impact on the client's daily routines and quality of life. Which response by the nurse best demonstrates understanding about the importance of healing rather than curing the client's condition?

"There are changes that I can help you make that can help you live a full life despite this health problem."

A nurse working in a long-term care facility recognizes the challenge of fostering and maintaining the mental health of residents. When admitting a new resident to the facility, which statement would be most appropriate for the nurse to make?

"Try to stay involved in activities that you find satisfying and interesting."

A nurse is teaching a group of older adults about ways to reduce the risk of lung cancer. Which statement by the group indicates to the nurse that the teaching was successful? Select all that apply.

"We need to avoid exposure to tobacco products." "We need to make sure our homes are adequately ventilated."

A gerontological nurse is conducting a program for a group of senior adults and their families about dementia. One of the family members asks, "One time my dad had delirium. Are delirium and dementia the same thing?" Which statement would be most appropriate?

A person who has dementia can suffer from delirium.

A nurse is developing a plan of care for an older adult client with several chronic conditions. Which information would be most important for the nurse to integrate into the plan when identifying goals for the client? Select all that apply.

Appropriate care measures focus on helping clients live in harmony with chronic disease. Controlling symptoms, promoting a sense of well-being, and enhancing the quality of life are appropriate goals for persons with chronic illnesses. Healing requires the mobilization of the body, mind, and spirit.

A visiting nurse becomes concerned about a caregiver. Although the caregiver does not seem overburdened, the nurse suspects that the caregiver may be drinking too much. The recycling bin contains many wine bottles, and visitors come to the home. Which action would the nurse most likely take?

Assess the caregiver's motivation and ability to provide care.

As per her routine, the daughter of an 82-year-old client recovering from a prostate resection has come to the hospital in the morning to be at the bedside. The daughter has approached her father's nurse and stated that he is uncharacteristically difficult to rouse this morning, with his only verbal response being occasional nonsensical muttering. Which activity would be most appropriate?

Assessment to determine the cause of the client's delirium.

To the embarrassment of his family, an 81-year-old male client on the subacute unit of a hospital has made repeated, sexually inappropriate statements to female staff members. The client's family is adamant that such behavior is uncharacteristic. Which action would the nurse implement first?

Attempt to identify the underlying cause of the client's behavior.

An older adult is admitted to the hospital for surgery. A day later, the client seems confused and disoriented, imagining there is a trapdoor in the ceiling above the bed. The client's wife panics, telling a nurse that several of her husband's relatives have had Alzheimer's disease but that until now he has seemed "sharp as a tack." Which action would be the priority?

Checking the client's chart for medications that can cause delirium

The nurse is assessing an older adult client's hearing. Which finding would lead the nurse to suspect that the client is experiencing a problem? Select all that apply.

Client leans head to one side Client looks directly at speaker's lips during interview Client consistently asking, "What did you say?" Client asks to have words repeated

A nurse is assessing an older adult for possible complications after surgery. Which finding would lead the nurse to suspect that the client may be developing a respiratory complication?

Decreased lung sounds

A nurse is conducting an educational program for a client newly diagnosed with type 2 diabetes. The nurse determines that the teaching has been successful based on which outcome? Select all that apply.

Demonstration of the proper technique for medication administration Verbalization of understanding of diabetes and its management Demonstration of the correct method of blood glucose testing

The daughter of a 79-year-old client with a diagnosis of small cell lung cancer has learned that the client has been found to have bone metastases. The daughter has approached the oncologist who is caring for the client with information that she has found on the Internet that promises to cause remission of cancer through intensive antioxidant therapy. The daughter is adamant that the health care provider facilitate the treatment and liaise with the providers who are located overseas. The nurse interprets the daughter's behavior as indicating which stage of the dying process?

Denial

A nurse is providing care for an 82-year-old client on the palliative care unit of a hospital. The client has a long-standing diagnosis of diabetes that has manifested in serious cardiac problems. The client is not expected to survive the weekend. Which interpretation would be most appropriate by the nurse in light of the chronic care that the client has long received?

Dying in comfort and dignity is the final component of high-quality chronic care.

A nurse is assessing an older adult client with a disability. When evaluating the client's activities of daily living, about which component would the nurse gather data? Select all that apply.

Eating Toileting Dressing

An older adult client comes to the clinic for a yearly checkup. During the interview, the client states, "I don't really eat that much, I'm not that hungry, but I keep gaining weight. Just look at my fat face!" The nurse interprets the client's statement as suggesting which condition?

Hypothyroidism

An older adult has experienced a progressive loss of mobility over the last several years because of multiple sclerosis. Combined with a narrowing social circle, the client has characterized life as "not worth living" and expressed to her nurse a desire to "end it all." Which response by the nurse would be most appropriate?

Implement measures to ensure the client's safety.

An 80-year-old male client who is receiving treatment for chronic obstructive pulmonary disease in the medical unit of a hospital has been displaying frequent signs of anxiety since admission. Which action would the nurse implement as the priority?

Implementing a predictable routine along with explanations prior to nursing interventions

An older adult client is being admitted to the acute care facility and is asked if the client has an advance directive. The nurse understands that this document achieves which result?

It gives the client control over time care.

A nurse is preparing a presentation about chronic conditions and older adults. The nurse identifies the need to address the high incidence and prevalence of these conditions among this population. Which phenomenon would the nurse most likely include as contributing to the high incidence? Select all that apply.

Longevity is increasing. Many previously fatal diseases are now treatable.

A nurse is conducting a presentation to a group of older adults at the local senior center about visual changes. After teaching the group about these changes, the nurse determines that the teaching was successful when the group identifies which condition as the most common cause of blindness in people over age 65 years?

Macular degeneration

The nurse is providing care to a group of older adult residents who are at risk for pressure injuries due to immobility. Which intervention would the nurse include in a client's plan of care to address a hyperemic area?

Off-load the area under pressure.

Despite the fact that the client is now receiving palliative care because of the progression of congestive heart failure (CHF), a nurse views the care that was provided for the client as a success. The nurse arrives at this conclusion most likely based on which information?

The client was able to live independently and provide self-care until very late in the progression of the disease.

An older adult and spouse live in their home of 50 years. The client has a diagnosis of osteoarthritis. The nurse is making a home visit to the client. Which factor would the nurse most likely identify as having the greatest impact on the client's ability to manage the condition?

The course and progression of the client's condition

A gerontological nurse is describing the effects of aging on the endocrine system to a client diagnosed with diabetes. Which information would the nurse most likely integrate into the discussion about how aging affects the endocrine system and its hormones?

The endocrine system's ability to regulate body activities decreases.

The nursing staff at a long-term care facility are providing care for a resident who requires total assistance secondary to severe Alzheimer's disease. Which intervention would the nursing staff implement to foster the resident's dignity, personal worth, and individuality? Select all that apply.

Using the resident's name during interactions despite the fact the client is disoriented to person. Attempting to engage the resident in conversation despite evidence of cognitive losses. Giving the resident choices and options even though the client has difficulty making decisions. Ensuring that any nursing interventions for the resident are performed in privacy as much as possible.