Healthy Aging

The nurse is performing a male reproduction system assessment of an older adult client. The nurse expects which age-related finding? a. Asymmetric tests b. Reduced size of testes c. Absence of pubic hair d. Foreskin that is difficult to retract

b. Reduced size of testes Rationale:

Which gerontologic assessment finding of the auditory system are related to the inner ear? Select all that apply. One, some, or all responses may be correct. ___ Hair cell degeneration ___ Reduced blood supply to the cochlea ___ Atrophic changes of the tympanic membrane ___ Decline in the ability of filter out unwanted sounds ___ Less effective vestibular apparatus in the semicircular canals

1. Hair cell degeneration 2. Reduced blood supply to cochlea 3. Less effective vestibular apparatus in the semicircular canals Precess of elimination: First know: 1. what is gerontologic assessment? Yes - Hair cell degeneration (We are assess finding of auditory system...inner ear.) Yes - Reduced blood supply to the cochlea (Cochlea is spiral cavity of inner ear.) X - Atrophic changes of the tympanic membrane (Atrophic means a wasting away or diminution. The tympanic membrane is also called the eardrum. It separates the outer ear from the middle ear. When sound waves reach the tympanic membrane they cause it to vibrate. ... The tympanic membrane is made up of a thin connective tissue membrane covered by skin on the outside and mucosa on the internal surface. X - Decline in the ability of filter out unwanted sounds Yes - Less effective vestibular apparatus in the semicircular canals

Which skin damage is caused by chronic exposure to ultraviolet rays? Select all that apply. One, some, or all responses may be correct. ___ Dryness ___ Photoaging ___ Vascular lesions ___ Wrinkling of skin ___ Benigh neoplasm

1. Photoaging 2. Wrinkling of skin Rationale: The skin damages that happen from chronic exposure to ultraviolet rays are photoaging and skin wrinkling. Dryness, vascular lesion, and benign neoplasm are changes related to aging.

Which precipitating factors for depression would be common in the older adult without neurocognitive problems? Select all that apply. One, some, or all responses may be correct. 1. Dementia 2. Multiple losses 3. Declines in Health 4. A milestone birthday 5. A traumatic injury

2. Multiple losses 3. Declines in Health Rationale: Depression in the older adult is most often associated with the loss of family members and friends (e.g., death, relocation) and declines in mobility, health, and income.

The health care provider prescribed haloperidol 0.5 mg intramuscularly (IM). The haloperidol is available in a vial that contains 2 mg/mL. How much solution will the nurse administer? Record your answer using two decimal places. Include a leading zero if applicable. ___________ mL.

Desire Dose = 0.5 mg Dose On-Hand = 2 mg Volume = 1 mL Formula: (Desire Dose/Dose On-Hand) X Volume (0.5 mg/2 mg) X 1 mL = ?? 0.25 X 1 mL = 0.25 mL Answer = 0.25 mL Checks Answer: If 2 mg : 1 mL Then __ mg : 0.25 mL Solve, (2 mg)(0.25 mL) = (x mg)(1 mL) Then, (2 mg)(0.25 mL)/1 mL = __ mg -> (2 mg)(0.25) = 0.5 mg. Since, Desire Dose is 0.5 mg. Then, 0.25 mL is our answer!

Which theory proposes that older adults experience a shift from a materialistic to cosmic view of the world? a. Activity theory b. Continuity theory c. Disengagement theory d. Gerotranscendence theory

d. Gerotranscendence theory Rationale:

An 82-year-old retired schoolteacher is admitted to a nursing home. During the physical assessment, the nurse would identify which ocular problem common to person at this client's developmental level? a. Tropia b. Myopia c. Hyperopia d. Presbyopia

d. Presbyopia Rationale:

The nurse recognizes which mental process is associated with deterioration that accompanies aging? a. Judgment b. Intelligence c. Creative thinking d. Short-term memory

d. Short-term memory Rationale:

Which finding in older adult clients is associated with aging? a. Decrease in height b. Decrease neck rigidity c. Increased fine-motor dexterity d. Increased range of motions (ROM)

a. Decrease in height Rationale: Loss of height and deformity and shortening of the trunk are common in older adults because of vertebral compression and degeneration. Rigidity in the neck, shoulders, back, hips, and knees increase

While caring for an older adult client, which symptom would require an immediate reassessment of the client's needs and plan of care? a. Memory loss or confusion b. Neglect of self-care c. Increased daily fatigue d. Withdrawal from usual activities

a. Memory loss or confusion Rationale: Memory loss or confusion would require an immediate reassessment. All are common signs of depression due to the aging process; however, memory loss or confusion requires immediate intervention....

Which characteristic about confusion would the nurse keep in mind when an older client with Alzheimer disease is admitted to a long-term care facility? a. Occurs with a transfer to new surroundings b. Will be unchanged despite reality orientation c. Is a common finding and expected with normal aging d. Results from brain changes that make interventions futile.

a. Occurs with a transfer to new surroundings Rationale:

Which is the purpose of block and parish nursing? a. To provide services to older clients b. To promote health throughout a school curriculum c. To provide nursing services with a focus on health promotion and education d. To deliver primary care to a client population living in a community.

a. To provide services to older clients Rationale:

Which findings are expected when assessing the skin of an older adult? Select all that apply, One, some, or all responses may be correct. 1. Scaly skin 2. Tenting of skin 3. Transparent skin 4. Increased wrinkles 5. Pigmented lesions

2. Tenting of skin 3. Transparent skin 4. Increased wrinkles 5. Pigmented lesions Rationale: Decreased subcutaneous fat with degeneration of elastic fibers allow tenting of the skin and increased wrinkles. Decreased dermal thickness results in paper-thin, transparent skin.

Which principles would promote learning in older adults? Select all that apply. Once, some, or all responses may be correct. 1. Emphasize abstract material 2. Use past experiences while teaching 3. Teach by presenting multiple examples at a time. 4. Keep the environmental distractions to a minimum. 5. Use audio, visual, and tactile cues to enhance learning

2. Use past experiences while teaching 4. Keep the environmental distractions to a minimum. 5. Use audio, visual, and tactile cues to enhance learning

Which are extrinsic factors responsible for falls in older adults? Select all that apply. Once, some, or all responses may be correct. 1. Impaired vision 2. Cognitive impairment 3. Environmental hazards 4. Inappropriate footwear 5. Improper use of assistive devices.

3. Environmental hazards 4. Inappropriate footwear 5. Improper use of assistive devices. Rationale:

Nurses care for clients in variety of age groups. In which age group is the occurrence of chronic illness the greatest? a. Older adults b. Adolescent c. Young children d. Middle-aged adults

a. Older adults Rationale:

A client who had type 1 diabetes and chronic bronchitis is prescribed atenolol for the management of angina pectoris. Which clinical manifestation will alert the nurse to the fact that the client may be developing a life-threatening response to the medication? a. Paroxysmal nocturnal dyspnea b. Supraventricular tachycardia c. Malignant hypertension d. Hyperglycemia

a. Paroxysmal nocturnal dyspnea Rationale: Atenolol is associated with the adverse reactions of bradycardia, heart failure, and pulmonary edema; these are the most serious responses to atenolol

Which characteristic of a therapeutic milieu would the nurse consider important for a confused older adult with socially aggressive behavior? a. Sets limits b. Has variety c. Is group oriented d. Allows freedom of expression

a. Sets limits Rationale: The therapeutic milieu characteristic would be to set limits. Because clients with socially aggressive behavior have poor control, these individuals require a therapeutic environment in which appropriate limits for behavior are set for them. Variety will increase anxiety. The daily routine should be structured and repetitive. A group-oriented environment is too stimulating for a person with socially aggressive behavior. Freedom of expression may result in injury to the client or others, because the client may be unable to control impulses. Note: A therapeutic milieu is a structured environment that creates a safe, secure place for people who are in therapy. It is the therapeutic environment that supports the individual in their process toward recovery and wellness.

Which physiological changes of the musculoskeletal system would the nurse associate with aging? Select all the apply. One, some, or all responses may be correct. a. Slowed movement b. Cartilage degeneration c. Increased bone density d. Increased range of motion e. Increased bone prominence

a. Slowed movement b. Cartilage degeneration e. Increased bone prominence Rationale: The physiologic changes of the musculoskeletal system related to aging are: 1. Slowed movements 2. Cartilage degeneration. 3. Increased bone prominence decreased bone density, and decreased range of motion.

Which approach would the nurse take for an older adult client who is confused, does not recognize family member, and often soils clothing with feces and urine? a. Toileting the client every 2 hours b. Placing the client in orientation therapy c. Supervising the client's bathroom activities closely d. Explaining to the client how offensive the behavior is to others.

a. Toileting the client every 2 hours Rationale:

Which intervention would the nurse provide while caring for an older adult client who is reported to have decreased estrogen production? a. Use minimal tape on client's skin b. Cover the client with warm clothing c. Perform blood glucose test for the client d. Monitor for bradycardia

a. Use minimal tape on client's skin Rationale: Decreased estrogen production associated with aging affects skin texture and makes the skin dry and thin. Therefore the nurse should refrain from using tape on the client's skin to prevent skin injury. Warm clothing and monitoring heart rate are needed for older adult clients with decreased general metabolism or hypothyroidism but are not relevant with estrogen deficiency. A client exhibiting signs of decreased glucose tolerance, such as slow wound healing and recurrent yeast infections, should be tested for blood glucose levels.

Which age-related skin change occurs in older adults clients and increases their potential for developing pressure ulcers? a. Atrophy of he sweat glands b. Decreased subcutaneous fat c. Stiffening of the collagen fibers d. Degeneration of the elastic fibers.

b. Decreased subcutaneous fat Rationale: In older adults, a decrease in subcutaneous fat leads to skin shearing, which may lead to pressure ulcers. Atrophy of the sweat glands will cause dry skin and decreased body odor. Stiffening of the collagen fibers and degeneration of the elastic fibers will result in the development of wrinkles.

Which action would the nurse take for an older resident in a nursing home with Alzheimer disease who hoards leftover food and other seemingly valueless articles and stuffs them into pockets "so the other won't steal them"? a. Remove the resident's unsafe and soiled articles during the night b. Give the resident a small bag in which to place selected personal articles and food. c. Explain to the resident why the nursing home's policy for cleanliness and safety must be followed. d. Tell the resident that the staff is required to keep harmful object out of reach in the resident's closet.

b. Give the resident a small bag in which to place selected personal articles and food. Rationale:

Which response reported by an older adult client would the nurse identify as consistent with the diagnosis of macular degeneration? a. "My vision is best when I dim the lights." b. I always see halos around lights, especially at night." c. I can't see objects in my periphery vision d. "I can't see objects in the. center of my vision fields"

b. I always see halos around lights, especially at night." Rationale: The macula is the central vision area of the retina; therefore, macular degeneration affects central vision and makes it difficult to see objects within direct, central vision.

Which intervention would the nurse implement first when providing care for an older adult male client who is immobile and incontinent of urine? a. Restrict the client's fluid intake b. Regularly offer the client a urinal c. Apply incontinence pants d. Insert an indwelling urinary catheter

b. Regularly offer the client a urinal Rationale: Regularly offering the urinal is the first step. Retraining the bladder includes a routine pattern of attempts to void, which may increase bladder muscle tone and produce a conditioned response.

For which condition is an adult client with a weakened urinary sphincter at risk? a. Bladder distension b. Skin irritation c. Tendency to fall d. Urinary retention

b. Skin irritation Rationale: The weakening of the urinary sphincter results in involuntary dribbling of urine, which increases the risk of skin irritation and infections. Therefore maintaining thorough hygiene in the perineum area reduces the chance of occurrence of infection or skin rash. The nurse should observe for signs of bladder distention in clients who have a tendency to retain urine. Keeping a bedside light at night is an intervention to prevent night falls in clients who have nocturia. A weakened urinary sphincter will cause loss of urine.

The registered nurse (RN) is teaching the nursing student about providing care to an older adult with dementia. Which statement made by the nursing student indicates a need for further education? a. "I should serve food that is easy to eat." b. "I should assist the client with eating." c. "I should monitor weight and food intake once a month." d. "I should offer food supplements that are tasty and easy to swallow."

c. "I should monitor weight and food intake once a month." Rationale: The nurse should monitor an older client's weight and food intake at least once a day because of the client's dementia. The nurse should serve food that is easy to eat provide assistance with eating. The nurse should also offer food supplements that are tasty and easy to swallow.

Which initial response would the nurse make to a 67-year-old man with type 2 diabetes who sadly confides in the nurse that he has been unable to have an erection for several years? a. "at your age, sex isn't that important." b. "That is a natural occurrence at your age." c. "You sound upset about not being able to have an erection." d. Maybe it's time for you to speak to your primary health care provider about this."

c. "You sound upset about not being able to have an erection." Rationale:

An 85-year-old client is alert and able to participate in care. According to Erikson, which developmental stage will the client need to adjust to? a. Industry versus inferiority b. Identity versus role confusion c. Generativity versus stagnation d. Autonomy versus shame/doubt

c. Generativity versus stagnation Rationale:

The nurse is preparing to teach a community health program for senior citizens. Which physical finding would the nurse include that are typical in older adults? a. Increased skin elasticity and a increase in testosterone production b. Impaired fat digestion and an increase in pepsin production c. Increased blood pressure and decreased cardiac output. d. An increase in body warmth and some swallowing difficulties.

c. Increased blood pressure and decreased cardiac output. Rationale:

The nurse recognizes that a common conflict experienced by older adults is the conflict between which? a. Youth and old age b. Retirement and work c. Independence and dependence d. Wishing to die and wishing to live.

c. Independence and dependence Rationale:

Which information about benign prostatic hyperplasia (BPH) is important for the nurse to consider when caring for a client with that condition? a. It is a congenital abnormality b. A malignancy usually results c. It predisposes to hydronephrosis d. Prostate-specific antigen decreases.

c. It predisposes to hydronephrosis Rationale: Inability to empty the bladder as a result of pressure exerted by the enlarging prostate on the urethra causes a backup of urine into the ureters and finally the kidneys (Hydronephrosis).

Which intrinsic factor is associated with the fall of an older adult? a. Wet floor b. Poor light c. Lack of exercise d. Inappropriate footwear

c. Lack of exercise Rationale: Intrinsic risk factors associated with the fall of an older adult may include deconditioning. Wet floors, poor lighting, and inappropriate footwear are extrinsic risk factors.

which action would the nurse take for an older client with Alzheimer disease who sleeps very little and becomes more disoriented from sleep deprivation? a. Shut the client's door when during the night b. Apply a vest light on the client's room at night c. Leave a dim light on in the client 's room at night d. Administer the client's prescribed as as-needed sedative medication.

c. Leave a dim light on in the client's room at night. Rationale: The nurse leave a dim light on in the client's room at night. A small light in the room may prevent misinterpretation of shadows, which can heighten fear and alter the client's perception of the environment. A disoriented and confused client should be closely observed, not isolated by closing the door. Restraints are a last resort; less restrictive interventions should be used first. Sedatives should be used sparingly in older adults, because they nay cause further confusion and agitation.

Which kind of service does block nursing offer to the elder clients? a. Diagnostics b. Health screening c. Running errands d. Communicable disease control

c. Running errands Rationale:

When teaching about aging, the nurse explains that older adults usually have which characteristic? a. Inflexible attitudes b. Periods of confusion c. Slower reaction times d. Some senile dementia

c. Slower reaction times Rationale: A decrease in neuromuscular function slows reaction time. The ability to be flexible has less to do with age than with character. Confusion is not necessarily a process of aging, but it occurs for various reasons such as multiple stresses, perceptual changes, or medication side effects. Most older adults do not have organic mental disease.

Which psychosocial health concern involves accepting descriptive statements stated by a confused older client? a. Reminiscence b. Reality Orientation c. Validation therapy d. Therapeutic communication

c. Validation therapy Rationale: Validation therapy is the psychosocial concern involved in accepting the descriptive statements made by a confused older client. Reminiscence is recalling the past. Reality orientation involves helping a confused older client agree with the nurse's statements. Therapeutic communication enables the nurse to perceive and respect the older client's uniqueness and healthcare expectations.

An 80-year-old client is admitted to the hospital with severe dehydration. The client's daughter asks the nurse how her mother could have become dehydrated. Which response by the nurse is correct? a. " the body's fluid needs decrease with age because of tissue changes." b. "Access to fluid may be insufficient to meet the daily needs of the older adults." c. " Memory declines with age, and the older adult may forget to ingest adequate amounts of fluid." d. "The thirst reflex diminishes with age, and the recognition of the need for fluid is decreased."

d. "The thirst reflex diminishes with age, and the recognition of the need for fluid is decreased." Rationale:

Which intervention would the nurse include in the nursing home plan of care for an older adult with Alzheimer disease who has nighttime wandering? a. Order a vest restraint for the client to be applied at night b. Obtain a prescription for a sedative so the client will sleep better at night. c. Request that the family provide a companion to stay with the client at night. d. Assign the client to a room near the nurses' station for closer supervision at night.

d. Assign the client to a room near the nurses' station for closer supervision at night. Rationale:

Which action would the nurse take when caring for an older adult with a history of recent memory loss? a. Instruct the client to move slowly when changing positions. b. Remind the client to look where he or she places the feet while walking. c. Adjust the daily schedule to accommodate sleep pattern d. Employ electronic devices that provide alerts.

d. Employ electronic devices that provide alerts

The client has a visual impairment. Which technique would the nurse use to communicate? a. Face the caregiver while speaking. b. Provide bright, diffuse, glare lighting c. Stand or sit far away from the client while remaining in the client's full view. d. Encourage the older adult to use assistive devices such as eyeglasses.

d. Encourage the older adult to use assistive devices such as eyeglasses. Rationale:

Which priority nursing intervention would the nurse include in the plan of care for an older adult who sustained a right hip fracture? a. Oxygen therapy b. Cardiac monitoring c. Nutrition supplements d. Venous thromboembolism (VTE) prevention

d. Venous thromboembolism (VTE) prevention Rationale: After hip surgery, development of a VTE commonly occurs.

Which age-related finding would the nurse discover when assessing the health of a 69-year-old client? a. Big, wide opened eyes b. Presence of facial hair c. A bruise on the elbow d. Walking with neck bent forward

d. Walking with neck bent forward Rationale: Rationale Aging is associated with changes in gait. Walking with neck bent forward suggests a gait change, supporting the nurse's conclusion. Wide opening of eyes is not an age-related change. The release of sex hormones in both men and women causes growth of facial hair, which is normal. A bruise could be a result of an injury and does not occur with aging.