Med-Surg: Healthcare of the older adult

A nurse is educating teenagers on ageism. Which of the following statements by the nurse is appropriate?

"Ageism is the bias against older people based solely on chronological age."

An older adult female patient tells the nurse, "I have lost an inch of height and have a hump on my back. What can I do about this?" What is the best response by the nurse?

"In order to prevent further bone loss, eat a diet high in calcium and low in phosphorus."

The nurse works on a unit with elderly clients. Which of the following clients would the nurse visit first? The client who reports

"It feels like I have food stuck in my throat."

A patient with Alzheimer's disease is prescribed donepezil (Aricept). When teaching the patient and family about this drug, which of the following would the nurse include?

"The drug helps to control the symptoms of the disease."

The nurse is assisting an older adult patient with dietary planning. The nurse emphasizes the importance of adequate intake of fruits, vegetables, and fish. What should the patient's daily carbohydrate intake be?

55% to 60%

Which of the following older adults is at highest risk for medication-related toxicity?

A 65-year-old with renal insufficiency

An elderly client is contemplating a move to a continuing care retirement community (CCRC). The nurse assesses that the client requires assistance with food preparation and recommends placement in

Assisted-living apartment

A nurse is teaching a nutrition class to a group of elderly clients at a retirement center. The nurse tells the clients that as a result of aging, they will need to decrease

Calories

An elderly client reports to the nurse that food does not taste right. During a dietary assessment, the nurse learns that the client uses a lot of sugar and salt. The client states, "It makes the food taste better." The nurse intervenes by

Encouraging the client to use lemon, spices, and herbs in the diet

An elderly client is reporting changes in bowel movements from every day to every 3 to 4 days. The client also states that the stools are hard. Nursing interventions include instructing the client to

Increase fluid intake.

An older adult male patient tells the nurse that he wakes several times a night to pass his urine but never feels as though he fully empties his bladder. What suggestion can the nurse make to help control this in the evening?

Limit drinking a lot of fluid in the evening, especially caffeinated beverages.

A client with moderate Alzheimer's disease has been eating poorly, losing weight, and playing with food at meals. The nurse best intervenes by

Placing one food at a time in front of the client during meals

Which refers to the decrease in lens flexibility that occurs with age, resulting in the near point of focus getting farther away?

Presbyopia

What is a nurse's role in providing home care for a patient with Alzheimer's disease?

Provide emotional and physical support.

A female elderly client tells the nurse she experiences vague pain during sexual intercourse with her spouse. It is best for the nurse to

Refer the client to a gynecologist for evaluation.

Which of the following is a factor that contributes to urinary incontinence in the older female adult?

Relaxed perineal muscle

When assessing the older adult, the nurse anticipates an increase in which component of the respiratory status?

Residual lung volume

After teaching students about age-related changes in the sense of taste in older adults, the instructor determines that teaching was successful when the students identify which taste as being most affected?

Sweet

A nurse is assessing a patient brought to the emergency room by his daughter. Which statement by the daughter would most likely lead the nurse to suspect that the patient may have an infection?

"All of a sudden he seemed to become confused."

The patient asks the nurse why she seems to have bone changes since she has gotten older. What is the best response by the nurse?

"Bone changes from aging result from a loss of calcium."

A family of a patient with Alzheimer's disease asks the nurse what causes this condition? Which response by the nurse would be most appropriate?

"Evidence shows that there are changes in nerve cells and brain chemicals."

The nurse is attempting to take vital signs of an older adult hospitalized following knee surgery. The patient continuously yells, "It's 1999 and you are going to hurt me." What action should the nurse do first?

Reorient the patient.

A client with Alzheimer's disease is admitted for hip surgery after falling and fracturing the right hip. The client's spouse tells the nurse about feeling guilty for letting the accident happen and reports not sleeping well lately because the spouse has been getting up at night and doing odd things. Which nursing diagnosis is most appropriate for the client's spouse?

Risk for caregiver role strain related to increased client care needs

Students are preparing a class presentation on elder abuse. Which of the following would they include as the most common type of elder abuse?

Neglect

A client reports to the nurse that her elderly mother has become increasingly angry and responds inappropriately to conversations within the past few months. She notes that her mother does not respond when the mother's back is turned. The best intervention of the nurse is to

Ask if the mother could come in for a hearing evaluation.

A hospitalized older adult complains of increased coughing and shortness of breath. The nurse assesses the vital signs as temperature 100.2°F oral, respirations 18, pulse 88, and BP 128/80. What action should the nurse do next?

Assess lung sounds and sputum.

The nurse is preparing an elderly hospitalized client for discharge to home within the hour. The nurse should

Assess the need for pneumococcal and influenza vaccinations.

Family members report to the nurse that their elderly grandmother has had a sudden onset of confusion and that they are having difficulty providing care for her. The nurse

Assesses the grandmother for adventitious lung sounds

A nurse is obtaining the health history of a 72-year-old woman who has come to the ambulatory care center for an evaluation. When obtaining information about the woman's sleep patterns, which of the following would the nurse expect to assess?

Complaints about frequently waking up during the night

Which of the following states is characterized by a decline in intellectual functioning?

Dementia

Which of the following is an age-related change in the respiratory system?

Decreased gas exchange

Students are reviewing information about age-related changes in the older adult. They demonstrate a need for additional study when they identify which of the following as an age-related change in the respiratory system?

Decreased residual lung volume

When assessing an older adult's gastrointestinal system, the nurse would identify an increase in which of the following as normal?

Feeling of fullness

Which of the following is the leading cause of death in the elderly?

Heart disease

A client reports to the nurse that her mother had macular degeneration and is concerned that she, too, may be at risk. The nurse tells the client to

Wear sunglasses with ultraviolet (UV) protection when outside.

The reason that federal and state governments carefully regulate the treatment given in licensed health care facilities, particularly long-term care facilities, is expressed by which statement?

Vulnerability of older adult patients

Age-related changes associated with the cardiovascular system include

decreased cardiac output.

The most common affect or mood disorder of old age includes

depression.

To encourage adequate nutritional intake for a client with Alzheimer's disease, a nurse should:

stay with the client and encourage him to eat.

A nurse is providing care to a patient with delirium. Which interventions would be most appropriate to implement? Select all that apply.

• Providing a calm, quiet environment • Supervising nutritional intake • Using familiar cues about the environment

After teaching an older adult about measures to relieve constipation, which statement by the patient indicates a need for additional teaching?

"I should use a laxative every other day."

A nurse is caring for a client with dementia. A family member of the client asks what the most common cause of dementia is. Which response by the nurse is most appropriate?

"The most common cause of dementia in the elderly is Alzheimer's disease."

A client reports to the nurse that her grandmother with Alzheimer's disease recently moved in with her and her two school-aged children. The client states the grandmother becomes agitated and starts yelling and crying frequently. The woman asks, "What can I do?" The nurse first responds:

"What precipitates the outbursts?"

The nurse is working in a long-term care facility. When assessing her patients, what body system dysfunction should the nurse look for as the leading cause of morbidity and mortality in the older adult population?

Cardiovascular

Which of the following actions by the nurse demonstrates ageism?

Directing all health decisions to the older adult's child

A client has recently brought her elderly mother home to live with her family. The client states that her mother has moderate Alzheimer's disease and asks about appropriate activities for her mother. The nurse tells the client to

Ensure that the mother does not have access to car keys or drive an automobile.

An elderly client exhibits blood pressure of 110/76 while prone, 100/72 sitting, and 92/64 standing. The nurse instructs the client to

Ingest five or six small meals each day.

An elderly client is hospitalized for treatment related to leukemia. Family members want to visit with a toddler who has a cold. It would be best for the nurse to

Instruct the family to remove the toddler from the room for the protection of the client.

The nurse is describing hospice services to the family of a patient with end-stage heart failure. Which of the following would the nurse be least likely to include as a major focus of care?

Invasive therapy

An elderly client reports that he feels like he voids frequently during the day and at night but cannot empty his bladder. The nurse instructs the client to

Limit ingestion of caffeinated beverages.