Older Adult quiz

During which stage of pressure ulcer development does the ulcer extend into the underlying structures, including the muscle and possibly the bone?

Stage IV

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

"I should use a laxative every other day."

In which stage is a pressure ulcer considered a partial-thickness wound?

Stage II

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."

The nurse is evaluating whether a client's walker is the right height for the client. While the client's hands are on the hand grip, the nurse assesses the client's elbows. The nurse determines that the walker is at the right height when the client's elbows are in which position?

25-degree flexion

The nurse recognizes which disorder as a developmental disability in a patient?

Cerebral palsy

A nurse is caring for an elderly bedridden adult. To prevent pressure ulcers, which intervention should the nurse include in the care plan?

Develop a written, individual turning schedule.

This type of disability represents one that occurs any time from birth to 22 years and results in impairment of physical or mental health, cognition, speech, language, or self-care.

Developmental

A nurse is talking on the phone with a doctor and states, "I am calling you about Mrs. Nye, my client with cancer in room 213." This is an example of what type of language that is important to all people?

People-first

A client with multiple sclerosis is being discharged. The nurse understands that living with chronic conditions imposes many challenges, including the need for which accomplishments? Select all that apply.

Validate family functioning Validate individual self-worth Alleviate and manage symptoms

A client at an extended-care facility who has Alzheimer's disease is awake throughout the night. The nurse intervenes with activities that will promote sleep at night, which include

Walking the client in the facility yard during the day

The nurse is caring for a client with muscular dystrophy who is confined to bed. The client develops a pressure ulcer on the sacrum. The nurse documents the pressure ulcer as a(n)

secondary condition.

An older adult female client tells the nurse, "I have lost an inch [2.5 cm] 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 and nursing assistant are moving a client who slid down in the chair. What does the nurse encourage the assistant to avoid shearing when moving the client to a higher position in the chair?

Lift the client, do not slide them.

Which action by the nurse demonstrates ageism?

Directing all health decisions to the older adult's child

The nurse is evaluating the laboratory values of a client whose nursing diagnosis is "risk for impaired skin integrity." Which of the following values places the client at greatest risk?

Albumin, 1.5 g/dL

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.

A nurse is assigned to work with a client who has a disability. The nurse believes that all people with disabilities have a poor quality of life and are dependent and nonproductive. What type of barrier will this client experience?

Attitudinal barrier

A nurse is assessing a patient's level of independent functioning. Which tool would the nurse most frequently use?

Functional Independence Measure

A nurse prepares a diabetes prevention health seminar for community residents. Her teaching points should emphasize the most important factor influencing metabolic syndrome (pre-diabetes). What is that factor?

Obesity

Older adults, who are more subject to falls, may fracture one or more ribs and be more susceptible to which condition after a rib fracture?

Pneumonia