Prep U Aging Adult

The geriatric nurse is evaluating her orientee's understanding of the theories of aging. The nurse knows that the orientee understands when the orientee states which of the following?

"In the genetic theory of aging, cells become exhausted from continual energy depletion."

An older adult client tells the nurse, "I just don't seem to have an appetite and food just doesn't taste as good as it used to." The nurse understands that which factor may be playing a role in this client's lack of appetite? Select all that apply.

- decreased number of taste buds - decreased saliva production

An older adult client is placed on an inpatient unit following a minor stroke after moving in with an adult child recently. The client states to the nurse, I have difficulty finding meaning in life." The nurse suspects that the client is suffering from depression. Which factors may contribute to this client's depression? Select all that apply.

-The depression may have gone undetected since it is an under diagnosed disorder. -The stroke may be a contributing factor. -A recent change in living environment can cause depression

After obtaining the health history from an older adult client, the nurse develops a plan of care and identifies a nursing diagnosis of Risk for Impaired Physical Mobility. A history of which condition would support this nursing diagnosis? Select all that apply.

-arthritis -hip fracture -stroke

A nurse is preparing to medicate an older adult client with an opioid analgesic. Which of the following does the nurse consider in the use of this medication?

Delirium, sleep disturbances, cognitive changes, and diminished functional abilities may result when pain is not managed adequately.

A 78-year-old woman is status post right hip fracture after a fall. She has stopped going to her church over the past few months. She has also asked her neighbor to help her and do her gardening, an activity she previously loved. The client tells the nurse "I just don't enjoy gardening like I used to. I am always worried about falling." What would most concern the nurse regarding the client?

Depression

An older adult client comes to the health center reporting difficulty sleeping. Which statement by the client would the nurse need to address?

I find myself napping on and off throughout the day

A nurse is conducting an education session about appropriate measures to promote sleep with an older adult who is experiencing frequent awakenings at night and then awakening early in the morning. The nurse determines that the education was successful when the client states:

I need to try and go to bed and get up at the same time each night

A nurse is assessing middle adults living in a retirement community. What behavior would the nurse typically see in the middle adult?

Looks inward, accepts life span as having definite boundaries, and has special interest in spouse, friends, and community

A nurse has attended an inservice workshop that addressed the phenomenon of ageism in the health care system. Which of the following practices is indicative of ageism?

Speaking to older adults with the presumption that they have mild cognitive deficits

An older adult client tells his home care nurse that he doesn't seem to sleep as well as he used to. The nurse is aware that the sleep changes that occur in the older adult client which cause a less restful sleep include:

a decrease in the deep sleep stage of the sleep cycle

A nurse arrives at the home of an older adult client. The agency was called because a neighbor noticed that the client was home alone. The nurse finds the client alone in the living room. When asked about the client's daughter who lives there and has been caring for her, the client says, "She went on vacation for about a month. She'll be back soon." Further assessment reveals that there are no other family members or services currently involved. The nurse would identify this situation as:

abandonment

Traumatic life events have had a damaging effect on a 55-year-old woman's psychosocial development in recent years. According to Erikson, a failure to achieve the tasks associated with middle adulthood may result in which of the following?

an unhealthy fixation on her own needs and health

A nurse is providing care to a group of older adults at a senior center. Which condition would the nurse anticipate as occurring most often?

arthritis

When educating the middle-age adult, it is important to discuss which of the following?

calcium replacement

When completing an assessment, especially of the older adult, the nurse knows the importance of including spiritual development. Older adults have completed moral development and many experience self-transcendence, which may be defined as what?

capability to reach beyond prior limits with more awareness of other people's values and beliefs

In regard to lifespan considerations, the most important functional health pattern to assess in the elderly client is

cognition-perception

An older adult client enjoys good overall health, but has just been diagnosed with pneumonia and has begun receiving an intravenous (IV) antibiotic. Shortly after being administered the first dose, the client pulled out his IV line and is now attempting to scale his bed rails. Which of the following phenomena most likely underlies this change in the client's cognition?

delirium

When the home care nurse visits a female client age 78 years who is recently widowed, the nurse finds that the home is cluttered with trash. The client appears sad and disheveled. The nurse should assess the client for symptoms of:

depression

A nurse is preparing a presentation for a group of families who are providing care to their older adult parents. One of the family members asks the nurse, "How common is Alzheimer's disease?" The nurse responds by telling the group that after age 65, the prevalence of Alzheimer's disease:

doubles every 5 years

A nurse is teaching the importance of nutrition to a group of clients using geragogy. Which of the following clients is the nurse addressing?

elderly people

An older adult informs the nurse that she is having a difficult time sleeping at night. What action may assist the client in getting a better night of sleep?

encourage a routine for sleeping and waking

Erikson identified ego integrity versus despair and disgust as the last stage of human development, which begins at about 60 years of age. Which intervention would best foster older patients' ego integrity?

encouraging life review

An older adult client comes to the clinic for his yearly influenza vaccination. During the visit he asks the nurse, "I've heard about this other vaccine for pneumococcal pneumonia. How often do I need to get this vaccine?" The nurse would encourage the client to receive this vaccination at which frequency?

every 5 years

A nurse is performing a home assessment for a 90-year-old widower who lives in a third story apartment. As the nurse considers his home environment, the nurse knows that the greatest risk of injury-related death or disability for the client comes from:

falls

The middle adult is sometimes called the "sandwich generation". According to Erikson, the developmental task of the middle adult is what?

generativity vs stagnation

After graduation, if you especially want to care for the aged population, you would consider the nursing specialty that focuses on the health and illnesses of the aging. This specialty is:

gerontologic nursing

Based on Havighurst's theory of human development, which nursing intervention would best facilitate the accomplishment of a developmental task of older adulthood?

helping a patient move independently using a walker

The nurse performs an assessment on a newly admitted older adult client. The client receives a score of 12 on the Braden scale. What is the risk for impaired skin integrity for this client?

high risk

Mrs. Jimenez, age 79, became a widow earlier this year and now resides alone in the house that she and her husband shared for 30 years. Her children have encouraged her to move, but she expresses a desire to remain in her home, despite some slight mobility challenges. The nurse who provides occasional home healthcare for Mrs. Jimenez should first propose which of the following?

home modification

A 77-year-old woman is on the nurse's unit s/p left knee replacement. The client typically stools every morning but has not had a bowel movement in 3 days. The nurse knows that which medication places the client at increased risk for constipation?

hydromorphone

A nurse is orienting a new group of nurses to the senior health care center. When describing the typical population that the group would encounter, the nurse would identify which condition as being most common based on current demographics?

hypertension

A nurse encourages residents of a long-term care facility to continue a similar pattern of behavior and activity that existed in their middle adulthood years to ensure healthy aging. This intervention is based on which aging theory?

identity-continuity theory

When assessing a client during the middle adult years, the nurse recognizes which of the following as a normal physical change?

increased loss of calcium from the bones

A nurse is preparing a presentation for families who are caring for older adults at home. Which information would the nurse most likely include about an older adult's cognition?

many older adults retain full cognitive function into advanced age

A male client reports chronic insomnia. Which medication would the nurse not want to administer to the client?

nasal decongestant for an upper respiratory infection

The nurse is assessing an older adult client who has suffered injury to his nervous system. The client has a history of chronic pain and currently reports pain on a scale of 8 out of 10. The nurse identifies this type of pain as most likely:

neuropathic pain

A nurse is providing care at an ambulatory care center to a wide range of older adults from diverse racial and ethnic groups. Based on recent statistics, which group would the nurse most likely identify as projected to be the largest?

non-hispanic whites

The nurse is preparing a presentation on chronic pain management to a group of older adult members of a community senior citizens center. Which chronic disease should the nurse focus on in her presentation?

osteoarthritis

While assessing an older adult, the client reports pain resulting from shingles. The nurse identifies this as which type of pain?

postherpetic neuralgia

An client 81 years of age is in a long-term-care facility. His family could no longer cope with his progressing senile dementia, including wandering away and unpredictable behavior. Late one night the nurse finds the client wandering in the hall. He says he is looking for his wife. What should the nursing approach should be?

remind him of where he is and assess why he is having difficulty sleeping

The student nurse is conducting an informal study on pain management in the older adult population in a local long-term care facility. Which older adult client population will the student most likely find to receive the least effective pain management?

residents 85 years or older

A nurse is developing a plan of care for a client who recently lost his spouse. Which of the following would be most appropriate for the nurse to suggest to help the client cope with his loss?

seeking support from his faith

In a report, the night nurse tells the incoming nurse that one client with dementia has sundowning syndrome. Which of the following nursing diagnoses would be most appropriate for this client?

sleep deprivation

An older adult is admitted to the health care facility with a diagnosis of depression. The nurse would be especially alert for:

suicidal thoughts

Which activity performed by an older adult client would make the client's family suspicious of the onset of dementia?

the client is an accountant and has had three episodes of bookkeeping errors

A nurse is preparing a presentation for a group of older adults about health promotion. Which statistic would the nurse need to keep in mind about this group?

the group experiencing the largest growth is those 85 years of age and older

A nursing student is studying depression in the elderly adult. Faculty members knows the student has mastered the information when she states which of the following?

treatment of depression includes counseling

A client with Alzheimer's disease becomes agitated and is unable to communicate. The nurse notes that this is a change from his regular demeanor. The nurse performs a thorough assessment of the client, determining that he has an abscessed tooth. This assessment can be termed:

validation therapy

A client is in the postoperative phase of an abdominal resection and colostomy. When educating the client on ostomy care by providing educational materials to read, it is important to assess the client's:

vision

Which group of individuals in the older adult population is most likely to be widowed?

women over the age of 75

A nurse is reviewing the medical records of clients at a long-term care facility who are experiencing weight loss. The clients' medical conditions have been ruled out as a cause. The nurse understands that which situation would most likely be a factor? Select all that apply.

• evidence of depression • use of appetite-suppressing drugs • need for staff to assist with meals

A nurse is teaching a group of older adults about the need for continued physical activity. The nurse determines that the education was successful when the group identifies which outcomes as a benefit? Select all that apply.

• improvement in thinking • reduced risk of stroke • reduced risk of injuries • improved balance

The nurse is assessing an older adult client that states, "I feel lonley." What factors does the nurse identify as contributing factors to the client's lonliness? Select all that apply.

• loss of an important relationship • depression • cognitive changes

A nursing student is studying the normal physiologic changes of older adults. The faculty member knows that the student comprehends the information when the student makes which statements? Select all that apply.

•"Height may decrease 1 to 3 in (2.5 to 8 cm)." •"There is an increased sensitivity to glare." •"Fluids and electrolytes remain within normal ranges."

The nurse is assigned to care for a client age 87 years admitted to the medical unit for congestive heart failure. It is the fourth hospital day, and the response to treatment has been good. The client is no longer short of breath and the lung sounds are clearing. There is still a diet restriction of decreased sodium and fluids are limited to no more than 1000 mL per day. The nurse is preparing the client and family for discharge. The nurse's discharge education, in order to promote the older client's health, will include which instructions? Select all that apply.

•Gradually increase activities as tolerated. • Do not use the salt shaker at meals. • Increased stress may interfere with recovery.

A older adult client is admitted to a nurse's unit with a community-acquired pneumonia requiring 14 days of intravenous antibiotic treatment. What does the nurse identify to the client as a contributing factor that affects the older adult client? Select all that apply.

•Humoral immunity declines. •Older adults are more susceptible to pneumonia following respiratory infections.

The nurse is caring for a client diagnosed with dementia. Which behaviors would the nurse most likely assess? Select all that apply.

•asking questions repeatedly • socially inappropriate behavior • wandering • irritabilty

When providing care to a client with dementia, which interventions would be most appropriate? Select all that apply.

•maintain levels of sensory stimulation that are tolerable • ensuring the use of assistive sensory devices • using validation therapy

A nurse is providing care to an older adult who is experiencing delirium. Which risk factors would the nurse identify as being most common? Select all that apply.

•pre-existing cognitive impairment •advanced age •sleep deprivation