theo final questions

A client with osteoarthritis of the right knee is afraid of falling because of joint instability. What should the nurse recommend to this client to enhance stability? A)Cane B)Crutches C)Walker D)Wheelchair

A

An older client asks if food additives are a risk factor for cancer. Which of the following statements would be most accurate? A)There is no clear evidence that food additives are a risk factor for cancer. B)There is clear evidence that food additives are a risk factor for cancer. C)Food additives never cause cancer. D)Food additives are a well-known cause of cancer.

A

An older client asks why so many older people are diagnosed with cancer. What should the nurse respond to the client? A)"The immune system changes and the body doesn't recognize cancer cells to destroy them." B)"There wasn't enough exposure to environmental carcinogens over the lifespan.' C)"The body's organs begin to fail, causing cancer to develop." D)"There is no real answer to that. It depends upon the person's genetics."

A

An older client's capillary blood glucose level at 0700 hours is 58 mg/dL yet is not demonstrating any symptoms of hypoglycemia. What should this assessment finding indicate to the nurse? A)Impaired autonomic nervous system B)Medication dosage needs to be changed C)Caloric intake needs to be increased D)Recheck the blood glucose level

A

The nurse is performing a respiratory assessment on an older adult client and identifies an outward curvature of the thoracic spine. What will the nurse do next? A)Instruct client to perform incentive spirometry. B)Refer to physical therapy. C)Teach strengthening exercises. D)Document kyphosis.

A

Which of the following may be indicators of elder client abuse? Select all that apply. A)Infliction of injury on the client B)Infliction of pain on the client C)Sexual abuse D)Neglect E)Rigidity in family roles

A, B, C, D

What assessment findings support a diagnosis of hyperthyroidism in the older adult? (Selectall that apply.) a. Tremors b. Heat intolerance c. Tachycardia d. Palpable goiter e. Atrial fibrillation

A, D, E

An older adult reports waking up with a headache and a nosebleed. What should the nurse assess first in this client? A)weight B)blood pressure C)heart rate D)body temperature

B

The nurse notes that an older adult client's blood glucose levels have been consistently dropping over the last several weeks. What supplement should the nurse ask if the client is using? A)zinc B)garlic C)magnesium D)chromium

B

Which is the most important chronic care goal for the older client? A)Diagnosis B)Healing C)Cure D)Treatment

B

After a health assessment an older adult client is scheduled for tests to determine the presence of diabetes. Which finding was the basis for this scheduling this client's diagnostic testing? A)leg cramps B)cataracts C)neuropathy D)hypertension

C

An adult daughter reduced work hours to provide care for older parents who live in their own home. Which observation indicates that the daughter might need assistance with the parents' needs? A)Father sits with grandchildren to help with homework B)Daughter's husband maintains the parents' lawn C)Daughter skips meals because of finances D)Mother helps fold clothes that daughter has laundered

C

An older adult admitted to the emergency department exhibits dyspnea and a sudden change in level of consciousness. The nurse should assess for which disorder? A)aortic aneurysm B)myocarditis C)myocardial infarction D)cor pulmonale

C

An older adult client recently experienced a syncopal (fainting) episode after standing up quickly while gardening. The nurse ensures the client's safety and confirms the client is not injured. Which assessment is the nurse's next priority? A)"When did you last eat a meal?" B)"Did you experience any fatigue or blurred vision?" C)"What medications do you take?" D)"What did your provider say about this?"

C

An older adult client resists getting out of bed to walk after experiencing a myocardial infarction. What should the nurse explain to this client? A)"Walking helps metabolize the food that you eat." B)"Walking prevents another heart attack from occurring." C)"Walking prevents any problems caused by lack of activity." D)"Walking reduces the need for heart medication."

C

An older adult client states that many peers have hypertension. When explaining this phenomenon, what should the nurse describe? A)Ineffective health maintenance by many older adults B)Age-related decreases in tissue perfusion C)Age-associated vasoconstriction D)Hypothyroidism

C

An unemployed adult son lives with an older client who provides the meals and spending money for the son. Which role best describes the son in this family situation? A)Deviant B)Victim C)Dependent D)Decision-maker

C

During an assessment of the head and neck the nurse suspects that an older adult client has emphysema. What finding caused the nurse to make this clinical determination? A)grey skin color B)bluish cast around the lips C)ruddy complexion D)yellow sclera

C

The nurse assesses a 90-year-old client who has chronic obstructive pulmonary disease (COPD). The nurse should include which interventions in the client care plan? A)Teaching about the identification of peripheral edema B)Vascular disease prevention measures C)Infection prevention measures D)Information on the benefits of regular exercise

C

Which blood test is done to identify mutations in either one of two breast cancer genes? A)BRAC 1 and 2 B)CAM 1 and 2 C)BRCA 1 and 2 D)BARC 1 and 2

C

Which end-of-life nursing diagnosis is associated with the aging client and fear? A)Disturbed body image B)Deficient knowledge C)Disturbed thought process D)Impaired skin integrity

C

An older male expresses concern about missing the men's prayer meeting at church while he's hospitalized. What is the nurse's best action? A)Offer to telephone the chaplain the next day B)Encourage the client not to worry about one missed meeting C)Document the presence of spiritual distress D)Ask the client about the prayer meeting and listen attentively

D

The nurse notes that an older client with diabetes has a change in hand writing and is becoming more difficult to read. What should the nurse suspect is occurring with this client? A)elevated triglycerides B)heart disease C)metabolic syndrome D)neuropathy

D

A 71-year-old client with a history of cardiovascular disease presents with hypotension, tachycardia, loss of hair on the extremities, and cyanosis. Which intervention will the nurse include in the plan of care? A)Administer nitroglycerin as needed. B)Administer nadalol as needed. C)Administer epinephrine as needed. D)Administer propranolol as needed.

A

A 79-year-old client who was admitted for pneumonia develops an infection caused by Clostridium difficile (C. diff.). What will the nurse suspect as the cause for this client's sudden illness? A)Client had several doses of broad-spectrum antibiotic. B)Client has a longstanding history of type 2 diabetes. C)Client refuses to wash hands before eating. D)Client refuses to eat sufficient fruits and vegetables.

A

A 99-year-old resident has fallen. Which functional consequence of this fall most strongly affects the plan of care? A)A 99-year-old is at much higher risk of a fracture from a fall than a younger adult. B)A 99-year-old will have diminished muscle strength related to muscle mass loss. C)A 99-year-old is more likely to have limited range of motion, affecting performance of some activities of daily living (ADLs). D)A 99-year-old who has fallen is unlikely to develop fear of falls.

A

A Greek Orthodox priest arrives to visit a client with a terminal illness. What should the nurse expect the client to receive from this clergy member? A)last rites B)string tied at the wrist C)confession D)baptism

A

A client is undergoing chemotherapy. What assessment data suggest the client is demonstrating age-related changes that increase the risk for medication toxicity? A)decreased glomerular filtration rate B)reduced physical stamina and activity level C)diminished pH production by the gastrointestinal system D)muscle strength deterioration and bone density loss

A

A client recently diagnosed with plantar fasciitis reports heel pain. Which information will the nurse provide during client teaching? A)Ice the area to relieve inflammation. B)Wear sandals for less impact on foot. C)Massage the area to increase circulation. D)Increase the amount of walking each day.

A

A client with a chronic respiratory problem is in a weakened state and unable to cough effectively. What action will the nurse take first? A)Assess for signs of infection. B)Teach visitors the importance of handwashing. C)Encourage increased fluid intake. D)Assist with incentive spirometry.

A

A nurse admits an older adult client with a history of dysphagia to the hospital with a productive cough and fever. Which is the most important action the nurse will take? A)Request thickened liquids. B)Measure the vital signs. C)Suggest the client take vitamin C. D)Encourage the client to stop smoking.

A

A nurse cares for an older adult who is nonresponsive and surrounded by family. Which statement by the nurse is most appropriate? A)"I am here for you; how can I be helpful?" B)"I'll leave you alone so that you can grieve in private." C)"She was a really nice lady; she did a good job raising you." D)"I know just how you feel, my mother died last month."

A

A nurse discusses common illnesses at the local health fair. The older adult asks, "Why do all my friends seem to get pneumonia? We never did when we were younger." Which intervention should the nurse include in the teaching? A)hand hygiene B)yearly pneumococcal polysaccharide vaccine C)yearly examinations D)jogging/running

A

A nurse identifies clients who are at risk for modifiable risk factors for cardiovascular disease. Which client should the nurse identify as having modifiable cardiovascular functional consequences? A)An older adult client who is obese who has type 2 diabetes B)An older adult client admitted to the hospital with hepatitis A C)An older adult client who has had a second myocardial infarction D)An older adult client with a strong family history of myocardial infarctions at an early age

A

A nurse in the long-term care facility assesses an 86-year-old client who has recently become lethargic and difficult to arouse. Vital signs are all stable and within normal limits. Breath sounds are diminished. Which action by the nurse should be the priority? A)Send the client to the emergency department. B)Tell the aides to keep an eye on the client. C)Place the client on high fall risk precautions. D)Call the family and give them an update.

A

A nurse is reviewing possible first-line medications for a new, older type 2 diabetic. Whatcontraindication does the nurse identify for metformin (Glucophage)? a. Patient drinks three to four alcoholic drinks/day b. Patients parents both took insulin c. Creatinine 0.9 mg/dL d. Potassium 3.8 mEq/dL

A

A nurse manager of an intensive care unit develops plans to improve end-of-life care for clients in the unit. Which action is the priority? A)Guide staff to improve communication with families about end-of-life decision making. B)Increase communication between professionals about end-of-life decision making. C)Create a script for nurses to use when discussing hospice and palliative care. D)Survey clients and families about their end-of-life needs.

A

A nurse who works in a palliative setting is aware of the need to facilitate a "good death" for as many clients as possible. Which intervention should be included? A)Empower the client and family to maintain as much control as possible. B)Ensure that a minimum of nursing interventions are performed. C)Discuss openly and explicitly the client's strengths and weaknesses. D)Emphasize spiritual needs rather than physical comfort and medical needs.

A

A patient has been admitted with new atrial fibrillation. What additional diagnostic testingdoes the nurse anticipate? a. Thyroid hormones b. Platelet count c. Urinalysis d. Blood glucose

A

A patient is observed sitting on the side of the bed crying. When approached the patient does not say anything but continues to cry and hold the nurse's hand. What should the nurse do to communicate being present with the patient? A) Sit down next to the patient B) Leave the patient alone to cry C) Encourage the patient to stop crying D) Ask the patient to use the call bell if he or she wants to talk

A

A patient with cancer asks the nurse to pray with him but the nurse does not feel comfortable with prayer. What should the nurse do? A) Decline politely and ask a coworker to pray with the patient B) Arrange transportation so that the patient can attend prayer meetings at his church C) Pray with the patient after making sure he understands that the nurse would prefer not to D) Pray with the patient realizing that the patient's needs are more important than the nurse's beliefs

A

After reviewing an older adult client's medical record the nurse realizes that the annual influenza vaccination is contraindicated. What information did the nurse use to make this clinical determination? A)allergic to eggs B)has a history of chronic obstructive pulmonary disease (COPD) C)received the pneumococcal vaccination 1 week ago D)uses an inhaler to treat asthma

A

An 85-year-old client broke two teeth after hitting them on the siderail of the bed. The nurse has confirmed that the client is not bleeding. Which assessment will the nurse perform next? A)Signs and symptoms of respiratory compromise B)Cardiac status C)Nutritional status D)Ability to swallow

A

An adult daughter is crying uncontrollably after seeing the body of her late mother in the hospital bed. What should the nurse consider when consoling the daughter? A)the daughter most likely has not had much exposure to death B)the daughter feels guilty that the client died C)the daughter is overwhelmed with feelings about her own death D)the daughter is relieved that the client has passed away

A

An emergency room nurse cares for the family of an older adult client who died unexpectedly. In the waiting room, upon hearing of the death, two family members kneel to the floor moaning and do not respond. Which intervention by the nurse is most appropriate at this time? A)Allow the family to grieve in this manner directing others away. B)Call an emergency response team to care for these family members. C)Assess these family members' vital signs and neurologic status. D)Bring these family members to the body of their loved one.

A

An older adult client is brought to the emergency department from home with a sudden change in mental status and productive cough, accompanied by significant weakness. Which intervention will the nurse implement? A)Obtain a sputum specimen. B)Percuss the abdomen. C)Administer a purified protein derivative (Mantoux) test. D)Measure peak flow.

A

An older adult client is diagnosed with a toxic multinodular thyroid goiter. What teaching should the nurse prepare for this client? A)thyroidectomy B)medications C)dietary changes D)radioactive iodine

A

An older adult client reports coughing more often while eating. Which intervention will the nurse teach the client to prevent this from happening? A)Drink more water during meals. B)Eat more foods with a dry consistency. C)Warm the palate with warm fluids before eating. D)Lean the head back while swallowing.

A

An older adult client reports fatigue and shortness of breath walking short distances since retiring from a job as a mail carrier. After the health care provider has ruled out disease, which will the nurse include in the client teaching? A)Walk 30 minutes daily. B)Sleep 10 hours per night. C)Conserve energy by separating activities. D)Consider a part-time job.

A

An older adult client reports weakness, fatigue, dizziness, palpitations, and fainting. Which assessment will the nurse utilize for this client? A)Measure heart rate. B)Evaluate for chest pain. C)Examine feet and ankles. D)Percuss the abdomen.

A

An older adult client who is a vegetarian is diagnosed with early signs of osteoporosis. Which food item should the nurse encourage the client to ingest? A)tofu B)rice C)cauliflower D)beans

A

An older adult client with emphysema experiences activity intolerance. Which intervention should the nurse add to this client's plan of care? A)schedule rest periods between activities B)use pursed lip breathing C)provide the seasonal influenza inoculation D)deep breathe and cough every 8 hours

A

An older adult requests an hour of solitude to pray. What is the nurse's best action? A)Arrange for an uninterrupted hour alone. B)Request that she leaves the door open. C)Assess for signs or symptoms of spiritual distress. D)Ask nursing assistant to check on her at 30 minute intervals.

A

An older adult requests the services of someone who gives massages. The nurse should try to contact which person? A)Sobadora B)Curandera C)Bruja D)Espiritualista

A

An older adult with diabetes is experiencing pruritus from hyperglycemia. What nursing diagnosis should the nurse associated with this client's pruritis? A)Impaired skin integrity B)Anxiety C)Disturbed sleep pattern D)Altered peripheral tissue perfusion

A

An older client admits that the thought of dying is not pleasant, because it is an expectation that life eventually ends. What should this client's statement suggest to the nurse? A)The client has had previous experiences with death. B)The client is not ready to accept that death occurs. C)The client is delusional. D)The client intends to avoid talking about death in the future.

A

An older client asks if artificial sweeteners cause cancer. Which of the following answers would be most accurate? A)This link has not been proven. B)There is a link. C)There might be a link. D)This link has been proven.

A

An older client tells the nurse to send family home because an adult daughter keeps complaining about wasting time sitting in a hospital room. On which family dynamic is the client having an issue? A)Feelings about family members B)Community ties C)Communication pattern D)Attitude, values, and beliefs

A

An older client that the nurse has visited periodically over several years has died. What should be done to support the nurse's feelings about the client's death? A)encourage the nurse to cry B)suggest the nurse not visit the family C)remind the nurse to be professional D)recommend the nurse avoid the funeral

A

An older client with asthma asks what nonpharmacological actions to use to loosen airway passages. What should the nurse recommend to this client? A)eat a meal with garlic or peppers B)drink a glass of milk C)eat a piece of cheese D)sip on a caffeinated beverage

A

An older patient has osteoporosis and is reluctant to exercise because I already have a boneproblem, so how will it help? What response by the nurse is best? a. It can improve posture, balance, and reduce falls. b. It will give you heart-healthy benefits. c. Exercise will make you feel younger. d. If you join a gym, you can socialize with new people.

A

An older patient tells the nurse that he meditates to seek enlightenment. Because of this, the nurse might inquire if he wishes to have which item eliminated from his daily dietary intake? A) Beef B) Cereal C) Refined sugar D) Leavened bread

A

At the conclusion of a health history the nurse conducts a spiritual assessment with the patient. Why is this assessment important? A) Strong spiritual beliefs facilitate health and healing B) A spiritual crisis can trigger a psychosomatic disease C) It is the nurse's job to facilitate communication between the patient and the clergy D) The nurse needs to be careful that therapeutic regimens do not violate a patient's religious beliefs

A

The adult daughter of an older client is upset because the client won't let her wash the dishes. What should the nurse explain about the physical advantages of this activity? A)exercises the fingers in warm water B)helps improve focus C)makes the client feel useful D)clears the mind

A

The children and spouse of a client dying of renal failure are eager to interact with the client as much as possible in the days before death. Consequently, the client's daughter has questioned the nurse's decision to administer the client's scheduled opioid analgesic stating that the client does not appear to be in pain at the present time and that the drug tends to make the client drowsy. Which should be the nurse's initial response? A)Explain the rationale for preventative pain control to the family. B)Administer another analgesic that is less likely to have a sedative effect. C)Document the family's reservations, giving the drug after the family leaves. D)Withhold the analgesic and report the interaction to the health care provider.

A

The children of a 77-year-old client, who has recently moved to an assisted living facility, are adamant that the client's common law partner of 2 years be barred from participating in care. The children state that the partner is manipulative, but the client disagrees. Which action would be appropriate for the nurse? A)Accept that the relationship plays a positive role for the client. B)Document the children's concerns and investigate the truth of their claims. C)Organize a family meeting to facilitate reconciliation. D)Ask the partner to demonstrate that the partner is not a negative influence.

A

The family of a patient who has type 2 diabetes calls the clinic to report a very small sore onthe patients foot. What action by the nurse is best? a. Have the patient come to the clinic today. b. Have the family wash and bandage it. c. Tell the patient to check for a fever. d. Have the patient go to the emergency room.

A

The nurse admits a client to the skilled care unit with symptoms of fatigue, weakness, and lethargy. Before the primary care provider completes a diagnosis of depression, which laboratory test would the nurse expect to be completed? A)T4 and TSH B)Triglyceride and cholesterol C)Estrogen and testosterone D)Random blood glucose and A1c

A

The nurse instructs an older adult client on diaphragmatic breathing exercises. What should the nurse explain as being the ratio of inhalation to exhalation when performing these exercises? A)1:3 B)1:2 C)1:1 D)1:4

A

The nurse instructs an older client on dietary changes to reduce the risk of cardiovascular disease. Which client statement indicates that teaching has been effective? A)"Olive oil is good for me to use." B)"I should limit eating oatmeal, rye, and barley." C)"There's no reason for me to cut down on drinking beer." D)"Fish should be eaten occasionally."

A

The nurse is caring for an 80-year-old client with confusion who is being prepared for discharge. The nurse notes the client's adult child has left-sided weakness from a stroke several years earlier. What nursing action will best address the client and caregiver's safety? A)Assess the caregiver's ability to help the client at home. B)Provide the caregiver information on elder abuse. C)Encourage the caregiver to hire a home health aide. D)Ask the health care provider to send the client to a nursing home.

A

The nurse is caring for an aging client with diabetes who has developed peripheral neuropathy. What nursing diagnosis best relates to this complication? A)Disturbed sensory perception B)Impaired skin integrity C)Anxiety D)Disturbed sleep pattern

A

The nurse is caring for an older adult client recovering from pneumonia. Which action will the nurse recommend as part of the discharge plan? A)Drink lots of fluids to thin your secretions. B)Avoid coughing to prevent relapse. C)Visit your health care provider for a pneumonia vaccine. D)Take vitamin C daily to prevent infection.

A

The nurse is changing the dressing on a large wound. The client is very calm and quiet and does not make eye contact with the nurse. What is the nurse's best action? A)Ask client to rate the pain level on 0 to 10 scale B)Suggest the client pray while packing the wound C)Tell the client it's okay to cry or be uncomfortable D)Proceed with the dressing change

A

The nurse is discussing smoking cessation with an older adult client who has smoked two packs per day of cigarettes since the client's late teens. The client responds, "At this point in my life, I think it is probably too late to quit." How should the nurse best respond to the client's statement? A)"Actually, you will start to enjoy some health benefits almost as soon as you quit." B)"Three months after you quit, you will have the same risk of heart disease as a lifetime nonsmoker." C)"You will be able to avoid having a future heart attack if you quit smoking now." D)"In a way that is true, but you would feel much better about yourself if you managed to quit."

A

The nurse is explaining a medical procedure to an older adult client. How should the nurse interpret and act on the client's quiet demeanor and nodding of the head? A)Ask the client if there are any questions. B)Ask the client to sign the informed consent. C)Expect the client to respond to the information. D)The client demonstrates full understanding of the procedure.

A

The nurse is preparing a care plan for a client who practices Islam. What activity should the nurse include when accounting for time management of treatments? A)Prayer five times a day B)Adherence to the Eightfold Path C)Discussion of reincarnation D)Reading of the Torah

A

The nurse is preparing a list of patients who will need the annual influenza inoculation. Which older adult will most likely refuse this vaccination? A) A 71-year-old Christian Scientist B) A 68-year-old man who attends a Unitarian church C) A 68-year-old female patient who identifies herself on admission as a Jehovah's Witness D) A 78-year-old who says that she is a member of the Church of Jesus Christ of Latter Day Saints

A

The nurse is preparing to provide an older, newly diagnosed diabetic patient with informationregarding type 2 diabetes. The nurse initially: a. asks if the patient prefers a video or a pamphlet. b. invites the patients spouse to be present during the instruction. c. selects a quiet, well-lighted space for the class. d. ensures that the patient is pain-free and comfortably seated.

A

The nurse knows that which developmental task described by Erikson applies to older adulthood? A)Integrity versus Despair B)Intimacy versus Isolation C)Identity versus Role Confusion D)Generativity versus Stagnation

A

The nurse manager of a geriatric medicine unit learns that spiritual care services are underutilized by patients and their families. Which phenomenon explains this finding? A) While spiritual needs are a universal part of the human condition, many people do not acknowledge these needs. B) The high-stress environment of a hospital is incompatible with the solace and quiet necessary for addressing spiritual needs. C) Spiritual needs are less apparent during times of immediate and tangible need, such as acute illness requiring hospital treatment. D) Many older adults who have experienced a lifetime of self-sufficiency and practical resourcefulness do not have spiritual needs.

A

The nurse notes that an older adult client has a decrease in muscle mass and tone. Which recommendation will the nurse make as a part of client teaching? A)Perform resistance exercises. B)Begin weightlifting at the gym. C)Get up from your chair several times per day. D)Use an assistive device to walk more.

A

The nurse notes that an older adult client has decreased breath sounds. What should the nurse suspect is occurring with this client? A)Decreased tidal volume B)Reduced ciliary movement C)Untreated chronic lung disease D)Undiagnosed pneumonia

A

The nurse notes that an older adult client with diabetes is prescribed rosiglitazone. Which assessment should the nurse complete before providing this medication to the client? A)blood pressure B)body mass index C)bowel sounds D)abdominal circumference

A

The nurse notes that an older client's blood glucose levels are low every Thursday morning. Which information should the nurse consider as the explanation for this finding? A)drinks beer after bowling every Wednesday evening B)had limited food in the house because of bad weather C)beta-blocker medication discontinued by the provider D)skipped two doses of medication the previous week

A

What behavior demonstrates to the nurse that the significant other of a client with a terminal illness has come to accept the certainty of the client's death? A)Sharing stories of happy times together B)Holding hands during visits C)Asking that a chaplain is available when visiting D)Providing the client with religious readings

A

What intervention demonstrates attention to a fundamental right of all individuals facing death? A)When death is imminent, a staff member stays with a client who is dying B)Difficult discussions are avoided in the client's presence. C)Physical care is minimal in order to preserve physical strength. D)Decisions concerning after-death arrangements are directed to family.

A

When conducting a risk for cancer community assessment for the older adult population, which information is most important in determining a nursing education plan for the public? A)More than half of all persons diagnosed with cancer are over age 65. B)More than half of all persons diagnosed with cancer are over age 80. C)More than half of all persons diagnosed with cancer are over age 75. D)More than half of all persons diagnosed with cancer are over age 70.

A

When explaining family member roles in the care of older adults, which of the following is on the list as a family member victim role? A)An economically abused family member B)The deviant C)The family scapegoat D)The problem child

A

Which endocrine function nursing diagnosis is associated with the aging client and altered neurovascular functions secondary to neuropathies? A)Risk for altered peripheral tissue perfusion B)Noncompliance C)Anxiety D)Risk for disuse syndrome

A

Which endocrine function nursing diagnosis is associated with the aging client who has vaginitis as a result of diabetes? A)Sexual dysfunction B)Hypoglycemia C)Fluid volume deficit D)Urinary frequency

A

Which intervention is most important to include in the plan of care for a 79-year-old client diagnosed with decreased coronary blood flow? A)Observe for restlessness or change in consciousness. B)Assess vital signs every 8 hours. C)Demonstrate relaxation techniques. D)Administer beta-blockers.

A

Which is the priority nursing intervention for the management of delirium? A)Giving the client low-dose oxygenation and maintaining his or her fluid and electrolyte balance. B)Providing psychological support through cognitive and social stimulation. C)Reducing noise and placing familiar objects in the client's environment. D)Giving the client a clock, a watch, and calendars to provide the client with temporal orientation.

A

Which nursing intervention can help the older adult achieve a spiritual attitude of gratitude? A)Encourage a life review of positive aspects and achievements. B)Promote feelings of a connection to a higher power. C)Remind client that everyone has made mistakes in their life. D)Help the client to feel entitled to high quality care.

A

Which statement best captures the typical character of health problems in the lives of older adults? A)Most older adults experience an interplay between a number of chronic conditions and occasional acute health problems. B)Chronic conditions account for the normal downward direction of an older adult's health status. C)Older adults' lives are dominated by the increasing number of acute health problems due to age-related changes. D)Older adults can expect a relatively consistent decline in their health over time as a result of acute health problems.

A

A client will be returning to home, having to use a wheelchair for several months. Which area(s) of the home environment should the nurse identify as needing modifications to support this client's needs? Select all that apply. A)doorways that are not wide enough B)bathroom sink in a cabinet C)three stairs in entry way D)kitchen table that is high enough for wheelchair arms to go under E)living room furniture that is easily movable

A, B, C

An older adult client reports attempting smoking cessation cold turkey several times without success. Which recommendation(s) will the nurse make to this client? Select all that apply. A)nicotine patches, gum, or lozenges B)acupuncture C)sugar-free hard candy instead of smoking D)snack instead of smoking E)deep breaths instead of smoking

A, B, C

An older male patient with end-stage renal disease is sad and believes that he will die within a few days. Which interventions should the nurse use to promote hope in the patient? (Select all that apply.) A) Using humor at the bedside B) Facilitating a life review for the client C) Helping the client to find pleasure during current life activities D) Encouraging the client to focus on a time of life that was more pleasant E) Introducing the client to an individual who has a much poorer prognosis and/or health status

A, B, C

The community health nurse works with many older clients who have chronic conditions. The nurse should prepare to teach what skills to clients? Select all that apply. A)Injecting medications B)Changing dressings C)Applying prosthesis D)Diagnosing illness E)Establishing intravenous access

A, B, C

The nurse is caring for an older adult client who has pneumonia. Which of the following factors may have contributed to this client's diagnosis? Select all that apply. A)Poor chest expansion B)Lowered resistance to infection C)Increased exposure to pathogens compared to younger people D)High-risk behaviors E)Deep breathing

A, B, C

The nurse plans an education program about hypertension for older adult community members. Which action(s) will the nurse recommend to prevent or improve hypertension? Select all that apply. A)regular exercise B)smoking cessation C)low sodium diet D)glass of wine with dinner E)drinking caffeinated beverages

A, B, C

An older adult client has been experiencing dizziness when moving from a sitting to a standing position. The nurse is concerned about the client's risk for falls. What instruction(s) should the nurse provide the client regarding how to get out of bed in the morning? Select all that apply. A)Stretch muscles before moving B)Move to a sitting position on the side of the bed C)Sit for several minutes on the side of the bed D)Spend several minutes in bed resting E)Bend at the waist while sitting to touch the ankles

A, B, C, D

An older adult couple wants very much to maintain their independence and avoid asking their children for help. Which suggestion(s) would be most effective in helping the couple maintain independence? Select all that apply. A)"Find someone you can trust to telephone you every day to make sure you are doing okay." B)"Arrange to use Meals on Wheels or look for other ways to get prepared foods." C)"Have grab bars, a wheelchair ramp, or other needed modifications done if necessary." D)"Try hiring a part-time worker to help out with some chores and run errands for you." E)"Do as much for yourselves as you can possibly tolerate, even if it means you get really tired."

A, B, C, D

An older client asks a nurse to explain the benefits of exercise. The nurse should include which of the following? Select all that apply. A)Improved body tone B)Improved digestion C)Improved appetite D)Improved circulation E)Improved hair growth

A, B, C, D

An older client is demonstrating a change in mental status. Which laboratory tests should the nurse expect to be prescribed to rule out a physiological reason for the client's change in cognitive functioning? Select all that apply. A)Blood glucose B)Blood urea nitrogen C)Complete blood count D)Sedimentation rate E)C-reactive protein

A, B, C, D

The nurse is caring for a 75-year-old client who has been diagnosed with respiratory risk associated with aging. Which risk(s) will the nurse discuss with the client? Select all that apply. A)Pain may be mistaken for an ailment other than a respiratory problem and delay treatment. B)Dislodged loose teeth can cause a lung abscess. C)Reduced fluid intake can cause drier mucous membranes. D)Mucus can contribute to cause mucus plugs and infection. E)Changes in food preferences create a risk for aspiration.

A, B, C, D

The nurse notes that an older adult client with diabetes is prescribed metformin. For which information in the client's health history will the nurse question the health care provider before giving the client the first dose? Select all that apply. A)alcohol use disorder B)peripheral vascular disease C)congestive heart failure D)hepatic disease E)osteoarthritis

A, B, C, D

The nurse notes that an older client is to begin receiving hospice care. What should the client and family expect when receiving this care? Select all that apply. A)Caregiver support B)Family support C)Palliative care D)Client support E)Curative treatment

A, B, C, D

The nurse teaches an older patient safety rules for exercising. What do these rules include?(Select all that apply.) a. Carry medical identification. b. Check blood glucose before exercising. c. Drink plenty of water. d. Have quick-acting glucose. e. Knowing signs of hyperglycemia.

A, B, C, D

When assessing an older adult client's risk for cancer, which information should the nurse integrate when determining nursing care for the client? Select all that apply. A)Occupational history B)Nonmodifiable risk factors C)Modifiable risk factors D)Current lifestyle E)Stress level

A, B, C, D

When teaching an older patient about diet therapy, the nurse plans to assess for barriers toadherence, including which factors? (Select all that apply.) a. Lifelong habits b. Cultural influences c. Finances d. Dependency e. Inability to learn

A, B, C, D

Which question(s) will the nurse ask to assist in revealing respiratory disorders in an older adult client? Select all that apply. A)Do you ever have chest pain? B)Do you ever have a heavy feeling in your chest? C)Do you ever have wheezing? D)Do you have any breathing problems when the weather gets hot or cold? E)Do you use a dehumidifier in your hom

A, B, C, D

A nurse is evaluating older adult clients for type 2 diabetes. Which client(s) will the nurse evaluate for a comorbidity of type 2 diabetes? Select all that apply. A)client with hypertension B)overweight client C)client with hyperthyroidism D)client being treated for hyperlipidemia E)client diagnosed with cardiovascular disease

A, B, C, D, E

A nurse is reviewing the medical records of several older adult clients. Which factor(s) would the nurse most likely identify as challenging older adults' emotional homeostasis? Select all that apply. A)Sensory deficits B)Greater awareness of own mortality C)Increased vulnerability to crime and abuse D)Altered function or body image E)Increased dependence on other

A, B, C, D, E

An older adult client who has a history of smoking, is at risk for decreased ciliary function of the lungs. Which intervention(s) will the nurse implement for this client? Select all that apply. A)Administer oxygen as prescribed. B)Teach the client deep-coughing techniques. C)Align the client in an upright position. D)Perform postural drainage. E)Instruct the client in the use of humidifier.

A, B, C, D, E

An older adult client who has a history of smoking, is at risk for decreased ciliary function of the lungs. Which intervention(s) will the nurse implement for this client? Select all that apply. A)Instruct the client in the use of humidifier. B)Align the client in an upright position. C)Perform postural drainage. D)Administer oxygen as prescribed. E)Teach the client deep-coughing techniques.

A, B, C, D, E

A nurse cares for a 100-year-old client in hospice. The client contemplates perspectives regarding end-of-life care. Which historical perspectives most likely represent how this client's life experiences have had a formative influence on the client's views on death and dying? (Select all that apply.) A)"I never thought that I would be this old." B)"I outlived my children and my two spouses." C)"My brother died in a work-related accident." D)"My family shouldn't have to take care of me." E)"I lost an infant to small pox."

A, B, C, E

A nurse is developing a teaching program for a 66-year-old client who was just diagnosed with type 2 diabetes. When providing this teaching, which educational material(s) will be appropriate for the nurse to use? Select all that apply. A)audio recording of instructions B)online interactive presentation C)video presentation D)printed handouts on white paper with font size 24 E)commercial pamphlet with pictures and font size 12

A, B, C, E

An older adult client experiences impairment in physical mobility. Which intervention(s) will the nurse include in the client's plan of care? Select all that apply. A)Remind to maintain good body alignment B)Design an exercise program appropriate for the client's status C)Coach to change positions every hour D)Encourage family to do more for the client E)Promote a healthy nutritional intake

A, B, C, E

Hospice care addresses which important effort(s) for the dying older client? Select all that apply. A)Symptom control B)Pain relief C)Spiritual care D)Acute medical care E)Psychosocial support

A, B, C, E

The nurse is caring for an older client whose death is believed to be imminent. The nurse should anticipate what assessment findings? Select all that apply. A)Profuse perspiration B)Cold extremities C)Pallor D)Constipation E)Weak, rapid pulse

A, B, C, E

The nurse reviews interventions to reduce an older client's risk of trauma when at home. What should the nurse emphasize during this teaching? Select all that apply. A)Wear well-fitting low-heeled shoes B)Remind to wear eyeglasses at all times C)Use the cane when ambulating D)Place reading material on the floor E)Use the bannister when walking the stairs

A, B, C, E

The nurse suspects that an older adult client's blood pressure is low. What did the nurse observe to make this clinical determination? Select all that apply. A)Dizziness B)Drowsiness C)Confusion D)Slow tremor E)Restlessness

A, B, C, E

Which of the following stages may the dying client experience? Select all the apply. A)Denial B)Acceptance C)Bargaining D)Repression E)Anger

A, B, C, E

An intensive care nurse cares for an older adult client with sepsis. The client exhibits illogical thinking and agitation. Which intervention(s) will the nurse implement? Select all that apply. A)Post pictures of client's family in the room. B)Assure a quiet, dark sleep time. C)Administer a benzodiazepine. D)Assess for pain. E)Initiate a fall prevention program.

A, B, D, E

An older adult client has decreased muscle tone and strength. For which environmental impact(s) should the nurse assess in this client? Select all that apply. A)Shuffling gait B)Lifting of the feet during ambulation C)Slower response to stimuli D)Ability to stand from a seated position E)Level of fatigue

A, B, D, E

During an assessment an older male patient states that he has not been happy in life because he does not deserve to be loved. The nurse realizes that this patient believes love has been withheld because of which criteria? (Select all that apply.) A) Productivity B) Social position C) Education level D) Physical condition E) Material possessions

A, B, D, E

Special attention must be paid to promoting which of the following qualities for the older client diagnosed with dementia? Select all that apply. A)Dignity B)Individuality C)Complementary therapies D)Freedom E)Connection

A, B, D, E

The nurse is assessing an older patient with elevated plasma triglyceride levels. What otherassessment finding leads the nurse to suspect metabolic syndrome? (Select all that apply.) a. Blood pressure of 148/90 mm Hg b. A fasting blood glucose of 109 mg/dL c. Reports of frequent urination d. Weight measurement of 50 inches e. HDL level of 52 mg/dL

A, B, D, E

The nurse is planning care to address a patient's spiritual distress. Which interventions would be appropriate to include in this plan of care? (Select all that apply.) A) Pray with the patient upon request as needed and desired B) Find a volunteer to read the Bible to the patient upon request C) Remind the patient that spiritual needs are often addressed last D) Contact the patient's church to have the clergy visit the patient E) Help the patient identify factors contributing to spiritual distress

A, B, D, E

Which content categories are most important to include in the diabetic care plan for an older client? Select all that apply. A)Symptom recognition B)Nutrition C)Respiratory implications D)Prevention of complications E)Monitoring

A, B, D, E

A nurse demonstrates an understanding of the risk factor for hypothermia when asking an older adult which assessment questions? Select all that apply. A)"Have you ever been diagnosed with hypothyroidism?" B)"Have you lost weight recently?" C)"What is your current A1C result?" D)"Do you self medicate with acetaminophen?" E)"How long have you lived in area that experiences extreme hot temperatures?"

A, C

When conducting a class for a group of nursing students on major chronic conditions in the older adult, which statement is most accurate? Select all that apply. A)The manner in which a chronic condition is managed can affect quality of life B)Most of the chronic conditions that are common in the older adult have a moderate effect on the quality of daily life C)Most of the chronic conditions that are common in the older adult can significantly affect the quality of daily life D)Most of the chronic conditions that are common in the older adult have no effect on the quality of daily life E)Most of the chronic conditions that are common in the older adult have little effect on the quality of daily life

A, C

The nurse assessing patients for diabetes looks for the classic signs, including which of thefollowing? (Select all that apply.) a. Polyuria b. Polycythemia c. Polydipsia d. Polyphagia e. Polyandrony

A, C, D

The nurse identifies interventions to help an older client experience healing. Which outcomes should the nurse expect as evidence that healing has occurred? Select all that apply. A)Demonstrates a sense of well-being B)Level of anxiety reduced C)Symptoms are controlled D)Quality of life enhanced E)Amount of pain medication used decreased

A, C, D

A nurse who works in a nursing facility is admitting a new client on hospice who is diagnosed with end-stage liver cancer. What nursing intervention(s) is important for this client? Select all that apply. A)Administer the pain medication as needed. B)Have a constant supply of food. C)Allow time for family and friends to visit. D)Spend time to listening to the client. E)Keep personal effects within reach.

A, C, D, E

An 88-year-old client is examined in the dental clinic for poor dentition. Which information will the nurse include in the discharge instructions? Select all that apply. A)Drink sufficient water. B)Puree food for ease of intake. C)Eat a healthy diet. D)Perform oral care after each meal. E)Rinse mouth with warm saline regularly.

A, C, D, E

An adult daughter is concerned about an aging parent who lives in the home alone. What should the nurse suggest the daughter discuss during the next telephone call with the client? Select all that apply A)Last food eaten B)Favorite television show C)Last purchase of groceries D)Usual bedtime E)Usual time up in the morning

A, C, D, E

An older adult client reports experiencing stiff hands and knees. Which part(s) of the client's environment may need to be adjusted? Select all that apply. A)Door handles B)Carpeting C)Sink faucets D)Stove knobs E)Stairs

A, C, D, E

The nurse determines that a patient is experiencing spiritual distress. What did the nurse assess in this patient? (Select all that apply.) A) Anger B) Smiling C) Complaining D) Poor appetite E) Refusing to make plans

A, C, D, E

The nurse determines that an older adult client is at risk for falls. What age-related factor(s) in the health history caused the nurse to have this concern? Select all that apply. A)Becomes dizzy when standing up B)Treated for diverticular disease C)Female aged 80 years D)Cataracts in both eyes E)Limps when walking

A, C, D, E

The nurse is assessing an older adult. The nurse should identify which factors as age-related challenges that may place the older adult at risk for death by cancer? Select all that apply. A)Lower rate of receiving early detection tests than younger adults. B)Decreased number and function of T-cells. C)Exposure to carcinogens over the years. D)Presence of one or more comorbidities. E)Inability of organs to tolerate chemotherapy.

A, C, D, E

The nurse is caring for an older adult client at risk for falls. The nurse surveys the client's surroundings in the hospital for safety concerns. Which will the nurse survey? Select all that apply. A)client's ability to use the call button B)assignment to a carpeted room C)adequate lighting at night D)spills and tripping hazards E)bed in low position

A, C, D, E

The nurse is concerned that an older client is experiencing signs of hyperthyroidism. What did the nurse assess to make this clinical determination? Select all that apply. A)Insomnia B)Anorexia C)Diarrhea D)Staring E)Hyperreflexia

A, C, D, E

The nurse is creating a diabetic education plan for an older client. Which topic would be the most important to include when addressing contributors to the incidence of diabetes mellitus? Select all that apply. A)Obesity B)Physiologic deterioration of glucose tolerance C)Inactivity D)Diet E)Genetic factors

A, C, D, E

the nurse is caring for an older client who is at the end of life and who is in the anger stage. When working with the client's family, the nurse should assess for what responses by family members? Select all that apply. A)Guilt B)Apathy C)Grief D)Anger E)Embarrassment

A, C, D, E

A client asks about the benefits of having total knee replacement surgery. What benefit(s) should the nurse identify for this client? Select all that apply. A)Reduces pain B)Eliminates the need for exercise C)Improves joint function D)Enhances muscle tone E)Restores joint motion

A, C, E

An older adult client has a diagnosis of chronic obstructive pulmonary disease (COPD). Which symptomatology is unexpected and will require follow-up? Select all that apply. A)cough and dyspnea B)apneic spells and fatigue C)chest pain and shortness of breath D)wheezing and clubbing E)hemoptysis and orthostatic hypotension

A, C, E

Which activities demonstrate a hospice nurse's understanding of effective self-care? Select all that apply. A)Engaging in self-reflection of personal values regularly B)Mourning the lack of power over a client's death C)Participating in a grief support group D)Minimizing the role he/she plays in the process of a "good death" E)Attending the funeral service of a client who recently died

A, C, E

The nurse is teaching a newly diagnosed diabetic patient about metformin. What informationdoes the nurse include? (Select all that apply.) a. Alcohol intake should be limited and taken with food. b. Overweight patients sometimes poorly tolerate metformin. c. Oral hypoglycemic agents can increase the risk of hyperglycemia. d. Metformin has been the cause of anorexia in older patients. e. Oral hypoglycemic agents affect vitamin D absorption.

A, D

An older client recently diagnosed with hyperglycemia asks the nurse about drug therapy. Which of the following preferred medications would be described in the nurse's response? Select all that apply. A)Gliclazide B)Glibenclamide C)Gabapentin D)Glipizide E)Glimepiride

A, D, E

A 74-year-old has been diagnosed with type 2 diabetes based on the results of a glucose tolerance test during a current hospital stay. The care team has prescribed oral glimepiride. Which of the following guidelines should the client's nurse use in the administration of the new drug? A)Give the glimepiride when the blood glucose exceeds 200 mg/dL (11.1 mmol/L). B)Administer the drug 30 minutes before each meal, beginning the drug with a low dose. C)Obtain drug levels to determine the therapeutic serum concentration of the drug. D)Hold the drug if the client exhibits signs and symptoms of hyperglycemia.

B

A client taking warfarin received an influenza vaccination. For what should the nurse monitor this client over the next 1 to 4 weeks? A)Increased blood pressure B)Bleeding C)Deep vein thrombosis D)Gastrointestinal dysfunction

B

A nurse admits an older adult from a long-term care facility into the hospital for a persistent respiratory infection. Which diagnostic testing should the nurse anticipate? A)electrocardiogram B)Mantoux testing C)lung cancer screening D)cardiac stress testing

B

A nurse is teaching an older adult client's family about the concept of caregiver burden. Which point is priority for the nurse to communicate to the family? A)"Do not feel guilty about having to hire help. Most older adults' care is currently provided by professionals and formal services." B)"You will find it difficult to provide for your loved one's needs if you yourself do not have a strong support system." C)"If you do eventually feel overburdened, moving your loved one to a nursing home will provide you with relief." D)"You will actually find that, for you, the benefits of providing for your loved one outweigh the negative consequences."

B

A nurse plans care for a frail older adult in long-term care. Which intervention should be included in the plan of care to reduce the risk of respiratory infections? A)oxygen administration B)oral care C)tracheal suctioning D)pulmonary function testing

B

A nurse plans culturally competent care for a variety of clients. Which culture has strong ties to low health status? A)member of LGBT community B)low socioeconomic status C)resident of urban community D)Hispanic ethnicity

B

A nurse speaks at a staff development in-service. Which statement by a nurse participant shows the need for education? A)"There is a huge amount of diversity within the group that is labeled 'Asian.'" B)"It is inaccurate to link the prevalence of particular diseases with particular minority groups." C)"I know that the consequences of racism are still present and they are linked to health disparities." D)"I am sure the percentage of client-care hours that we spend working with minority clients is bound to increase."

B

A patient has type 2 diabetes. The family reports the patient has become very forgetful. Whatresponse by the nurse is best? a. We should assess her for Alzheimer disease. b. Forgetfulness is a common sign in diabetes. c. Have her blood sugars been under good control? d. Does she recognize you and know your names?

B

A patient is demonstrating signs of spiritual distress but refuses to be visited by clergy or to participate in religious services. What should the nurse do to help the patient? A) Arrange for a volunteer to read inspirational essays to the patient B) Do not challenge the patient's decision or attempt to change his mind C) Pray that the patient will come to recognize his need for spiritual support D) Talk with the hospital chaplain about looking in on the patient without talking about religion

B

A patient tells the nurse that she has practiced meditation for years since it has helped her with mental clarity. Which type of meditation should the nurse document that the patient practices? A) Mindfulness B) Concentrative C) Transcendental D) Trans-mutational

B

A type 2 diabetic patient is admitted to the hospital with a gastrointestinal illness and a bloodglucose of 480 mg/dL. After stabilizing the patient, what action by the nurse is best? a. Educate the patient on safe food handling. b. Ask if the patient took the diabetic medication. c. Teach the patient ways to avoid dehydration d. Delegate frequent blood sugars to the aide.

B

An Advance directive protects an older dying client's rights under which important law? A)The Health Information Technology for Economic and Clinical Health Act (HITECH) B)The Patient Self Determination Act (PSDA) C)The Health Insurance Portability and Accountability Act (HIPAA) D)The American Recovery and Reinvestment Act (ARRA)

B

An adult daughter is upset that an older client refuses to accept the diagnosis of a terminal illness. What should the nurse explain to the daughter? A)"It means that the client is going to die very soon." B)"Denying the inevitable helps absorb the shock of the news." C)"It motivates people to stay alive as long as possible." D)"It is an indication that the disease has affected the client's brain function."

B

An adult daughter with a physical disability plans to quit her job to take care of her ailing parents. What should the nurse say in response to the daughter's plan? A)"Your parents will be so happy to hear this." B)"Will you physically be able to do all of this care?" C)"These are the best years of your parents' lives and they should be shared." D)"You are so fortunate to have both of your parents at this age."

B

An older adult client diagnosed with chronic obstructive pulmonary disease (COPD), who has smoked 1 pack per day for 30 years, expresses regret about ever starting smoking. Which response by the nurse would be appropriate? A)"Even though it will not affect the course of your COPD, quitting smoking would probably make you feel better about yourself." B)"Even though you have smoked for a long time, there are still benefits to quitting smoking." C)"If you continue to smoke, any medical treatment for your COPD is likely to be ineffective." D)"There is little you can do about the damage to your lungs now. There is really no need for regret."

B

An older adult client had been conscientious about health throughout adulthood and is now disappointed at having been recently diagnosed with type 2 diabetes. The client had been unwilling to discuss this new diagnosis for the past several weeks but has now begun asking the nurse questions about this disease. On which concern will the nurse base the care plan? A)prepared to enhance self-care B)ready to learn C)ready to improve comfort D)ready to decrease powerlessness

B

An older adult client has a respiratory rate of 28 breaths/min and shallow. What medication should the nurse consider is contributing to this client's respiratory rate? A)Anticoagulant B)Analgesic C)Antispasmodic D)Antibiotic

B

An older adult client has stopped going out with friends because the client has been experiencing urinary incontinence and is afraid of having an "accident" in public. When the client's child asks the client about it, the client says, "I'm getting too old for such foolishness." The client's child encourages the client to go to the client's provider for an evaluation, but the client refuses to do so. Which is occurring with this older adult? A)The client's provider is sympathetic; however, the client and the provider are unable to find a solution. B)The client sees incontinence as an inevitable consequence of aging. C)The client is experiencing learned helplessness and low self-efficacy. D)The client views incontinence as a negative functional consequence of aging.

B

An older adult client is diagnosed with an elevated cholesterol level. Which food item should the nurse instruct the client to limit to help reduce body lipid levels? A)olive oil B)egg yolks C)skim milk D)turkey

B

An older adult client is diagnosed with hypertension. Which recommendation will the nurse include in the client teaching? A)Drink caffeinated drinks. B)Eat foods low in sodium. C)Begin weightlifting. D)Enjoy a glass of wine daily.

B

An older adult client is diagnosed with pneumonia. What assessment finding indicates that the client is experiencing cerebral hypoxia? A)cough B)restlessness C)dry mouth D)fever

B

An older adult client who lives alone has been diagnosed with type 1 diabetes. To ensure safe medication use, what will the nurse assess? A)client's vision B)client's dexterity C)client's bilateral muscle strength D)client's body weight

B

An older adult client with a long-standing history of chronic obstructive pulmonary disease (COPD) was recently placed on warfarin after experiencing atrial fibrillation. Upon discharge from the hospital, which statement by the client indicates a need for further teaching? A)"I will avoid using over-the-counter antihistamines since they can dry my mucosal secretions." B)"I will continue to use smokeless tobacco since it is a lot better than smoking." C)"I will not take any herbal preparations without my health care provider's knowledge." D)"I will watch my intake of dark green leafy vegetables since they may impact the effects of warfarin."

B

An older adult client with a recent diagnosis of diabetes states feeling exasperated and overwhelmed by the regimen of glucose testing, dietary modifications and medications. The nurse will assess for further signs of what concern? A)altered perception B)loss of power C)injury risk D)infection risk

B

An older adult client, diagnosed with asthma, is experiencing an increased residual capacity of the lungs. Which action will the nurse implement for this client? A)Administer low-flow oxygen. B)Have client use incentive spirometry. C)Apply the warm air humidifier. D)Encourage the client to breathe through the nose.

B

An older client is concerned because of a weight gain despite no change in dietary intake. What should the nurse respond to this client? A)"It means you have a thyroid disorder that needs to be treated." B)"The basal metabolic rate slows with aging." C)"Everyone gains weight as they age." D)"It's likely that you have a disorder that needs to be investigated."

B

An older client questions if a lung infection is present even without a change in body temperature. What should the nurse explain to this client? A)"An infection does not always cause a fever." B)"Normal body temperature levels change with aging." C)"You might have had a fever but didn't notice it." D)"A fever could have occurred during the night when you were sleeping."

B

An older client reports having a "horrible" relationship with an older sibling as a child which has changed over the years to one of mutual respect. What could be a reason for the change in relationship between the siblings? A)The client is looking for someone to help with personal needs B)The relationship evolved with maturity C)The siblings are mourning the death of their parents D)They are waiting for the right time to resolve previous conflicts

B

An older client who lives alone is being discharged after joint replacement surgery. What question should the nurse ask to determine this client's family support system? A)"Who does your laundry?" B)"Who do you call for emotional support?" C)"Who drives you to the bank?" D)"Who cleans your apartment?"

B

An older client who suffered a stroke two weeks ago is being discharged with residual expressive aphasia. When addressing the client's aphasia, what suggestion should the nurse make to the family to best ensure the client's safety at home? A)Refer to occupational therapy B)Install an emergency alarm system C)Suggest home-delivered meals D)Monitor for signs of aspiration

B

An older female expresses remorse for a past indiscretion. What is the nurse's best response? A)"There is a bridge group meeting this evening you could attend." B)"Forgiving yourself has many benefits, including your health." C)"Thinking about the past can cause unnecessary stress." D)"There is nothing you can do to change the past."

B

An older female patient in the resident care facility insists that her hair be kept covered at all times. Of which branch of the Jewish faith is she most likely a member? A) Reform B) Orthodox C) Rabbinica D) Conservative

B

An older female patient tells the nurse that even though she believes in a higher power she is not interested in information on the hospital's chaplaincy services since she has never been religious. What does the nurse recognize as the relationship between religion and spirituality? A) Some people are religious, while others are spiritual. B) Religion is a particular, structured way of expressing spirituality. C) Religion is the essence of our being that connects us with the Divine. D) All human beings have an innate desire for religious structure and spiritual fulfillment.

B

An older female patient tells the nurse that through periods of trial and tribulation, the Bible has been the source of ongoing strength and support. Which statement supports this patient's beliefs by researched evidence? A) Patients from low socioeconomic levels tend to be more religious. B) Religious commitment has a positive effect on health care outcomes. C) Patients holding strong religious convictions experience great emotional stress during illness. D) Among the elderly, high levels of religiosity correlate with greater levels of physical disability.

B

An older male client with dementia makes a rude comment to the nurse using offensive racial language. What is the nurse's best response? A)"You'll be reported if you continue to use that language." B)"Please don't use that language with me." C)"I'll get your medication to help relax you." D)"You will get used to me before the shift is over."

B

An older male patient admits to doing many things in life that he is not proud of and is having a difficult time getting them out of his mind. How should the nurse respond to the patient's statement? A) "Remember that no one has lived a perfect life." B) "Is there anyone that you might want to ask forgiveness from?" C) "Is there anything I can do to help you focus on more positive things?" D) "Do you think that you were really any worse than most other people?"

B

An older patient has been diagnosed with metabolic syndrome. What action by the nursetakes priority? a. Educate the patient on medications. b. Teach lifestyle changes the patient can manage. c. Encourage 60 minutes of aerobic activity daily. d. Instruct the patient on a low-fat diet.

B

An older patient just learning of having a terminal illness begins to cry. Which statement or question should the nurse make to facilitate the patient's spiritual health? A) "Remember that everything in life, even the bad things, happens for a reason." B) "Is there anything in your spiritual beliefs or practices that might bring you comfort at this time?" C) "It's not appropriate for me to pray with you, but would you like me to arrange a visit from the chaplain?" D) "It's likely best for you to try to focus on what is going right in your life, even though that's likely hard right now."

B

During a respiratory health promotion interview, an older client asks if it is important to have a dental examination after age 65. Which of the following is the most accurate response? A)"Other health matters are usually prioritized over your teeth in older adulthood." B)"Infections of the oral cavity can lead to respiratory infections." C)"Most lung diseases are attributable to changes in oral health." D)"Infections of the oral cavity can increase appetite and lead to poor nutritional status."

B

During assessment of an older adult, the nurse discovers that the individual has been reluctant to divulge recent losses in activities of daily living to the client's primary care provider. Which factor has been demonstrated to contribute to such reluctance? A)The older adult may be experiencing cognitive deficits that influence decision-making psychosocial problems. B)The older adult may fear a loss of independence if problems are disclosed. C)The older adult may realize that age-related changes are normally not treatable. D)The older adult may recognize that health care systems are not able to address multiple interacting conditions.

B

Following knee replacement surgery 10 days earlier, an older adult client diagnosed with an infection in the knee has a synovial fluid culture ordered. Obtaining the sample helps to determine the causative microorganism and to select an appropriate antibiotic. The above course of events characterizes what major health belief system? A)magico-religious paradigm B)scientific paradigm C)analytical paradigm D)holistic paradigm

B

For patients from which of the religious groups would an opportunity to fast in the weeks before Easter be most important? A) Jewish B) Eastern Orthodox C) Seventh-Day Adventist D) Episcopalian (Anglican)

B

Immediately after learning of a terminal illness an older client says that death is just a part of living and should be expected. Which phrase best describes this client's statement? A)Denial will occur in a short while B)Acceptance is the final stage of the stages of dying C)The client is not able to express anger D)This is one way to express bargaining

B

The nurse identifies that a client being treated for cancer is at risk for infection. Which information did the nurse use to make this clinical determination? A)new onset of mouth ulcers B)white blood cell count 1000/mm3 (1× 109/l) C)difficulty ambulating D)shortness of breath with ambulation

B

The nurse is caring for a client who is being discharged on a low-sodium diet for hypertension. Which recommendation will the nurse include in the discharge instructions? A)Unlimited intake of canned vegetables. B)Use fresh herbs to season meals. C)Eat small portions if consuming fast food. D)Replace coffee with canned soda.

B

The nurse is concerned that a client with type 2 diabetes mellitus is at risk for cardiovascular problems. What information caused the nurse to have this concern? A)heart rate 90 beats/min and regular B)Triglyceride level 200 mg/dl (2.26 mmol/l) C)capillary refill 3 seconds D)blood pressure 130/80 mm Hg

B

The nurse is concerned that an older client is at risk for developing type 2 diabetes mellitus and an increased risk for hypothermia. What assessment finding caused the nurse to have this concern? A)heart rate 88 beats/min and regular B)body mass index 30.3 C)blood pressure 140/90 mm Hg D)respiratory rate 22 breaths/min and regular

B

The nurse is concerned that an older client may not be able to self-inject insulin as prescribed. What health problem did the nurse assess to make this clinical determination? A)distant breath sounds B)arthritis of the hands C)muscle atrophy D)hypoactive bowel sounds

B

The nurse is educating a 64-year-old client who has been diagnosed with kidney failure regarding chronic illness. What teaching about the implications of this chronic illness should the nurse provide? A)There are strategies for eliminating or reducing the need to leave the home. B)The disease will be lifelong and demanding but likely manageable. C)The focus of treatment will be ensuring a comfortable and respectful death. D)Lifestyle modifications will ensure that treatment cures the disease.

B

The nurse is facilitating a health promotion class at a senior center. Which statement made by a participant requires additional teaching from the nurse? A)"I have found that doing deep breathing exercises helps expand my lungs." B)"I use my puffer regularly to prevent any problems with my breathing in the future." C)"I am vigilant about staying away from anyone who has a cold or flu." D)"My spouse and I both get our flu shots like clockwork each fall."

B

The nurse notes that an older client is experiencing shortness in breath while lying supine. Which action should the nurse perform first? A)Turn onto the left side B)Raise the head of the bed 30 degrees C)Encourage to deep breathe and cough D)Apply oxygen via face mask

B

The nurse notes that an older client with diabetes "accidentally forgets" to take prescribed medications and does not adhere to the recommended eating plan. Which defense mechanism should the nurse suspect this client is demonstrating? A)depression B)denial C)regression D)anger

B

The nurse reviews medications prescribed to treat an older adult client's diabetes. For which health problem should the nurse check before giving the medications? A)emphysema B)liver disease C)multiple sclerosis D)arthritis

B

The nurse reviews the use of inhaled medication with an older client. Which technique should the nurse recommend to determine if medication is present within the device? A)turn the inhaler upside down B)place the inhaler in a bowl of water C)compare the weight with a full inhaler D)shake the inhaler

B

The nurse suggests that an older adult client be assessed for hyperthyroidism. What information in the client's medical record did the nurse use to come to this conclusion? A)The client uses vitamin B supplements. B)The client takes amiodarone. C)The client has lactose intolerance. D)The client avoids caffeinated beverages.

B

The nurse suspects that an older adult client has an undiagnosed cardiovascular problem. Which finding caused the nurse to come to this clinical decision? A)respiratory rate 18 breaths/min and regular B)absence of leg hair C)capillary refill 3 seconds D)skin warm and dry

B

The physical, emotional, and social health of older adult caregivers is assessed using which important tool? A)LCT B)TLC C)CTL D)TrLC

B

The son of an aging parent has no information about the client's insurance or home maintenance needs. What should the nurse suggest to the son? A)Suggest moving in with the client B)Locate and create a file for all important papers and policies C)Consider having the client placed in a skilled facility D)Become power-of-attorney for the client's affairs

B

When conducting a cancer presentation for the hospital advisory board about older adult cancer risk in the community, which information is most important to include? A)Age-related changes have no affect on the ability to resist cancer B)Age-related changes may reduce the ability to resist cancer. C)Age-related changes do not reduce the ability to resist cancer. D)Age-related changes may increase the ability to resist cancer

B

When conducting a community health presentation for the older adult about cancer, the nurse would include which of the following important information? A)Most new cases of cancer are directly attributable to genetic factors B)The risk of cancer rises with age, even in older adults who overall good health C)Females are diagnosed with cancer more often than males at a nearly 2:1 ratio D)Cancer is usually untreatable in adults who are older than 75 years

B

Which assessment finding is most significant when determining care for the older adult client with sarcopenia? A)Decrease in joint cartilage formation as result of a reduction in protein synthesis B)Decrease in muscle mass as a result of a reduction in protein synthesis C)Decrease in muscle protein degradation as a result of a reduction in protein synthesis D)Decrease in bone density as a result of a reduction in protein synthesis

B

Which client is at an increased risk for developing respiratory inefficiency as a result of kyphosis? A)A 12-year-old diagnosed with rickets B)A 73-year-old retired teacher C)A 30-year-old with a family history of type 2 diabetes D)A 45-year-old with a history of alcohol use

B

Which end-of-life nursing diagnosis can be often associated with the aging client and infections? A)Deficient knowledge B)Impaired skin integrity C)Disturbed thought process D)Disturbed body image

B

Which end-of-life nursing diagnosis is associated with the aging client and dehydration? A)Disturbed body image B)Impaired skin integrity C)Disturbed thought process D)Deficit, knowledge

B

Which end-of-life nursing diagnosis is associated with the aging client and emaciation? A)Disturbed thought process B)Impaired skin integrity C)Deficit, knowledge D)Noncompliance

B

Which end-of-life nursing diagnosis is associated with the aging client and isolation? A)Deficit, knowledge B)Disturbed thought process C)Impaired skin integrity D)Disturbed body image

B

Which endocrine function nursing diagnosis is associated with the aging client and altered neurovascular functions secondary to neuropathies? A)Noncompliance B)Risk for altered peripheral tissue perfusion C)Anxiety D)Risk for disuse syndrome

B

Which herb can be effective in controlling nausea without antiemetic drug side effects for the older dying client? A)Chamomile B)Ginger C)Green tea D)Black tea

B

Which is the most common type of pneumonia in the older adult? A)Klebsiella B)Pneumococcal C)Legionella D)Streptococcus

B

Which is the most important nursing action for the older dying client engaged in silent depression? A)The use of probing questions B)Silently sitting C)The use of cheerful words D)Smiling

B

Which nursing diagnosis is associated with the aging client and chronic diabetes? A)Grieving B)Ineffective tissue perfusion C)Disturbed thought process D)Constipation

B

Which of the following common infections is a leading cause of death among older adults? A)Tuberculosis B)Pneumonia C)Herpes simplex D)Influenza

B

Which of the following manifestations of infections are common in the older client? A)Increased thirst B)Fever can be undetected C)Increased appetite D)High baseline temperature

B

Which statement should the nurse use to plan interventions to address the behavior of an older patient sitting quietly alone in a room? A) Spending a lot of time alone is a sign that an elder is lonely or grieving. B) Uninterrupted periods of solitude and inactivity are therapeutic for the elderly. C) Solitude should be discouraged among elders because it leads to social isolation. D) Occupational therapy should be arranged for an elder often observed doing nothing.

B

While ambulating, a client with chronic obstructive pulmonary disease (COPD) becomes confused. What should the nurse do first? A)Measure blood pressure B)Have the client sit down C)Apply oxygen D)Coach to deep breath and cough

B

A client recently retired from a desk job inquiries about improving overall health. Which recommendation(s) will the nurse make to get the client started in this pursuit? Select all that apply. A)Drink a glass of red wine each night. B)Get your blood pressure checked. C)Participate in mentally challenging activities. D)Gradually increase exercise to 30 minutes daily. E)Eat lots of fruits and vegetables.

B, C, D, E

A client with osteoarthritis is experiencing chronic pain. Which action(s) should the nurse implement to improve this client's comfort? Select all that apply. A)Limit the use of analgesics B)Apply heat to the area C)Assist with maintaining good body alignment D)Coach in the use of relaxation techniques E)Instruct on ways to minimize stress to joints

B, C, D, E

A nurse works to protect vulnerable populations and reduce health disparities. Which nursing actions work toward that goal? (Select all that apply.) A)The nurse acknowledges that the clients in subgroups will not change beliefs or actions. B)The nurse communicates a nonjudgmental attitude toward health belief systems. C)The nurse asks the client how the care system can incorporate the clients' health beliefs. D)The nurse teaches each client about preventive care. E)The nurse incorporates clients' belief systems into the plan of care.

B, C, D, E

An older client with chronic bronchitis is having difficulty managing periods of dyspnea and anxiety. Which action(s) by the nurse would be beneficial? Select all that apply. A)Recommending spending most time out of the home B)Encouraging the need to avoid temperature extremes C)Discussing how to reduce environmental irritants D)Teaching about the disease process E)Explaining how to use transportable oxygen

B, C, D, E

During the acceptance stage of dying, the older client would benefit from which nursing action? Select all that apply. A)Negotiation B)Touching C)Comforting D)Being near E)Nonverbal communication

B, C, D, E

Family caregiving for the older client at home includes which type of assistance? Select all that apply. A)Monitoring the impact of caregiving B)Protecting the client C)Cooking for the client D)Providing meals E)Supervising the client

B, C, D, E

The nurse is assisting an older adult client with meal choices consistent with the Dietary Approaches to Stop Hypertension (DASH) dietary pattern. Which food choice(s) will the nurse suggest to the client? Select all that apply. A)Peanut butter B)Low-fat yogurt C)Steamed broccoli D)Beets E)Whole wheat bread

B, C, D, E

The nurse is concerned that a client is developing metabolic syndrome. What did the nurse assess to make this clinical determination? Select all that apply. A)Nerve pain in the legs and feet B)Central obesity C)Elevated triglyceride level D)Elevated fasting blood glucose level E)Elevated blood pressure

B, C, D, E

What are contributing factors to an interrupted family process during the care of an older client? Select all that apply. A)Increased communication by a family member B)Change in family member role C)Injury of family member D)Change in family member function E)Illness of family member

B, C, D, E

Which nursing action maintains self-care capacity in the older client with a chronic condition? Select all that apply. A)Making evidence-based decisions for the client B)Education about the disease C)Stabilization of health status D)Improvement of health status E)Education about disease management

B, C, D, E

An older client is diagnosed with an anginal syndrome. What should the nurse instruct the client to avoid to reduce the frequency of anginal chest pain? Select all that apply. A)Bicycling B)Emotional stress C)Cold wind D)Walking E)Strenuous activity

B, C, E

An older adult client nearing death lives in a long-term care facility. The client refuses to eat anything but dessert at a meal. Which action(s) will the nurse take to supplement this client's nutrition? Select all that apply. A)Order a special meal for the next mealtime. B)Encourage the family to bring food from home. C)Go to the local fast food restaurant and bring back a treat. D)Obtain another dessert from dietary. E)Increase socialization at mealtime.

B, D

A nurse demonstrates understanding of the age-related changes to the older adult regarding body temperature, when implementing what interventions? Select all that apply. A)Instructing the client to go indoors when he or she starts to sweat B)Asking the client if he or she feels the cold similarly as when younger C)Identifying hypothermia when the client's temperature nears 95.2°F (35°C) D)Asking if the client has spent time outdoors in very cold weather E)Encouraging the client to drink additional fluids when outdoors in hot weather

B, D, E

A nurse plans interventions in a skilled nursing facility to prevent lower respiratory infections. Which nursing intervention(s) should be included in the plan? Select all that apply. A)Encourage annual pneumonia vaccinations. B)Encourage annual influenza vaccinations. C)Encourage influenza vaccinations every 5 years. D)Encourage annual chest radiographs to detect tuberculosis. E)Encourage hand hygiene for residents and staff.

B, E

A client entering end-of-life is surrounded at the bedside by family members and clergy. Which action should the nurse take to provide holistic care to this client? A)Leave the client and family alone B)Prepare post mortem care items C)Meet the client's and family's needs D)Close the door to the room

C

A client receiving end-of-life care is experiencing severe constipation. What should the nurse request from the health care provider to help this client? A)Antiemetic B)Stool softener C)Laxative D)Enema

C

A middle-aged son grocery shops and transports an older parent to health care appointments instead of attending a son's soccer game. Which generation would the son most closely identify? A)Nuclear B)Single-parent C)Sandwich D)Skipped

C

A nurse assesses older adults at a pulmonary clinic. Which question might best assist in identifying those at risk for pulmonary disorders? A)"Do any of your children smoke around you?" B)"Where do you exercise?" C)"What type of job did you have?" D)"In what state did you grow up?"

C

A nurse assesses older adults at a pulmonary clinic. Which question might best assist in identifying those at risk for pulmonary disorders? A)"Where do you exercise?" B)"In what state did you grow up?" C)"What type of job did you have?" D)"Do any of your children smoke around you?"

C

A nurse caring for a hospitalized client is not familiar with this client's ethnicity and cultural characteristics. What is the best way for this nurse to become familiar with this client's cultural characteristics? A)Check the internet for a local ethnic association B)Contact a local religious organization C)Ask the client to describe his or her life story D)Request the family members stay with the client

C

A nurse interviews an older adult with pulmonary disease. The client states, "I worked hard all my life in the shipyard, I provided for my family. I never smoked, why did I get this disease?" Which response by the nurse is best? A)"You feel like you are being punished." B)"It is a good thing that you never smoked." C)"Tell me more about your work in the shipyard." D)"Pulmonary disease can happen to anyone."

C

A nurse is preparing to administer metoprolol (Toprol) to an older male patient. What actionby the nurse is best regarding endocrine disorders? a. Administer the medication as ordered. b. Check the patients ID using two sources. c. Say, Many men experience ED with this drug. d. Tell the patient to discuss the side effects with his provider.

C

A nurse reads up on some of the more common cultural groups in the local area. How should the nurse interpret the information that is available about cultural groups? A)It is unjust to categorize individual clients as being members of a specific cultural group. B)Cultural generalizations replace a client's assessment and care. C)Cultural generalizations can be useful and accurate, but they do not replace individualized assessment and care. D)It is simplistic and problematic to make generalized claims about members of a particular cultural group.

C

A nurse's colleague states, "Older people who live in the country are a lot healthier than city folk." Which statement by the nurse is most appropriate? A)"The differences aren't large, but rural adults do have better health outcomes than do city dwellers." B)"Higher levels of family support translate into longer average life spans for rural adults." C)"Chronic conditions are more common among rural adults." D)"This is mostly attributable to the problem of homelessness."

C

A recent widow says that friends and neighbors promised to keep in touch after the death of her spouse yet no one has contacted the widow in months. What action might be helpful for this widow? A)Contact family and friends for the widow B)Encourage the widow reach out and call friends C)Suggest the widow attend a support group D)Ask immediate family members to call the widow

C

An older adult client has been on bedrest while recovering from a stroke. Which action will the nurse take to prevent muscle atrophy? A)Reposition the client every 2 hours. B)Raise the head of the bed 30 degrees several times per day. C)Direct the client in active range-of-motion exercise. D)Move the client into sitting position routinely.

C

An older adult client has expressed interest in preventing osteoporosis because of noticing the high prevalence of the disease in the client's peer group. What dietary measures should the nurse recommend? A)a high intake of organic fruits and vegetables B)a high-protein, low-carbohydrate diet C)a high intake of salmon and fortified cereals D)vitamin C supplements and a high-potassium diet

C

An older adult client has smoked for 30 years and has a history of chronic obstructive pulmonary disease (COPD). The client's spouse assists with cooking, cleaning, and transportation. The spouse has become ill, and they now receive assistance from a home health nurse. Which intervention should be the immediate priority? A)setting up medications for the clients B)smoking cessation plan C)determining a plan for providing meals D)assisting the clients to perform instrumental activities of daily living (IADLs)

C

An older adult client has suffered traumatic injuries and is going into kidney failure. The client is still lucid and states, "I hope God forgives me before it's too late for me." The client's spouse tells the nurse, "My spouse must be talking out of mind, because we are both atheists." What is the nurse's best action? A)Remind the client about being an atheist B)Tell the spouse that most people feel the same when seriously injured C)Offer a clergy visitation to the client D)Obtain the spouse's permission to call clergy

C

An older adult client is breathing and has a heartbeat; however, the client has no active brain waves. How will the nurse classify this client's status? A)the client is dead because there are no brain waves B)the client is alive because there is a heartbeat C)the level of death needs to decided before status can be defined D)the client is alive because breathing is occurring

C

An older adult client is scheduled to undergo hip replacement surgery after a fracture resultant from a fall. Which age-related change may have contributed to the client's susceptibility to bone fracture? A)loss of neural control of balance B)increased protein synthesis C)increased bone resorption D)infections of the synovial capsules

C

An older adult client with an overactive parathyroid has been diagnosed with demineralization of the bones. Which action will the nurse take to support this client? A)Discourage the client from napping. B)Reinforce the need for the client to complete tasks quickly. C)Keep the client's necessary articles close to the client. D)Maintain bedrails in the low position.

C

An older adult has just been diagnosed with diabetes. Which endocrine function nursing diagnosis is associated with the aging client and fear of disease impact? A)Noncompliance B)Risk for infection C)Anxiety D)Risk for injury

C

An older adult states being upset about missing weekly Bible study while she is hospitalized. What the nurse's best action? A)Offer pen and paper so the client can keep a journal. B)Suggest that the client make a craft as a substitute for Bible study C)Remind the client that there is a Bible in her bedside table. D)Advise the client that music class is scheduled in one hour.

C

An older adult who is dying becomes extremely panicky, stating, "I know that I'm suffocating." The nurse interprets this reaction as most likely related to which condition? A)Dyspnea B)Hypokalemia C)Dropping levels of blood gases D)Anxiety

C

An older client has no interest in joining a gym and does not like dancing or organized sports. What should the nurse suggest to help increase this client's physical activity? A)make the bed once a week B)lift each plate individually when emptying the dishwasher C)cancel the housekeeping service D)sit outside during early morning hours

C

An older client reports following the prescribed eating plan and taking medication for diabetes as prescribed. Which finding suggests that the client would benefit from additional teaching about the treatment plan? A)eye examination within normal limits B)urine glucose negative C)hemoglobin A1c 8.8% D)absence of ankle edema

C

An older client spends long periods of time outdoors tending a vegetable garden. What should the nurse recommend to reduce the risk of the client developing skin cancer? A)Limit exposure to the sun before 10 am and after 4 pm B)Reduce alcohol intake to one drink per day C)Use a sunscreen with a SPF of 15 or 30 when outdoors D)Eat more fresh fruits and vegetables

C

An older client who practices meditation describes his experience as being in a calm, nonreactive state where he focuses on the sensations he experiences. Which type of meditation does this client most likely practice? A)Existential B)Transcendental C)Mindfulness D)Concentrative

C

An older client with a terminal illness who has been depressed for several weeks admits to having a supply of pain medication intended to be used to commit suicide. What should the nurse do? A)ask that the client tell the nurse when the plan will be implemented B)search the client's belongings for the pills when the client is asleep C)report the conversation to the provider and suggest suicide precautions D)recommend that the client perform the act when not hospitalized

C

An older client with diabetes admits to stopping routine exercise sessions because of "feeling funny" afterwards. What should the nurse include when responding to this client? A)feeling funny means the health problem is getting worse B)not eating before exercise would help the problem C)exercise affects the metabolism of insulin D)restricting fluids is the best approach to eliminate this problem

C

An older client's capillary blood glucose level at 0700 hours is 58 mg/dL yet is not demonstrating any symptoms of hypoglycemia. What should this assessment finding indicate to the nurse? A)Caloric intake needs to be increased B)Medication dosage needs to be changed C)Impaired autonomic nervous system D)Recheck the blood glucose level

C

An older female patient, experiencing cancer pain and nausea and vomiting from chemotherapy, asks the nurse to pray for her during this difficult time. How should the nurse respond to the patient's request? A) Facilitate a visit from a chaplain to the client at the bedside. B) First determine whether the client shares a similar religious tradition as the nurse. C) Pray for the client, asking a higher power to intervene and provide peace and relief. D) Explain that praying is beyond the nurse's scope of practice and explore alternative interventions.

C

During assessment of an older adult, the nurse discovers that the individual has been reluctant to divulge recent losses in activities of daily living to the client's primary care provider. Which factor has been demonstrated to contribute to such reluctance? A)The older adult may recognize that health care systems are not able to address multiple interacting conditions. B)The older adult may be experiencing cognitive deficits that influence decision-making psychosocial problems. C)The older adult may fear a loss of independence if problems are disclosed. D)The older adult may realize that age-related changes are normally not treatable.

C

The community health nurse is caring for multiple clients. Which client(s) is a highest risk for respiratory conditions? Select al that apply. A)A 32-year-old male crop farmer who has been diagnosed with asthma-like syndrome B)A 37-year-old female custodian being treated with smoking cessation therapy C)A 60-year-old male government employed construction worker preparing for retirement D)A 46-year-old female in an assisted living facility due to traumatic brain injury E)A 54-year-old immobile female patient with spinal injury

C

The hospital's nursing staff becomes very attached to an older adult client. When the client dies, the nurse on duty hugs family members and cries with them. Which statement best describes the nurse's behavior? A)An overreaction to a common situation. B)It would be appropriate in any similar situation. C)It is appropriate in this situation. D)The nurse has lost emotional control.

C

The nurse completes an assessment of an older client. Which finding caused the nurse to suspect that the client is experiencing hypothyroidism? A)elevated blood pressure B)hunger C)puffy face D)muscle weakness

C

The nurse is caring for an older adult client with sarcopenia. Which activity will the nurse recommend for the client to maintain mobility? A)aerobic exercises B)flexibility exercises C)resistance exercises D)balance exercises

C

The nurse is caring for older patients in a long-term care facility. When ensuring for these patients' dignity, which statement reflects the role of dignity as it relates to the spiritual needs of the older adult? A) Older adults who have lived a life of integrity and service have earned dignity. B) An acknowledgment of spiritual needs is necessary for the presence of dignity. C) Older adults may lack many of the attributes that are valued in society, but they can derive a sense of dignity from spirituality. D) Older adults who have moved successfully through Erikson's stages of development can experience dignity in spite of disability.

C

The nurse is concerned that an older client's personal care needs will not be met at home. Which family characteristic caused the nurse to have this concern? A)Son handles the client's finances B)Neighbor transports the client to appointments C)Former daughter-in-law was the primary caregiver D)Daughter cleans the house and prepares meals

C

The nurse is interviewing an 80-year-old client who has come to the health center for a visit. The client tells the nurse, "I have been feeling nervous and irritable and seem to have a lump in my neck." Which action will the nurse take first to complete the assessment? A)Auscultate the lungs. B)Take an apical pulse. C)Palpate the thyroid gland. D)Test the blood sugar.

C

The nurse is planning care for a client with a terminal illness. What should the nurse identify as the goal of pain control for this client? A)treat pain when it occurs B)use the most powerful medication C)prevent pain from occurring D)provide meperidine at first complaint of pain

C

The nurse is preparing to conduct a client's spiritual assessment. What is likely the most important spiritual need of all individuals? A)Forgiveness B)Gratitude C)Love D)Dignity

C

The nurse notes that an older adult client's morning blood glucose measurements are elevated on Mondays but lower on the other days of the week. What should the nurse suspect is occurring with this client? A)Missing medication on Mondays B)sleeping later on Monday mornings C)eating more on Sundays D)inconsistent measuring of blood glucose levels

C

The nurse observes signs that a patient being assessed may have an underactive thyroid. The data supporting this includes: a. heat intolerance, low-grade fever, and patchy hair loss. b. polycythemia, tachycardia, and oral candidiasis. c. muscle cramps, fatigue, and cold intolerance. d. increased blood pressure, postural hypotension, and blurred vision.

C

The nurse overhears an older client say to an adult son "you can never get married while I'm alive because I need you more than anyone." What should the nurse suspect is occurring within this family? A)son enjoys spending time with the client B)client has limited financial resources C)client manipulating the son D)overdependence of the son on the client

C

The nurse plans care for an older adult client with asthma. Which should be included to help ensure a clear airway? A)Keep the head of the bed at a 10-degree angle. B)Limit the use of pain medication. C)Turn, deep breathe, and cough every 2 hours. D)Restrict fluids.

C

The nurse plans care for an older adult client with several chronic conditions. What should the nurse identify as an appropriate goal for this client? A)Assist family set caregiving expectations. B)Educate on self administration of medications. C)Achieve the highest possible quality of life. D)Resume normal activities of daily living.

C

The nurse prepares an educational session on cancer prevention for a group of older adult clients. What should the nurse include about the role of exercise in cancer prevention? A)It is the best way to avoid skin cancer. B)It is best performed out of doors to prevent cancer. C)It can decrease the risk of breast cancer. D)It helps prevent the development of pancreatic cancer.

C

The nurse prepares an educational session on safety for residents in an extended care facility. What should the nurse include in this teaching? A)interchange balance between the feet B)place a cane over the wrist when descending stairs C)climb stairs slowly D)avoid slippers when walking in the bedroom

C

The nurse reviews goals established for a client with diabetes. Which laboratory finding suggests that the goal to control blood glucose level has been achieved? A)postprandial glucose 192 mg/dl (10.66 mmol/l) B)random blood glucose 220 mg/dl (12.21 mmol/l) C)hemoglobin A1c 5.8% (0.58) D)fasting plasma glucose 135 mg/dl (7.49 mmol/l)

C

The nurse suggests that an older adult client be assessed for hyperthyroidism. What information in the client's medical record did the nurse use to come to this conclusion? A)The client avoids caffeinated beverages. B)The client uses vitamin B supplements. C)The client takes amiodarone. D)The client has lactose intolerance.

C

The nurse suspects that an older adult client is experiencing an alteration in tissue perfusion. What assessment finding caused the nurse to make this clinical decision? A)respiratory rate 18 breaths/min B)elevated blood pressure C)ankle edema D)warm, dry skin

C

The nurse suspects that an older client is developing or has undiagnosed cancer. What did the nurse assess to make this clinical determination? A)stress incontinence B)ankle edema C)hoarse voice D)dry skin

C

The spouse of a patient with dementia remains upbeat and is appreciative of having good health and a loving family. The nurse realizes that the spouse is demonstrating which component of spirituality? A) Hope B) Fatalism C) Gratitude D) Transcendence

C

What assessment findings support an older patients diagnosis of hypothyroidism? a. A 2-cm wound noted on medial aspect of left foot b. An apical rate: 98/min c. A patient report that I always wear a sweater d. A weight loss of 10 pounds over 6 weeks

C

What response should the nurse provide when the spouse of a client in the final stage of the dying process asks, "How will I know when death is imminent?" A)"All you have to do is sit with your spouse and be fully present." B)"Try to remember to take care of your needs first." C)"It can vary, but I will explain some of the more common signs to you." D)"Everyone's experience of death is different, so there is little way of predicting."

C

When caring for an older client who practices Hinduism, what is the nurse's best action in addressing the client's spiritual needs? A)Offer the Torah for frequent reading B)Offer to pray with the client often C)Encourage the expression of concerns D)Ensure the Koran is accessible

C

When explaining family member roles in the care of older adults, what characteristic of a family member most clearly suggests that he or she plays a deviant role? A)Not involved in daily activities B)Not geographically close C)Strayed from family norms D)Consulted for problem solving

C

When explaining family member roles in the care of older adults, which of the following is on the list as an important family decision-making role provider? A)The person who is called for direct services B)The person who is called for home management of another family member C)The person who is called for a crisis D)The person who is called for personal care

C

Which assessment finding is most important in identifying who fulfills family functions for the older adult? A)Which neighbors regularly check on them B)How close the client lives to family C)Who handles financial affairs D)Who maintains the home

C

Which documentation demonstrates that the nurse effectively assessed an older adult diabeticpatients cardiac status? a. radial pulse: 88 and regular b. carotid pulses equal and strong c. BP 126/78 recumbent and 122/78 sitting d. nail beds pale in color

C

Which endocrine function nursing diagnosis is associated with the aging client who has vaginitis as a result of diabetes? A)Fluid volume deficit B)Urinary frequency C)Sexual dysfunction D)Hypoglycemia

C

Which of the following is the most complete information for a nurse to include during a presentation on elder care? A)Government services no longer provide care for older adults B)Greater numbers of families are providing more complex care for older adults. C)Greater numbers of families are providing more complex care for older adults for longer periods of time. D)Fewer families are providing care for older adults

C

While ambulating a client with chronic obstructive pulmonary disease (COPD), the nurse stops the activity and has the client sit in a chair for a short while. What did the nurse assess to make this change in activity? A)respiratory rate 20 per minute B)increase in coughing C)respiratory rate 10 per minute D)heart rate 90 beats per minute

C

A quality control nurse for a large group of long-term care facilities assesses the quality of care at the end of life for the residents. Which measure(s) indicates quality care? Select all that apply. A)Increase in the percent of residents with advanced dementia. B)Increase in the number of residents who refuse treatments at the end of life. C)Increase in the number of staff trained in palliative care. D)Increase in the use of hospice services. E)Increase in the number of deaths in the hospital.

C, D

After reviewing information in a health history, the nurse determines that client would benefit from information to prevent the development diabetes. What information caused the nurse to make this decision? Select all that apply. A)Peripheral edema B)Elevated blood pressure C)Pockets of fat tissue D)Sedentary lifestyle E)Obesity

C, D, E

How can a nurse manager of an extended care unit for older adults address this population's diverse needs? Select all that apply. A)Preventing discrimination by avoiding celebrations of any holidays B)Making health care literature readily available in English C)Addressing the need for special interest groups D)Establishing a list of available translators on call E)Planning meals to include ethnic food varieties

C, D, E

A client who recently fell is sitting in the lounge and limits walking to using the bathroom. What does this client's behavior indicate to the nurse? A)Undiagnosed health problem that caused the fall B)Need for an assistive device for walking C)Undiagnosed injury from the fall D)Psychological restriction of activity

D

A client with a terminal illness puts on the call light every 20 minutes. What stage of the dying process should the nurse consider this client is experiencing? A)depression B)denial C)bargaining D)anger

D

A client with rheumatoid arthritis asks if there are any dietary changes that might help the condition. Which nutrition information will the nurse include in client teaching? A)Include fruits high in vitamin C. B)Avoid foods high in cholesterol. C)Eat more dairy products. D)Avoid "nightshade" foods.

D

A middle-aged female client refuses to take hormone replacement therapy during and after menopause because of the fear of developing breast cancer. What should the nurse respond to this client? A)"Taking hormones will cause cancer." B)"That's a good idea." C)"Taking hormones does not cause cancer." D)"The evidence is inconclusive about hormones and cancer development."

D

A nurse assesses an older adult's overall respiratory function. Which interview question would be most appropriate? A)"Did either of your parents experience lung diseases?" B)"What do you do to actively maintain your respiratory health?" C)"Would you be interested in finding out more about environmental smoke?" D)"Have you ever worked where you were exposed to dust or other pollutants?"

D

A nurse cares for an older adult client who has noted Hinduism as religious preference on admission records. This client is transferred to the hospice unit. Which action by the nurse bestshows caring? A)Pray with the client and family. B)Ask the family to tell the nurse about Hinduism. C)Notify the family's pastor. D)Assess the client's spiritual needs.

D

A nurse explores resources available to assist clients. Which older adult client meets the eligibility requirements for hospice care? A)client with cancer who is living with uncontrolled, persistent pain B)client who is immobilized and unable to afford specialized nursing care C)client with AIDS who lacks family support to provide needed care D)client who has experienced a stroke and been given 3 months to live

D

A nurse in an intensive care unit prepares to perform postmortem care on an older client who practices Judaism. Family members are at the client's bedside. Which action by the nurse is appropriate? A)Liaise with the hospital chaplain to visit the family in the chapel. B)Address the client's oldest son when discussing the client's care. C)Determine which family member(s) will be staying at the bedside during care. D)Allow the family to remain with the client.

D

A nurse is assessing several older clients. Which older client would the nurse suspect is displaying the effects associated with overusing bronchodilating nebulizers? A)A client with acute delirium B)A client with shortness of breath on exertion C)A client with complaints of chest pain D)A client with new onset of a cardiac arrhythmia

D

A nurse is providing health education to an older adult with osteoarthritis. Which statement indicates that the client needs additional teaching? A)"I will avoid high-impact exercises. " B)"I will lose weight if it turns out that I need to." C)"I will get adequate intake of vitamins C, D, and E." D)"I will try to limit my use of walkers and assistive devices."

D

A nurse performs a reflective cultural self-assessment. Which outcome should the nurse expect? A)an accurate ranking of different cultures according to their specific merits B)identification of the flaws and weaknesses of the nurse's own culture C)the ability to assess clients according to their cultural affiliation rather than their individual characteristics D)progression from judgmental views of other cultures to recognition of positive attributes

D

An active older adult client rock climbs and snowboards in the free time. Which will the nurse recommend to reduce the risk of broken bones? A)Cease taking so many risks. B)Perform regular stretching activities. C)Decrease protein in the diet. D)Continue weight-bearing activities.

D

An older adult client arrives with an adult child for a health visit. What should the nurse keep in mind as a priority when assessing this client? A)the needs that cannot be fulfilled in the home environment B)the older adult client's ability to be totally independent with care C)the importance of keeping the older adult client safe in the home environment D)the child's role in the older adult client's care

D

An older adult client experienced a severe stroke several days ago. The nurse has just entered the client's room to find the spouse softly crying at the bedside, making no attempt to acknowledge the nurse's presence. Which therapeutic response by the nurse is appropriate? A)"Did you feel like you were able to discuss the client's treatment options thoroughly?" B)"Do you feel like your spouse was able to live a full life?" C)"What is it that makes you the saddest about your spouse's situation?" D)"I am here; should I leave you alone for now?"

D

An older adult client has a long history of poor eating habits and low activity levels. The client now has a diagnosis of type 2 diabetes mellitus. Which nursing intervention should be the priority? A)education about the role that the client's lifestyle has played in the diagnosis B)maintenance of function and activities of daily living C)adherence to diabetes screening protocols D)self-care measures to aid in the management of the client's disease

D

An older adult client has been performing strength training exercises as recommended; however, the client's muscle tone has not improved. The client is upset. What should the nurse emphasize with this client? A)Change the timing of the activity B)Accept the current level of muscle tone C)Decrease the amount of weight used D)Increase the amount of weight used

D

An older adult client hesitates to discuss health issues related to a chronic condition with the nurse or health care provider. What should the nurse suggest to this client? A)Talk with a friend. B)Meet with clergy. C)Talk with family. D)Attend a support group.

D

An older adult client is diagnosed with a reduced elastic recoil of the lungs during expiration. Which action will the nurse take to care for this client? A)Administer analgesics to provide sedation. B)Perform all activities of daily living together in the morning. C)Encourage the client to lay flat in bed. D)Teach controlled coughing.

D

An older adult client is diagnosed with chronic venous insufficiency of the lower extremities. Which should the nurse include when teaching the client about this disorder? A)Limit walking during the day. B)Wear tight socks. C)Perform deep knee bends. D)Avoid prolonged sitting.

D

An older adult client is experiencing changes in balance when walking. What activity might be appropriate for this client? A)Jogging B)Cycling C)Weight lifting D)T'ai chi

D

An older adult client was prescribed thyroid medication 6 month ago. The client is concerned because the dosage of has been increased after every health care provider examination since then. What should the nurse respond to this client? A)"More medication means your thyroid is recovering." B)"Your thyroid problem is getting worse." C)"More medication is prescribed before having surgery on the thyroid." D)"The dose is adjusted slowly so that you do not develop heart problems."

D

An older adult client with osteoarthritis walked 2 miles (3 km) last week. The client says since that time, "I have not been doing very much; I am afraid it will hurt like last time." Which action by the nurse is most appropriate? A)Encourage the client to walk the 2 miles (3 km) every day. B)Have the client take ibuprofen every morning. C)Obtain a cane for use to improve balance and reduce the client's fears. D)Discuss moderation in activity, encouraging continued movement.

D

An older adult client's apical pulse is 120 beats/min after completing physical therapy exercises. What action should the nurse take? A)assess for orthostatic blood pressure B)notify the health care provider C)maintain on bed rest D)reassess in 2 hours

D

An older client asks if stress can cause cancer. Which of the following answers would be most accurate? A)Stress does not affect the immune system. B)Stress causes cancer. C)Evidence conclusively supports this relationship. D)Evidence does not conclusively support this relationship.

D

An older client asks questions about scheduled diagnostic tests a week after the nurse completed the teaching. Which nursing diagnosis should the nurse select for this client? A)Sensory/Perceptual alteration B)Noncompliance C)Powerlessness D)Knowledge deficit

D

An older client desires to begin an exercise program. What should the nurse recommend as a first step for this client? A)identify activities that are enjoyable B)purchase sturdy well-fitting shoes C)wear loose comfortable clothing D)have a recent physical examination

D

An older client enjoys wearing a religious necklace and will not remove it at bath time and bedtime. What is the nurse's best action? A)Explain the safety hazard that is posed by the necklace B)Ask the client to put the necklace away while in the hospital so that it does not get lost C)Ask the family to take the necklace home so that there is no longer a problem D)Allow the client to wear the necklace

D

An older client is newly diagnosed with type 2 diabetes mellitus. Which medication should the nurse expect to be prescribed for this client? A)glibenclamide B)insulin C)hydrochlorothiazide D)metformin

D

An older client with Alzheimer's disease is diagnosed with diabetes. Which sulfonylurea should the nurse expect to be prescribed for this client? A)pioglitazone B)rosiglitazone C)acarbose D)gliclazide

D

An older client with diabetes has foul-smelling concentrated urine. What should the nurse realize that this finding indicates? A)Dehydration B)Inadequate caloric intake C)Excessive glucose in the urine D)Urinary tract infection

D

An older male states that he sleeps better in a reclined chair. He borrowed one from a friend after his surgery, but now he must give it back and wants to buy his own. What safety suggestions should the nurse make about recliners for older adults? A)"The back, seat, and arm rests should be one unit." B)"It should have soft, cushions on the back and seat." C)"Fire resistant upholstery is uncomfortable." D)"It should have an easy pull side lever for elevating feet."

D

How will the nurse calculate the maximum heart rate for an older adult in a new exercise program? A)The client's age plus 15 B)The client's age multiplied by 1.2 C)200 minus the client's age D)220 minus the client's age

D

The nurse caring for an older adult with type 2 diabetes mellitus places importance on assessing the patient for: A) painful nodules on the fingers and toes. B) reddened rash and brittle nails on the hands. C) heartburn and flatus after meals. D) skin temperature and hair growth pattern on the legs.

D

The nurse completes an assessment of an older client. Which finding caused the nurse to suspect that the client is experiencing hypothyroidism? A)elevated blood pressure B)hunger C)muscle weakness D)puffy face

D

The nurse is administering prescribed interventions aimed at boosting the body's immune abilities in an older client with a chronic condition. What is the most likely goal of this treatment? A)Stress management B)Preserving client safety C)Promoting function D)Infection prevention

D

The nurse is assessing an older adult client who has rubor and a lack of hair growth on the lower extremities. Which action will the nurse take? A)Massage the feet. B)Apply cool compresses to the legs. C)Spread lotion on the lower legs and feet. D)Elevate the legs.

D

The nurse is aware of the spiritual dimension in Erikson's conceptualization of the older adult's growth and development. When applying Erikson's theory to the care of older patients, what does the nurse realize as being a spiritual component of Erikson's final development task? A) Awareness that one is loved by others and has provided unconditional love. B) A confidently held hope that a transcendent and positive afterlife awaits one following death. C) A sense of contribution that one's relationships and endeavors have benefited society and one's family. D) A sense of wholeness rooted in the knowledge that life experiences make sense and have served a purpose.

D

The nurse is caring for an older patient who is nearing death and realizes that no professional clergy needs to be contacted. This patient is most likely a member of which faith? A) Pentecostal B) Unitarianism C) Seventh-Day Adventists D) Church of Jesus Christ of Latter Day Saints

D

The nurse is educating a 73-year-old client regarding a new cancer diagnosis. What nursing intervention is associated with client understanding of the condition? A)managing chemotherapy-related nausea and vomiting B)discussing available community resources to support autonomy C)exploring the use of complementary therapies rather than medical interventions D)discussing client's perception of effectiveness of planned treatments

D

The nurse is educating a client with cancer who has exhausted treatment options and is asking about complementary and alternative medicine (CAM). What statement by the client indicates a need for additional teaching? A)"Finding a well-educated and experienced CAM provider is important." B)"It is essential to learn the risks as well as benefits of using CAM." C)"I have to get my health care provider's opinion before starting any treatments." D)"I have an aunt who is using CAM; she will know what I should do."

D

The nurse is reinforcing teaching to the family of a client with a terminal illness. Which action will the nurse take first? A)Discourage "bargaining" because the client is terminally ill. B)Give the family information on support groups. C)Arrange an appointment with the hospital chaplain. D)Assess the family's knowledge of the client's diagnosis.

D

The nurse is reviewing the food journal of an older adult client who is overweight. Which entry supports that the client understands the low-cholesterol diet? A)The client has salsa and tortilla chips at happy hour weekly. B)The client eats shrimp salad twice per week. C)The client drinks low-fat milk for breakfast. D)The client eats high-fiber foods, like broccoli, regularly.

D

The nurse is teaching a peer about the concept of spirituality. What should the nurse teach this colleague? A)Spirituality consists of human-created structures. B)Religion is synonymous with spirituality. C)Most spiritual individuals identify with a particular religion. D)Religion is an expression of spirituality.

D

The nurse is visiting an older client who has smoked for 50 years and has emphysema that severely affects the client's quality of life. The client has had multiple hospital admissions this past year. Which area would the nurse identify as the priority for this client? A)Discussing the use of inhalers B)Reviewing deep-breathing exercises C)Assessing the air quality in the home D)Assessing ability to perform activities of daily living

D

The nurse notes that an older adult client is prescribed chemotherapy as part of cancer treatment. What should the nurse realize about the dose prescribed for this client? A)The medication is different than that for a younger client. B)The dose is higher than that prescribed for a younger client. C)The dose is the same as that prescribed for a younger client. D)The dose is less than that prescribed for a younger client.

D

The nurse notes that an older client uses the arm rests when moving from a seated to a standing position. When visiting with family in the lounge, which piece of furniture should the nurse recommend that the client use? A)folding chair B)sofa C)stool D)love seat

D

The nurse notices that an older client has been walking slower. What should the nurse suspect be occurring with this client? A)poor oxygenation B)depression C)activity intolerance D)sarcopenia

D

The nurse observes that the client is short of breath when walking to the bathroom. Which action will the nurse take to support this client? A)Order adult briefs. B)Direct the client to use the bedpan. C)Encourage the client to walk more slowly. D)Provide a bedside commode.

D

The nurse prepared to perform postural drainage on an older adult client with chronic obstructive pulmonary disease (COPD). What action should the nurse take first? A)encourage fluids B)assist to empty the bladder C)lower the head of the bed D)administer aerosol medications

D

The nurse suspects that an older adult client has chronic obstructive pulmonary disease (COPD). Which did the nurse assess in this client? A)increased fremitus in the lower lobes B)resonant sound upon percussion C)wheeze-like sound when the client breaths in D)no tactile fremitus in the upper lobes

D

The nurse teaching a 79-year-old with type 2 diabetes about the importance of regular exercisesuggests that the patient: a. swim 10 laps in the community center pool three times a week. b. enroll in a daily lunch time aerobics class at the senior center. c. lift 5 pound weights in a routine of 10 repetitions in each arm. d. walk on the treadmill each morning for 30 minutes.

D

The spouse of an older adult client explains how difficult it has been to get the client to see the health care professional. At this visit, the client is diagnosed with cancer. What does the spouse's statement reinforce about cancer in older adult clients? A)Older adults have more chronic illnesses than younger clients. B)Older adults' finances limit the ability to pay for health care. C)Older adults have no interest in taking care of their health. D)Older adults have the lowest rates of receiving early detection tests.

D

Two nurses are discussing the relationship between spirituality and religion. Which statement explains this relationship? A) They are the same. Both connect individuals to the Divine and to other living things. B) They are directly related. The more spiritual the individual, the greater his or her commitment to religion. C) They interact inversely. Heavy involvement in organized religion diminishes spirituality and vice versa. D) They are different. Spirituality is a sense of connection to the Divine; religion is a structure of beliefs, rituals, and rules.

D

What is the rationale for preventing complications in the older client with a chronic condition? A)Complications risk decreasing disability. B)Complications risk slow decline. C)Complications risk enhancing self-care capacity. D)Complications risk weakening self-care capacity.

D

What should the nurse use to help guide interventions to meet the spiritual needs of a patient? A) The client's prognosis for recovery B) The nurse's own religious tradition C) The denominational affiliation of the chaplain D) The presence of icons and religious books at the bedside

D

When caring for gay, lesbian, bisexual, and transgender (LGBT) older adults, the nurse realizes which fact? A)Members of the older adult LGBT population have similar health status as needs as other older adults. B)Almost 100% of LGBT older adults disclose their sexual orientation. C)Nearly 30% of the older adult population identifies themselves LGBT. D)Many older adults who identify themselves as LGBT have been victimized.

D

When orienting a new staff nurse to the gerontological unit, the charge nurse should provide which information about the older adult Native American/First Nations population? A)Most are hospitalized due to acute conditions. B)Most live on reservations. C)Most live in nursing homes. D)Most receive less than optimal health care.

D

Which assessment findings support the suspicion that an older patient has osteoporosis? a. The patients reports an allergy to dairy products. b. A lactase enzyme is a part of the patients drug regime. c. Bones in one of the patients lower legs are shorter than in the other. d. The patient is inch shorter than at his or her previous physical

D

Which end-of-life nursing diagnosis is associated with the aging client and anxiety? A)Impaired skin integrity B)Deficit, knowledge C)Disturbed body image D)Disturbed thought process

D

Which endocrine function nursing diagnosis is associated with the aging client who is experiencing urinary frequency as a result of diabetes? A)Risk for injury B)Anxiety C)Risk for infection D)Disturbed sleep pattern

D

Which endocrine function nursing diagnosis is associated with the aging client who is experiencing urinary frequency as a result of diabetes? A)Risk for injury B)Risk for infection C)Anxiety D)Disturbed sleep pattern

D

Which important questions would the nurse ask the older client to assess attitudes, values, and beliefs? A)Do you think that you'll have enough money to continue your lifestyle as long as you'd like? B)Do you admire your brother? C)Do you love your son and do you think he's turned out the way that you had hoped? D)Do you feel that the younger should take care of the old or that children owe their parents nothing?

D

Which is the most important remediable risk factor for cardiovascular disease in older adults? A)aggressive personality B)stress C)sedentary lifestyle D)smoking

D

The nurse is caring for an older client who is confused and wanders the halls. What intervention is appropriate? A)Raise two of the client's four siderails when in bed B)Assist the client into a geriatric chair C)Administer sedatives on a PRN basis D)Apply a seat belt when the client is in a wheelchair

a

Aware that older adult patients often present with nonclassic symptoms of type 2 diabetesmellitus, the nurse is particularly suspicious of a patient reporting: a. bouts of diarrhea alternating with periods of constipation. b. recent problems reading and an infected sore on the toe that will not heal. c. periods of depression and severe indigestion after eating. d. dizziness when getting up too quickly and a red rash on the hands.

b

The nurse recognizes that an older adult on both antihypertensive and antidepressant drugtherapies has a specific need for: a. regular blood pressure monitoring. b. an effective history focusing on sexual function. c. an increase in daily fluid intake. d. frequent assessment of emotional stability.

b