.
An older client asks the nurse practitioner what measures can be taken to maintain a healthy heart. Which regimen would the nurse recommend?
"D. Eating complex carbohydrates and limiting your use of alcohol are appropriate measures for reducing your risk for cardiovascular disease."
During a health promotion seminar, a nurse is teaching a group of older adults at a senior center about some of the normal changes that accompany the aging process. After teaching the group, the nurse determines that the seminar was successful based on which statement made by the group?
"Your brain actually becomes smaller as you age and this affects how quickly we older adults react."
An older adult with heart disease asks the nurse, "What foods can I eat to help reduce any further problems with my heart?" Which response(s) by the nurse would be appropriate? Select all that apply.
A. "Be sure to use cold-pressed olive oil." B. "Try increasing your intake of fiber." C. "Reduce your intake of fried foods."
A nurse is assessing an older adult's reproductive system. Which question would be most appropriate for the nurse to ask to gather information?
A. "Do you ever have secretions, blood, or other discharge from your genitals?"
A client has been asked to keep a food journal to address ongoing issues with constipation. When reviewing the journal, the nurse notes that the client has a bagel and coffee for breakfast, macaroni and cheese for lunch, and soup and salad for supper during
A. "Eat oatmeal for breakfast 3 to 4 days per week."
A nurse conducts a class for family members who are providing care to older adult relatives. An attendee asks, "My mother has had frequent urinary tract infections. What can I do?" Which suggestion would be most appropriate?
A. "Encourage your mother to consume more fluids during the day."
A 71-year-old client, who has been experiencing several weeks of lower back pain and pelvic heaviness, has been diagnosed with a cystocele. When developing a teaching plan for this client, which information would the nurse most likely include?
A. "Incontinence of urine is a common consequence of this problem."
The nurse educator who directs care at an assisted living facility is conducting a health promotion session with residents. Which statement about maintaining and promoting bladder health would the nurse include?
A. "Making your urine more acidic through your diet can reduce the incidence of infections."
A gerontological nurse is teaching a group of staff nurses about the differences in presentation and course of pneumonia in older adults. Which difference would the nurse include in the discussion?
A. "Older adults may not experience chest pain or exhibit a high fever."
A nurse manager is educating a group of nurses working in a long term care facility about sensory organ function and taste. Which information would the nurse incorporate in her teaching?
A. "The function of the cranial nerves mediating taste declines with age."
The nurse in the emergency department assesses a 76-year-old female client. The client's bladder is visibly distended and the client has not voided since the previous evening. Which assessment question would be most important to determine the source of the client's condition?
A. "When was your last bowel movement?"
The nurse is teaching a client, who is moderately obese but otherwise healthy, about the benefits of exercise. Which statement would the nurse include?
A. "You'll need to monitor your heart rate when you're exercising to make sure it doesn't go more than 10 beats over your target rate."
A nurse is reviewing the medical records of several clients. Which client would the nurse most likely identify as being at greatest risk for developing esophageal cancer?
A. A 74-year-old male client with alcohol abuse who has chewed tobacco for many decades
Several older adult clients are being cared for on a subacute medical unit. After assessing each client, which client would the nurse identify as being at highest risk for a cerebrovascular accident (CVA)?
A. A 79-year-old who has poorly controlled hypertension and smokes half a pack of cigarettes daily
A postmenopausal woman comes to the women's health clinic for a visit. The client reports vaginal itching. Inspection reveals vaginal redness and clear vaginal discharge. The client is diagnosed with senile vaginitis. Which change would the nurse explain as often a contributing factor?
A. Alkaline vaginal pH
The nurse recognizes the effectiveness of applying heat in the treatment of pain and often recommends the use of heating pads or warm water soaks. For which client would the nurse strongly stress the need for safe use of heat?
A. An 80-year-old client with painful bunions and a history of peripheral neuropathy.
An 85-year-old client with limited mobility is incontinent of urine. An expected outcome identified on the plan of care is that the client will maintain skin integrity. Which intervention would the nurse most likely implement?
A. Assess the client for wetness every 2 hours.
A postmenopausal woman tells the nurse that she experiences discomfort during intercourse. Which teaching will the nurse include while educating the client? Select all that apply.
A. Begin routine use of a vaginal moisturizer to ease dryness. B. Use water-soluble lubricant before and after sex to ease pain due to dryness. C. Spend more time in the arousal phase. D. Avoid soaps that cause drying.E. Have sex more frequently.
A gerontological nurse is educating caregivers of older adults about the importance of physical activity. Which suggestion would help families increase the physical activity of their older relatives?
A. Being creative in suggesting pastimes that can stimulate movement
A nurse is providing hospice care to a client with end-stage Parkinson's disease. Which finding would the nurse need to address when implementing care?
A. Bradykinesia
A nurse has admitted a 79-year-old female client to the unit from the emergency department following a fall. A diagnosis of osteoporosis is confirmed in the client's medical history. Assessment also reveals that the client displays kyphosis. Which medication(s) would the nurse anticipate administering to the client? Select all that apply.
A. Calcium supplements B. Calcitonin C. Vitamin D supplements E. Estrogen
. A nurse is evaluating an older adult client's lifestyle to determine the client's risk for neurovascular problems. The nurse determines the need to develop a teaching program for the client based on which factor(s)? Select all that apply.
A. Cigarette smoking B. Failure to use seat belts C. Sexually transmitted infections D. Alcohol abuse E. Obesity
A gerontological nurse educator is presenting an in-service program about women's health and cancer in the older woman to the nursing staff at a long- term care facility. After teaching the group, the nurse educator determines that the teaching was successful when the group identifies which site as most common for the development of a vulvar malignancy?
A. Clitoris
A nurse is admitting a client to the facility. When evaluating the client's circulation in the extremities, which action would the nurse do first?
A. Conduct a health history and then inspect the legs
A nurse is providing care to an older adult woman diagnosed with ovarian cancer. Which finding(s) would the nurse most likely identify as supporting this diagnosis?
A. Constipation B. Ascites D. Bloating
. A 74-year-old client, who is in the hospital for rehabilitation following hip replacement surgery, has been experiencing incontinence since admission. Which intervention(s) would the nurse implement to facilitate the restoration of the client's bladder function? Select all that apply.
A. Determine and assess the client's recent voiding pattern. D. Offer to assist the client to the commode every 2 hours while awake. E. Assess the client for contributing factors such as constipation.
After an assessment, the nurse suspects that an older client may have developed an abdominal aortic aneurysm. Which finding(s) would support the nurse's suspicion? Select all that apply.
A. Diagnosis of angina C. History of arteriosclerosis E. Experienced a myocardial infarction
An older client has been treated for three episodes of respiratory infections related to chronic bronchitis within 6 months. The client complains of shortness of breath when walking outside in the cold weather. Which recommendation by the nurse would be appropriate?
A. Drink plenty of water
While making a home visit, the nurse determines that the quality of a client's indoor air environment needs to be improved. Which instruction(s) would the nurse most likely include? Select all that apply.
A. Dust furniture with a damp cloth B. Keep windows closed C. Avoid smoking inside the home D. Vacuum the floor coverings regularly
An older adult client is diagnosed with benign prostatic hyperplasia (BPH) after reports of trouble urinating. Which action(s) will the nurse take? Select all that apply.
A. Encourage the client to keep active. B. Teach the client to do Kegel exercises. C. Recommend the client incorporate meditation. D. Instruct the client in double-voiding.
An older adult client has been confined to bed for the past 3 months due to a recent motor vehicle accident. Which action(s) will the nurse take to help the client transition to increased mobility? Select all that apply.
A. Encourage the client to move in bed. B. Provide assistive care devices, as appropriate. C. Include the client in goal setting.
A nurse is incorporating exercise into the daily interactions with clients experiencing Alzheimer's disease in the care facility. Which intervention would be appropriate for the nurse to include?
A. Encouraging the clients to wave their arms in greeting
A nurse is assessing an older adult male client. The client tells the nurse, "I am urinating quite often but it feels like I am not emptying my bladder completely." The nurse interprets the client's statement as suggesting which condition?
A. Enlargement of the prostate
An older client with a terminal illness is extremely thin and is prescribed to use oxygen via a face mask at home. To ensure that the client's oxygenation needs are met, which intervention would be the priority?
A. Ensuring a tight seal around the face mask
A 77-year-old client, who has undergone surgery, has been experiencing abdominal pain and rectal discomfort. In addition, the client has a temperature of 101.5 °F (38.5 °C) and has had four small, loose bowel movements since the morning. Based on these assessment findings, the nurse would suspect which condition?
A. Fecal impaction
An older adult client taking medication for hypertension asks what else can be done to reduce the blood pressure. Which action(s) will the nurse recommend? Select all that apply.
A. Follow a low-fat, low-cholesterol diet. B. Exercise regularly. C. Reduce the use of salt or sodium.
A 75-year-old client has presented to the emergency department with recent fatigue, nausea, and vomiting. The client's temperature is 101.8 °F orally and urinalysis indicates proteinuria and slight hematuria. Based on these findings, which condition would the nurse most likely suspect?
A. Glomerulonephritis
A dentist examines the mouth of an 80-year-old male client with a history of pipe smoking. The dentist notes white patches in the client's mouth. Which action would most likely occur next?
A. Have the lesion biopsied
A nurse is monitoring a group of older adults exercising at the local senior wellness center. The nurse immediately calls 9-1-1 based on which assessment finding?
A. Inability to speak and maintain balance
A nurse is developing a teaching plan for a 90-year-old client about ways to prevent urinary tract infection. Which will the nurse include? Select all that apply.
A. Ingest 64 oz (2 L) of fluid per day. B. Wipe front to back .C. Urinate as soon as the need presents. D. Avoid caffeine and alcohol. E. Drink cranberry juice.
A nurse is providing care to an older adult woman at an assisted living facility. The woman was diagnosed with cervical cancer. Which finding would the nurse identify as supporting this diagnosis?
A. Leukorrhea
A gerontological nurse is conducting an educational program at a local senior center about the importance of exercise and staying active. Which health change would the nurse most likely include in the discussion regarding the importance of exercise?
A. Lowering blood pressure B. Maintaining muscle strength C. Sharpening mental acuity E. Slow rate of bone loss
. A nurse is teaching an older adult with a history of bronchitis how to reduce his signs and symptoms. The nurse determines that the teaching was successful when the client identifies which action? Select all that apply.
A. Maintaining a high fluid intake C. Consciously expectorating secretions D. Avoiding respiratory infections
An 81-year-old client has developed a fecal impaction while convalescing at home after hip surgery. Which action would be appropriate for the nurse to take?
A. Manually remove the feces with a gloved finger.
A nurse is reviewing the plans of care for several older adult clients on the medical unit. While reviewing the clients' medical records, which finding(s) would the nurse identify as supporting risk for infection? Select all that apply.
A. reduced vital capacity B. reduced ciliary activity D. underinflation of lung bases E. less efficient cough response
A nurse is providing care to a 65-year-old male client who has just had prostate surgery. The nurse is teaching the client about postoperative activities. The nurse determines that the teaching was successful based on which client statement?
C. "It's important for me to avoid becoming constipated."
A gerontological nurse is discussing sexual health with a 74-year-old female client of an assisted living facility. Which statement would the nurse most likely include in the discussion?
C. "Many changes occur in the reproductive system with aging, but none of them rules out the possibility of having satisfying experiences sexually."
A 75-year-old client tells the nurse, "When I feel the need to urinate, I cannot hold it until I get to the toilet." Which suggestion would be appropriate?
C. "Remind yourself to urinate every two hours during the day."
The nurse is assisting an aging client with ambulation. The client has been diagnosed with osteoarthritis. Which of the following instructions is most appropriate for the nurse to give the client?
C. "Stand straight and tall."
A 70-year-old client has just been diagnosed with Parkinson's disease. Which information would the nurse use to educate the client and family?
C. "The disease progresses slowly with therapy helping to minimize disability."
The son and daughter of an 80-year-old client have expressed concern to the nurse that their mother has become extremely impatient and irritable since her stroke earlier in the year. Which response by the nurse would be appropriate?
C. "This is not uncommon after a stroke. It must be difficult for you since it is uncharacteristic of her personality."
A nurse, providing care to several male clients in the long-term care facility, is reviewing the clients' medical records. Which client would the nurse identify as being at greatest risk for a loss of sexual function?
C. A 65-year-old male who has had a radical prostatectomy.
. A gerontological nurse is working at a local community health clinic that serves a large older adult population. When reviewing the medical records of several clients, the nurse anticipates the need for podiatric surgery for which client?
C. A 66-year-old who has bunions from many years of wearing high-heeled shoes.
The nurse is providing care to a group of older adult clients. The nurse would anticipate administering an anti-inflammatory medication to which client?
C. A 71-year-old client with rheumatoid arthritis
An older client has been diagnosed with sarcopenia after gradually losing stamina over a period of time. Which recommendation will the nurse make for the client?
C. Begin a resistance exercise training (RET) program.
A gerontological nurse practitioner is assessing a 65-year-old client. The client has a history of anemia along with intermittent bloody urine. The client denies any abdominal or flank pain, cloudy urine, or dysuria. Based on these findings, which condition would the nurse practitioner suspect?
C. Bladder cancer
During an assessment, the nurse notes that an older client has a gray discoloration of the skin. The nurse interprets this finding as associated with which condition?
C. Chronic bronchitis
A nurse is assessing a client during a home care visit. Which observations would alert the nurse to immediately intervene?
C. Cigarette burns on client's fingers
An older client, who has been treated for diabetes mellitus for 10 years, continues to have difficulty controlling blood glucose levels. When teaching the client about potential complications associated with diabetes, which information would the diabetes nurse educator include?
C. Complications of arteriosclerosis
The nurse is providing care to an older adult who has been diagnosed with a venous thromboembolism. Which age-related change would the nurse identify as a contributing factor?
C. Decreased elasticity of blood vessels
The nurse is assessing a client with abdominal and rectal discomfort, diarrhea, and fever. Which initial data source would the nurse use to determine a possible cause of the client's symptoms?
C. Defecation record for frequency and character of bowel movements
During a home visit, the nurse notes that an older adult client has increased joint pain and shortness of breath since moving in with an adult child 6 months ago. Which factor might the nurse identify as contributing to this client's
C. Family assistance limiting mobility
A client is prescribed Levodopa as part of the treatment plan for Parkinson's disease. When teaching the client about this drug, which item would the nurse encourage the client to avoid?
C. Foods high in vitamin B6
An older adult client has a triglyceride level of 300 mg/dL. After teaching the client about necessary dietary changes, which change(s) if stated by the client indicates successful teaching? Select all that apply.
C. Increase the intake of fish and chicken D. Use skim milk and nonfat cottage cheese E. Add fresh fruit and vegetables to meals each day
A client with dementia has difficulty swallowing and frequently coughs when eating. Recently, the client has developed a nonproductive cough with a temperature of 99 °F. The nurse is concerned that this client is at risk for developing which health problem?
C. Lung abscess
A nurse is developing a plan of care for an older adult experiencing dysphagia. Which intervention would the nurse perform first?
C. Observe the client's food intake
The nurse is caring for an older adult client with chronic pulmonary disease and ineffective respirations. Which intervention will the nurse include in the plan of care?
C. Perform daily deep-breathing exercises.
The nurse is preparing to implement a new postural drainage order for an older client with copious secretions caused by community-acquired pneumonia. Which action by the nurse would be most appropriate?
C. Perform postural drainage allowing adequate periods of rest between position changes
. A 75-year-old woman comes to the women's health clinic reporting a feeling of heaviness in the pelvic area and a feeling of a mass in her vagina. Which condition would the nurse suspect?
C. Perineal herniation
A nurse is reviewing the plan of care of a 78-year-old client in a long-term care facility diagnosed with Parkinson's disease. Which intervention would need to be modified?
C. Phrase questions and directions in a simple and understandable manner applicable to the client's decreased cognition
A 71-year-old male client has presented to the nurse practitioner's clinic complaining of abdominal and flank pain and blood in his urine for the past 48 hours. Assessment reveals the client's temperature is 102 °F orally. Based on these findings, which condition would the nurse suspect first?
C. Renal calculi
An older adult client who resides in an assisted living facility experiences dizziness and lightheadedness when getting out of bed in the morning and when standing up quickly from a chair. Which intervention by the nurse is appropriate?
C. Review the medication regimen.
A 79-year-old client has a number of health problems, including Parkinson's disease. When assessing this client, which finding(s) will the nurse attribute to the client's diagnosis of Parkinson's disease? Select all that apply.
C. Slow movement with poor balance D. Walking with a shuffling gait E. Blank facial expression F. Emotional instability
A healthy and active older adult client comes to the clinic complaining of constipation. Which age related change would the nurse identify as a contributing factor to the client's constipation?
C. Slower peristalsis
During a neurological evaluation, the nurse practitioner asks an 83-year-old client to draw the face of the clock and then tell the nurse what time the clock reads. Which assessment finding would lead the nurse to suspect expressive aphasia?
C. The client draws a clock but is unable to state the time
A 77-year-old client has presented to the primary care provider with a complaint of recent hematuria. Which of the following aspects of the client's history would most clearly signal to the care provider a risk of bladder cancer?
C. The client has been a smoker since the age of 15.
A nurse is assessing a 71-year-old client's urinary function. Which finding would the nurse identify as a cause for concern?
C. The pH of urine sample is 9.0
A 75-year-old adult is a new attendee at strength training class. Which schedule would be most appropriate for this client to engage in?
C. Twelve repetitions with low-weight free weights at least twice weekly.
An older client wants to use complementary therapies to help treat hypertension that has not responded to medication therapy. Which suggestion would be appropriate for the nurse to make?
C. Yoga and hawthorn berries
. An older client recovering from surgery is experiencing left calf edema. On inspection, the area is red and painful to touch. When developing this client's plan of care, which intervention would the nurse include?
D. Applying elastic stockings and administering anticoagulants as ordered
A 70-year-old client comes to the clinic for a visit. The client reports some episodes of vaginal spotting. The client states, "I just got married again after being widowed for 10 years. My spouse and I are enjoying our new relationship." Based on the client's report, which assessment data should the nurse prioritize?
D. Ask about bleeding or other symptoms after intercourse
The nurse is planning care for an older client with NYHA class III congestive heart failure (CHF) being admitted to a skilled nursing facility. Which action would be appropriate to include during the client's first week of hospitalization?
D. Assisting to a chair on day 1 with progressive daily ambulation
A gerontological nurse is working with an older adult client to develop an individual exercise program for weight loss. Which outcome for the client is most appropriate?
D. Client will walk with family member each morning for 30 minutes.
A 60-year-old client, who participates in outdoor activities, is diagnosed with angina. When teaching the client about this condition, which activity would the nurse encourage the client to avoid?
D. Cross-country skiing
A nurse is teaching an older adult client who has been recently diagnosed with a hiatal hernia. The nurse determines that the teaching was successful when the client identifies which action as helping to minimize the discomfort?
D. Staying upright for 1 hour after eating
An older adult client with a history of environmental exposure to chemicals reports shortness of breath. Assessment of which finding would lead the nurse to suspect that the client has chronic obstructive pulmonary disease (COPD)?
D. Sticky, translucent, grayish white sputum
A nurse is providing care to an 80-year-old client who experienced an ischemic cerebrovascular accident (CVA) 3 weeks ago. Which intervention would the nurse implement to address the cognitive changes that have accompanied the client's stroke?
D. Talking to and giving explanations to the client while performing routine care tasks
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?
"Even though you have smoked for a long time, there are still benefits to quitting smoking."
A gerontological nurse initiates an activities program at the long-term care facility. Which activity(ies) will the nurse plan? Select all that apply.
A. daily walks outdoors C. life story activities E. board games F. charitable activities
A home care nurse is making a home visit to a 65-year-old client with Parkinson's disease. When evaluating the environment, which component would the nurse emphasize to the client and spouse?
D. Shower with non-slip surface and rails
Which activity(ies) will the nurse include when planning activities to improve mood for clients at a wellness center? Select all that apply.
A. group dinnersB. field trips to local museums C. support groupsD. weekly comedy movie night E. art classes
A gerontological nurse is developing a plan of care to promote the independence of a client who requires a wheelchair for mobility. Which intervention would be most appropriate for the nurse to include?
B. Provide a long-handled reaching device.
A nurse is preparing a seminar on neurologic health issues in older adults to a group of staff members at a local senior center. Which information would the nurse most likely incorporate into the seminar?
"A higher than normal body mass index reduces the risk of neurovascular disease."
The nurse is preparing discharge instructions for an older client with chronic obstructive pulmonary disease. Which instruction would the nurse include about using inhaled bronchodilators?
"A. Usually, when you take one or two puffs, you should have relief for around four hours."
An older client, recovering from a myocardial infarction (MI), asks the nurse, "Will I still be able to be sexually active?" Which response by the nurse would be appropriate?
"C There are positions that produce less strain on the heart during sexual activity."
A nurse is conducting a health promotion class for a group of older adults at a local community health center. During the class, several members of the group asks the nurse, "What can we do to make sure that we do all we can to stay neurologically healthy?" Which response by the nurse would be appropriate?
"Quitting smoking and maintaining a healthy body weight can cut your risk of neurological diseases."
As part of the treatment regimen for the diagnosis of colon cancer, a 73- year-old client has recently received a colostomy. During the early stages of client teaching, which information would be the nurse include as priority? Select all that apply.
A. Modifications in food and fluid intake that surgical creation of the colostomy necessitates B. The lifestyle adjustments and effect on self-concept that often accompany colostomies D. Allowing a caregiver to assist with colostomy hygiene when needed E. The importance of monitoring for signs of infection at the colostomy site
A gerontological nurse recognizes that dyspareunia is a common problem among older women and conducts a program on this topic for a group of nurses working at the women's health clinic. The nurse determines that additional teaching is necessary when the staff identifies which condition as a risk factor?
A. Multiparity
The nurse is conducting an assessment of several clients who have come to the senior health center for evaluation. Which client would the nurse identify as being at greatest risk for bladder cancer?
A. Older male who retired as a manager for a dye factory
. The nurse encourages an 80-year-old client not to fall asleep slumped in the recliner to prevent the possibility of transient ischemic attacks (TIAs). When explaining the rationale for this action, which effect would the nurse describe?
A. Prevention of impaired cerebral blood flow
A nurse is developing a plan of care for an older adult. Which intervention would be most appropriate for the nurse to include to promote tissue perfusion? Select all that apply.
A. Reminding the client to change positions frequently B. Ensuring the client maintains an adequate body warmth C. Encouraging the client to engage in physical activity when possible D. Assessing for and preventing sources of pressure on the body E. Educating about the risk of obesity and alcohol abuse
. A nurse is providing care to a 75-year-old client who is experiencing urinary incontinence. Assessment reveals that the client is not fully emptying the bladder with each void. Which intervention(s) would the nurse implement to enhance voiding and prevent retention? Select all that apply.
A. Running water while the client is voiding B. Massaging the bladder area with each void C. Soak the client's hands in warm water during voiding D. Having the client stand upright to void
A nurse providing care to an 85-year-old woman with dementia notes that the client is incontinent every evening and is particularly restless. Further assessment reveals that the client often touches her genital area. Which condition would the nurse most likely suspect?
A. Senile vulvitis
An older client with asthma is prescribed an inhaler. The nurse is assessing the client for possible factors that might impact the client's ability to comply with this treatment. Which condition would the nurse identify as impacting the client's compliance?
A. Severe arthritis
After presenting with severe depression following the death of an adult child, a 77-year-old client is prescribed an antidepressant. Recently, the client was diagnosed with an oral fungal infection. Which suggestion by the nurse would be appropriate?
A. Sipping water to promote saliva
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. Teaching about the disease process B. Discussing how to reduce environmental irritants C. Explaining how to use transportable oxygen D. Encouraging the need to avoid temperature extremes
On admission to the hospital, an 81-year-old client is recognized to be at risk for incontinence. When reviewing the client's medications and medical history, which component would the nurse identify as posing the greatest threat to the client's continence?
A. The client takes a diuretic for treatment of congestive heart failure and over- the-counter antihistamines during allergy season.
A 66-year-old client is suspected of having cervical cancer. When assessing this client, which finding(s) would the nurse identify as supporting this suspicion? Select all that apply.A. Vaginal bleeding
A. Vaginal bleeding B. White vaginal discharge
An older client, who recently retired from working as a waitress for 40 years, describes leg cramps that interfere with sleeping. The client also experiences dizziness when getting out of bed first thing in the morning. The nurse interprets these findings as suggesting which condition?
A. Varicose veins
The nurse is teaching a client with emphysema to progressively increase activity. When should the nurse instruct the client to stop activity?
A. When there is a decrease in respiratory rate and pulse
The nurse supports a number of seniors in a community health clinic. Which client will the nurse identify at highest risk for dental caries?
A. client with a poor diet
A nurse is conducting a class for a group of older adult women. For which client will the nurse recommend Kegel exercises?
A. client with stress incontinence
A 70-year-old male, who has undergone prostate surgery, is preparing for discharge. When developing this client's discharge plan, the nurse would most likely include teaching related to which area?
D. Resumption of sexual relations
A gerontological nurse is conducting a nutrition and diet program for a group of older adults at the local senior center. Which suggestion would be appropriate for the nurse to make to promote gastrointestinal (GI) health?
B. "Be sure to consume food with fiber and plenty of fluids."
The nurse is teaching a client who has been diagnosed with cholelithiasis about gallbladder disease. The nurse determines that the client has understood the teaching based on which client statement?
B. "I can treat the gallstones without surgery."
The nurse practitioner teaches a 78-year-old woman about breast health. The nurse determines that the teaching was successful based on which client statement?
B. "I will call you if I find any lump in my armpit."
A 76-year-old client has been diagnosed with an axial hiatal hernia following several months of belching and heartburn. Which response by the nurse would be appropriate when teaching this client about indigestion?
B. "Losing weight and eating a bland diet might help alleviate some of the symptoms you're experiencing."
A 75-year-old adult, who has been a runner all his adult life and has just participated in another 5K race, comes to the clinic for a routine checkup. During the visit, the client tells the nurse, "My blood pressure at the finish line was 200/110 mm Hg." The client has no history of hypertension. Which response by the nurse would be appropriate as a reason for the systolic blood pressure (SBP) being over 200 mm Hg?
B. "This is a consequence of an age-related change.
The nurse completes discharge teaching for an older adult client admitted to the hospital with renal calculi. Which instruction would the nurse emphasize when giving discharge instructions?
B. "Your intake of fluids should be at least 2 liters each day."
A gerontological nurse is working to develop programs to address female reproductive cancers in older adult women. As part of this process, the nurse reviews the medical records of several female clients in the long-term care facility. Which client would the nurse identify as being at risk for vaginal cancer?
B. A 70-year-old woman with a history of cervical cancer
A nurse is assisting a group of older adult clients with an exercise regimen. Which client would the nurse expect to achieve the greatest benefits related to musculoskeletal function?
B. A 76-year-old who swims laps four times weekly and does light weight training on the other 3 days.
After injuring the right arm and hip in a fall, an 80-year-old client is brought to the emergency department. Further assessment reveals intact skin without edema or redness. After reporting to the medical staff, which decision will the nurse anticipate?
B. Assess the client further despite the absence of obvious signs or symptoms.
An 84-year-old client, who resides in a long-term care facility, has recently become incontinent of bowel. Which intervention by the nurse would be the priority?
B. Assessing for evidence of fecal impaction
An older adult client just had an episode of incontinence and the nurse is assisting the client in cleaning up. The client says, "I am so sorry that you have to do this." Which topic will the nurse include in client teaching?
B. Attempt to void every 2 hours.
A 68-year-old woman comes to the clinic for a follow-up visit. The client has a history of recurrent vaginitis. When teaching the client about preventive measures, which instruction would the nurse most likely include?
B. Avoiding perineal contact with heavily perfumed soaps and sprays.
A nurse is interviewing several older adults who are attending a class at the local senior center. The nurse would ensure immediate follow-up by the primary care provider for which client?
B. Client reporting some numbness of hands
A nurse is providing care for a 75-year-old male client who has not voided urine since the beginning of the shift. The client states that this has happened before but he is unable to void even though he feels like he has too. An ultrasound bladder scan indicates that there is 780 ml of urine in the client's bladder. The nurse would suspect which condition as the most likely cause of the urinary retention?
B. Prostatic hypertrophy
A client experienced a cerebrovascular accident and now has expressive aphasia. When providing care to this client, which intervention would be the priority?
B. Devising a picture chart for the client to point for requests
An older adult resident is experiencing paresis after a cerebrovascular accident. Which intervention(s) will the nurse include in the plan of care to promote improved physical activity? Select all that apply.
B. Encourage family to assist in efforts to increase the client's mobility. D. Promote a nutritional intake of calcium and protein. E. Provide diversional activities based on the client's interests and level of function.
An older client with hypertension has been admitted to a nursing home to recover from orthopedic surgery. Which action would be appropriate for the nurse to include in this client's plan of care to improve tissue perfusion?
B. Encouraging the client to ambulate several times each day
A 66-year-old male client has had a diagnosis of benign prostatic hyperplasia (BPH) for several months and is now scheduled for transurethral prostate resection (TURP) surgery. The client states to the nurse, "Finally I'll be able to get my sex life back in order." Which information would the nurse include in the response?
B. Explaining that surgery is unlikely to bring a rejuvenation of sexual performance.
Relatives brought an older adult client to the health center because they noticed a behavior that seems to be getting progressively worse. After assessing the client, the nurse practitioner explained that the behavior they noticed was characteristic of Parkinson's disease. Which symptom did the relatives most likely notice first?
B. Faint tremor in the hands or feet
At 65 years of age, a client is starting to exercise again after 10 years of relative inactivity. When discussing the exercise program with the nurse, which aspect would the nurse encourage the client to do first?
B. Have a physical exam performed.
An 82-year-old client of a long-term care facility has experienced a gradual decline in physical activity as dementia has progressed. Which intervention would be most appropriate for the nurse to implement to meet this client's activity needs?
B. Identify the client's existing interests and integrate these into an activity regimen.
The nurse notes excessive swelling of the ankles and legs in a client with a history of lower extremity swelling. Which change in the client's plan of care would the nurse anticipate?
B. Limiting excessive activity
A client with cardiovascular disease wants to know why magnesium supplements are prescribed. Which information would the nurse integrate into the response? Select all that apply.
B. Lowers total cholesterol D. Dilates arteries E. Raises high-density lipoprotein cholesterol
A nurse is preparing a program at a local health fair, promoting activities to reduce clients' risk of cerebrovascular accidents (CVA). Which activity would the nurse emphasize as a helpful measure(s) for risk reduction? Select all that apply.
B. Managing hypertension C. Maintaining adequate hydration E. Controlling diabetes
The nurse is performing a respiratory assessment of an older adult. Which finding(s) will the nurse immediately report? Select all that apply.
B. Neck vein distention C. Elevated blood pressure D. Change in mental status
. An older adult client requires oxygen therapy. Which guideline would the nurse integrate when implementing this intervention?
B. Oxygen therapy should be used with caution to prevent carbon dioxide
. An older adult is recovering from hip replacement surgery. The nurse assesses the client's status. Which factor is most likely to affect tissue perfusion?
B. Prolonged immobility after surgery
An older client, who enjoys good health, is experiencing a decline in stamina despite being physically active over the years. The client's history and physical exam is unremarkable. The nurse suspects that the client is experiencing age- related changes that are affecting stamina. Which change would the nurse suspect?
B. Reduced heart contractility and a prolonged cardiac cycle
An older client with cardiovascular disease is losing weight because of a poor appetite. Which intervention(s) should the nurse use to help support this client's nutritional needs? Select all that apply.
B. Serve favorite foods in an attractive manner D. Provide several small meals throughout the day
1. After completing an assessment of an older adult client, the nurse interprets which finding as a pathological process rather than age-related respiratory changes?
B. Slight wheeze on exhalation
An older adult client is diagnosed with chronic obstructive pulmonary disease. The client has no specific dietary restrictions or limitations. Which food would the nurse most likely recommend?
B. Spicy foods and garlic
The nurse is reviewing the medical record of a 72-year-old client admitted for treatment of a myocardial infarction. The client has a history of hypertension and heart failure. During the night, the client voided four times. Upon reviewing the client medication regimen, which medication would the nurse identify as being implicated in the client's nocturia?
B. Thiazide diuretic
The nurse visits a client with a diagnosis of Alzheimer disease who is experiencing functional incontinence. The client lives at home with a spouse, who is the primary caregiver. Which action(s) will the nurse recommend to the caregiver? Select all that apply.
B. Toilet the client every 2 hours during the day,C. Toilet the client upon waking and before bed.
A client who has just died has undergone an autopsy that revealed the presence of Lewy bodies in the client's brain. Based on this information, the nurse would suspect that the client would have exhibited which manifestation?
B. Tremor
The nurse working in the women's health clinic is obtaining a complete history from the 68-year-old client. When gathering information about the client's sexual history, which action would be appropriate?
B. Use open-ended questions specific to sexual functioning.
A nurse is teaching exercises to a client who has had surgical repair of a fractured hip. The client is receiving analgesics to control pain. Because the client's ability to exercise is limited, which activity will the nurse instruct the client to perform?
B. arm circles to strengthen arms for walker use
During an interview the nurse uncovers the client is experiencing incontinence when coughing. Which client will likely experience this type of incontinence?
B. multiparous client
The nurse discusses dental health with an 81-year-old client. Which client statement would the nurse identify as accurate?
C. "Fluoride treatments might help strengthen the enamel on my teeth."
The nurse is facilitating a health promotion class at a senior center. Which statement made by a participant requires additional teaching from the nurse?
C. "I use my puffer regularly to prevent any problems with my breathing in the future."
An older adult client is preparing for a total hip replacement. The nurse teaches a caregiver how to assist the client with exercises. Which statement by the caregiver indicates to the nurse that additional teaching is needed?
C. "I will exercise each joint for the client, each day."
An 80-year-old client reports ongoing problems with urinary frequency. The client's history and physical examination are unremarkable. Because the nurse identifies this concern as a normal age-related change, which change is the likely cause?
C. hypertrophy of the bladder muscle and thickening of the bladder
The nurse is teaching a 65-year-old client who has chronic constipation. When reviewing the client's dietary habits, the nurse finds that the client's diet is low in fiber. Which response by the nurse would be appropriate when teaching the client about prevention of constipation?
D. "Add fiber gradually to minimize symptoms of gas or bloating."
The daughter of an older client with diabetes and peripheral vascular disease wants to soak the client's feet. Which information about soaking the feet would the nurse most likely include in the teaching plan?
D. "Foot soaking is likely to worsen the client's foot problems."
A nurse is interviewing a client about the client's gastrointestinal health. Which statement by the client would lead the nurse to suspect that the client is experiencing a potential pathological process rather than a normal age-related change?
D. "I tend to regurgitate a lot of my food after a meal these days."
The family of an older client who is experiencing neurologic problems asks the nurse, "What can we do to make sure that our parent stays as independent as possible?" Which suggestion by the nurse would be most appropriate?
D. "Install different types of assistive devices in the home."
The daughter of a 79-year-old client with neurologic dysfunction asks the nurse, "What can I do to make sure that my dad stays safe in his home?" Which response by the nurse would be appropriate?
D. "Install smoke alarms, replacing the batteries often."
As part of a health promotion initiative, a nurse is conducting a program for a group of older adults. The nurse determines that the teaching was effective based on which statement by the group?
D. "Older women still need to have a yearly gynecological exam."
A 75-year-old man has been diagnosed with prostate cancer. The client is prescribed hormonal therapy as part of the treatment plan. The client tells his spouse and the nurse, "These pills are going to make me a woman." Which response by the nurse about the reason for this treatment would be appropriate?
D. "The hormonal therapy is designed to prevent the tumor from spreading."
Following several months of joint pain in the hands and knees, a 73-year-old client has been diagnosed with osteoarthritis. Which instruction by the nurse would be of most use to the client?
D. "There are changes you can make in your diet to help control your osteoarthritis and surgical options exist if it worsens."
. During a health promotion class at a senior's center, a 67-year-old client asks the nurse, "What can be done to help manage my spouse's diverticular disease?" Which response by the nurse would be most appropriate?
D. "Try to encourage your spouse to increase the amount of fiber in the diet."
A 71-year-old man has been diagnosed with gout. When teaching the client about dietary recommendations, which suggestion would the nurse most likely include?
D. "You should avoid alcohol, as well as many kinds of meat and seafood."
The nurse measures the blood pressure of an 80-year-old client. Which reading would the nurse interpret as being within an acceptable range for this client?
D. 128/78 mmHg
A gerontological nurse is providing care to several older adult clients. On which client's plan of care will the nurse include teaching of Kegel exercises?
D. 67-year-old woman living with stress incontinence since birthing children
A nurse is assessing several older clients. Which older client would the nurse suspect is displaying the effects associated with overusing bronchodilating nebulizers?
D. A client with new onset of a cardiac arrhythmia
The nurse is discussing nutritional health with an 89-year-old client. Which factor would the nurse interpret as a potential pathological process rather than a normal age-related change?
D. A decrease in the number of teeth and chewing ability
A 70-year-old client with gallbladder cancer is receiving transdermal doses of a narcotic analgesic. Which intervention would the nurse implement to minimize any gastrointestinal (GI) issues?
D. Add a toileting program to the nursing plan of care.
An exercise physiologist approaches the gerontological nurse manager at a local assisted living facility about beginning an exercise program for the clients at the facility. Which characteristic would the nurse manager require that the program include?
D. Addressing cardiovascular endurance, flexibility, and strength training
The nurse is preparing to perform postural drainage with an older client. Which action would the nurse perform first?
D. Administering aerosol medications
An older adult client comes to the clinic for a routine follow-up visit. During the visit, the client asks the nurse, "What foods would be best to eat so that I can stay as healthy and active as possible and prevent any muscle or bone problems?" The nurse would encourage a balanced diet, emphasizing the intake of which foods?
D. Dairy products and lean meats
A 70-year-old client tells the nurse, "I've been taking a laxative every day for years." Which would the nurse suspect as being related to this laxative abuse?
D. Dehydration
A nursing assistant is providing morning care to a 91-year-old female client with vascular dementia. The assistant notes that the woman's vulva is inflamed and reddened and reports this finding to the nurse. After a thorough assessment, the nurse determines that the findings reflect an age-related change in the clients reproductive system. which change would the nurse most likely identify as being responsible?
D. Fragility of the woman's vulva
A client, who is prescribed deep breathing and coughing every hour, has a nonproductive cough and is easily fatigued. What can the nurse do to increase the client's secretions?
D. Give the client a piece of hard candy to eat.
An older client experiences aching and swelling in the right leg. The nurse notes cyanosis of the extremity and suspects a possible venous thromboembolism. The nurse suspects which site is most likely involved?
D. Iliofemoral segment
A nurse is reviewing the medical record of a 78-year-old male client who has low testosterone. Which will the nurse recommend as a natural method of increasing testosterone?
D. Increase exercise.
An older client with a history of anginal syndrome and congestive heart failure is admitted to the cardiac care unit with a myocardial infarction. When assessing this client, which finding would the nurse most likely report to the health care provider?
D. Increase in body temperature
An older adult client with type 2 diabetes has elevated blood sugar levels, but urine samples are negative for glucose. The nurse interprets this finding as indicating which change?
D. Increase in the renal threshold for glucose
5. The nurse is teaching an 87-year-old client about preventing constipation. Which action would be important to teach this client?
D. Increase intake of liquids
The nurse assesses an older adult client who has recently developed nausea and vomiting, blurred vision, and palpitations. The history reveals that the client recently increased the dosage of digoxin. Which change would the nurse most likely attribute to the client's symptoms?
D. Kidney changes affecting elimination of digoxin
A nurse is providing care to an older adult client who has experienced an ischemic stroke. When developing the client's plan of care, the nurse focuses on improving the client's chance of survival and minimizing the limitations that impair a full recovery. Which intervention would the nurse identify as the priority during the acute phase?
D. Maintain a patent airway
The nurse is assessing an older adult client brought to the emergency department by a companion. Which finding would lead the nurse to suspect that the client is experiencing congestive heart failure?
D. Moist lung crackles on auscultation with shortness of breath on exertion
. During a physical examination, the nurse notes that the older adult client has a smooth red tongue. Which follow-up intervention would the nurse anticipate?
D. Nutritional screening
A newly admitted older adult client has severe edema in the lower extremities and no hair on the legs. Based on these findings, which assessment will the nurse perform?
D. Palpate the peripheral pulses of the legs.
An 81-year-old client of an assisted living facility has reported problems with nighttime muscle cramping that causes significant pain. Which intervention would be most appropriate to include in the client's plan of care?
D. Performing passive stretching of the limbs
An older adult client develops rapid, shallow respirations, with retraction of the respiratory muscles. Which action would the nurse do first to improve this client's ineffective breathing pattern?
D. Raise the head of the bed at least 30 degrees
As part of a health promotion initiative, a nurse is teaching a group of older men the importance of screening and prevention of reproductive health. The nurse promotes regular self-exams as a means for identifying which condition at an early stage?
D. Testicular tumors
A gerontological nurse manager is implementing a program at a local senior center to provide activity and exercise for the older adults. Which outcome would the nurse manager identify as the most direct effect of this program?
D. The older adults risk of household accidents will be reduced.
A gerontological nurse is conducting a program for a group of older adults at the local community health center. Which information would the nurse include in the discussion about dental health?
D. The presence of dental problems can be indicative of a variety of other diseases.
The nurse is caring for an older adult client with right-sided paralysis who uses a wheelchair. Which intervention should the nurse include in this client's care plan to promote respiratory health?
D. encouraging deep-breathing exercises three times per day
The nurse is visiting a client with asthma, whose spouse has recently died. The client continues to live in the same home. The nurse notes the home is stuffy and the client is experiencing a significant amount of wheezing. Which action will the nurse take?
D. improving the air quality in the house
A nurse is assessing an older adult client who has been admitted to the long- term care facility. Which finding would the nurse interpret as a potential pathological process rather than a normal age-related change?
D. red and swollen gums
A nurse is reviewing the medical record of an older adult client who was just admitted to the facility. The client has a history of angina. Based on the nurse's understanding of this condition, which assumption would be most appropriate for the nurse to make?
The client will have an order for nitroglycerin as needed and will be intolerant of strenuous activity.
