ch 14: health care for older adults

Which measure would the nurse incorporate while providing patient education to older adults?

Conduct teaching sessions in midmorning.

The nurse is working with an older adult after an acute hospitalization. The nurse's goal is to help this person be more in touch with time, place, and person. Which technique would the nurse try?

Reality orientation

Which therapy does the nurse suggest to help older adults recall their past to resolve current conflicts?

Reminiscence

Which modifiable risk factor is the most preventable cause of disease and death in the United States?

Smoking

Which statement by the patient with a pelvic fracture, who has a history of osteoporosis, relates to extrinsic risk factors for a fall?

"I forget my cane while walking."

Which statement made by the patient indicates the need for further teaching regarding proper medication use?

"I will use over-the-counter medicines along with prescribed drugs."

Which concept is a barrier that health care providers must overcome to promote health and control disease in older adults?

Lack of consistent guidelines

Which factor leads to the inability to distinguish between the colors blue and black?

Lens discoloration

Which approach would the nurse take regarding the assessment of an anxious older adult who has recently started to make mistakes regarding date and time?

Let the patient continue to think in his or her own way.

A student nurse is caring for a 78-year-old patient with multiple sclerosis. The patient has had an indwelling Foley catheter for 3 days. Eight hours ago the patient's temperature was 37.1° C (98.8° F). The student nurse reports this recent assessment to the registered nurse (RN): the patient's temperature is 37.2° C (99° F); the Foley catheter is still in place, draining dark urine; and the patient is uncertain what time of day it is. Based on knowledge about presentation of symptoms in older adults, what would the RN tell the student?

The nurse will notify the health care provider of the findings.

How do reminiscence strategies evaluate the memory of an older adult?

They resolve current conflicts by recollecting the past.

Which intervention would help reduce confusion in a patient with Alzheimer's disease?

Validation therapy

Which question asked by the nurse would be beneficial when assessing the risk for stroke in the older-adult patient with a history of smoking?

a) "Do you have a history of head trauma?" b) "Do you have a history of hypertension?" c) "Do you have a family history of heart disease?"

Which question asked by the nurse would be appropriate to further assess an older-adult patient with a history of excessive alcohol abuse?

a) "Do you have history of skipping meals?" b) "Do you have a history of frequent accidents?" c) "Do you face any difficulty while handling financial issues?"

Which question asked by the nurse helps assess the intrinsic risk factors for a fall?

a) "Do you have impaired vision?" b) "Are you on medication for pain?" c) "Are you on medication for seizures?"

Which statement by the patient leads the nurse to suspect the older adult is at risk of coronary artery disease?

a) "I'm always worried about my finances." b) "I have gained 15 pounds in one month." c) "I tend to eat fast food because it's affordable."

Which kind of house is appropriate for an older adult with severe arthritis who recently underwent knee replacement surgery?

a) A house with only one floor b) A house with no exterior steps

Which change would be considered a normal physiological change of the eye during old age?

a) Altered color perception b) Yellowing of the lenses c) Decreased accommodation to far vision

Which nursing intervention would be beneficial for older-adult patients who are diagnosed with chronic obstructive lung disease (COPD)?

a) Assessing for bacterial infection b) Monitoring respirations and breath sounds

Which activity is an instrumental activity of daily living (IADL)

a) Cooking meals b) Shopping c) Writing checks d) Making phone calls

Which change in the condition of the older adult living in a nursing home may indicate the onset of a new illness?

a) Decline in functional ability b) Sudden onset of urinary incontinence

Which physiological change would the nurse anticipate as being normal for an older-adult patient?

a) Decreased saliva production b) Loss of skin elasticity c) Loss of visual acuity d) Increased blood pressure

The nurse is caring for an older-adult patient admitted with an exacerbation of heart failure. On hospital day 3, the nurse notes patient behavior suggestive of acute delirium. For which cause of acute delirium would the nurse assess the patient?

a) Dehydration b) Immobilization c) Sleep deprivation

Persistent pain can lead to which consequence?

a) Depression b) Changes in gait c) Sleep difficulties

Which finding is commonly exhibited in an older adult with suspected delirium?

a) Fluctuation in alertness b) Worsening of symptoms during the night

Which safety advice would the nurse provide an older adult who wishes to start an exercise regimen?

a) Go slow. b) Wear supportive shoes. c) Exercise with a partner. d) Avoid exercising outdoors in extreme weather.

Which observation may be considered abnormal in a 70-year-old woman?

a) Hard breasts b) Hypertension

A 71-year-old patient enters the emergency department after falling down stairs at home. The nurse is conducting a fall history with the patient and spouse. The patient has had diabetes for over 15 years and experiences some numbness in the feet. The patient wears bifocal glasses. The blood pressure is stable around 130/70. The patient does not exercise regularly and complains of weakness in the legs when climbing stairs. The patient is alert, oriented, and able to answer questions clearly. Which factor places this patient at risk of falls?

a) Impaired vision b) Residential design c) Leg weakness d) Exercise history

Which effect does touch have on an older adult?

a) It induces relaxation. b) It provides sensory stimulation. c) It can convey respect and sensitivity. d) It orients the person to reality.

Which clinical feature differentiates dementia from delirium?

a) Judgment is impaired in dementia. b) Duration of dementia is months to years. c) Consciousness is unaffected in a patient with dementia.

Which supportive measure would help in rehabilitating an older adult in the early stages of Alzheimer's with declining cognitive function who has difficulty performing activities of daily living (ADLs)?

a) Make the environment safe for the patient to move in. b) Limit choices in dressing and eating. c) Institute measures to correct underlying physiological alterations.

Which effect does reality orientation have on the older adult?

a) Minimizing confusion b) Promoting socialization c) Restoring a sense of reality d) Improving the level of awareness

How can the nurse help maintain the nutrition status of an older adult with dementia?

a) Monitor food intake. b) Routinely monitor weight. c) Serve food that is easy to eat. d) Provide assistance with eating.

Which factor places an older adult at risk of falls?

a) Osteoporosis b) Alterations in bladder function c) Cognitive impairment d) Peripheral neuropathy

Which teaching strategy will likely lead to effective learning in an older adult? Select all that apply. One, some, or all responses may be correct.

a) Pausing frequently before providing any new information b) Ensuring the presence of a family member during the teaching session c) Using lay terms while providing medical information to the patient

Which extrinsic factor increases the risk of falls among older adults?

a) Poor lighting b) Inappropriate footwear c) Improper use of assistive devices d) Unfamiliar environment of a hospital room

Which sensory change is the nurse likely to find in the older-adult patient?

a) Presbyopia b) Presbycusis c) Changes in proprioception d) Buildup of cerumen

What intervention is necessary to enhance quality of life and maximize functional performance for an older adult with cognitive impairment?

a) Provide unconditional positive regard. b) Activate bed and chair alarms. c) Keep a routine and limit choices for dressing. d) Be vigilant for drug reactions and interactions.

The nurse is caring for a patient preparing for discharge from the hospital the next day. The patient does not read and has hearing loss. The family caregiver will be visiting before discharge. Which strategy can the nurse implement to facilitate the patient's own understanding of the discharge instructions?

a) Sit facing the patient so the nurse's lip movements and facial expressions can be seen. b) Present one idea or concept at a time. c) Include the family caregiver in the teaching session.

An older adult is in the early stages of Alzheimer's disease. The patient has been forgetful in the last few months and also has difficulty memorizing events or numbers. Which clinical presentations would indicate development of dementia in this patient?

a) Slow onset of symptoms b) Slow progression of symptoms c) Impairment of recent and remote memory

Which finding places the older adult with renal failure and hypertension at risk of an adverse drug event (ADE)?

a) Taking a total of eight different medications during the day b) Patient's health history

Which clinical feature is associated with delirium?

Calls out repeatedly with the same phrase

Which visual manifestation would the nurse expect to find in a patient with presbyopia?

Decline in the ability of the eyes to accommodate from near to far vision

The nurse is caring for an older-adult patient who is having difficulty recalling directions after hospitalization. On assessment, the nurse noticed that hypoxia has intensified the condition. The nurse suspects the patient has which condition?

Delirium

Which describes gynecomastia?

Enlarged breasts in men

In which health care setting would the nurse find an older adult with chronic dehydration exacerbated by acute illness?

Hospital care

An older adult has trouble eating meat and is showing signs of protein deficiency. Which factor is the likely cause of the nutritional deficit?

Ill-fitting dentures