Geri

Which finding is consistent with a pathologic condition rather than the aging process when assessing an 85-year-old client's vital signs?

-A pulse rate irregularity

Which response would the nurse give to a client with peripheral arterial disease (PAD) who asks, "What is intermittent claudication?"

-Aching, cramping, and tiredness of the legs that occur with walking

When an older adult client demonstrates mild confusion after surgical repair of a hernia, which action would the nurse take to provide for the clients safety?

-Activate the position-sensitive bed alarm.

For which reason would the nurse request that the health care provider increase the intravenous fluid infusion for an older client with an infection?

-Acute confusion

Which nursing intervention would the nurse provide to an older client with hypertension?

-Advise the client to limit salt intake. -Teach stress management. -Instruct the client to quit smoking.

Which factor would the nurse explain has contributed to the increased incidence of fractures associated with osteoporosis in the United States when presenting at a women's health conference?

-Aging of the American population

An older client with severe nausea and vomiting is admitted to the hospital for rehydration therapy. Which intervention has specific gerontologic implications the nurse must consider?

-Assessment of skin turgor -Administration of antiemetic drugs -Replacement of fluid and electrolytes

An older adult client with dementia has developed dehydration as a result of vomiting and diarrhea. Which assessment finding best reflects the fluid balance of this client?

-Blood laboratory results

Which finding is an early sign of dehydration in an elderly client?

-Change in mental status

Which manifestation described by an older client reporting cold symptoms lasting over 1 week indicates a need to see the health care provider?

-Chest hurts -Feels worse -Has fever of 102.2°F -Has green sputum -Has aching and chills

An older nursing home resident with the diagnosis of early-onset dementia likes to talk about the old days and at times has a tendency to confabulate. Which purpose best describes the reason for the client's confabulation?

-Increases self-esteem

Which nursing action is most appropriate to reduce falls in older adults in the hospital?

-Instructing the client to call the nurse before going to the bathroom

Which intervention by the nurse promotes perfusion and healing of the surgical wound in an older adult?

-Keeping the client adequately hydrated

Which intervention is most effective to implement to best limit confusion in an older client diagnosed with dementia who sleeps very little and becomes increasingly disorientated?

-Leave a dim light on in the clients room at night.

Which ocular symptom would the nurse expect the client with a diagnosis of dry age-related macular degeneration to report?

-Loss of central vision

The nurse manager is educating a group of nurses regarding older adults and risk for suicide. Which factor will be included in this presentation?

-Loss of independence -Chronic health conditions -Access to many medications

An older client, with a history of multiple admissions for heart failure, is returned to the hospital by an adult child. After admission for observation to the coronary care unit, the client calmly states, "I know I'm sick, but I really can take care of myself at home." Which result will the nurse conclude the client is attempting to achieve?

-Maintain independence

A client with dementia has been cared for by the spouse for 5 years. During the last month, the client has become agitated and aggressive and is incontinent of urine and feces. Which intervention is the priority while this client is in an inpatient behavioral health facility?

-Manage the behavior.

The nurse assesses a 65-year-old client's electronic medical record and notices a history of increased lens density. Which nursing action would be appropriate for this client?

-Monitoring the client's blood glucose levels -Assessing if the client is under antiplatelet medication

Which precipitating factor for depression is most common in the older adult without cognitive problems?

-Multiple losses -Declines in health

Which type of abuse involves a caregiver failing to give medications on time to an older adult?

-Neglect

Which factor would a nurse suggest can be improved to decrease the susceptibility of infection in an older client?

-Nutritional status

Which action would the nurse implement when caring for an older adult brought to the emergency department after being found in the street without a coat during a snowstorm?

-Obtain a rectal temperature. -Assess the fingers for areas of frostbite. -Determine client's level of consciousness. -Ask for client identification.

Which system would provide a safe environment for the client with type 2 diabetes and hypothyroidism in a long-term facility?

-Occupational Safety and Health Administration (OSHA)

Which health problem does the nurse identify from an older clients history that increases the client's risk factors for a cerebrovascular accident (CVA, or brain attack)?

-Transient ischemic attacks (TIAs)

Which environmental characteristic provides a therapeutic milieu for an older client who is disoriented?

-Trusting relationships

For the older adult population, which genitourinary factor contributes to urinary incontinence?

-Urinary tract infection

Which physiological change that occurs with aging must be taken into consideration when the nurse provides care for the older adult?

-Urinary urgency -Loss of skin elasticity -Swallowing difficulties -Elevated blood pressure

Which pain assessment method would the nurse use for an adult client with Down syndrome and limitations in mental functioning?

-Using the Wong-Baker Faces Pain Rating Scale

Which deficiency is the most common in the older adult and can result in dizziness and falls?

-Water

Which food would the nurse teach a group of geriatric clients with decreased circulating estrogen to include in their diets?

-Yogurt

Which physical finding is most likely to be observed in an abused older adult?

-hematomas

Which change in skin is expected by the nurse when completing the assessment of an older adult?

-Increased wrinkles -Hyperpigmented patches

Which principle would guide the nurse's actions in promoting and maintaining the health of older adults?

-There is a strong correlation between successful retirement and good health.

Which principle would the nurse use in promoting health of the older adult?

-There is a strong correlation between successful retirement and maintaining health.

Which statement regarding developmental changes in older adults indicates the need for additional learning?

"Immobilization in older adults is only caused by degenerative disease."

Which teaching point will the nurse include when providing instructions to an in-home caregiver of a client with middle-stage Alzheimer disease?

-"Adapt the home for client safety and convenience." -"Designated caregiver is responsible for legal and financial decisions." -"Develop a medication schedule so that you are consistent with medication administration." -"Caregivers will need to provide hygiene, elimination, feeding, and exercise assistance." -"Coping is difficult with changing personality and behaviors. Support groups are helpful."

Which explanation by the nurse would help the family member of an 80-year-old client with dementia to understand the aging process in relation to the client appearing thin and older?

-"As we age, we lose the tissue that helps puff out the skin."

Which statement regarding developmental changes in older adults indicates the need for additional learning?

-"Immobilization in older adults is only caused by degenerative disease."

Which statement made by the nurse to an older client on medication for hypertension explains the client's dizziness on standing?

-"Older blood vessels respond more slowly to position changes."

Which statement by the nurse explains home safety for a client with peripheral arterial disease (PAD)?

-"Remove all throw rugs from your home."

The nurse is caring for an older adult client who is being transferred back to their long-term care facility. The nurse is reporting off to the receiving nurse. Which statement made by the nurse using SBARR indicates "background"?

-"The client's lab reports are within normal limits."

An older client is hospitalized with the diagnosis of dementia of the Alzheimer type. The son tearfully tells the nurse, "! should never have allowed my father to live alone like he wanted to do, but he hasn't been this bad! I'm to blame! He didn't even recognize me right off the bat." Which response by the nurse is most therapeutic?

-"This must be a difficult time for both of you. Please share some of your other observations with us that will help us plan his care."

Which question would a home-care nurse ask an older adult, dependent on care provided by their adult son, who recently has become very withdrawn and has multiple bruises in various stages of healing on their arms and torso?

-"What can you tell me about how these bruises occurred?"

Which response would the nurse provide when a 70-year-old client asks if the pneumococcal vaccine needs to be administered yearly?

-"lt is unnecessary to have any follow-up injections of the pneumococcal vaccine after this dose."

Which change is responsible for redundant flesh around the eyes noted by the nurse when assessing an older adult?

-Decrease in muscle laxity -Decrease of subcutaneous fat

Which physiological change is responsible for dryness and uneven color observed by the nurse assessing the skin of an older adult?

-Decreased activity of sebaceous glands

Which nursing intervention can help an older adult successfully complete Erikson's major task at this stage?

-Develop a sense of satisfaction when considering past achievements

Which sensory loss associated with aging would the nurse expect to find in an older adult client just admitted to a nursing home?

-Diminished sensation of pain -Impaired hearing of high-frequency sounds

Which finding would the nurse expect when assessing an older adult with hearing loss secondary to aging?

-Dry cerumen -Difficulty hearing high-pitched voices

Which symptom is most important to communicate to a health care provider when differentiating between the common cold and influenza in the older adult?

-Elevated temperature

Which nursing intervention would help prevent sepsis in an older adult client who has an indwelling urinary catheter?

-Empty the urinary drainage bag when it is one-half full. -Wash hands and wear clean gloves when performing catheter care. -Use alcohol to clean the drainage port before reconnecting it to the bag. -Consult the health care provider to have the catheter removed as soon as possible.

Which nursing intervention would help prevent sepsis in an older adult client who has an indwelling urinary catheter?

-Empty the urinary drainage bag when it is one-half full. -Wash hands and wear clean gloves when performing catheter care. Keep the urinary drainage bag tubing hanging off the bed, with dependent loops. -Use alcohol to clean the drainage port before reconnecting it to the bag. -Consult the health care provider to have the catheter removed as soon as possible.

Which strategy would the nurse use with a group of older adults at a local senior center to support their successful attainment of Erikson's Stage of Ego Integrity?

-Encourage clients reminisce and share the good things that they have done in life

Which would the nurse incorporate into the plan of care for the older adult experiencing chronic pain?

-Exercise

Which sleep promotion technique would the nurse advise for a client who complains about being unable to sleep well at night and then feeling sleepy throughout the next day?

-Exercise daily

Which intervention would the nurse implement when assessing an older adult client who has a hearing impairment?

-Face the client when speaking.

Which symptom of depression is commonly observed in older adults?

-Fatigue -Sadness -Agitation

Which intervention would the nurse anticipate will be prescribed initially for a client who had a hemorrhoidectomy?

-Giving a warm bath after bowel movements -Administering stool softeners

Which group is at high risk for contracting influenza and should receive annual flu vaccinations?

-Health care providers -People with diabetes mellitus -People older than 65 years of age -Residents of long-term care facilities -People with chronic cardiovascular disorders

An older adult is brought to the clinic by a family member because of increasing confusion over the past week. Which direction would the nurse give the client to determine orientation to place?

-Identify the name of the clinic's town.

Which diminishing function in the older adult client would result in a decreased ability to fight infection?

-Immunocompetence

Which clinical indicator is the nurse most likely to identify when exploring the history of a client with open-angle glaucoma?

-Impairment of peripheral vision

An 89-year-old client with osteoporosis is admitted to the hospital with a compression fracture of the spine. Which factor of special concern will the nurse identify when caring for this client?

-Inability to maintain an optimal level of functioning

Which client assessment would the nurse determine represents the highest risk for development of pressure ulcers?

-Incontinence and inability to move independently

Which physical findings, common in older adults, would the nurse include in the teaching for senior citizens at a community health program?

-Increased blood pressure and decreased hormone production

Which manifestation is associated with decreased tissue elasticity of the eye in an older adult?

-Increased blurring of vision

Which condition can cause decreased nutritional status in an older adult?

-Increased dental caries.

An older client with a history of congestive heart failure expresses concern about potential exposure to tuberculosis. The client states that a roommate at the extended care facility where the client resides sleeps a lot, coughs a great deal, and sometimes spits up blood. Which reason is the primary motivation for the nurse pursuing more information about the roommate?

-Older adults with chronic illness are affected adversely by tuberculosis

Which age group is the occurrence of chronic illness the greatest?

-Older adults.

The nurse is preparing to administer pain medication to an older adult. Which assessment would the nurse make before giving the medication to promote safety?

-Other prescribed medications

Which condition would be suspected in a client with rigidity, tremor, bradykinesia, and impaired postural reflexes?

-Parkinson disease

Which finding would the nurse consider a risk factor for osteoporosis?

-Patient has a sedentary lifestyle. -Patient is a White woman. -Patient is an Asian woman.

Which issue would be the nurse's primary focus when helping an older client with a fractured femur out of bed for the first time in 5 days?

-Possibility of inability to tolerate activity

An older adult client is talking to the nurse about his Vietnam experiences and shares that he still has flashbacks. While sitting with him the nurse notices that he is jumpy and exhibits startled reactions and poor concentration. Which term does the nurse use to identify these symptoms when providing the change-of-shift report?

-Posttraumatic stress disorder (PTSD)

An older adult client is talking to the nurse about his Vietnam experiences and shares that he still has flashbacks. While sitting with him the nurse notices that he is jumpy and exhibits startled reactions and poor concentration. Which term does the nurse use to identity these symptoms when providing the change-of-shift report?

-Posttraumatic stress disorder (PTSD)

Which assessment finding in an older adult client with dysphagia would the nurse immediately report to the health care provider?

-Pulse oximeter reading of 88% on room air

In discharge planning for an ambulatory client with Parkinson disease (PD), which equipment would the nurse promote for home use, to foster the client's independence?

-Raised toilet seat

Which nursing action is most important when providing health education and promotion of self-care to the older adult client?

-Reinforcing the client's strengths and promoting reminiscing

Which initial nursing action is recommended for an unresponsive older adult admitted on a hot, humid day with the nursing assessment findings of hot, dry skin; respiratory rate of 36 breaths/min; and heart rate of 128 beats/min?

-Remove the clothing.

While creating a perioperative teaching program for older adults, which principle of learning would the nurse take into consideration?

-Requires continued reinforcement

An older client with Alzheimer dementia is consistently found sleeping in the semi-Fowler position. Which area of the client's body does the nurse determine is at the greatest risk for developing a pressure ulcer?

-Sacrum

An older adult client whose family has been visiting on the psychiatric unit is visibly angry and says to the nurse, "My daughter-in-law says they can't take me home until the doctor lets me go. She doesn't understand how important this is to me; she's not from our culture." Which therapeutic response will the nurse provide?

-Say, "You feel she doesn't want you at home."

Which characteristic best explains the diagnosis of Alzheimer disease?

-Slow, relentless deterioration of the mind

Which clinical finding is an expected response to the aging process?

-Slowed neurologic responses -Forgetfulness about recent events -Reduced ability to maintain an erection

Which action would the nurse perform when conducting health assessment interviews with older clients?

-Spend time in several short sessions to elicit more complete information from the clients.

Which action would the nurse pertorm when conducting health assessment interviews with older clients?

-Spend time in several short sessions to elicit more complete information from the clients.

Which type of caregiver is the most frequent abuser of older adults?

-Spouse

Which sign or symptom would the licensed practical nurse (LPN) report immediately to the registered nurse (RN) for an older client who has been immobile for several days after hip fracture and repair?

-Sudden-onset dyspnea

Which nursing intervention is appropriate during an initial visit with an older, depressed client who lives alone and performs all tasks of daily living?

-Supporting the client's usual routine

An older client with the diagnosis of dementia, Alzheimer type, is admitted to a long-term care facility. The client is confused and forgetful, wanders, and has intermittent episodes of urinary incontinence. Which nursing intervention will best meet this client's elimination needs?

-Take the client to the bathroom at regular intervals.

Which intervention would be the priority for the nurse to implement when caring for an older diabetic client with a large leg ulcer?

-Teaching how to transfer from a bed to a chair in the least painful manner

Which client is the nurse working in the memory care unit most concerned about ?

-The client who sustained a fall while going to the restroom

Which advice would a nurse provide an older-adult client who reports, "I walk 2 miles a day for exercise, but now that the weather is hot I am worried about becoming dehydrated"?

Fluids should be increased if the urine is getting darker.

Which information would the nurse consider when caring for an older adult hospitalized for weight loss and dehydration caused by nutritional deficits?

The nutritional needs of an older adult are unchanged except for a decreased need for calories.