Gerontological Topic 4

A client weighs 176 lb (80 kg). Which amount of protein will the nurse instruct this client to ingest each day?

80 grams

The nurse is asked to serve as a member of the organization's ethics committee. What should the nurse realize about personal ethics when participating on this committee?

A wide range of ethical principles can be used to guide personal actions

An 87-year-old client has a history of depression, hypothyroidism, and a recent diagnosis of breast cancer. The client's adult child tells the health care provider that the client cannot participate in decision making about care because of the client's age. How should the nurse proceed?

Ask the client to discuss the issues involved in the medical treatment and the decisions needed.

A female client becomes upset when a psychiatrist enters the client's room and begins asking questions about mental health. What should the nurse do?

Ask the psychiatrist to leave the room so that the client can talk freely

The nurse is caring for an older adult male client with a history of diabetes and hypertension who had a myocardial infarction 2 months ago. The client has recovered to the point that they are able to climb up two flights of stairs, but the client and spouse have not resumed sexual relations. The client states having sexual desires and not knowing why they are having problems achieving an erection. What action will the nurse take first?

Review the list of current prescribed and over-the-counter medications.

When discussing sexuality with an older adult, the nurse should prioritize what topic?

Risks of STIs such as HIV

Which client need would the nurse prioritize while providing care for an older adult client with dementia?

Safety

The nurse is upset about the outcome from an ethics committee. What should the nurse do?

Talk with the nurse manager about the outcome

A male older client has arteriosclerosis and is experiencing decreased sexual function. Which treatment could the nurse suggest for the client to speak to his health care provider about?

Testosterone therapy

The nurse in the health care provider's office is caring for an 82-year-old-female client with a stage 2 pressure injury to the right heel. The client, who has dementia, lives with their family and was brought to office by the adult child. The adult child states it is too difficult to get the client out of bed, so the client spends most of day in bed on their back with the television on. On further inspection, the nurse notes a stage 3 pressure injury on the client's sacrum. The client is incontinent of urine and wears a diaper. No perineal breakdown is noted. Inspection of the client's skin reveals no other areas of breakdown, bruises, or lesions.

The nurse suspects that this client may be experiencing neglect. as evidenced by pressure injuries

A nurse working for human services visits a long-term care facility. Which resident assessment finding indicates poor quality care?

Unintentional weight loss

The nurse cares for an older adult client who wants to prevent eye diseases. The client likes to go to sunnier climates in the winter. What best teaching should the nurse provide to help the client to care for oneself?

Wear UV protective sunglasses when outside.

The nurse in the outpatient chemotherapy clinic is caring for an 87-year-old male client with stage 4 colorectal cancer who no longer wishes to receive chemotherapy. Complete the following sentences by choosing from the lists of options. When the nurse supports the client's decision to stop treatment despite the nurse's own beliefs, the nurse is respecting the client's right to When the nurse answers the client's questions truthfully about what will happen without chemotherapy, the nurse is displaying

autonomy veracity

A nurse is planning the care for older adult clients to promote their optimal wellness. The nurse is determining the interventions using the Functional Consequences Theory. Which intervention will be most appropriate to meet the client's goal?

facilitating early mobilization to prevent muscle wasting and loss of function in a hospitalized older adult client

An older adult client is admitted to a nursing unit with the above laboratory results. Which client concern is priority?

fluid volume deficit

A grandmother from the baby boomer generation is planning to retire soon and expresses to a nurse concern over taking care of her grandchildren. Her daughter has assumed she would be saving in daycare costs because her mother is retiring and can take care of the children. What discussion topic should the nurse prioritize with the grandmother?

"Do you have a desire to provide daycare for your grandchildren?"

An older female expresses remorse for a past indiscretion. What is the nurse's best response?

"Forgiving yourself has many benefits, including your health."

An older female client states that after a date of dinner and drinks, she was unable to achieve orgasm. She states, "I guess I'm just too old to date and have a relationship with a man." What is the nurse's best assessment question?

"How much alcohol did you consume?"

A nurse is educating an older adult client about successful aging after the client states, "There is not much left for me because of my age." Which statement made by the client indicates that the education provided was successful?

"I am going to start playing the piano again and volunteering at the local nursing home."

A client is having conflict with a neighbor in the facility where she resides. The nurse has worked with a client to role play a strategy to address this person. What statement by the client to the neighbor shows that the older adult has learned how to express her feelings?

"I feel upset when you do not speak to me in the hallways."

The nurse is teaching a group of older adult clients with chronic heart disease about health promotion. Which statement indicates a need for further teaching?

"If I am taking my cholesterol medication as prescribed, I can eat like I used to do."

An older client expresses sadness over not being able to attend religious services while hospitalized. What is the nurse's best response to the concern?

"It sounds like you are really connected with your religious group."

An older adult client tells the nurse, "I sure would like to live to be 100." The client has a family history of relatives living into their late 90s. The client has had no health problems and is at the clinic for an annual physical examination. The client practices law part-time at a law firm and volunteers at a homeless shelter weekly. The client fishes and hunts with friends from the church. Which response by the nurse is best?

"Keeping fit and dealing with stress in a positive way helps your chances of living to be 100 years of age."

While the nurse is providing education during end of life care to an older adult client and family, a family member states, "Can't you see my loved one is sick? This information is too much." What is the nurse's best response?

"Tell me how I can best share this information with you and your loved one."

When discussing end of life wishes with an older adult client, the client asks, "What is the difference between a living will and a do no resuscitate (DNR) order?" How will the nurse respond?

"The living will's purpose is to make your wishes known about a broad range of medical interventions, while a DNR order pertains only to medical interventions for resuscitation."

A nurse is discussing an older adult client's recent diagnosis of rheumatoid arthritis with a colleague. Which of the nurse's statements reflects an accurate view of the relationship between aging and wellness?

"We need to teach the client to increase functional activities."

Until recently, an older adult client lived alone in the client's home in a rural area. The client fell and fractured an ankle and was placed in a long-term care facility for physical therapy. After the physical therapy was finished, the client told the nurse, "I want to stay at the facility; I am happy living there and I like the social interaction." What response by the nurse is best?

"We offer an independent living center that provides social interaction, would you like me to get our admissions coordinator?"

An older female diagnosed with arthritis reports movement limitations during sex. What is the nurse's best recommendation?

Suggest alternate positions

A co-worker on the dementia unit states she's frustrated by sexual advances from an older adult client when she simply calls him sweetheart. She states, "I call everybody sweetheart." What is the nurse's best response?

Suggest the co-worker reword her usual greeting.

An older couple who are residents in different halls at a nursing home and require the same levels of care have formed a new relationship and ask to live together. What is the charge nurse's best action?

Arrange for the two clients to share a room

Which laboratory value can the nurse most safely exclude when reviewing changes in hormone levels that can affect sexual function in older adult clients?

Albumin

An older client enjoys wearing a religious necklace and will not remove it at bathtime and bedtime. What is the nurse's best action?

Allow the client to wear the necklace

An older client of devout Muslim faith has recently died of natural causes. What is the nurse's best action?

Allow the family to wash the body

Which medication, on an older adult client's list of medications taken at home, may be linked to sexual problems?

Angiotensin-converting enzyme (ACE) inhibitor

A gerontological unit manager is utilizing which method of data analysis for performance appraisal when comparing fall rates at one facility with fall rates at a similar facility?

Benchmarking

What is the best nursing action to implement for the client who has presbycusis?

Check for cerumen impaction before audiometry.

The nurse is assessing the decision-making capacity of an older adult client. Which finding is most likely to have an impact on decision-making capacity?

Cognitive changes causing inability to verbalize consequences of decisions

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?

Cultural generalizations can be useful and accurate, but they do not replace individualized assessment and care.

An older female client's lab results reveal a low estrogen level. Which symptom should the nurse most likely expect from the client?

Excessive vaginal dryness

The nurse is caring for an older client who identifies himself as a highly-observant Episcopalian. On Fridays, what is the nurse's best action in accordance with the client's religious beliefs?

Exclude meat from client's food trays

The nurse is developing a teaching plan for an older client taking antidepressants. The nurse should include which instruction?

Explain potential changes in sexual function.

Which is a contributing factor to the unavailability of a sexual partner in older adulthood?

Infirmity of spouse

The gerontological nurse is completing the admission database for an older adult client admitted for surgery. What safety component of the nutritional assessment should the nurse prioritize?

Inspection for loose teeth

The nurse knows that which developmental task described by Erikson applies to older adulthood?

Integrity versus Despair

When planning a health fair about healthy sexual function for older adults, the nurse should include which recommendations? Select all that apply.

Limited alcohol intake Ample rest Good nutrition Good hygiene

The nurse is preparing to conduct a client's spiritual assessment. What is likely the most important spiritual need of all individuals?

Love

An older client with heart failure lives alone. What should the nurse consider to help meet this client's monitoring needs?

Make routine telephone calls to find out how the client is doing

The nurse reads the menu selection and waits for the client to make a choice. Which type of intervention is the nurse providing for this client?

Partially assisting

An older adult is being taken to the surgical holding area. Her daughter is not allowed in the holding area and asks the nurse to pray with her mother right before she goes into surgery. What is this nurse's best action?

Pray specifically for safety and healing with the client in the holding area

An older adult states being upset about missing weekly Bible study while she is hospitalized. What the nurse's best action?

Remind the client that there is a Bible in her bedside table.

An older client says that sometimes an adult daughter is frustrated with needing to always be at the client's home to provide care and will withhold providing prescribed medications. What action should the nurse take first?

Report the client's statement

What is the best nursing action when faced with an ethical decision?

Seek guidance from a clinical ethics consultant or the multidisciplinary care team

The nurse receives an award which includes a monetary gift. Since the nurse practices utilitarianism, which action will the nurse take?

Share the monetary gift

A nurse is responsible for assessing an older adult client in an acute care setting. Which statement accurately captures the complexity involved in assessing this client?

Signs and symptoms of illness are often obscure and less predictable among older adults.

A nurse plans culturally competent care for a variety of clients being seen at the clinic. Which client has the greatest health inequity?

older adult client with heart disease and hypertension living below poverty level who reports not taking their medications because they need to buy food

The hospice nurse is admitting an 82-year-old female client with end-stage heart failure to an inpatient hospice facility. The client is alert and oriented to person, place, and time and is concerned about how decisions will be made about end-of-life care because the client has no children nor spouse. Complete the following sentence(s) by choosing from the lists of options. The nurse explains that it is a priority for the client to

prepare advance directives the client's preferences for care are known

A nurse performs a reflective cultural self-assessment. Which outcome should the nurse expect?

progression from judgmental views of other cultures to recognition of positive attributes

The nurse leader considers opening a home health agency. What should the nurse research for more information about the regulations for this type of care facility?

public law