Gerontology final ch 25- 36
A nurse is teaching an older adult who is experiencing an acute attack of gout. Which of the following should the nurse include in the teaching? a. Avoid foods high in purine. b. Encourage the patient to take in 1L of fluid daily c. Consume one glass of red wine daily. d. Recommend that the patient eat 12-16 oz of foods high in protein such as red meat.
a. avoid foods high in purine
A frail, elderly widow is admitted to the hospital after sustaining a fall. The client lives alone and has no living relatives. After cognitive testing reveals mild cognitive impairment, the interdisciplinary team on the Acute Care for the Elderly Unit recommends long-term care placement and that a durable power of attorney for health care (DPOA-HC) be established. When the client seems confused over what a DPOA-HC's responsibilities are, the nurse responds that: a. "A DPOA-HC is a person you name to make health care decisions for you when you can't make them for yourself." b. "A DPOA-HC is a person you trust to make financial decisions for you and to manage your money." c. "A DPOA-HC is a person appointed by the court to make sure you get good care and to manage your affairs." d. "A DPOA-HC is a person who is appointed by the court to make home placement decisions.
a. "A DPOA-HC is a person you name to make health care decisions for you when you can't make them for yourself."
An older adult is concerned that if her spouse, who recently suffered a stroke, is placed in a nursing home, "they will take everything in order to pay for his care." What response will the nurse make? a. "A spouse is allowed to keep a percentage of the family income and cash as well as the family home, car, and personal property" b. "You should consider transferring the assets to your son so that your husband will qualify for Medicaid" c. "Have you considered caring for your husband at home since Medicare will cover custodial care at home?" d. "Are you aware that your children have a legal obligation to provide financial support toward the care of disabled parents?"
a. "A spouse is allowed to keep a percentage of the family income and cash as well as the family home, car, and personal property"
Which statement made by a nurse regarding a resident of a long-term care facility requires follow-up by the nurse manager? a. "If he doesn't take his medication, he'll get no dessert tonight." b. "She can't take a walk outdoors today; it's much too cold and snowy." c. "The grandchildren have colds so they should not visit this week." d. "I don't understand why, but she wants a different doctor to see her."
a. "If he doesn't take his medication, he'll get no dessert tonight."
Which statement best demonstrates an older adult's success at achieving self-actualization? a. "My father was an alcoholic, but he did love us." b. "I always feel safe when my son is visiting." c. "My heart problems are better since I had the surgery." d. "I've been elected president of my service organization again."
a. "My father was an alcoholic, but he did love us."
Which description would be most characteristic of a self-actualized individual? a. An economically disadvantaged older black man who regularly checks out books from the local library to read to neighborhood children. b. A wealthy white older woman who is constantly searching for a better laxative. c. A middle-class white man who was forced into an early retirement and is living in fear of being evicted from his apartment d. The older wife of a famous celebrity who travels the world but starves herself and seeks plastic surgery in her quest to fight the physical signs of aging.
a. An economically disadvantaged older black man who regularly checks out books from the local library to read to neighborhood children.
Which intervention best demonstrates that the nurse understands the spiritual needs of a terminally ill client? a. Arranging care so that the client's prayer time is not interrupted b. Assuming the responsibility of notifying the hospital chaplain of the client's admission c. Providing the client with the schedule of religious services offered in the chapel d. Suggesting that the family attend worship services with the client whenever possible
a. Arranging care so that the client's prayer time is not interrupted
An older adult client has been voluntarily admitted for treatment of alcohol dependency. In implementing care, the nurse plans which intervention based upon knowledge about alcohol and aging? a. Assessing the client for both depression and anxiety b. Discussing the poor prognosis of this disorder with the client c. Explaining the need for proper nutrition to minimize the effects of alcoholism d. Identifying the effects of chronic alcoholism on the human body
a. Assessing the client for both depression and anxiety
Which activity assures the nurse that the client's wish to "leave a living legacy" has been accomplished? a. Donating his body to the local teaching hospital for research purposes b. Discussing his experiences as a World War II veteran in Europe to a reporter c. Keeping a journal to be passed on to his great-grandchildren d. Making a pilgrimage to a location with personal religious significance
a. Donating his body to the local teaching hospital for research purposes
An older woman tearfully tells a nurse, "I must buy my neighbor all of his groceries, or he will not drive me to the store or the doctor." This is an example of which type of elder mistreatment? a. Financial exploitation b. Psychological abuse c. Caregiver neglect d. Abandonment
a. Financial exploitation
A nurse is planning an educational session on osteoporosis to be given at a senior center. Which of the following should be discussed as preventive measures for osteoporosis? a. Following a diet with adequate amounts of calcium and vitamin D b. Increasing the intake of beverages containing phosphorus c. Having a yearly dual-energy X-ray absorptiometry DXA (or DEXA) scan d. Including isometric exercise for at least 30 minutes three times per week
a. Following a diet with adequate amounts of calcium and vitamin D
Which behavior suggests that an older adult who has lost his life partner is successfully managing the exploration stage of the adjustment process? a. He enrolls in a cooking class. b. He explains that he can't make a decision about moving "just yet." c. He agrees to eat some of his "favorite soup" his daughter has made. d. He is heard saying, "I'll never get over the loss, but my life has a purpose."
a. He enrolls in cooking class
An older client admitted to the hospital after having sustained a fall at home is diagnosed with a right hip fracture and experienced a surgical reduction of the fracture. At 2:30 AM, she awakens from sleep insisting that her daughter is in the other room and wants to see her. Attempts to reorient her to the surroundings are unsuccessful. In reviewing the client's record, what data would be considered a primary risk factor for the delirium? a. History of dementia b. Death of the client's husband last month c. The client's age d. History of cardiac disease
a. History of dementia
What intervention should a nurse implement when an older male diagnosed with dementia is observed masturbating in the unit's dayroom? a. Remove the resident from the dayroom and complete an assessment of his behavior. b. Cover the resident's lap with a blanket and leave him in the dayroom. c. Counsel the resident by telling him that his behavior is inappropriate. d. Distract the resident so that he will stop the behavior.
a. Remove the resident from the dayroom and complete an assessment of his behavior.
The nurse is caring for an older client who experienced a hip replacement surgery 10 hours ago. Which intervention will help minimize this client's risk of developing delirium? a. Requesting that staff offer fluids each time they interact with the client b. Medicating the client to best facilitate restorative sleep c. Encouraging the client to remain still and thus minimize pain d. Suggesting that visitors are limited to family members only
a. Requesting that staff offer fluids each time they interact with the client
An older adult with gastric cancer with bone metastases is being discharged from the hospital after beginning a regimen of opioid analgesics to control the metastatic pain. What should be included in the discharge teaching plan? a. The development of a plan to prevent constipation b. Benefits of grief counseling c. Increasing calories in the diet d. Preventing pressure ulcers
a. The development of a plan to prevent constipation
When the daughter of a client diagnosed with moderate Alzheimer's disease (AD) asks about the possible benefits of enrolling her mother in art classes, the nurse's response is based on the knowledge that: a. creative activities are not limited to cognitively intact older adults; even individuals with dementia can benefit from creative activities. b. individuals with dementia who have rational language skills can benefit from creative activities. c. cognitively impaired elders cannot benefit from creative activities due to altered brain processes. d. cognitively impaired elders are usually too agitated to participate in creative arts.
a. creative activities are not limited to cognitively intact older adults; even individuals with dementia can benefit from creative activities.
The nurse suspects that the spouse of a terminally ill client is experiencing anticipatory grief when he: a. dramatically reduces the time he spends attending to the client. b. refuses to leave the client's bedside regardless of the reason. c. sobs inconsolably whenever he visits. d. spends hours recalling details of their life together.
a. dramatically reduces the time he spends attending to the client.
When performing a pain assessment on a client who is aphasic, the nurse should consider: a. reports from the family or staff at the nursing home about changes in functional status. b. that the patient is lying quietly in bed so she is not likely to be experiencing pain. c. that the patient's previous stroke interrupted pain pathways so she does not feel pain. d. that older adults do not tolerate opioid analgesics well and may exhibit side effects.
a. reports from the family or staff at the nursing home about changes in functional status
When assessing an older client for indications of depression, the nurse bases the intervention on the knowledge that: a. the older client's symptoms may be atypical for the disorder. b. depression is a common mental disorder among the older population. c. the older client is generally willing to discuss his or her mental health symptoms. d. depression is not as commonly seen in this population as are anxiety disorders.
a. the older client's symptoms may be atypical for the disorder.
The most significant etiology for chronic obstructive pulmonary disease (COPD) is: a. tobacco use b. chronic bronchitis. c. exposure to carcinogens in the workplace. d. emphysema.
a. tobacco use.
The original intent of Social Security was to: a. provide a hospital insurance plan. b. minimize the dependency of older members on younger members of society. c. provide the blind, older adult, or disabled with adequate financial support. d. penalize women financially for numerous zero wage years while raising children.
b. minimize the dependency of older members on younger members of society
Which question has priority when assessing a client for risk factors related to the use of sildenafil (Viagra)? a. "How old are you?" b. "Are you currently being treated for hypertension?" c. "Do you have a history of respiratory infections?" d. "Have you ever been told you have prostate problems?"
b. "Are you currently being treated for hypertension?"
Which question will best assess the ability of the LGBT older couple to successfully adjust to the challenges of aging? a. "How long have you been in this relationship?" b. "Can you tell me about your support system?" c. "As a couple are you financially secure?" d. "Do you as a couple share similar religious beliefs?"
b. "Can you tell me about your support system?"
How should the nurse reply when an older adult asks, "How much alcohol is good for you?" a. "Alcohol isn't good for you so avoid it as a general rule." b. "Experts in the field recommend only one regular sized drink a day." c. "It's been said that red wine has health benefits, but that doesn't mean drink a whole bottle." d. "If you are only drinking on special occasions, limit yourself to two drinks."
b. "Experts in the field recommend only one regular sized drink a day."
An older adult is considering residential care/assisted living (RC/AL). The nurse knows that the older adult needs additional teaching when the older adult states which of the following? a. "I read a recent article that stated that more older adults would prefer to move to an assisted living community than a nursing home if they could no longer care for themselves." b. "I am happy that Medicare pays for the cost of living in an RC/AL." c. "I will have to check with my long-term care insurance company. I heard that it might pay for RC/AL." d. "RC/AL costs significantly less than nursing home care."
b. "I am happy that Medicare pays for the cost of living in an RC/AL."
An older client diagnosed with dementia resides with his daughter. When the homecare nurse visits, the daughter tearfully tells the nurse that her father scratched her hand and cursed at her when she was attempting to feed him. She states, "I don't know why he hates me and wants to hurt me. I try so hard to take good care of him. I love him." How will the nurse respond to the client's daughter? a. "Let's think about what you may have done to anger your father?" b. "Let's try to figure out what your father was trying to say with his behavior." c. "Scratching is usually a sign of untreated pain. Do you think your father is in pain?" d. "Maybe you should consider having a home health care provider take over responsibility for your father's physical care."
b. "Let's try to figure out what your father was trying to say with his behavior."
A 70-year-old diabetic patient has just received instruction from a nurse on glucose self-monitoring. He tells the nurse: "I hear that those test strips cost a lot. I am not sure that I can afford anything else. The only health insurance I have is Medicare Parts A and B." The best response by the nurse is: a. "I am sorry, but Medicaid is the only insurance that covers the cost of diabetic testing supplies." b. "Medicare Part A will cover the cost of the supplies to manage your diabetes." c. "Medicare Part B will cover the cost of the supplies to manage your diabetes." d. "I am sorry, but Medigap insurance is the only insurance that covers the cost of diabetic testing supplies."
b. "Medicare Part A will cover the cost of the supplies to manage your diabetes."
An older client in an adult day care program tells the nurse, "I'm very stressed because another neighbor passed away." The most therapeutic response by the nurse is: a. "You are experiencing grief, not stress." b. "Tell me what you did when your other neighbor passed away." c. "Are you worrying about your own death?" d. "Let's get involved in some activities and not think about sad things."
b. "Tell me what you did when your other neighbor passed away."
A nurse is organizing a support group for older individuals with COPD in the community. The nurse knows that which of the following individuals is most likely to have COPD? a. A 75-year-old Hispanic male who is a retired truck driver and never smoked. b. A 72-year-old non-Hispanic white female who never worked outside of the home and has a history of asthma. c. A 67-year-old divorced African Amercan male who is a retired physician. d. A 70-year-old widowed Asian woman who is a retired college professor.
b. A 72-year-old non-Hispanic white female who never worked outside of the home and has a history of asthma
What is the role of the nurse in assisting older adults with travel interests? a. Suggesting that they travel with a seniors' group b. Addressing arrangements to have medical care, if needed, during their travels c. Providing information regarding pet care services for their beloved dog d. Reassuring the client that their concerns about safety are unfounded
b. Addressing arrangements to have medical care, if needed, during their travels
Which intervention best addresses the principle that is the basis for communicating with a client experiencing postsurgical delirium? a. Reminding the client that delirium is generally acute and reversible b. Assuming that the client's statements are an attempt to express needs c. Allowing the client sufficient time to formulate an answer to questions d. Using nonverbal communication techniques to communicate with the client
b. Assuming that the client's statements are an attempt to express needs
The nurse is providing care to a client diagnosed with dementia. What option is an example of the appropriate use of implied consent by the nurse? a. Preparing to draw blood from a client's arm after asking, "Can I see your arm?" b. Changing the client's dressing when the client asks, "Will you change this bandage now?" c. Using the client's monthly allowance to buy a watch when he continuously asks for the time d. Arranging for a benign mole to be removed after the client states, "I don't like this here."
b. Changing the client's dressing when the client asks, "Will you change this bandage now?
An older adult with rheumatoid arthritis is taking ibuprofen (Advil) daily. What instructions are most important for the nurse to provide to assure the expected outcomes for this client? a. Ibuprofen (Advil) should be taken twice a day to ensure maximum pain relief. b. Consider the use of other OTC NSAIDS such as Naprosyn to reduce the risk of GI toxicity. c. Ibuprofen should always be taken on an empty stomach. d. Ibuprofen is contraindicated in persons with rheumatoid arthritis.
b. Consider the use of other OTC NSAIDS such as Naprosyn to reduce the risk of GI toxicity
A nurse is caring for a patient with a diagnosis of delirium. Which of the following is an expected assessment finding for this patient? a. Normal attention span b. Fluctuation in symptoms c. Normal sleep cycle d. Increased appetite
b. Fluctuation in symptoms
Which statement best demonstrates the primary benefit of intergenerational partnering and the activities that it creates? a. These types of activities can help establish new relationships. b. Intergenerational activities can foster a sense of meaning and purpose. c. Such partnering can increase the self-esteem of the younger people. d. These activities can decrease social isolation in the older people.
b. Intergenerational activities can foster a sense of meaning and purpose.
When a terminally ill client expresses a need "for something more to help me cope with the pain," the nurse bases the recommendation of meditation on which principle concerning this alternative therapy? a. It is efficient and usually takes less than 5 minutes to implement. b. It has been shown to decrease anxiety and depression. c. It improves cognitive abilities. d. It has been known to eliminate emotional distress.
b. It has been shown to decrease anxiety and depression.
The cost of nursing home care is significant. The primary payer for nursing home care is: a. Medicare. b. Medicaid. c. Long-term care insurance. d. Medigap insurance.
b. Medicaid
When acting as a fictive kin, in which activity will a paid caregiver engage? a. Being responsible for paying the client's bills b. Organizing the client's birthday celebration c. Accompanying the client to doctor's appointments d. Assuring the client has clean, appropriate clothing available
b. Organizing the client's birthday celebration
Which of the following reactions to the loss of a spouse or long-term partner is a unique example of older adult male bereavement? a. Withdrawing from friends and family b. Remarrying within months of the loss c. Focusing on "doing" rather than "feeling" d. Experiencing moderate to severe depression
b. Remarrying within months of the loss
A woman is terminally ill. Although it has never been discussed in the family or stated outright by her physician, she is growing to believe that she will die because of her illness. Upon which concept will the nurse base therapeutic intervention on? a. Closed awareness b. Suspected awareness c. Mutual pretense d. Open awareness
b. Suspected awareness
A nurse administers the Short Michigan Alcohol Screening Test Geriatric Version (S-MAST-G) to an older adult. The older adult receives a score of "2." The nurse knows that this score is indicative of: a. no problem with alcohol. b. a problem with alcohol. c. a mild problem with alcohol. d. a severe problem with alcohol.
b. a problem with alcohol
The nurse preparing educational information on the most common mental health disorder among the older adult population should include: a. methods for reducing anxiety. b. a written depression screening tool. c. local schizophrenia support groups d. signs and symptoms of alcoholism
b. a written depression screening tool.
A nurse assesses an older patient for asthma. The nurse knows is the strongest risk factor for asthma is: a. positive family history of asthma. b. airway inflammation caused by allergic reaction to inhaled substances. c. genetic predisposition to severe allergies. d. history of smoking
b. airway inflammation caused by allergic reaction to inhaled substances.
An older adult has recently experienced a number of stressful life events. The client comes to the ambulatory clinic and tells the nurse that, "On top of all I've had to endure, now I've got this flu!" In rendering care for this client, the nurse recognizes that: a. the client is exhibiting attention-seeking behaviors to substitute for poor coping skills. b. crisis and stressful situations may produce emotions that erode the health of the older people. c. the client is exhibiting learned helplessness as a result of the recent stressors. d. a period of crisis will ultimately lead to a lower level of physical and mental functioning
b. crisis and stressful situations may produce emotions that erode the health of the older people
A 78-year-old patient who is dying of colon cancer with metastases to the liver is refusing to eat or drink. He is alert and oriented, and states that he has no desire to eat, which is causing the family great distress. In order to best address the client and family, the nurse should: a. explain the family's concern to the client. b. educate the family that this is normal behavior in this situation. c. contact the physician for an order for enteral feeding. d. contact the dietitian for feeding supplements.
b. educate the family that this is normal behavior in this situation.
When working with a bereaved individual, the goal of nursing interventions is to: a. assist the individual to go through the stages of grief work in the optimal order. b. foster the griever's movement from disequilibrium and instability to a new steady state. c. encourage the individual to talk about his or her feelings about the deceased individual. d. offer support and advice about how to successfully achieve grief work.
b. foster the griever's movement from disequilibrium and instability to a new steady state
Symptoms of HIV are often under-recognized in older adults because: a. there is a very low incidence of HIV in older adults. b. many of the classic symptoms are also common to other conditions common in older adults c. presenting symptoms are markedly different from those in younger adults. d. AIDS progresses much slower in older adults so symptoms are not recognized easily
b. many of the classic symptoms are also common to other conditions common in older adults
An older adult says to the nurse, "I don't know why I can't handle booze like I used to when I was younger." The nurse's response is based on the knowledge that: a. older adults develop higher blood alcohol levels due to age-related changes in the neurological system. b. older adults develop higher blood alcohol levels due to age-related changes that alter absorption and distribution of alcohol. c. older adults develop higher blood alcohol levels due to slowed reaction times. d. older adults develop higher blood alcohol levels due to cognitive changes.
b. older adults develop higher blood alcohol levels due to age-related changes that alter absorption and distribution of alcohol.
An older widow who is a newly admitted resident of a long-term care facility develops a romantic relationship with a male resident. When the resident's daughter demands that the staff "put a stop to this sexual behavior right now," the nurse's response is based on the understanding that: a. such activity in a long-term care facility is inappropriate. b. older adults need to express love and intimacy. c. sexual desire is usually absent in older adults. d. sexual activity can be dangerous for older adults with chronic illnesses
b. older adults need to express love and intimacy
The initial step to effect the safe management of mild to moderate acute pain that has not been controlled with over-the-counter medications is to: a. begin acetaminophen (Tylenol) every 4 hours for 24 hours. b. supplement with nonpharmacological interventions. c. administer a single low dose of short-acting opioid and monitor for relief. d. titrate dosage of a short-acting opioid upward over 24 hours to achieve relief.
b. supplement with nonpharmacological interventions.
Asthma is often underdiagnosed in older adults because: a. older adults frequently do not have any of the classic signs and symptoms. b. symptoms of asthma are often attributed to normal age-related changes. c. asthma is very uncommon in older adults. d. asthma symptoms are usually very mild in older adults
b. symptoms of asthma are often attributed to normal age-related changes.
An older married couple is considering selling their home and moving into a continuing care retirement community (CCRC). The major benefit of a CCRC is: a. they provide affordable living for older adults. b. they have all levels of care in one location, allowing community members to easily transition between levels. c. they are paid for by Medicare. d. they allow the older adult's family to retain ownership of the property after the owner dies.
b. they have all levels of care in one location, allowing community members to easily transition between levels.
In order to focus on the older population with the greatest risk for suicide, the nurse would conduct a depression screening that targets: a. African American men. b. white men. c. white women. d. African American women
b. white men.
Which statement made by the resident of a long-term care facility is evidence that the facility is providing care in accordance with the Bill of Rights for long-term care residents? a. "It's so nice to have my hometown newspaper available here." b. "Going out to the theater with the other residents is a nice social activity." c. "I was told that if I didn't want to change rooms, I didn't have to." d. "The whole place was decorated so beautifully for the holidays.
c. "I was told that if I didn't want to change rooms, I didn't have to."
Which statement by the person preparing for retirement indicates they may need specialized counseling and targeted education? a. "I'm so glad I'll have a pension to draw from." b. "I don't know what I'm going to do since practicing law has always filled my days." c. "I'm waiting until I'm eligible for Medicare so I can be sure to continue treatment for my heart failure." d. "I'm really looking forward to quitting this government job."
c. "I'm waiting until I'm eligible for Medicare so I can be sure to continue treatment for my heart failure."
Which of the following statements made by a family caregiver would a nurse consider most indicative of elder abuse? a. "I get so frustrated because my father used to be so competent and now cannot even feed himself." b. "Mom cannot pay her own bills anymore. We went to the bank and arranged for me to have access to her checking account and help her pay the bills." c. "My dad wanders at night and I can't be bothered with him. I mix sleeping pills in his dinner so that he will fall asleep." d. "Mom asks me to do everything for her, but I think it is better if she keeps on doing as much as she is capable of."
c. "My dad wanders at night and I can't be bothered with him. I mix sleeping pills in his dinner so that he will fall asleep."
An older client with a history of hypertension and osteoarthritis who has recently fallen and fractured two ribs is prescribed extra strength Tylenol for the pain. What statement by the client requires further evaluation by the nurse? a. "I find that when I drink herbal tea and then take my Tylenol at bedtime, I sleep through the whole night." b. "I heard that meditation may help me deal with the pain without taking all that Tylenol." c. "Two extra strength Tylenol tablets (500 mg/tablet) every 4 hours around-the-clock and my pain is gone." d. "I make sure that I take my Tylenol with breakfast when I first get up."
c. "Two extra strength Tylenol tablets (500 mg/tablet) every 4 hours around-the-clock and my pain is gone."
Following the death of her husband, the client states, "How will I go on? I just don't know how I can live without him." What is the best response by the nurse? a. "Many people have lost their spouse and have done well. You will too." b. "Don't worry. Your family will help you get through this." c. "You're going to get through this one day at a time and I will be there to help you." d. "Look on the bright side. Your husband is no longer suffering."
c. "You're going to get through this one day at a time and I will be there to help you.
The daughter of an older patient with chronic bronchitis says to the nurse, "I don't understand why my father has not been prescribed antibiotics for his bronchitis. The last time I had bronchitis I got antibiotics." The nurse considers the following when formulating a response: a. Antibiotics tend to be less effective in older adults than in younger adults. b. Antibiotics are not prescribed in chronic bronchitis since the cause is usually not bacterial. c. Antibiotics are usually indicated in frail older adults when the strong possibility of pneumonia or an acute exacerbation of bronchitis is suspected. d. Normal age-related decreases in immune response delay the presentation of classic symptoms.
c. Antibiotics are usually indicated in frail older adults when the strong possibility of pneumonia or an acute exacerbation of bronchitis is suspected.
A nurse suspects that her next-door neighbor, an older woman, is a victim of elder abuse by her daughter. What is the appropriate action for the nurse to do in this situation? a. Because the neighbor is not a patient, the nurse should not get involved. b. Visit the neighbor frequently to confirm the suspicions. c. Complete a confidential report with the adult protective services in the area. d. Ask the neighbor herself if she is being abused.
c. Complete a confidential report with the adult protective services in the area.
Which intervention has priority before touching a client's consent zone? a. Draping the area to minimize exposure b. Having another nurse present c. Explaining why the area will be touched while asking permission d. Assuring the client that the touch is absolutely necessary
c. Explaining why the area will be touched while asking permission
Which intervention addresses a right guaranteed a long-term care facility resident? a. Ethnic foods are made available to culturally diverse residents who would like them. b. Each resident has access to a telephone in his or her room. c. Family members are welcome at any time. d. A professional hairdresser is available 3 days a week
c. Family members are welcome at any time.
Which of the following manifestations would a nurse expect in a 70-year-old patient who has advanced osteoarthritis? a. Swan neck deformity of the hand b. Morning stiffness lasting >30 minutes c. Heberden's nodes on the distal phalanges d. Enlarged great toe
c. Heberden's nodes on the distal phalanges
When an older adult is considering long-term care insurance (LTCI), what is important for the nurse to encourage the client to consider? a. The older one is when applying, the lower the rates will be. b. It is financially better to avoid purchasing LTCI through a group policy. c. It is wise to scrutinize all exclusions before enrolling d. All policies cover care at home as well as in a long-term care facility
c. It is wise to scrutinize all exclusions before enrolling
An elder is experiencing severe chronic pain resulting from a terminal illness. Which intervention by the nurse would be most appropriate when he verbalizes a desire to find "some sort of meaning to all of this"? a. Introduce a sensory distraction, such as television. b. Reassure him that this is normal phase that everyone experiences. c. Listen and help him express his feelings about life and death. d. Ask the doctor to order a psychiatric consult for possible depression.
c. Listen and help him express his feelings about life and death.
An older client who was recently admitted to the subacute setting after having a knee replacement is very anxious and refuses to get out of bed, stating that it is too painful. Which intervention will the nurse implement? a. Share with the patient that it's important to get out of bed and that there is pain medication available if it does hurt. b. Use the Hoyer lift to get her out of bed so that the knee will not experience much movement and so there will be little pain. c. Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed. d. Allow the patient to remain in bed, but share that getting up will be required at least twice a day starting the next morning.
c. Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed.
Which nursing intervention best addresses the need for social support demonstrated by an older adult couple who will be assuming responsibility for the raising of two grandchildren? a. Facilitating a support group for children being raised by grandparents b. Helping the grandparents express their feeling regarding this unexpected role change c. Offering a monthly parenting class for this cohort of grandparents d. Suggesting couple's therapy to assist in managing any new stress on their marriage
c. Offering a monthly parenting class for this cohort of grandparents
A "good coper" is more likely to have which characteristic? a. History of mental illness. b. Expectations of perfection c. Optimistic outlook d. Demanding of others
c. Optimistic outlook
Kyphosis in the older adult can be a result of which of the following? a. Osteoarthritis b. Rheumatoid arthritis c. Osteoporosis d. Gout
c. Osteoporosis
The partner of a client comments, "Our sex life will certainly suffer now that he's had a heart attack." Which statement is the basis for the nurse's response? a. The client should no longer have sexual relations because of the demand on his heart. b. The energy expenditure during sex is equivalent to briskly climbing six flights of stairs. c. People with heart disease may reduce their sexual activity out of fear of their condition. d. The couple will benefit from attending a cardiac support group
c. People with heart disease may reduce their sexual activity out of fear of their condition
A nurse plans for the discharge of a 75-year-old patient who has the diagnosis of osteoporosis. Which of these actions would the nurse consider first? a. Avoid stressful situations. b. Schedule an annual DXA/DEXA scan. c. Remove clutter from the floors of the home. d. Encourage consumption of a high-protein diet.
c. Remove clutter from the floors of the home
An older adult is being treated for severe pain resulting from a history of osteoarthritis. In her discharge teaching, which information is most important to relay for the successful management of the pain? a. Check for incompatibilities before taking any new medications. b. Arrange to take a dose of analgesic prior to physical activity. c. Take the analgesic around-the-clock as prescribed. d. Be alert for the signs of overdose toxicity
c. Take the analgesic around-the-clock as prescribed.
An older adult is admitted to the hospital after a serious fall. When noting that the client has been prescribed meperidine (Demerol) for muscle pain, the nurse: a. administers the medication so as to prevent from developing the fear of pain. b. questions the client and family concerning any allergies to analgesic medications. c. calls the physician to question the appropriateness of this medication order. d. conducts a pain assessment and determines the client's need for an analgesic medication.
c. calls the physician to question the appropriateness of this medication order.
After first managing the pain being experienced by the client with gout, the treatment focuses on: a. strengthening the affected joints through a controlled exercise plan. b. minimizing joint disfigurement by using therapeutic splinting. c. preventing systemic involvement by altering the client's diet. d. managing chronic pain by taking regular doses of salicylates.
c. preventing systemic involvement by altering the client's diet.
A nurse who is caring for an older patient with bipolar disorder knows that the patient needs additional education when the patient states: a. "Bipolar disorder often results in 'a leveling out' of symptoms as one ages." b. "Relapses in bipolar disorder tend to be precipitated by medical problems." c. "The length of the phases of depression and mania varies." d. "Bipolar disorder is the most commonly diagnosed psychiatric disorder in older adults."
d. "Bipolar disorder is the most commonly diagnosed psychiatric disorder in older adults."
A Navy war veteran is seeking advice about getting treatment for a chronic respiratory problem at the local veterans' hospital. The nurse's initial response is to ask: a. "Why aren't you considering the local general hospital for the care that you need?" b. "Are you willing to travel to a veterans' hospital that offers respiratory diagnostic services?" c. "Have you ever been treated at a veterans' hospital before?" d. "Is the problem related to something that occurred while you were in the Navy?"
d. "Is the problem related to something that occurred while you were in the Navy?"
When educating a client on the use of an adjuvant medication, which statement best demonstrates the nurse's understanding of this therapy? a. "These medications are used instead of opioids to decrease the likelihood of addiction." b. "Adjuvant medications are prescribed because they seldom cause any significant side effects." c. "These types of medications are used to eliminate the side effects of opioid medications." d. "These drugs are intended for another purpose but have been found to be effective to treat pain."
d. "These drugs are intended for another purpose but have been found to be effective to treat pain."
Which option is an example of elder exploitation? a. A homebound client is left alone for days at a time by the caregiver. b. An older client is smacked if he doesn't eat all of his food. c. A client diagnosed with Alzheimer's disease is bathed only twice a month. d. A homebound client can only get groceries by agreeing to pay for her neighbor's groceries, too.
d. A homebound client can only get groceries by agreeing to pay for her neighbor's groceries, too.
Which behavior is characteristic of grief by a disenfranchised adult child in response to a parent's death following a lengthy, painful illness? a. Crying out loudly while invoking "God's help" to go on with life b. Announcing to family members, "I've already grieved the loss" c. Having difficulty even deciding what to wear to the funeral d. Going on a drinking binge instead of attending the funeral
d. Going on a drinking binge instead of attending the funeral
Which statement regarding touch and touch zones is most accurate? a. People between the ages 66 and 100 are the most often touched. b. Newly graduated nurses tend to touch clients less often than do nursing students. c. When performing pericare, the nurse is working within the zone of intimacy. d. Illness, confinement, and dependency are stresses on the intimate zone of touch.
d. Illness, confinement, and dependency are stresses on the intimate zone of touch.
Which outcome regarding the effects of therapeutic touch on the skin is inaccurate? a. Brings about sensory stimulation. b. Helps relieve physical and psychosocial pain. c. Is known to reduce anxiety and tension. d. Improves skin integrity
d. Improves skin integrity
A widowed grandmother is about to assume the role of custodial parent for her 6-year-old grandchild. Which intervention has priority when preparing the grandmother for long-term success in this new role? a. Reviewing the developmental milestones of childhood b. Identifying local sources of child counseling services c. Discussing the common challenges of parenting a 6 year old d. Teaching stress management and relaxation techniques
d. Teaching stress management and relaxation techniques
The nurse sits at the bedside of a comatose, terminally ill older client reading the wishes expressed in the numerous cards the client has received. Which concept of grief work is the nurse addressing with this intervention? a. Everyone needs social interaction. b. The nurse needs to "attend to the patient." c. Hearing is believed to be the last sense to be lost. d. The individual is living until he or she is dead
d. The individual is living until he or she is dead.
A nurse is interviewing an older woman who is a new patient in an outpatient medical clinic. Which of the following findings by the nurse is considered a risk factor for osteoporosis? a. The woman is obese and has hip pain with ambulation. b. The woman drinks three glasses of skim milk daily. c. The woman eats three to five servings of shrimp and liver per week. d. The woman has an estrogen deficiency
d. The woman has an estrogen deficiency
Compared with acute pain, persistent pain requires the nurse to: a. monitor vital signs more frequently. b. document the character of the pain as burning. c. administer analgesics at least every 4 hours. d. educate the client to the benefit of specific lifestyle changes.
d. educate the client to the benefit of specific lifestyle changes.