HG & D Part 2

· A nurse is speaking with a client with a hearing impairment. The nurse refrains from doing which of the following, which is least helpful when communicating with this client?

o Using many exaggerated hand gestures while talking

· The nurse answers the call light of a newly admitted patient. The patient tells the nurse she is blind and asks the nurse to assist her to the bathroom. Which action by the nurse is most appropriate?

o Walk slightly ahead of the patient and allow the patient to hold the nurse's elbow.

· To help prevent falls related to muscle weakness, what type of exercises should be selected for the aging patient?

o Weight-bearing

· When should family members of a stroke victim expect to see some of the neurologic involvement disappear?

o Within 3 to 6 months

· The health-care worker can support grieving families at the time of death by:

o allowing the family time to stay with the loved one after the death.

· An elderly patient has been blind for the past 10 years. He is hospitalized with congestive heart failure (CHF). In the care of a long-term blind individual, it is important to

o announce when you enter and leave the room.

· This is the clouding of the normally clear and transparent lens of the eyes that is very common as a person ages.

o cataracts

· The primary goal of end-of-life care is:

o comfort and care to promote death with dignity.

· The document naming the person or persons who should make health-care decisions if a patient cannot make informed decisions for him- or herself is the:

o durable power of attorney.

· The school-age siblings of a dying child should be:

o involved in the plan of care for their sibling.

· The health-care worker caring for a dying 78-year-old Hispanic woman understands that in Hispanic families when death is near, the family will:

o prohibit pregnant women and children from the bedside.

· When parents ask if their school-age child should attend the funeral of their grandmother, the health-care worker would base a response on the understanding that attendance will:

o provide an closure for the child.

· When planning health-promotion classes for geriatric adults, the health-care worker should include information pertinent to:

o safe home environment, immunizations.

A terminally ill patient is unresponsive and having periods of apnea. The patient's family is arguing at the bedside about where the funeral should be held. The health-care worker should

o take the family members aside and explain that the patient may be able to hear them.

The sensitive health-care worker can demonstrate therapeutic presence by

remaining near the patient and family

· The statement that best depicts the preschooler's understanding of death is:

o "I know that my brother got taken because I had a fight with him."

· When a terminally ill patient says, "I feel that death is just around the corner," the most appropriate response would be:

o "Is this feeling something you would like to talk about?"

· A member of an older patient's family asks you why medications are ordered at half of the usual dose. Which of the following is the most appropriate response?

o "Medications for the older adult may be at lower doses initially until responses are evaluated. to prevent toxicity or untoward reactions"

· The normal range for intraocular pressure is:

o 10-22 mmHg

· Which areas are affected only minimally by age?

Cognition

· Older adults often have an atypical response to illness or infection. What is an atypical response in a previously active and alert older adult?

Disorientation, weakness, or incontinence

· The nurse is caring for a patient with a do-not-resuscitate (DNR) order. Although the nurse may disagree with this order, what is his or her legal obligation?

o To follow the order

· An 84-year-old female patient presents to the emergency department with symptoms of delirium: acute confusion and hallucinations. Her caregiver brought along her current medications. The nurse notes that the patient takes 21 different routine medications. What does the nurse suspect is the cause of the delirium?

Polypharmacy

· Sensorineural hearing loss and the most common form of loss in older adults, resulting in difficulty hearing high-pitched tones and conversational speech:

Presbycusis

· The nurse provides information to a client regarding breast self-examination (BSE). Which client statement indicates a need for further teaching regarding BSE?

o "I don't need to do that; I'm too old for that."

· The nurse reminds the 80-year-old patient that her respiratory system has decreased resistance to respiratory infections. For what is this patient at increased risk?

o Pneumonia

What is age-related vision change caused by the loss of elasticity of the lens called?

o Presbyopia

· What is one positive aspect of Parkinson disease?

o Intellectual function is not impaired.

· The nurse recognizes that an older adult patient with COPD has a higher incidence of developing which age-related skeletal change that will alter the ability to exchange air effectively?

o Kyphosis

· When an older female patient complains of painful sexual intercourse, what should the nurse recognize as the probable cause?

o Mucosal drying

· A 68-year-old Alzheimer's patient is wandering up and down the hospital hallway. What should be the nurse's initial response?

o Offer assistance to the toilet. When reaching the bathroom, point to the toilet sign on the door to reinforce the concept of the toilet.

· The nurse recommends a breathing technique to help a patient with chronic obstructive pulmonary disease (COPD) to empty the lungs of used air and to promote inhalation of adequate oxygen. What is this method of breathing called?

o Pursed-lip breathing

· The nurse working in a long-term care facility is approached by the son of a resident, who wants his 78-year-old father to have a heating pad because "his feet are always cold at night." The nurse should incorporate which concept when formulating a response to the family member?

o Older adults often have slower neurological response times and are therefore more at risk for burns.

· Which approaches should be included when teaching medication safety to an older, homebound adult? (Select all that apply.)

o Always dispose of expired medications in the toilet or the sink; never throw them in the trash can. o Never share medications with others. o Keep medications in their original containers.

· What is the most common cause of dementia?

o Alzheimer's disease

· What is the best test to identify the risk of osteoporosis in postmenopausal women?

o Bone density scan

· A nurse is gathering data from a client with a history of untreated cataracts. The nurse asks the client about the presence of which of the following signs of a cataract?

o Difficulty with driving at night and blurred vision

· When communicating with an older adult patient, the nurse becomes aware of the fact that the patient is well satisfied with his accomplishments over a lifetime and has no regrets concerning aging. Which of Erikson's developmental stages has the patient achieved?

o Ego integrity

· Abuse and neglect of the older adult refers to violence toward individuals older than the age of 65. The National Center on Elder Abuse identifies important indicators of abuse as:

o Elder's frequent unexplained crying o Elder's unexplained fear of or suspicion of a particular person(s) in the home

· For what is the older adult patient at increased risk because of age-related changes in the musculoskeletal system?

o Falls related to posture changes

· The nurse observes a skin tear and multiple bruises on a 72-year-old patient's arm during his weekly blood pressure check. When the patient is asked about the impaired skin, he begins crying and states,"I'm so clumsy; I fell into the door." The nurse notes this in the clinical record. The following month, the patient has a 4-cm bruise on his left cheek. He shares that his alcoholic son moved in with him 6 weeks ago, and he just tries to keep out of his way. What would be the nurse's next action after noting the subjective and objective data in the clinical record?

o Report the findings to the Area on Aging in accordance with your state guidelines for elder abuse

· What should be suggested to a patient to aid with the pain of claudication?

o Rest

· What is a major difference between rheumatoid arthritis and osteoarthritis?

o Rheumatoid arthritis is inflammatory.

· The nurse recognizes that arthritis affects an individual's functional ability. Interventions are aimed at relieving:

o Stress on affected joints.

· Because of changes in the blood vessels, which become narrow with fatty deposits, the geriatric elder is at risk for:

o Stroke

· A nurse is caring for a client with severe cardiac disease. While the nurse is caring for the client, the client states, "If anything should happen to me, please make sure that the doctors do not try to push on my chest and revive me." The appropriate nursing action is to

o Tell the client that it is necessary to notify the physician of the client's request.

· The nurse is assisting an older adult patient out of bed when suddenly the patient begins to feel dizzy and fall. What is the likely cause of the fall?

o Orthostatic hypotension

· Which symptom of diabetes distorts tactile sensation?

o Peripheral neuropathy

· An appropriate nursing action helpful to older adults that is alert. oriented and independent with insulin-dependent diabetes mellitus (Type 1) is to:

o encourage confidence in the elder as a competent individual who can follow directions and manage the disease with proper instruction and doctor follow-up.

· While teaching a group of older adults at the senior center, the nurse encourages which health-promoting behaviors? (Select all that apply.)

o Have regular medical checkups o Take medications as prescribed by physician. o Eat a low cholesterol diet

· This term means paralysis of one side of the body:

o Hemiplegia

· A change of aging related to the circulatory system includes decreased blood vessel elasticity. For what should the nurse assess?

o Hypertension

· What is the result of a slowing of the impulse transmission in the nervous system?

o Longer reaction time

· The appropriate diet for an elderly person at risk for cardiovascular complications is:

o Low carbohydrate, low fat, low sodium

· When communicating with an older adult patient who has difficulty hearing, how should the nurse change her speech?

o Lower the tone of the voice