Med Surg Course Point Chapter 8

The nurse is concerned that an older adult is experiencing ageism. Which client statement did the nurse use to make this clinical determination?

"My grandchildren think I should work for my Social Security payments."

The client asks the nurse why she seems to have bone changes since she has gotten older. What is the best response by the nurse?

"Bone changes from aging result from a loss of calcium."

The nurse notes that an older adult is experiencing adverse effects and mild depression from multiple medications. Which question will the nurse ask the client to help determine the reason for these assessment findings?

"How would you describe your alcohol consumption?"

An older adult female has been widowed for several years. Which statements indicate to the nurse that the client may need to consider a change in living arrangements? Select all that apply.

"I don't like to cook for myself anymore." "There is no one to talk to most days of the week."

The nurse caring for residents of a long-term care facility is explaining the occurrence of elder abuse in such facilities. Which statement from the nurse indicates the need for more education?

"Older adults in long-term care facilities are at low risk for elder abuse."

An older adult develops sudden onset of confusion and is hospitalized. The family expresses concern that their loved one is developing Alzheimer disease. What response by the nurse is most appropriate?

"Several possible underlying factors could be causing the confusion. Alzheimer's usually does not present with sudden confusion."

An older adult asks, "What can I do to prevent getting a chest cold during the winter?" Which suggestion(s) will the nurse make to this client? Select all that apply.

"Stop smoking." "Get the annual flu shot." "Engage in regular exercise." "Make sure you drink enough fluid every day."

During a home visit, the nurse notes that an older adult's health status has not improved with prescribed medications. Which statement indicates to the nurse that the client may not be adhering to the prescribed medication regimen?

"That one little white pill that I take in the morning makes me feel sleepy all day."

A client with Alzheimer's disease is prescribed donepezil hydrochloride. When teaching the client and family about this drug, which of the following would the nurse include?

"The drug helps to control the symptoms of the disease."

A nurse is caring for a client with dementia. A family member of the client asks what the most common cause of dementia is. Which response by the nurse is most appropriate?

"The most common cause of dementia in the elderly is Alzheimer's disease."

A client reports to the nurse that her grandmother with Alzheimer's disease recently moved in with her and her two school-aged children. The client states the grandmother becomes agitated and starts yelling and crying frequently. The woman asks, "What can I do?" The nurse first responds:

"What precipitates the outbursts?"

The nurse is assisting an older adult patient with dietary planning. The nurse emphasizes the importance of adequate intake of fruits, vegetables, and fish. What should the patient's daily carbohydrate intake be?

55% to 60%

Which is a true statement regarding pharmacologic aspects of aging?

Absorption may be affected by changes in gastric pH.

An older adult has lost 10% of body weight because of diet changes and exercise. The nurse would provide anticipatory guidance regarding dosage changes in which of the client's daily medications based on this weight loss?

Diazepam

An older adult with mild dementia is diagnosed with a terminal illness. Which action will the nurse take to support this client's right to self-determination?

Ask the client if there is someone who can help make decisions for treatment.

An older adult seeks medical attention for a new onset of epigastric distress and bilateral arm pain. Which action will the nurse complete?

Assess cardiovascular function.

An older adult has a score of 12 on the Geriatric Depression Scale (GDS). What action should the nurse complete first?

Assess for the potential for self-harm.

Family members report to the nurse that their elderly grandmother has had a sudden onset of confusion and that they are having difficulty providing care for her. What is the nurse's best response?

Assess the grandmother for adventitious lung sounds

A nurse is teaching nursing assistants in an extended-care facility measures to protect the skin of elderly clients. Which of the following measures is the nurse likely to recommend?

Encouraging clients to avoid cigarette smoking

An older adult was found unable to get up after sustaining a hip fracture after falling at home. Which outcome will the nurse identify for this client's care?

Attain maximum level of functioning.

An elderly client with heart failure reports constipation that has progressively worsened over the last several months. The client's vital signs are pulse 86 beats per minute, blood pressure 94/56, and respirations 18 breaths per minute. It would be best for the nurse to instruct the client to

Avoid straining when having a bowel movement.

The nurse is teaching about preventing pneumonia and influenza to a group of clients in a senior citizens' wellness class. The nurse includes which of the following topics in the class? Select all options that apply.

Avoiding environmental smoke Participating in regular exercise Ensuring appropriate fluid intake

When administering medications to an older adult patient, which medication does the nurse understand may remain in the body longer due to increased body fat?

Barbiturates

The nurse is working in a long-term care facility. When assessing her patients, what body system dysfunction should the nurse look for as the leading cause of morbidity and mortality in the older adult population?

Cardiovascular

A nurse is obtaining the health history of a 72-year-old woman who has come to the ambulatory care center for an evaluation. When obtaining information about the woman's sleep patterns, which of the following would the nurse expect to assess?

Complaints about frequently waking up during the night

An elderly client reports fatigue without shortness of breath with walking 30 minutes five times each week. The nurse assesses the resting heart rate as 72 beats per minute; 10 minutes after walking, the client's heart rate is 92 beats per minute. What should the nurse instruct the client to do next?

Continue to walk at his current level.

A nurse is assessing an elderly client with senile dementia. Which neurotransmitter condition is most likely to contribute to this client's cognitive changes?

Decreased acetylcholine level

Which is an age-related change associated with the cardiovascular system?

Decreased cardiac output

The nurse is caring for an older adult who is prescribed several medications. For which medications will the nurse assess the client for potential extended renal function effects? Select all that apply.

Digoxin Procainamide Lithium

Which action by the nurse demonstrates ageism?

Directing all health decisions to the older adult's child

A client with Alzheimer disease becomes agitated while the nurse is attempting to take vital signs. What action by the nurse is most appropriate?

Distract the client with a familiar object or music.

The nurse notes that an older adult is experiencing symptoms of depression. Which nonpharmacologic recommendations will the nurse suggest to this client? Select all that apply.

Exercise Bright light Reminiscing Cognitive therapy Interactions with others

An older adult who is scheduled for the annual influenza vaccination has yet to receive the pneumococcal vaccination. Which action will the nurse take when the client is prescribed to receive both vaccinations?

Give the client the influenza vaccine first and then administer the pneumococcal vaccine in another site.

The nurse notes that an older adult adds salt to all foods before eating a meal. Which question would the nurse ask this client?

Have you tried adding herbs, garlic, or lemon to foods for added flavor?"

The family of an older adult seeks medical attention for the client because of an increase in inappropriate responses and avoidance of social interactions. On which body area will the nurse focus when assessing the client?

Hearing

A nurse is educating a group of middle-aged adults on aging. What information should the nurse include in the teaching?

How old you feel will be determined by your physical and cognitive abilities.

A nurse is providing care to a patient with delirium. Which interventions would be most appropriate to implement? Select all that apply.

Providing a calm, quiet environment Supervising nutritional intake Using familiar cues about the environment

An older adult reports a sensation of disorientation in relation to position. Which action will the nurse take for this client?

Identify treatable causes.

An older adult voids a small amount of urine in the toilet but experiences a large volume of incontinence while walking back to the bed. Which nursing intervention would be appropriate for this client?

Implement a prompted, timed voiding schedule.

A nurse notes that an older female client has lost 2 inches in height since her appointment last year. The client reports lumbar back pain as unchanged. Which of the following would the nurse instructs the client? Select all answers that apply.

Increase intake of foods that are high in calcium. Take calcium and vitamin D supplements daily. Obtain the prescribed bone density screening.

An elderly client exhibits blood pressure of 110/76 while prone, 100/72 sitting, and 92/64 standing. The nurse instructs the client to

Ingest five or six small meals each day.

An elderly client is hospitalized for treatment related to leukemia. Family members want to visit with a toddler who has a cold. It would be best for the nurse to

Instruct the family to remove the toddler from the room for the protection of the client.

The nurse is describing hospice services to the family of a patient with end-stage heart failure. Which of the following would the nurse be least likely to include as a major focus of care?

Invasive therapy

An elderly female client has been taking prednisone for breathing problems for many years. The nurse notes that the client's current height is 64 inches. Two years ago, her height was 66 inches. The nurse assesses this loss in height is most likely the result of

Loss of bone density

Students are reviewing information about visual changes and conditions associated with aging. The group demonstrates understanding of the information when they identify which condition as the major cause of vision loss in the elderly?

Macular degeneration

An elderly client, while being seen in an urgent care facility for a possible respiratory infection, asks the nurse if Medicare is going to cover the cost of the visit. What information can the nurse give the client?

Medicare has a copayment for many of the services it covers. This requires the client to pay a part of the bill.

An older adult seeks medical attention for a new onset of rectal bleeding. For which reason will the nurse perform a complete physical assessment with the client?

More than one body system may be affected

An older adult was diagnosed with Alzheimer disease 2 years ago and the disease has progressed at an increasing pace in recent months. The client has lost 7.5 kg (16 pounds) over the past 3 months, leading to a nursing diagnosis of Imbalanced Nutrition: Less than Body Requirements. What intervention should the nurse include in this client's plan of care?

Offer the client only one food item at a time to promote focused eating.

The reason that governments carefully regulate treatment given in licensed health care facilities, particularly long-term care facilities, is expressed by which statement?

Older adult clients are vulnerable.

Why are IV solutions usually given at a slower rate to older adults?

Older adults may have cardiac or renal disorders.

A client with moderate Alzheimer's disease has been eating poorly, losing weight, and playing with food at meals. The nurse best intervenes by

Placing one food at a time in front of the client during meals

A department of nursing within a health care organization is adopting the Functional Consequences Theory when caring for older adults. Which action would the nurse take to faciliate using this theory when caring for a client?

Plan interventions to address consequences of age-related changes.

Older adults, who are more subject to falls, may fracture one or more ribs and be more susceptible to which condition after a rib fracture?

Pneumonia

An elderly client recovering from a hip repair becomes disoriented and tries to get out of bed frequently. The client states, "I forget I am in the hospital." The best nursing intervention is to

Post a sign stating "You are in the hospital" at the client's eye level.

Which is an age-related change associated with the nervous system?

Postural hypotension

Which refers to the decrease in lens flexibility that occurs with age, resulting in the near point of focus getting farther away?

Presbyopia

Which action is included in a nurse's role when providing home care for a client with Alzheimer disease?

Provide emotional and physical support

What is a nurse's role in providing home care for a client with Alzheimer disease?

Provide emotional and physical support.

An older adult has experienced several acute illnesses over the past few months. Which assessment finding will the nurse use to identify the reason for the client's frequent illness?

Recent weight loss

The nurse is caring for an older adult who has no family but will be returning home after discharge. Which action by the nurse is appropriate to help ensure client needs will be met in the home environment?

Recommend the client contact their local area agencies for older adults for assistance.

Which is a factor that contributes to urinary incontinence in older female adults?

Relaxed perineal muscle

The nurse is attempting to take vital signs of an older adult hospitalized following knee surgery. The client continuously yells, "It's 1999 and you are going to hurt me!" What action should the nurse do first?

Reorient the patient.

When assessing an older adult, the nurse anticipates an increase in which component of respiratory status?

Residual lung volume

An older unmarried adult with no children loses consciousness as a symptom of a chronic condition. Which action will the nurse take to help guide the type of care the client desires to receive?

Review the client's advance directive.

A nurse is preparing a health promotion class for a group of seniors at a local community center. As one part of the presentation, the nurse is planning to address sexuality and sexual function. Which statement would be least appropriate to include?

Sexual desire typically becomes progressively less.

Which assessment finding by the nurse and statement by an older adult would require the nurse to report suspected elder abuse?

Stage II decubitus ulcer on coccyx; "No one is able to turn or lift me anymore."

The nurse is visiting the home of an adult client. Which action will the nurse take to reduce the client's risk for falling at home? Select all that apply.

Suggest small area lamps in the rooms. Recommend contrast colors to mark edges of steps. Discuss the advantages of grab bars in the bathroom

Which characteristic distinguishes normal aging from pathological changes associated with aging?

Universality

A client at an extended-care facility who has Alzheimer's disease is awake throughout the night. The nurse intervenes with activities that will promote sleep at night, which include

Walking the client in the facility yard during the day

A clinic nurse is meeting with a group of older adults living in a community that has been experiencing extremely hot summer days. Which of the following measures would the nurse encourage the clients to practice to protect their health during the hot summer days? Select all answers that apply.

Wear lightweight shirts and shorts. Take cool showers. Circulate air with a fan or air conditioner. Increase fluid intake.

Ageism refers to

bias against older people based solely on chronological age.

A nurse is teaching a nutrition class to a group of elderly clients at a retirement center. The nurse tells the clients that as a result of aging, they will need to decrease

calories

A nurse is preparing a presentation for a local senior center about the health status of older adults. What trends in health promotion and disease prevention activities would the nurse explain as contributing to declining death rates in the older adult population? Select all that apply.

improved nutrition early detection of elevated cholesterol levels screening for hypertension decreased smoking

A client in a nursing home is diagnosed with Alzheimer's disease and is exhibiting the following symptoms: difficulty with recent and remote memory, apraxia, irritability, depression, restlessness, difficulty swallowing, and occasional incontinence. What stage of Alzheimer's disease should the nurse describe the client?

middle

Students are preparing a class presentation on elder abuse. Which of the following would they include as the most common type of elder abuse?

neglect

The nurse is preparing a teaching tool that focuses on elder abuse. Which type of abuse will the nurse highlight as being the most common?

neglect