PrepU Chapter 23: The Older Adult

An older adult client comes to the health center reporting difficulty sleeping. Which statement by the client would the nurse need to address?

"I find myself napping on and off throughout the day."

A nurse is teaching an elderly client's family about the causes of mental impairment. The nurse sees that the teaching has been effective when the family says which of the following?

"Sundowning is a common problem of dementia."

A nursing student is studying the normal physiologic changes of older adults. The faculty member knows that the student comprehends the information when the student makes which statements? Select all that apply.

* "Height may decrease 1 to 3 in (2.5 to 8 cm)." * "There is an increased sensitivity to glare." * "Fluids and electrolytes remain within normal ranges."

Nurses who care for diverse populations must be aware of patterns of disease that are more likely to affect certain ethnic or racial groups. Which examples accurately reflect these profiles? Select all that apply.

* Black men in America are 30% more likely to die from heart disease than non-Hispanic White men. * Hispanics have higher rates of obesity than non-Hispanic Whites. * Black adults in America have the highest mortality rate of any minority for most major cancers. * Tuberculosis is 11 times more common in Asians in America than Whites.

An older adult client comes to the senior center for a check-up. During the visit, the client tells the nurse that he knows he should be more active than he is. The nurse reinforces the client's statement, explaining that physical activity helps to lower the risk of which condition? Select all that apply.

* Heart disease * Stroke * Diabetes

A older adult client is admitted to a nurse's unit with a community-acquired pneumonia requiring 14 days of intravenous antibiotic treatment. What does the nurse identify to the client as a contributing factor that affects the older adult client? Select all that apply.

* Humoral immunity declines. * Older adults are more susceptible to pneumonia following respiratory infections.

A older adult client is admitted to a nurse's unit with a community-acquired pneumonia requiring 14 days of intravenous antibiotic treatment. What does the nurse identify to the client as a contributing factor that affects the older adult client? Select all that apply.

* Humoral immunity declines. *Older adults are more susceptible to pneumonia following respiratory infections.

The older population, persons 65 and older, numbered over 43 million in 2012. There are limited resources to care for this aging population. Factors that influence society's attitude to this age group include which of the following myths?

* Old age begins at 65. * Most older adults live in nursing homes. * The majority of senior citizens are not in good health. * Loneliness and isolation are problems associated with this age group.

After obtaining the health history from an older adult client, the nurse develops a plan of care and identifies the client has impaired physical mobility. What information would support this impairment? Select all that apply.

* The client states the hip and knee joints hurt and are stiff when ambulating. * The client states that he or she must use a walker for stability. * The client reports weakness on one side of the body following a stroke.

When describing the older adult's risk for infection, which aspect would the nurse most likely address? Select all that apply.

* decline in humoral immunity * lowered antibody responses * inadequate nutrition

An older adult client's daughter asks if the doctor can prescribe an antipsychotic medication for her father because he is so confused and agitated much of the time. The nurse is aware that the client should only be prescribed this medication when which strategy has failed? Select all that apply.

*Behavioral *Environmental *Social

The nurse is caring for an older adult client who is confused and agitated. When the client's family comes to visit the nurse asks how long the client has been confused. The family states that the client has been confused for a long time and the confusion is getting worse. The client is subsequently diagnosed with dementia. What is the most common cause of dementia in an older adult client?

Alzheimer's disease

The nurse is evaluating a 42-year-old client who says that he is feeling stressed. Which of the following does the nurse know that could be a cause of stress for this age group?

Being caught in the sandwich generation

Which factor contributes to sleep disturbances in older adults?

Beta-blockers

The nurse is assessing a middle-aged adult age 48 years in the clinic. The nurse recalls the changes that occur in middle age as they complete the physical and cognitive examination. Changes that occur include what?

Cardiac output decreases.

A nurse is preparing to medicate an older adult client with an opioid analgesic. Which of the following does the nurse consider in the use of this medication?

Delirium, sleep disturbances, cognitive changes, and diminished functional abilities may result when pain is not managed adequately.

Erikson identified ego integrity vs. despair and disgust as the last stage of human development, which begins at about 60 years of age. Which intervention would best foster older clients' ego integrity?

Encouraging life review

An older adult client comes to the clinic for his yearly influenza vaccination. During the visit he asks the nurse, "I've heard about this other vaccine for pneumococcal pneumonia. How often do I need to get this vaccine?" The nurse would encourage the client to receive this vaccination at which frequency?

Every 5 years

Which of the following health promotion measures should occur most frequently in older adult women?

Fecal occult blood test

A nurse encourages residents of a long-term care facility to continue a similar pattern of behavior and activity that existed in their middle adulthood years to ensure healthy aging. This intervention is based on which aging theory?

Identity-continuity theory

When completing an assessment of the middle-aged adult, the nurse makes note of the client's cognitive development. Then nurse would expect to find what?

Increased motivation to learn

A nurse is assessing middle-age adults living in a retirement community. What behavior would the nurse typically see in the middle-age adult?

Looks inward, accepts life span as having definite boundaries, and has special interest in spouse, friends, and community

The nurse practitioner is examining a 55-year-old female client. Which of the following findings would be uncommon for this age group?

Lower extremity pulses are weak

A healthy 52-year-old client asks the nurse what she can do to maintain her health. Which of the following does the nurse recommend?

Perform self-examination of the skin every month

A nurse caring for older adults in a long-term care facility is teaching a novice nurse characteristic behaviors of older adults. Which statement is not considered ageism?

Personality is not changed by chronologic aging.

In a report, the night nurse tells the incoming nurse that one client with dementia has sundowning syndrome. Which of the following nursing diagnoses would be most appropriate for this client?

Sleep deprivation

There is an 86-year-old female on the medical inpatient unit. She explains that the hospital is quite noisy and that she is having difficulty sleeping. Which is not true regarding sleep in the older adult?

Sleep medications are usually the first choice in treating sleep disturbance.

A nurse has attended an inservice workshop that addressed the phenomenon of ageism in the health care system. Which of the following practices is indicative of ageism?

Speaking to older adults with the presumption that they have mild cognitive deficits

Which of the following assessment findings of a male client age 77 years should signal the nurse to a potentially pathologic finding, rather than a normal age-related change?

The client is oriented to person and place but is unsure of the month.

A nurse is providing discharge instructions to an elderly client and his daughter. The daughter asks for suggestions to help keep her father healthy. Which of the following could the nurse suggest?

The client should have his eyes examined every year for glaucoma.

A nurse is preparing a presentation for a group of older adults about health promotion. Which statistic would the nurse need to keep in mind about this group?

The group experiencing the largest growth is those 85 years of age and older.

Which group of individuals in the older adult population is most likely to be widowed?

Women over the age of 75

An older adult client tells his home care nurse that he doesn't seem to sleep as well as he used to. The nurse is aware that the sleep changes that occur in the older adult client which cause a less restful sleep include:

a decrease in the deep sleep stage of the sleep cycle.

The nurse is caring for an older adult client on the medical unit admitted for diagnostic testing. He is alert and oriented and lives independently in his own home. Which nursing intervention will be most effective in the prevention of falls for this client?

ensuring his glasses are close by his bed

After graduation, if you especially want to care for the aged population, you would consider the nursing specialty that focuses on the health and illnesses of the aging. This specialty is:

gerontologic nursing.

A 72 year old client often actively engages in reminiscence when the nurse is delivering care. The nurse recognizes that:

reminiscence is a normal process in achieving ego integrity.

Based on an understanding of the cognitive changes that normally occur with aging, what might the nurse expect a newly hospitalized older adult to do?

take longer to respond and react