Week 1: Ch. 11: Health Care of the Older Adult

"It feels like I have food stuck in my throat."

The nurse works on a unit with elderly clients. Which of the following clients would the nurse visit first? The client who reports

stay with the client and encourage him to eat.

To encourage adequate nutritional intake for a client with Alzheimer's disease, a nurse should:

"What precipitates the outbursts?"

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:

Ensure that the mother does not have access to car keys or drive an automobile.

A client has recently brought her elderly mother home to live with her family. The client states that her mother has moderate Alzheimer's disease and asks about appropriate activities for her mother. The nurse tells the client to

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

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

"Evidence shows that there are changes in nerve cells and brain chemicals."

A family of a patient with Alzheimer's disease asks the nurse what causes this condition? Which response by the nurse would be most appropriate?

Assess lung sounds and sputum.

A hospitalized older adult complains of increased coughing and shortness of breath. The nurse assesses the vital signs as temperature 100.2°F oral, respirations 18, pulse 88, and BP 128/80. What action should the nurse do next?

"All of a sudden my dad seemed to become confused."

A nurse is assessing a client brought to the emergency room by his daughter. Which statement by the daughter would most likely lead the nurse to suspect that the client may have an infection?

Decreased acetylcholine 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?

"Are you basically satisfied with your life?"

A nurse is assessing an older adult for depression using the Geriatric Depression Scale. Which question would the nurse ask first?

Reports of being sensitive to glare

A nurse is completing the history and physical examination of an older adult patient. When assessing the pateint's eyes, which of the following would the nurse document as a normal finding?

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

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

Functional assessment

A nurse is preparing to assess an older adult patient. Which approach would the nurse most likely use?

-Place grab bars in the shower and tub. -Have routine vision and hearing screenings. -Wear nonslip shoes or socks when walking. -Review medications routinely for side effects.

A nurse is providing a fall prevention clinic for a group of older adults. What information should the nurse include?

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

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

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

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.

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

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

Assesses the grandmother for adventitious lung sounds

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. The nurse

1. Heart disease. 2. Malignant neoplasms. 3. Cerebrovascular disease. 4. Chronic obstructive pulmonary disease. 5. Alzheimer's disease. 6. Diabetes.

Nursing students are reviewing statistics related to the older adult population and leading causes of death in this age group. The students demonstrate understanding of this information when they rank the following conditions in the order from highest to lowest.

Macular degeneration

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?

Reorient the patient.

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?

Assess the need for pneumococcal and influenza vaccinations.

The nurse is preparing an elderly hospitalized client for discharge to home within the hour. What should be the priority for the nurse?

Cardiovascular

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?

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

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

Residual lung volume

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

Decreased muscle tone

Which factor alters urinary elimination patterns in older adults?

Relaxed perineal muscle

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

Postural hypotension

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

A 65-year-old with renal insufficiency

Which older adult is at highest risk for medication-related toxicity?

Diminished color perception

The nurse is assessing a 78-year-old woman and suspects that the patient may have age-related macular degeneration. Which assessment finding would most likely support this suspicion?

Older adult clients are vulnerable.

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

Use a water-based lubricant with sexual intercourse.

An older adult female patient informs the nurse that she is sexually active but has a problem with vaginal dryness. What can the nurse tell the patient that may help relieve this problem?

Use the purified protein derivative test to evaluate for tuberculosis.

An older adult patient has just been admitted to a long-term care facility. Which of the following would be most important to reduce the risk for infection?

Ageism

Several staff members are taking a break in the unit's conference room when one of them states, "I dread getting old and having to retire. I don't want to just sit on the porch in my rocking chair." The statement reflects which of the following?

bias against older people based solely on chronological age.

Ageism refers to

Ingest five or six small meals each day.

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

Increase fluid intake.

An elderly client is reporting changes in bowel movements from every day to every 3 to 4 days. The client also states that the stools are hard. Nursing interventions include instructing the client to

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

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

Participation in a social activity

An elderly client who lives in a retirement community is having a mild depressive episode over the past few weeks. The nurse intervenes by recommending

Avoid straining when having a bowel movement.

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

Loss of bone density

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

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

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?

Wear sunglasses with ultraviolet (UV) protection when outside.

A client reports to the nurse that her mother had macular degeneration and is concerned that she, too, may be at risk. The nurse tells the client to

Distract the client with a familiar object or music.

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

Refer the client to a gynecologist for evaluation.

A female elderly client tells the nurse she experiences vague pain during sexual intercourse with her spouse. It is best for the nurse to

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

Encouraging clients to avoid cigarette smoking

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?

"I should use a laxative every other day."

After teaching an older adult about measures to relieve constipation, which statement by the client indicates a need for additional teaching?

Assisted-living apartment

An elderly client is contemplating a move to a continuing care retirement community (CCRC). The nurse assesses that the client requires assistance with food preparation and recommends placement in

Encouraging the client to use lemon, spices, and herbs in the diet

An elderly client reports to the nurse that food does not taste right. During a dietary assessment, the nurse learns that the client uses a lot of sugar and salt. The client states, "It makes the food taste better." The nurse intervenes by

Pneumonia

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?

-Use low-sodium herbs and spices. -Use pepper instead of salt. -Use lemon instead of salt to flavor food.

The nurse brings the older adult patient a dinner tray and observes the patient placing excess amounts of salt on the food. What suggestions for flavoring can the nurse provide to decrease the amount of salt the patient is placing on her food?

Feeling of fullness

When assessing an older adult's gastrointestinal system, the nurse would identify an increase in which of the following as normal?

Directing all health decisions to the older adult's child

Which action by the nurse demonstrates ageism?

Heart disease

Which are leading causes of death among the elderly?

Dementia

Which condition is characterized by a decline in intellectual functioning?

They have less efficient defense mechanisms.

Which is an accurate rationale for why older adults are more susceptible to serious infections?

Decreased gas exchange

Which is an age-related change in the respiratory system?

Presbyopia

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