CH 8 - Management of the Older Adult Pt - Practice Questions

The admissions department at a local hospital is registering a 78-year-old client for an outpatient diagnostic test. The admissions nurse asks if the client has an advance directive. The client reports not wanting to complete an advance directive because they do not want anyone controlling their finances. What would be appropriate information for the nurse to share with this client?

"Advance directives are limited only to health care instructions and directives."

The nurse is planning an educational event for the nurses on a subacute medical unit on the topic of normal, age-related physiologic changes. What phenomenon should the nurse address?

A decrease in muscle mass and bone density

A 62-year-old woman started experiencing urinary incontinence six months ago and now wears disposable incontinent panties. The client does not drink any fluids after 5 pm and considers this problem part of aging. What priority modifications and advice should be given to this client?

"Urinary incontinence is not part of the aging process. You should see your HCP and increase your water intake."

The nurse is caring for a 91-year-old client who reports urge incontinence and sometimes falling when trying to get to the bathroom at home. The nurse identifies the nursing diagnosis of Risk for Falls related to impaired mobility and urinary incontinence. This client's risk for falls is considered to be which of the following?

A geriatric syndrome

The nurse is caring for a 77-year-old client who was recently admitted to the geriatric medical unit. Since admission, the client has spoken frequently of becoming a burden to their children and the challenge of "staying afloat" financially. When planning this client's care, the nurse should recognize a heightened risk of what nursing diagnosis?

Anxiety

An 80-year-old client is being admitted for dehydration and syncope. The client is found to be hypotensive, and intravenous fluids are ordered. What are some teaching strategies that the nurse should review with this client?

Before ambulation the client should rise slowly and take mini breaks between lying, sitting, and standing.

The case manager is working with an 84-year-old client newly admitted to a rehabilitation facility. When developing a care plan for this client, which factors should the nurse identify as positive attributes that enhance coping in this age group? Select all that apply.

Effective adaptation skills, Increased life experience, Resilience during change

A gerontologic nurse is overseeing the care in a large, long-term care facility. The nurse is educating staff about the significant threat posed by influenza in older, frail adults. What action should the nurse prioritize to reduce the incidence and prevalence of influenza in the facility?

Ensure that residents receive influenza vaccinations in the fall of each year.

A 59-year-old client has come to the health care provider's office for an annual physical and is being assessed by the office nurse. The nurse who is performing routine health screening for this client should be aware that one of the first physical signs of aging is what?

Failing eyesight, especially close vision

Which age-related physiologic change contributes to heart disease being the leading cause of death in older adults?

Heart muscle and arteries lose their elasticity.

A 65-year-old client has come to the clinic for a yearly physical. The client reports enjoying good health, but also reports having occasional episodes of constipation over the past 6 months. What intervention should the nurse first suggest?

Increase daily intake of water.

The nurse is caring for a 78-year-old client with cardiovascular disease. The client comes to the clinic with a suspected respiratory infection and is diagnosed with pneumonia. What should the nurse recognize about the altered responses of older adults?

Increased and closer monitoring of older adults' body systems must occur to identify possible systemic complications.

When the nurse observes physical indicators of illness in the older population, that nurse should be aware of which of the following principles?

Indicators that are useful and reliable in younger populations cannot be relied on as indications of potential life-threatening problems in older adults.

The nurse is providing education to a client with early-stage Alzheimer disease (AD) and the family members. The client has been prescribed donepezil hydrochloride. What should the nurse explain to the client and family about this drug?

It slows the progression of AD.

A nurse is planning discharge education for an 81-year-old client with mild short-term memory loss. The discharge education will include how to perform basic wound care for the venous ulcer on the client's lower leg. When planning the necessary health education for this client, the nurse should take which action?

Keep teaching periods short

The presence of a gerontologic advanced practice nurse in a long-term care facility has benefited both the clients and the larger community in which they live. Nurses in this advanced practice role have been shown to cause which outcome?

Less deterioration takes place in the overall health of clients.

The nurse is providing care for an 82-year-old client whose signs and symptoms of Parkinson disease have worsened over the past several months. The client reports no longer being able to do as many things as in the past. Based on this statement, what issue is of most concern to the client?

Loss of independence

When implementing a comprehensive plan to reduce the incidence of falls on a gerontologic unit, what risk factors should the nurse identify? Select all that apply.

Medication effects, Poor lighting, Sensory impairment

A 72-year-old client has returned to the community following knee replacement surgery. The client takes nine different medications and has experienced dizziness since discharge. The nurse should identify which nursing diagnosis?

Risk for falls related to polypharmacy and impaired balance

A 76-year-old client is in the emergency department with reports of nausea, dyspnea, and shoulder pain. The spouse stated the client woke up confused, slightly unsteady, and pale. Which problem or condition is most likely occurring?

Myocardial ischemia

After a sudden decline in cognition, a 77-year-old client who has been diagnosed with vascular dementia is receiving care at home. To reduce this client's risk of future infarcts, which action should the nurse most strongly encourage?

Rigorous control of the client's blood pressure and serum lipid levels

A 76-year-old client with Parkinson disease has been admitted with aspiration pneumonia and constipation. Which nursing intervention would help both diagnoses?

Sitting upright for meals

For several years, a community health nurse has been working with a 78-year-old man who requires a wheelchair for mobility. The nurse is aware that the interactions between disabilities and aging are not yet clearly understood. This interaction varies depending on what variable?

Socioeconomics

The home health nurse is making an initial home visit to a 71-year-old client who is widowed. The client reports having begun taking some herbal remedies. Which should the nurse be sure to include in the client's education?

There is a need to inform the primary care provider and pharmacist about the herbal remedies

A gerontologic nurse is aware of the demographic changes that affect the provision of health care. Which demographic change has the biggest impact?

A growing number of people live to a very old age.

A nurse is caring for an 81-year-old client who has become increasingly frail and unsteady when standing. During the assessment, the client reports having fallen three times in the month, though the client did not suffer any injury. The nurse should take action in the knowledge that this client is at a high risk for which type of injury?

A hip fracture

A gerontologic nurse is making an effort to address some of the misconceptions about older adults that exist among health care providers. The nurse has made the point that most people aged 75 years and over remain functionally independent. The nurse should attribute this trend to what factor?

Application of health-promotion and disease-prevention activities

A home health nurse makes a home visit to a 90-year-old client who has cardiovascular disease. During the visit the nurse observes that the client has begun exhibiting subtle and unprecedented signs of confusion and agitation. What should the home health nurse do?

Arrange for the client to see their primary care provider.

An occupational health nurse overhears an employee talking to a manager about a 65-year-old coworker. Which phenomenon should the nurse identify when hearing the employee state to the coworker, "You should just retire and make way for some new blood"?

Ageism

Nurses and members of other health disciplines at a state's public health division are planning programs for the next 5 years. The group has made the decision to focus on diseases that are experiencing the sharpest increases in their contributions to the overall death rate in the state. This team should plan health promotion and disease prevention activities to address what health problem?

Alzheimer disease

A 69-year-old client is readmitted with heart failure. The client reports taking all medications as prescribed. The client's grandchild usually helps to set up a weekly organizer pill container but is away at college. What should the nurse first do with this information?

Complete a comprehensive assessment reviewing the client's medication history, including over-the-counter medications

The nurse is caring for clients in the urology clinic. A new, 73-year-old client presents with reports of urinary incontinence and is prescribed an anticholinergic. Why might this type of medication be an inappropriate choice in the older adult population?

Confusion can be an adverse effect of this medication

A 55-year-old client is preparing to retire in the next five years. The client has made both financial and social plans to make a successful transition. What are some examples of social change that the client could plan?

Developing routines and friends not associated with work

A gerontologic nurse is basing the therapeutic programs at a long-term care facility on Miller's Functional Consequences Theory. To put this theory into practice, the nurse should prioritize which task?

Differentiating between age-related changes and modifiable risk factors

An 80-year-old client has been admitted to the hospital for hypertension and now requires oxygen. The client asks the nurse why oxygen is needed because they have never smoked and feel fine. The client requires oxygen in the hospital because of which respiratory changes or requirements?

Diminished respiratory efficiency and declining aerobic capacity

A 54-year-old female client visiting her gynecologist is postmenopausal and reports painful intercourse. What is a physical change that is occurring to the client's reproductive system to account for this problem?

Shortening of the vagina

A nurse will conduct an influenza vaccination campaign at an extended care facility. The nurse will be administering intramuscular (IM) doses of the vaccine. Which age-related change should the nurse be aware of when planning the appropriate administration of this drug? An older adult client has:

less subcutaneous tissue and less muscle mass than a younger client.

Gerontologic nursing is a specialty area of nursing that provides care for older adults in our population. Which goal of care should a gerontologic nurse prioritize when working with this population? Helping older adults:

use their strengths to optimize independence.