EAQ Chapter 10 The Older Adult Patient

The nurse is assisting with a data collection during the admission of an 80-year-old patient. Which questions would the nurse ask as part of the functional assessment?

"How do you organize your medications?" "Do you drive or have access to transportation? "Are you able to bathe, groom, and dress yourself?"

The nurse is assisting with data collection on a 72-year-old patient who tells the nurse that he does not enjoy eating like he used to when he was younger. Which questions should the nurse ask the patient to determine the cause of this change? Select all that apply.

"How is the health of your teeth?" "Do foods that were once flavorful seem bland to you now?" "Do you feel that your jaw muscles get sore and tired when eating something chewy?

The licensed practical nurse (LPN)/licensed vocational nurse (LVN) is the charge nurse at a long-term care facility. The nurse is evaluating a group of certified nursing assistants (CNAs) on their knowledge of developmentally appropriate care of the older adult. Which statement indicates that one of the CNAs requires further education?

"I will show respect for my older adult patients by performing all activities of daily living for them."

The nurse is providing patient education regarding healthy gastrointestinal function. Which statement, if made by the patient, indicates a need for further teaching?

"I will take a stimulant laxative every day."

An older middle-aged patient comes to the clinic for a yearly examination with concerns about what will happen to her as she ages. Which statements by the patient about aging need correction from the nurse? Select all that apply.

"I won't be having sex when I get older." "I'm afraid to retire; I've heard it causes death." "I won't be able to learn new things when I get old."

An older adult patient presents to the clinic with complaints of forgetting the names of people she just met, misplacing her keys, and telling the same story multiple times in one conversation. However, the patient proves to be an excellent historian by recounting experiences she had as a teenager. The patient asks what could be causing these issues. Which disorder might the nurse suspect as the cause of this short-term memory loss?

A chronic hypoxic

Old age represents an important stage of development and coping that occurs between the high points and accomplishments of the midyears and the concerns that are involved as the end of life approaches. Which task indicates the older adult is moving toward ego integrity?

Adapts to new lifestyles

Which medication can cause bleeding if taken in high doses?

Aspirin

A 77-year-old patient presents to the clinic for persistent generalized itching that has not improved with tepid baths, liberal moisturization, and the discontinuation of scented soaps and lotions. Which diseases and conditions might these symptoms indicate? Select all that apply.

Cancer Diabetes Liver disease

A 40-year-old patient tells the nurse that he gets tired more easily than when he was in his early 20s. Which cardiovascular change related to aging is responsible for this symptom?

Cardiac output decreases by 30% to 40%.

Which is a myth regarding old age?

Cognitive changes are a result of senility

The nurse at an assisted living facility is caring for a patient who was diagnosed with chronic obstructive pulmonary disease. Which normal respiratory physiologic changes of aging should the nurse consider? Select all that apply.

Compromised ciliary action Decreased pulmonary blood flow Weakening of respiratory muscles

A 70-year-old patient reports a decrease in hearing. After undergoing a complete health assessment, the patient's hearing loss is found to be secondary to an excessive buildup of ear wax. After the removal of excess wax, the patient reports significant improvement. Which disorder does this identify?

Conduction deafness

The nurse is caring for an older adult patient who was diagnosed with peptic ulcer disease. Which normal gastrointestinal physiologic changes of aging should the nurse consider when caring for this patient? Select all that apply.

Decrease in intestinal motility Increase risk for pernicious anemia

Which factor places an older adult at highest risk for dehydration?

Decreased ability to concentrate urine

The nurse is caring for a patient who resides in a long-term care setting. Which factor contributes to drug effects related to the physiologic changes of aging?

Decreased body water

The nurse is caring for a patient who lives in a life lease community facility. The patient diagnosed with peripheral vascular disease. Which normal cardiovascular physiologic changes of aging should the nurse consider when caring for this patient. Select all that apply

Decreased cardiac output Thickening of intimal vessel layer Murmurs with incomplete valve closure

Which drug effect is associated with the age-related change of decreased renal function?

Decreased drug elimination

an 80-year-old healthy patient presents for pulmonary function test to determine the patient's baseline pulmonary functioning. Which deviations from the pulmonary function test of a younger adult would the nurse expect? Select all that apply

Decreased forced vital capacity Decreased maximal voluntary ventilation Decreased forced expiratory volume in 1 second

A patient presents to the emergency department complaining of gastrointestinal disturbances. Which signs and symptoms, if exhibited by the patient, should the nurse report to the health care provider immediately? Select all that apply.

Diarrhea Tar-colored stools Unexplained weight-loss

Which characteristics of the frail elderly living at home put this population at increased risk for food poisoning? Select all that apply

Difficulty determining whether foods are spoiled through smell Inability to see expiration dates or mold on food items

What are causes of conduction deafness? Select all that apply

Ear Infection Excess deposition of ear wax

Which is a developmental task of old age as described by Erickson?

Ego integrity despair

The older adult patient reports shortness of breath when cutting grass with a push mower. Which term will the nurse use to document the patient's complaint?

Exertional dyspnea

A patient at the clinic reports that a recent visit to the eye doctor showed an increase in intraocular pressure. The nurse knows that this patient is a risk for which eye disease?

Glaucoma

Which of these roles does the licensed vocation nurse (LVN)/licensed nurse(LPN) play in gerontological nursing settings? select all that apply

Healer Educator Caregiver Advocate Innovator

The nurse is caring for an 88-year-old patient with pneumonia. Which age-related changes in the respiratory system concern the nurse? Select all that apply

Impaired gas exchange decreased tone of respiratory muscles diminished ability to clear respiratory secretions

The nurse is caring for an 77- year-old patient who is complaining of constipation. Which interventions may the nurse suggest to assist the patient to regain normal bowel function? Select all that apply

Increase daily activity level increase the intake of fiber by including more vegetables and whole grains in the diet

which adverse drug effect is associated with decreased serum albumin levels in older patients?

Increased free-drug concentration

The nurse is caring for an older adult patient who was diagnosed with osteoarthritis. Which normal musculoskeletal physiologic changes of aging should the nurse consider when caring for this patient? Select all that apply

Joint range of motion decreases with age Weight-bearing exercises can benefit quality of life Osteoarthritis is the most common form of arthritis

A patient who is aging is being physically assessed by the family practice nurse. The nurse documents that the patient has a curvature of the thoracic spine with a bent-over appearance. Which term can be applied to this curvature of the spine?

Kyphosis

Which are changes in the gastrointestinal tract related to aging? Select all that apply

Loss of taste buds Increased acid reflux Delayed gastric emptying

The nurse is contributing to data collection during the admission of a 75-year-old patient. The patient reports that objects are blurry when he looks directly at them but are clearer in his peripheral vision. Which age-related eye disorder would the nurse suspect?

Macular degeneration

As a result of a lack of evidence about the lives of older adults in the past, myths have developed to fill this gap in knowledge. Which statements about aging are correct?

Most older adults want to be as independent as possible Many older adults have extended family and support networks Cognitive changes are often consequence of illness or medication

Which of these statements are examples of ageism? Select all that apply.

Older adults refuse to change. Older adults are demented and senile. Older adults are nonproductive Older adults do not have sex.

The nurse is caring for a patient who lives in a life lease community facility. The patient diagnosed with cataracts and conductive hearing loss. Which changes is the nurse aware are normal? Select all that apply

Olfactory nerve fibers decrease The lens of the eye becomes more rigid Excessive earwax can contribute to conduction loss

The nurse is caring for a group of older adult patient's at a long-term care facility. Which actions will the nurse take with each patient? Select all that apply.

Practice safety techniques with the patient to avoid trip/fall incidents by reducing clutter Explain what tests/procedures are scheduled for that day in advance so that the patient will know what to expect Discuss the patient's diet with the dietitian to include as many of the patient's favorite foods as possible in the diet

A 55-year-old patient reports to the nurse, "I have been unable to read for the past few months even with my driving glasses on. "However, the patient has normal vision when wearing reading glasses. Which condition does the patient have?

Presbyopia

The nurse is caring for an older adult patient who was diagnosed with rosacea. Which normal integumentary physiologic changes of aging should the nurse consider when caring for this patient? Select all that apply

Pruritus is a common finding. Itching can be a sign of kidney disease. Genetics and sun exposure contribute to wrinkle

The licensed practical nurse (LPN) is repositioning a 78-year-old patient who is immobile. Which condition of the skin and its appendages, if observed by the LPN, should the LPN immediately report to the registered nurse?

Redness on the heel that does not blanch

A nurse at a long-term care facility is caring for a patient who has been diagnosed with Parkinson disease. Which normal neurologic physiologic changes of aging will the nurse consider when caring for this patient? Select all that apply

Reduced number of neurons Changes in temperature

Which changes in real function are evident in a 65-year-old patient? Select all that apply.

Reduction in bladder capacity to one-half Reduction in nephron number by one-half to two-thirds

the nurse is preparing a brochure for older adults in the clinic regarding expected age-related changes to the cardiovascular system, which include the stiffening of the heart muscles. Which consequence of this increased rigidity would the nurse describe in the brochure?

Reduction in coronary perfusion of 35%

The licensed practical nurse (LPN) is contributing to a discharge assessment of an older adult patient who is being treated with amitriptyline. Which nursing intervention takes priority?

Report oversedation

Which lung function parameter increases with age?

Residual Volume

An older adult is diagnosed with atherosclerosis affecting brain function. Which symptom is the patient most likely to display?

Short-term memory loss

A patient in a long-term care facility is reported by the laboratory to have hyperkalemia. Which medication is most likely responsible for this result?

Spironolactone (Aldactone)

Which factors determine cardiac output?

Stroke volume and heart rate

Which agency is responsible for credentialing a registered nurse wanting to work as a geriatric nurse practitioner?

The American Nurses Credentialing Center

Which data does the nurse collect during the functional assessment of a patient? Select all that apply

The financial situation of the patient The activities of daily living that the patient can perform The various community resources available to the patient.

The home health nurse is assessing a patient to determine if it is safe for the patient to continue to live at home alone. Which assessments would lead the nurse to question the safety of the patient living at home alone? Select all that apply.

The patient does not hear the doorbell. The patient is eating spoiled and expired yogurt. The patient uses furniture to guide herself through the home

Which defines aging?

The process of growing older or more mature

The nurse is preparing a community education class on age-related changes to the skin. Which changes would the nurse include? Select all that apply.

Thinness Skin lesions Brown spots Uneven pigmentation

the nurse is assisting a 72-year-old female patient with grooming. The patient looks in the mirror and states, "I am getting so old. Just look at my skin! I used to be beautiful." Which would be the nurse's most appropriate response?

You're upset by the way your skin looks

the nurse is assessing the psychosocial well-being of a 73-year old patient. Which statement, if made by the patient would prompt the nurse to discuss coping strategies with the patient

if i retire, i wont know what do do with myself, so i just keep working

The nurse is caring for a patient who has been experiencing short-term memory loss. The patient asks the nurse for information on how to help with memory problems. Which strategies will help with memory loss? Select all that apply

repetition mnemonics

the nurse is caring for a patient at a long-term care facility who has been diagnosed with diabetes mellitus type 2. Which action would indicate that this patient has accomplished Erickson's state of ego integrity versus despair?

some roles are given up, and new roles are developed