Foundations of Gerontology and Theories of Aging, Prep U: Culture, Spirituality, Etc.

The nurse is assessing a client who is in her first trimester of pregnancy. The client states that her nausea has been problematic at times, but says that she is able to partially control it using ginger supplements. What is the nurse's best response?

- "Take the lowest dose that you can because it can make your blood glucose levels fluctuate." - "Have you spoken with your care provider about the possibility of taking doxylamine?" - "Where did you first learn that ginger might be helpful for treating your nausea?" ** "Have you let your care provider know that you are taking ginger?"

A nurse is discussing sexual activity with older adults in a wellness clinic. Which of the following statements by an individual indicates a need for further exploration?

"My husband has an enlarged prostate."

An older male tells the nurse he sometimes loses his erection before or during sex. He says, "Maybe I'm just too old for sex." What is the nurse's best response?

"Occasional impotence is very normal in later adulthood."

An older female expresses that she wants to avoid hormone replacement therapy (HRT) for menopausal symptoms. What is the nurse's best response?

"Talk to your health care provider before you begin taking any herbal supplements."

An older adult couple tells the nurse they are concerned their sexual desire for one another will be threatened as they continue to age. What is the nurse's best response?

"The general pattern of sexual behavior is basically consistent throughout life."

A client has been prescribed valproic acid for the treatment of bipolar disorder. The client tells the nurse, "I know that vitamin B can help with depressive episodes, so I am going to give that a try." What is the nurse's best response?

** "Be sure to dialogue with your care provider before you start taking vitamin B supplements." - "Unfortunately, it is not safe to take supplements or herbal remedies while you are taking medications." - "Where did you first learn about the possible benefits of vitamin B?" - "Are you hoping that you will eventually be able to replace your medication with supplements?"

A Jehovah's Witness client is admitted after a serious car accident and continues to experience severe anemia after significant blood loss. The family remains adamantly opposed to blood product support. What is the nurse's best intervention?

- Continue to reinforce the need for and benefit of transfusion. - Provide a range of literature to address their religious conflict. - Request a consultation with the hospital chaplaincy department. ** Offer the client alternative treatment options to consider.

A client learns that she is pregnant, and asks the nurse for the names of abortion clinics. The nurse does not believe abortion is moral alternative. What is the most appropriate response by the nurse?

- Remind the client that abortion stops a beating heart. - Encourage the client to wait and think about it. - Tell the client that she will have to ask the health care provider. ** Give the client the available preprinted list of clinics.

The nurse is providing care for a client who is a recent immigrant. What principle should the nurse apply to the client's care?

- The client likely prefers the healthcare team to make decisions around care without involving the client. - The client likely has a limited understanding of health and illness. ** The client's preferences around touch and personal space may differ from the nurse's. - The client may mistrust the nurse's motives.

The nurse suspects that an older client's quality of life has been deteriorating over the last several years. Which chronic health problem most likely has contributed to this client's change in health status?

Arthritis

A gerontological nurse is caring for a client with diabetes who is having difficulty managing the disease due to financial concerns. Which intervention(s) will the nurse include in the care plan? Select all that apply.

Ask open-ended questions to learn more. Teach about low-cost ways to eat healthfully. Refer to social services for support. Counsel about options to lower prescription drug costs.

The nurse is concerned that unlicensed assistive personnel (UAP) engage in ageism. What did the nurse observe to come to this conclusion?

Asked how long the older client has been confused

The nurse plans care for an older client with a history of urinary tract infections. Which intervention should the nurse make a priority for this client?

Assist to void in an upright position

The nurse learns that within the last 6 months an older client has experienced pneumonia, a skin infection, and a urinary tract infection. Which theory of aging might help explain why this client is experiencing an increase infections?

Autoimmune reaction

The nurse should include which important safety tip when teaching an older adult about the effects of decreased sensitivity of baroreceptors?

Avoid relying on thirst to regulate fluid intake

Which stochastic theory of aging describes the possible effect of radiation on the aging process?

Cross-linking theory

Ageism can hinder the older adult from overcoming which developmental task according to Erikson?

Despair

A nurse in the ambulatory clinic assesses a 53-year-old woman who states, "Last night all of a sudden I got really sick, got really hot, and started sweating; then I had chills, and my chest was pounding." Which action by the nurse is priority?

Discuss the client's menstrual cycle with her.

An older adult on a fixed income is close to retiring and often fantasizes about owning a yacht and sailing around the world. This client may likely experience depression based upon the experience of which retirement phase?

Disenchantment

An older male client reports recurrent local genital infections. What is the nurse's most appropriate assessment question?

Do you have a history of diabetes? Diabetes can interfere with sexual function by leading to recurrent local genital infections. Erectile dysfunction is not the concern. Recurrent infections are not signs of heart failure. A change in libido does not directly lead to infection.

An older female client is diagnosed with a cystocele. The nurse should assess for what sign or symptom?

Dribbling urine A cystocele affects the bladder and results in discomfort and dribbling urine. The treatment for a cystocele is surgery.

The nurse assessing an older adult male client with low testosterone levels should be alert for which finding?

Elevated glucose level

The nurse is developing a teaching plan for an older client taking antidepressants. The nurse should include which instruction?

Explain potential changes in sexual function.

A nurse cares for an older adult client whose current hospital admission is prompted by an exacerbation of chronic renal failure. Which action by the nurse will best emphasize the goal of client wellness?

Explore the client's abilities and strengths

The nurse recognizes that which statement is true about older adults?

Functional age describes physical, psychological, and social aspects of aging

When planning a health fair about healthy sexual function for older adults, the nurse should include which recommendations? Select all that apply.

Good nutrition Limited alcohol intake Ample rest Good hygiene

An 68-year-old female tells the nurse she has found a topical product that claims to stop the aging process and eliminate the appearance of wrinkles. What is the nurse's best response?

Help the client critically evaluate the product's claims

When planning a community teaching fair for older adults, the nurse should include information about which most prevalent chronic conditions in older adults? (Select all that apply.)

High blood pressure, varicose veins, DM, Orthopedic impairments

A 65 year old client refuses to participate in a senior citizens' group because all of the people who attend are "old". What characteristics of aging is this client demonstrating?

Identity

The nurse is concerned that a 70-year-old client is aging faster than the chronological age suggests. What should the nurse recommend to this client to help delay the effects of aging? Select all that apply.

Increase eating fresh fruits and vegetables, Take a walk with the neighbor every morning, Attend religious services as desired, Play bridge with the ladies club every week

Which assessment finding is an expected consequence of the normal aging process in industrialized nations?

Increased systolic blood pressure

An older adult's family member expresses concern about her father's increasing difficulty swallowing. What is the nurse's best action?

Instruct her to increase his fluid intake with meals

An older male client states he is satisfied with his life accomplishments. According to Erikson's theory, what developmental task has this client achieved?

Integrity

The nurse knows that which developmental task described by Erikson applies to older adulthood?

Integrity versus Despair

An older adult couple is discussing their concern of the husband not being able to achieve erection. What is an appropriate suggestion for the nurse to offer this couple?

Longer time for foreplay and physical stimulation may be required to achieve erection.

An older client asks how much a diagnostic test will cost before scheduling a time to have it completed. Why should the client's finances be taken into consideration before scheduling the test?

Many older adults are asset rich but cash poor.

An older adult on a fixed income requires a walker and transportation to therapy two days a week after knee replacement surgery. The nurse should help ensure the client has which type of insurance coverage to cover these services?

Medicare Part B

An expensive anti-hypertensive medication is prescribed for an older adult. The gerontological nurse should suggest the client apply for which type of insurance coverage to cover the cost of medication?

Medicare Part D

Which is a true statement regarding healthcare and long-term care spending for older adults?

Most of the medicaid budget is spent on long-term care

The nurse prepares material to teach an older client about prescribed medications. What should the nurse keep in mind when providing these instructions?

Motivation to learn may be reduced.

According to one evolutionary theory of aging, the effects of natural selection decline with age. Which theory does this statement refer to?

Mutation accumulation theory

When reviewing theories of aging, the nurse should recognize which accurate explanation?

No single known factor causes or prevents the aging process

A gerontological nurse is teaching a nursing student about publicly supported programs that benefit older Americans. The nurse knows that the teaching has been effective if the student makes which statement?

Nursing home reform was implemented through the Omnibus Budget Reconciliation Act

A clinic nurse assesses a client who has limited speaking skills with the dominate language. The client's child interprets for the client. Which action by the nurse is most appropriate?

Obtain a professional interpreter.

When orienting a new nurse to gerontological unit, the charge nurse should include which information? (select all that apply)

Older clients demonstrate a variety of personality traits. Many of these clients are satisfied with their lives

When planning a community teaching fair for older adults, the nurse should include information about which most prevalent chronic conditions in older adults? (Select all that apply.)

Orthopedic impairments, High Blood Pressure, Varicose Veins, Diabetes mellitus

The majority of older Americans are living in which setting

Personal Residence

What is the priority safety recommendation the nurse should make for the older adult in regards to changes in the respiratory system?

Pneumococcal vaccination

An older male client reports a recent history of urinary frequency. After collecting a urine specimen, what is the nurse's next action?

Prepare for prostate examination

The home care agency models care delivery after the theory of thriving. Which nursing intervention supports this theory?

Provide information about caregivers to help a client in the home

What is the nurse's best action to assist a client suffering from presbyopia?

Provide more light to see adequately

What is the best nursing action to combat the effects of a less functional hypothalmus in older adults?

Regulate the room temperature

An older client who retired from a position that was held for 45 years plays golf every Wednesday, swims with the "guys" on Tuesdays and Thursdays, and has a "date night" with his spouse every Saturday. Which phase of retirement does the nurse realize this client is demonstrating?

Routine

An older client suffers from erectile dysfunction. The nurse should anticipate what initial treatment?

Sildenafil citrate

A recently retired 65-year old voices concern about her financial well-being. The nurse should tell her she will be receiving which benefit check?

Social Security

Which source of income is the older adult most likely to use to finance daily activities?

Social security

A nurse interviews a centenarian while gathering data for a large study. In the interview, the centenarian says, "You're only as old as you feel; some days I feel like I'm 50". To which definition of aging does this response correspond?

Subjective aging

The nurse is performing a cardiac assessment of an older adult client. Which of the following should the nurse identify as a possible age-related physiologic change?

Systolic Murmur

What is the best nursing action to address the thyroid changes in old age?

Teach the client to monitor caloric intake

The nurse knows that which statement is accurate about the subsets of the older adult population today?

The healthcare challenges of the young-old and old-old groups can vary greatly

The nurse is developing the plan of care for a hospitalized older adult. When is the best time to administer the prescribed diuretic to this client when scheduling around physical activities?

Timed so that peak action of medication occurs after activity

A diabetes nurse is providing care for an older adult client who is a regular client of the hospital's outpatient diabetes clinic. What assessment question most clearly addresses this client's potential for optimal function?

What are some goals that you have maximizing your level of wellness?

An older adult home health client has admitted to the nurse that the client's level of sexual activity with the client's spouse has declined in recent months and become wholly absent over the past several weeks. What assessment should the nurse prioritize in light of this revelation?

client's medication regimen

The nurse should anticipate that which client will require the most assistance with self-care and activities of daily living?

88 year old with orthostatic hypotension

A nurse who provides care to many older adults recognizes the importance of implementing a wellness approach to care. What principle underlies this approach to the health care of older adults?

A holistic approach to caring for older adults can foster their well-being at every stage of life.

An older client's daughter is concerned because her father has disengaged from the mainstream of society. What is the nurse's best response?

What factors have caused you to be concerned?

A nurse is completing an admission assessment. The nurse asks the client about social support systems and the client asks the nurse to explain social support systems. Which statement describes a social support system?

- "It is a source of payment options to aid in the hospital bill of the client." - "It is a health care system with a variety of educators available in the community." - "It is a group of physicians who are available to assist with care needed for the client's family." ** "It is a group of providers at home and in the community that help a client in times of need."

A nurse is discussing an older adult's recent diagnosis of rheumatoid arthritis with a colleague. Which of the nurse's statements reflects an accurate view of the relationship between aging and wellness?

We need to teach the client the rheumatoid arthritis is not part of the aging process and that the client should increase functional activities

A school nurse is called to assess a preadolescent, a newly immigrated Vietnamese person attending a new school. A teacher tells the nurse that the student sits in the back of the class and won't speak when spoken to, although the parents confirmed the student speaks English. Which assessment finding is most likely?

- The student is going through a socialization period. - The student is developing a peer support system. ** The student is experiencing cultural shock. - The student is becoming acculturated to the new school.

The nurse teaches a client with a pain disorder a progressive relaxation exercise. What client statement indicates the goal of progressive relaxation was attained?

- "Everyone here is so nice to me." - "My arm hurts more than ever." ** "My pain is better, and now I feel relaxed." - "I don't really understand why I'm here."

Which questions should the nurse ask when completing a cultural assessment for a new client? Select all that apply.

** "What are some of your health-related beliefs and practices?" - "What is your address?" - "What is your age?" ** "What are your spiritual beliefs?" ** "What are some of your personal values?"

After nsuccessful CPR efforts, the nurse must prepare an Islamic client for the morgue. Which nursing action should the nurse take?

- doing nothing; only the family and close friends may touch the body - providing routine post-mortem care - asking the client's family if they want to perform the ritualistic washing - doing nothing; the Burial Society will perform a ritual cleansing

A nurse is conducting an assessment of a client admitted to the health care facility for cardiac surgery. Which question would be most appropriate for the nurse to ask when assessing the client's spirituality?

** "What gives meaning to your life?" - "Do you consider yourself a spiritual person?" - "What religion do you practice?" - "How often do you go to church?"

An 85-year-old male states he is anxious to get back on the golf course once the weather permits. What is the nurse's best response?

Where is your favorite golf course?

The nurse is setting goals for end-of-life care with a client who states, "I'm not a religious person, but I consider myself a spiritual person." Based on this conversation, what is the best question to ask about the client's spirituality?

** "What are the beliefs that guide your daily decisions?" - "Have you ever practiced a particular spiritual tradition?" - "Are there rituals that you observe during parts of the year?" - "Do you think about things as being right or wrong?"

A client admitted with acute pyelonephritis now reports having a severe migraine, but declines PRN analgesics. What should the nurse discuss with this client? Select all that apply.

** Alternative therapies such as relaxation or music can help. - Short-term use of opioids has a high addiction risk. - Using opioids will prolong the inpatient hospital stay. - The client with pyelonephritis cannot use analgesics. ** Ask the client which migraine treatments are helpful when at home.

The nurse is providing care for a client who was prescribed escitalopram three weeks ago. What statement by the client should be of greatest concern to the nurse?

- "I have read a lot about the possible benefits of acupuncture online, so I think I will try it." - "I know that a lot of people who have depression are vitamin deficient, so I am taking a multivitamin each morning." - "My sister recommended doing a colon cleanse, so I am planning on doing it next weekend." ** "I have started taking St. John's wort because I have read it can help my mood."

A birthing couple informs the nurse that they would like to have the placenta after the baby is born. What is the nurse's best response?

- "Why would you want to do that?" ** "Let me check about how to go about doing this." - "Centers for Disease Control and Prevention policy does not allow the hospital to give the parents the placenta." - "This should be a decision between the physician and couple."

A client with diabetes comes to the clinic for a follow-up visit. During the visit, the client, who is Jewish, tells the nurse that a holiday will be coming up next week that requires the client to fast for the day. The client takes an oral antidiabetic medication daily and checks blood glucose levels twice a day. Which response by the nurse would be most appropriate?

- "You should not fast because it will cause your diabetes to go out of control." - "Take your medication, but check your glucose every 4 hours." ** "Tell me more about what is involved so we can plan for this better." -"Omit your medication on the day that you must fast."

A client is 2 days postoperative of a hip replacement. The prescriber removed the gauze dressing and gave the patient and nurse instructions to keep the site open to air. In the afternoon, the nurse observed the client rubbing an oil on the surgical site. What is likely the client's rationale regarding the application of the complementary oil?

- Antiperspirant will aid with vasoconstriction. - Fish oil has antiviral properties. ** Tea tree oil has antibacterial properties. - Baby oil can assist with smooth skin.

The nurse is providing care for a client who immigrated three months ago. The nurse observes that the client is reluctant to make eye contact when responding to the nurse's questions. What is the nurse's best response?

- Arrange for the client to receive care from a nurse who is from a similar culture. - Avoid making eye contact with the client. - Assess the client for potential culture-bound syndromes. ** Consider the norms around nonverbal communication in the client's culture.

The nurse asks the parent of a terminally ill infant if the parent would like the child to be baptized. The parent becomes upset and asks to speak to the nurse-manager. What is the nurse-manager's best response?

- Ask the on-duty chaplain to talk to the parent. ** Let the parent express the parent's own spiritual beliefs and wishes. - Apologize for the nurse's behavior and assign another nurse to this client. - Explain that the nurse is only trying to determine the parent's wishes.

The obstetrical nurse is caring for a client who is three hours postpartum. The client tells the nurse that nearly a dozen family members will be soon arriving to visit her and her infant. The client assures the nurse that this is the norm in her culture. What is the nurse's best action?

- Encourage the client to assert that the visit would be emotionally and physically tiring. ** Facilitate the visit, unless it is ruled out medically or logistically. - Communicate with a family member, and explain why having more than one visitor at a time is not permitted. - Make contact with a family member, and explain the client's need for rest.

A deceased client is a member of a culture where the family is expected to bathe the body after death. What should the nurse do to support the client and family at this time?

- Explain that facility personnel are responsible for the task of bathing. - Ask the family to observe the nurse bathing the body. ** Provide the needed supplies to the family. - Participate with the family when bathing the body.

The nurse is admitting a hospital client who does not speak English and who is accompanied by the client's school-aged child. The client appears to be in pain, but the nurse is unable to assess the character or history of the client's pain. How should the nurse best communicate with the client?

- Have a hospital interpreter come to the assessment; defer the assessment if none is available. ** Enlist the help of a hospital interpreter; ask the son to translate if none is readily available. - Ask the client's child to describe the client's pain to the best of the client's ability. - Perform as many components of the assessment as possible, and arrange for an older, English-speaking family member to come in.

A client who has been using benzodiazepines for anxiety wants to add an alternative therapy. The nurse suggests biofeedback. How will the nurse best describe biofeedback to the client?

- It is most helpful when used in conjunction with antianxiety medications. ** It is a way to concentrate on the body's response during a stressful situation. - It can balance the positive and negative energies emitted from the anxiety. - It is used to assist with controlling feelings and emotions toward others.

The parent of an Indonesian young adult reports through an interpreter to the nursing supervisor that the staff nurse sometimes shouts at the client. The nurse tells the supervisor that she has not been shouting at the client. What would the supervisor expect to note after observing a care interaction between the staff nurse and the young adult adolescent client?

- Loud music is playing in the room. - There is nurse-client conflict occurring. - The care procedures performed are painful. ** There is a language barrier present.

An alert and oriented adult client who is a Jehovah's Witness refuses a life-saving blood transfusion. The client's partner, who is not a Jehovah's Witness, requests that the client receive the blood. Which is the most appropriate action by the nurse?

- See if the client has an advanced directive prior to making the decision. - Honor the partner's request because refusing the transfusion would be suicidal. - Contact the hospital administrator and take protective custody of the client. ** Respect the client's right to refuse the transfusion.

A diabetic patient is reviewing the hospital menu to order lunch. The client asks the nurse for suggestions for "cold" foods to order. What is the nurse's understanding of why the client asking about suggestions for "cold" foods?

- The client is cold and wants to warm up. ** The client is balancing the disease with cold foods. - The client is warm and wants to cool off. - The client is concerned about the temperature in the room.

The nurse is attending a family meeting where a recent immigrant's treatment plan is being discussed. The client is a retired English teacher and defers to the oldest son when the care team asks the client questions. How should the nurse best interpret the client's action?

- The client is likely emotionally and financially dependent on the son. - The client's actions are most likely the result of elder abuse. ** The client's action may reflect cultural and familial norms. - The care team should explain North American cultural norms about decision making.

An Orthodox Jewish pregnant woman comes to the labor and birth suite with her birth attendant. Her partner is also present in the room. The woman is about to give birth when the nurse observes the partner move to the head of the bed outside the view of the birth. The nurse interprets this action as:

- demonstrating a lack of interest in the birth of the baby. ** reflecting on the couple's religious beliefs and practices. - reflecting the cultural position of the husband as the head of the house. - indicating the husband's anxiety related to the process of labor and birth.

A client with a history of posttraumatic stress is panting and breathing heavily while shouting out some strange words. The nurse reviews the nursing assessment and understands that the client is practicing a form of relaxation called power breathing. The best action for the nurse to take is to:

- monitor the client for respiratory difficulties. ** allow privacy, but check on the client frequently. - contact the physician for a psychiatric consult. - arrange for a sitter so the client is not left alone.

A client has received lunch. The client is served soup with crackers, an apple, and salad. The client uses the nurse call light and asks the nurse to bring a warm beverage. What alternative therapy is the client likely using?

- therapeutic touch - yoga - chiropractic therapy ** traditional Chinese medicine

An 80 year old male whose wife passed away two years ago has a busy schedule that includes golfing, bowling, dining out, and singing in the church choir. What is the nurse's best interpretation of this client's lifestyle?

The client is exhibiting survivor competencies of aging

An older adult has recently begun to display unprecedented lapses in short-term memory. The nurse overhears a colleague reassuring the person by saying, "Try not to worry; it's just a part of growing older." This is an example of which phenomenon?

age attribution

A nurse performs a reflective cultural self-assessment. Which outcome should the nurse expect?

progression from judgmental views of other cultures to recognition of positive attributes