Geri Final chapters 18-28
Which of the following characteristics of RA are unlike those of osteoarthritis (OA)? a. Myalgia and stiffness b. Joint pain that is curable c. Crepitus and instability d. Systemic and symmetrical
d. Systemic and symmetrical
Which are potential results of end-organ damage from chronic hypertension? (Select all that apply.) a. Carotid stenosis b. Diabetes mellitus c. Renal insufficiency d. Coronary artery disease e. Isolated systolic hypertension f. Familial hypercholesterolemia
a. Carotid stenosis c. Renal insufficiency d. Coronary artery disease
An older patient asks a nurse: "I went to my diabetes doctor and everything was stable. The nurse practitioner spent the entire time teaching me about decreasing my risks of heart disease. It seemed odd that she did not focus on teaching me how to better control my diabetes. Do you know why?" The nurse formulates a response based on the understanding that (Select all that apply.) a. promoting cardiovascular health has the potential to minimize the complications of diabetes. b. there is little evidence that demonstrates that the course of diabetes can be altered in an older adult. c. the benefits of better control of blood pressure and lipid levels are seen much quicker than the benefits of better glycemic control. d. older adults are less receptive to teaching about diabetes than they are to teaching about cardiovascular disease. e. diabetes is not a common chronic condition in older adults.
a. promoting cardiovascular health has the potential to minimize the complications of diabetes. c. the benefits of better control of blood pressure and lipid levels are seen much quicker than the benefits of better glycemic control.
Which of the following statements is true about rheumatoid arthritis (RA)? a. RA strikes unilaterally. b. RA affects more men than women. c. RA can affect body systems other than the joints. d. Morning stiffness in RA lasts less than 30 minutes.
c. RA can affect body systems other than the joints.
A nurse plans for the discharge of a 75-year-old patient who has the diagnosis of osteoporosis. Which of these actions would the nurse consider first? a. Avoid stressful situations. b. Schedule an annual dual energy x-ray absorptiometry (DEXA) scan. c. Remove clutter from the floors of the home. d. Encourage consumption of a high-protein diet.
c. Remove clutter from the floors of the home.
Which is the most likely reason that type 2 diabetes mellitus is often difficult to diagnose in older adults? a. Presenting symptoms occur very quickly. b. The disease rarely occurs in older adults. c. The classic symptoms may not be present in older adults. d. There are no recognizable symptoms; it is a "silent killer."
c. The classic symptoms may not be present in older adults.
An older adult is diagnosed with Alzheimer's disease (AD). The nurse knows that this diagnosis is made on the presence of which of the following? (Select all that apply.) a. A decline from a previous level of functioning b. Fluctuation of symptoms over the course of a 24-hour period c. An insidious onset d. A gradual decline in cognitive abilities e. The cognitive changes worsen in the evening hours
a. A decline from a previous level of functioning c. An insidious onset d. A gradual decline in cognitive abilities
Each of the following is a pharmacologic intervention for pain except which one? a. Acupuncture treatments b. Adjuvant therapy c. Lidocaine patch d. Capsaicin
a. Acupuncture treatments
The nurse understands that heart disease risk factors are which of the following? (Select all that apply.) a. Age b. Hypertension c. Diabetes d. Macular degeneration
a. Age b. Hypertension c. Diabetes
The nurse is caring for a patient diagnosed with hyperthyroidism. Which signs and symptoms indicate hyperthyroidism? (Select all that apply.) a. Atrial fibrillation b. Heart failure c. Constipation d. Heat intolerance
a. Atrial fibrillation b. Heart failure c. Constipation
A nurse is teaching an older adult who is experiencing an acute attack of gout. Which of the following should the nurse include in the teaching? a. Avoid foods high in purine. b. Encourage the patient to take in 1 L of fluid daily. c. Consume one glass of red wine daily. d. Recommend that the patient eat 12 to 16 oz of foods high in protein such as red meat.
a. Avoid foods high in purine.
An older woman who has chronic obstructive pulmonary disease (COPD) wants to perform self-care activities. Which instruction should the nurse include in patient teaching to help her achieve this goal? a. Bathe and eat slowly with periodic rest. b. Walk short distances without oxygen. c. Perform all activities of daily living (ADLs) and then rest. d. Bathe right after eating, and then rest.
a. Bathe and eat slowly with periodic rest.
An older woman had hip replacement surgery 1 day ago, and the nurse thinks that the woman also has dementia. Which patient assessment does the nurse use to determine whether this woman is experiencing pain? a. Holds her abdomen tightly b. Has stable vital signs c. Is not verbalizing d. Moves during sleep
a. Holds her abdomen tightly
Which comorbidity commonly associated with type 2 diabetes mellitus enhances the development of the microvascular complications of diabetes mellitus? a. Hyperlipidemia b. Hypothyroidism c. Venous insufficiency d. Chronic constipation
a. Hyperlipidemia
A nurse is educating a group of older adults on the impact of lifestyle changes on hypertension. The nurse includes which of the following in the education? (Select all that apply.) a. Learning how to read and interpret food labels b. The sodium content of commonly consumed foods c. Techniques to incorporate more physical activity into the daily routine d. The actions of calcium channel blocker medications on hypertension e. The importance of adhering to pharmacologic regimens for treatment of hypertension
a. Learning how to read and interpret food labels b. The sodium content of commonly consumed foods c. Techniques to incorporate more physical activity into the daily routine
Which is a healthy practice recommended for a person at risk for osteoporosis? a. Milk and orange juice at breakfast; cheese pizza at lunch; spaghetti served with spinach covered with melted cheese for dinner; and ice cream for dessert b. Long-term estrogen administration as adjunct therapy c. A bisphosphonate medication taken with a snack just before bedtime d. Coffee, raisin bran and milk, and sausage at breakfast; a can of cola and a hot dog on a high-fiber bun at lunch; cocktails before dinner; steak with brown rice, celery, and red wine for dinner
a. Milk and orange juice at breakfast; cheese pizza at lunch; spaghetti served with spinach covered with melted cheese for dinner; and ice cream for dessert
Which assessment is typical for a patient with osteoarthritis (OA)? a. Narrow joint spaces with crepitus b. Effects in symmetrical joints c. Morning stiffness for at least an hour d. Swelling from excess synovial fluid
a. Narrow joint spaces with crepitus
Which of the following statements are true about pain in older adults? (Select all that apply.) a. Pain is not a normal aging process. b. Pain sensitivity decreases with age. c. If patients do not complain, they do not have pain. d. Opioid analgesics are often the best treatment for persistent pain.
a. Pain is not a normal aging process. d. Opioid analgesics are often the best treatment for persistent pain.
A nurse is teaching an older adult who is experiencing an acute attack of gout. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) a. Rest the joint during the acute gout attack. b. Take ASA to relieve pain. c. Increase fluid intake to 2 L/day. d. Avoid foods high in purine. e. Avoid alcoholic beverages.
a. Rest the joint during the acute gout attack. c. Increase fluid intake to 2 L/day. d. Avoid foods high in purine. e. Avoid alcoholic beverages.
Persons with normal age-related sensory changes are likely to have the most difficulty distinguishing which of the following? a. Spoken pairs of phrases such as "she's praised" and "fees raised" b. Orange towel hanging on a beige wall c. "Go" and "to" in lowercase letters in fine print d. Spoken word pairs like "cupful" and "capful"
a. Spoken pairs of phrases such as "she's praised" and "fees raised"
Hyperglycemia is harder to detect in older adults because of which of the following? a. There is a higher tolerance for elevated levels of circulating glucose in older adults. b. Older adults tend to metabolize glucose at a faster rate than younger adults. c. Fingerstick glucose monitoring is inaccurate in older adults. d. The classic signs of elevated glucose levels, polyuria, polyphagia, and polydipsia are rarely present in older adults.
a. There is a higher tolerance for elevated levels of circulating glucose in older adults.
An older man with diabetes mellitus complains to the nurse that his feet feel like they are burning. Which of the following interventions should the nurse recommend to this older adult to reduce his discomfort? a. Wear well-fitting leather shoes. b. Wear knee-high nylon stockings. c. Soak his feet in warm water. d. Apply antifungal powder on his feet.
a. Wear well-fitting leather shoes
An older adult admitted for back surgery asks for opioid pain medication. The nurse knows the patient asks for pain medication 15 minutes before it is due. Which recommendation should the nurse implement? a. Validate the pain with other assessment data. b. Administer the pain medication as requested by the patient. c. Tell the patient that it is too soon for pain medication. d. Teach the patient alternative comfort measures.
b. Administer the pain medication as requested by the patient.
Which of the following interventions should the nurse use when communicating with a hearing impaired older patient? a. Stand beside the patient's chair when speaking. b. Always clearly identify yourself and others with you. c. Exaggerate your voice, depending on the cause of the hearing loss. d. Select colors for paint, furniture, and pictures with rich intensity.
b. Always clearly identify yourself and others with you.
Which population groups are most at risk for developing macular degeneration? (Select all that apply.) a. African American b. Asian American c. Caucasian d. Hispanic
b. Asian American c. Caucasian
An older man who has tinnitus complains to the nurse that it is very annoying. Which should the nurse implement to alleviate the stress he is experiencing from tinnitus? a. Irrigate the bilateral eustachian tubes. b. Assess for modifiable risk factors. c. Propose a hearing aid and a masker. d. Use white noise to override the tinnitus.
b. Assess for modifiable risk factors.
Which conditions are likely to cause an older adult chronic pain? (Select all that apply.) a. Hip replacement b. Bone metastasis c. Hypoproteinemia d. Migraine headache e. Compression fracture f. Postherpetic neuralgia
b. Bone metastasis e. Compression fracture f. Postherpetic neuralgia
An older man comes to the emergency department after falling at home, and he reports that he cannot walk without losing his balance. Which steps should the nurse implement for this patient? a. Arrange to transfer him immediately to the radiology department. b. Determine symptom onset or when he fell at home. c. Organize the reperfusion recombinant tissue plasminogen activator (rt-PA) infusion. d. Perform a comprehensive neurological assessment.
b. Determine symptom onset or when he fell at home.
Which of the following statements is true about diabetes mellitus? a. Type 2 diabetes is the result of the failure of the pancreas to produce insulin. b. Diabetes is diagnosed after two fasting plasma glucose readings over 125 mg/dL. c. Non-insulin-dependent diabetes mellitus is another name for type 1 diabetes. d. The incidence of diabetes mellitus does not increase with age.
b. Diabetes is diagnosed after two fasting plasma glucose readings over 125 mg/dL.
The nurse teaches an older adult who has diabetes mellitus and takes metoprolol (Lopressor) to recognize clinical indicators of hypoglycemia. Which clinical indicators of hypoglycemia does the nurse include in patient teaching as the indicators this man is most likely to detect? (Select all that apply.) a. Shaking b. Dizziness c. Weakness d. Diaphoresis e. Tachycardia f. Impaired vision
b. Dizziness c. Weakness f. Impaired vision
Which of the following are common side effects of Parkinson's disease (PD) and the medications used to treat it? (Select all that apply.) a. Skin irritation b. Dyskinesias c. Dystonia d. Nausea
b. Dyskinesias c. Dystonia
A 58-year-old African American man in good health has a blood pressure at 120/73 mm Hg at his annual physical examination. Which of the following is the best goal for the nurse to use to assist him in maintaining his health and wellness into older age? a. Alter modifiable risk factors. b. Prevent cardiovascular disease. c. Recognize disease in early stage. d. Maintain tight glycemic control.
b. Prevent cardiovascular disease
Which is the best goal when planning nursing care for an older patient with diabetes mellitus? a. Stabilize the serum glucose. b. Prevent disease progression. c. Set walking distance goals. d. Plan for consistent exercise.
b. Prevent disease progression.
Which of the following statements is true about analgesic medications for older adults? a. Opioids are less effective in older patients than in younger patients. b. Stool softeners and laxatives should be used with opioids. c. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) are generally harmless. d. The dose limit for acetaminophen is difficult to reach for older adults.
b. Stool softeners and laxatives should be used with opioids.
Which of the following behavior modifications should the nurse instruct a patient to accomplish to help reduce the risk factors for an occurrence of a stroke? (Select all that apply.) a. Increase the intake of green, leafy vegetables. b. Stop smoking. c. Control blood pressure. d. Increase physical activity.
b. Stop smoking. c. Control blood pressure. d. Increase physical activity
Which of the following is a true statement about joints in older adults? a. Osteoarthritis (OA) is an inflammatory joint disorder. b. Surgical joint replacement can cure OA. c. Joint damage in OA is reversed with medication. d. Very old patients should avoid joint replacement surgery.
b. Surgical joint replacement can cure OA.
A nurse is caring for an older adult with cognitive impairment who recently had hip surgery. The nurse assesses the client for pain. The nurse would suspect that the client is in pain when the client demonstrates which of the following? (Select all that apply.) a. The client ate all of her meals. b. The client pushes caregivers away when they attempt to change the dressing on her hip. c. The client rocks back and forth repetitively when sitting in a chair. d. The client sleeps soundly throughout the night. e. The client cries out repeatedly when anyone approaches her.
b. The client pushes caregivers away when they attempt to change the dressing on her hip. c. The client rocks back and forth repetitively when sitting in a chair. e. The client cries out repeatedly when anyone approaches her.
After completing an admission assessment on a patient who recently had a stroke, the nurse should choose which of the following nursing diagnoses as a priority? a. Risk for injury b. Altered thought process c. Altered cerebral perfusion d. Decreased mobility
c. Altered cerebral perfusion
Which of the following is a true statement about psychotic behavior in older adults? a. Usually, hallucinations in older patients are the result of psychological conflicts. b. Illusion, delusion, and hallucination are different terms for the same phenomenon. c. An older adult with psychotic behavior should be assessed for a variety of causes. d. Regardless of the cause, dissimilar hallucinations are treated with similar therapies.
c. An older adult with psychotic behavior should be assessed for a variety of causes.
The nurse notices that an older female nursing home resident is not eating and that her heart rate is faster than usual. Which should the nurse do to determine if pneumonia is a potential cause of the change in her status? a. Obtain a specimen for aerobic blood cultures. b. Promptly send the resident for a chest x-ray examination. c. Analyze sputum for color, texture, and volume. d. Compare tympanic temperature with the baseline.
c. Analyze sputum for color, texture, and volume.
When teaching a patient about foods that do not increase blood glucose, which should the nurse include? a. White bread b. Baked beans c. Broccoli d. Corn
c. Broccoli
The nurse sees an older woman with osteoarthritis (OA) and a low-grade fever. The patient tells the nurse that her pain is changing; it is worse at night and in her shoulder muscles. Which of the following does the nurse perform to prevent complications of this patient's condition? a. Assess her joints for swelling and redness. b. Obtain blood specimens for blood cultures. c. Direct her to report temporal or scalp pain. d. Tell her to apply moist heat for 20 minutes.
c. Direct her to report temporal or scalp pain.
Which of the following is used to treat the most common cause of impairment to an older person's hearing? a. Hearing aids b. Cochlear implants c. Ear canal irrigation d. Sign language
c. Ear canal irrigation
The nurse plans the care of an older female resident of a nursing home who has experienced a sudden deterioration in visual acuity. Which intervention should the nurse complete first? a. Prevent behavioral and social decline. b. Tell her to hold onto the rails during ambulation. c. Examine her mood and functional status. d. Use problem solving involving the resident.
c. Examine her mood and functional status.
An older nursing home resident reports that her hearing loss is getting worse. What is the first action of the nurse? a. Refer the resident for an evaluation for a hearing aid. b. Raise her voice in when speaking to the resident. c. Examine the resident's ears for cerumen impaction. d. Teach the resident to read lips.
c. Examine the resident's ears for cerumen impaction.
The nurse identifies which risk factors for osteoarthritis (OA)? (Select all that apply.) a. Men b. African Americans c. Old age d. Steroid use
c. Old age d. Steroid use
The nurse prepares an older man who has osteoarthritis (OA) for discharge. Which instruction does the nurse include in patient teaching to maintain safety for this man? a. Take ibuprofen (Motrin) rather than opioid analgesics. b. Increase rest periods to slow disease progression. c. Report joint instability to the health care provider. d. Avoid stretching the affected joint during exercise.
c. Report joint instability to the health care provider.
The nurse assists an older man who has type 2 diabetes mellitus to improve his glucose control. Which of the following instructions does the nurse give to this individual when he plans to walk more than usual in 1 day? a. Omit antidiabetic medication. b. Wear sturdy open-toed shoes. c. Supplement caloric intake. d. Prepare to administer insulin.
c. Supplement caloric intake.
The older adult is at a higher risk for acute psychological pain than a younger adult because older adults a. have many illnesses. b. possess fewer assets. c. experience more loss. d. live with impairments.
c. experience more loss.
Which of the following is a true statement about osteoporosis (OA)? a. OA is indicative of an underlying health problem. b. The most common site for OA fractures is in long bones. c. African American women have the highest risk for OA. d. A high risk of death follows an OA-related fracture.
d. A high risk of death follows an OA-related fracture.
The nurse admits an older man who had abdominal surgery. Admission vital signs are heart rate (pulse) (P), 73 beats/min; respiration rate (R), 20 breaths/min; and blood pressure (BP), 136/84 mm Hg. He is receiving intravenous (IV) fluids but has not requested pain medication since surgery. Seven hours later, his vital signs are P, 98 beats/min; R, 26 breaths/min; and BP, 164/90 mm Hg, and he denies pain. Which intervention should the nurse implement? a. Administer an opioid medication by IV route. b. Check the surgical dressing for bleeding. c. Report the vital signs to the health care provider. d. Ask if he has about discomfort at the surgical site or any other location.
d. Ask if he has about discomfort at the surgical site or any other location.
A home health nurse is completing an admission on a patient who recently experienced a transient ischemic attack (TIA). During the assessment, the patient begins to complain of a severe headache and numbness in his left arm. Which action should the nurse take next? a. Instruct the patient to take Tylenol. b. Ask whether patient suffers from migraine headaches. c. Reschedule the visit. d. Call 9-1-1.
d. Call 9-1-1.
The nurse administers an opioid analgesic to an older male postoperative patient in the surgical unit. Which is the most important intervention for the nurse to implement before leaving the patient's room? a. Place all side rails up. b. Position the patient comfortably. c. Offer toileting and a sip of water. d. Instruct him to ask for help before getting up.
d. Instruct him to ask for help before getting up.
The exercise tolerance of an older adult is impaired after a myocardial infarction because of a low ejection fraction. Rank the following interventions that the nurse should use to assist this individual to restore baseline functional status in order of importance, beginning with the first intervention. a. Provide a well-balanced diet. b. Assist with range of motion. c. Sit in chair four times daily. d. Keep arterial oxygen saturation (SaO2) above 95%.
d. Keep arterial oxygen saturation (SaO2) above 95%. a. Provide a well-balanced diet. b. Assist with range of motion. c. Sit in chair four times daily.
Which of the following diseases affects the eyesight of an older adult by damaging the central part of the retina? a. Glaucoma b. Presbyopia c. Cataract d. Macular degeneration
d. Macular degeneration
Which of the following statements is true about cardiopulmonary disease in older adults? a. Chronic obstructive pulmonary disease (COPD) can be reversed with proper treatment. b. Chest radiographic studies are a reliable indicator of whether pneumonia is present in an older patient. c. Persons older than 65 years should receive Pneumovax annually. d. Mouth hygiene is essential to prevent and treat pneumonia.
d. Mouth hygiene is essential to prevent and treat pneumonia.
An older adult arrives at the emergency department with a probable diagnosis of a hemorrhagic stroke. The nurse understands, based on the patient's age, that the most likely cause is which one of the following? a. Intracranial hemorrhage b. Decreased cardiac output c. Thrombosis d. Uncontrolled hypertension
d. Uncontrolled hypertension
An older, non-Hispanic white man has a fasting blood sugar level above 130 mg/dL. Which patient assessment does the nurse use to confirm a high risk for diabetes mellitus in this man? a. 68 years of age b. 120/80 mm Hg c. Palpable peripheral pulses d. Total cholesterol 198 mg/dL
a. 68 years of age
Which condition is a chronic obstructive pulmonary disease (COPD)? a. Bronchial asthma b. Histoplasmosis c. Bacterial pneumonia d. Mycobacterium tuberculosis
a. Bronchial asthma
An older man who has heart failure (HF) complains of increasing dyspnea over 2 days. Which of the following should the nurse assess to help determine whether the patient has adhered to his therapy? (Select all that apply.) a. Check for peripheral edema. b. Ask about his bowel pattern. c. Auscultate the lungs bilaterally. d. Compare his weight with baseline. e. Determine coughing frequency. f. Assess his diet over the past 48 hours.
a. Check for peripheral edema. c. Auscultate the lungs bilaterally. d. Compare his weight with baseline. f. Assess his diet over the past 48 hours.
The nurse is educating an older woman on foods high in calcium. Which foods should the nurse include? (Select all that apply.) a. Chinese cabbage b. Soy milk c. Cheese pizza d. Whole wheat
a. Chinese cabbage b. Soy milk c. Cheese pizza
Which of the following is the most important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults who have HF? a. Control fluid balance. b. Control blood pressure. c. Prevent deconditioning. d. Maintain patient safety.
a. Control fluid balance.
The nurse recognizes which of the following signs and symptoms as an indication of hypothyroidism? (Select all that apply.) a. Decline in cognitive function b. Decrease in functional status c. Decrease in thyroid-stimulating hormone (TSH) and thyroxine (T4) d. Heat intolerance
a. Decline in cognitive function b. Decrease in functional status d. Heat intolerance
Which of the following statements is true about dysarthria? a. Does not affect intelligence b. Stems from severe rheumatoid arthritis c. Physical therapy can be beneficial d. Can affect the balance
a. Does not affect intelligence
When preparing a patient teaching session on diabetic retinopathy, the nurse should include which interventions when discussing treatments for slowing the progression of the disease? (Select all that apply.) a. Glucose control b. Blood pressure control c. Laser therapy d. Cornea transplant
a. Glucose control b. Blood pressure control c. Laser therapy
A nurse is involved in primary prevention activities related to the promotion of respiratory health. The nurse is involved in which of the following activities? (Select all that apply.) a. Organizing an influenza vaccination clinic b. Promoting a smoking cessation program in the community c. Referring individuals with respiratory disease to the pulmonology clinic at the hospital d. Visiting a congressman representative to advocate for legislation on clean air e. Teaching individuals with chronic obstructive pulmonary disease measures to maximize lung function
a. Organizing an influenza vaccination clinic b. Promoting a smoking cessation program in the community d. Visiting a congressman representative to advocate for legislation on clean air
An older aphasic client has severe osteoarthritis, bilateral contractures of the lower extremities, and a stage IV pressure ulcer. The nurse practitioner prescribes analgesic medications to be administered around the clock, with as-needed doses to be administered as appropriate. What observation by the nurse would indicate that the pain regimen is effective? (Select all that apply.) a. The client slept throughout the night. b. The client winces only when turned and repositioned. c. The client slept during dressing change. d. The client cooperative during morning care. e. The client ate 80% of breakfast, 70% of lunch, and 100% of dinner.
a. The client slept throughout the night. c. The client slept during dressing change. d. The client cooperative during morning care. e. The client ate 80% of breakfast, 70% of lunch, and 100% of dinner.
The nurse should instruct a patient on which of the following modifiable risk factors for essential hypertension? (Select all that apply.) a. Tobacco use b. Alcohol c. Stress management d. Adequate rest
a. Tobacco use b. Alcohol c. Stress management
A 77-year-old client being treated for glaucoma asks the nurse what causes glaucoma. The nurse bases the response on the knowledge that the increase in intraocular pressure is a result of a. the exact etiology of glaucoma is variable and often unknown. b. spasms of the orbicular muscle. c. changes to the suspensory ligaments, ciliary muscles, and parasympathetic nerves. d. bits of broken coalesced vitreous from the peripheral or central part of the retina.
a. the exact etiology of glaucoma is variable and often unknown.
Which of the following is a true statement about heart disease in older adults? a. Myocardial infarction (MI) has many of the same symptoms in older patients as in middle-aged persons. b. Both excessive urination at night and decreased urination can be signs of heart failure (HF). c. Any exertion on the part of an older adult patient with heart disease can bring on another heart attack. d. A person with HF is likely to have trouble breathing, except when lying down.
b. Both excessive urination at night and decreased urination can be signs of heart failure (HF).
A new nurse in a long-term care facility is caring for a patient with Parkinson's disease (PD). The nurse should note which one of the following actions related to PD that is observed during the assessment? a. Tremors during sleep b. Cogwheel rigidity c. Frequent blinking d. Fast movements
b. Cogwheel rigidity
An older woman recently lost her brother, provides care for her husband who has health needs, and must move to a new location after 35 years in the same home. When she comes to the primary care facility with clinical indicators of influenza, the nurse recognizes which of the following? a. She is exhibiting attention-seeking behaviors. b. Crises and stressors can impair physical health. c. Her greatest need is respite care for her husband. d. Crisis leads to a lower functional status for the victim.
b. Crises and stressors can impair physical health.
The older adult who has type 2 diabetes mellitus has a sensory impairment and unstable blood sugar levels. Which of the following alterations in sensory function does the nurse address in the plan of care for stabilizing the blood sugar? a. Requires reading glasses at 2.0 strength b. Has difficulty hearing in crowded rooms c. Enjoys spicy food more than bland food d. Awakens with periodic left-foot numbness
b. Has difficulty hearing in crowded rooms
A nurse measures an older adult's blood pressure on the right arm and notes a reading of 150/100 mm Hg. The nurse waits 5 minutes and measures the blood pressure again in the right arm and obtains a reading of 152/100 mm Hg. What is the next action by the nurse? a. Immediately contact the medical provider. b. Measure the blood pressure in the left arm. c. Measure the blood pressure in sitting and standing positions. d. Document the findings in the medical record; elevated blood pressures are normal in older adults.
b. Measure the blood pressure in the left arm.
A nursing student is preparing a presentation on arthritis. The nursing student knows that differences between osteoarthritis (OA) and rheumatoid arthritis (RA) include (Select all that apply.) a. both OA and RA have an acute onset in older adults. b. OA is a localized process, but RA may be systemic. c. OA usually impacts distal interphalangeal joints, but RA impacts proximal interphalangeal joints. d. both OA and RA present with joint stiffness lasting 20 to 30 minutes after rest. e. initial treatment of both OA and RA is usually nonpharmacologic using heat or exercise.
b. OA is a localized process, but RA may be systemic. c. OA usually impacts distal interphalangeal joints, but RA impacts proximal interphalangeal joints.
The nurse uses comfort measures to enhance an older adult's pharmacologic pain management. Which of the following would be most helpful for the nurse to use to identify the relationships between the comfort measures, activity, and pharmacotherapy, and the older adult's pain level? a. Older adult's self-report b. Older adult's pain diary c. Faces Pain Scale-revised (FPS-R) d. Pain medication frequency
b. Older adult's pain diary
An older adult with type 2 diabetes who is being treated with insulin wants to increase his activity level and begin a walking program. What recommendations should the nurse provide to this patient? a. A walking program is not recommended for an older adult with diabetes. b. The walking regimen needs to be done on a regularly scheduled basis. c. Regular exercise should not exceed 30 minutes three times a week. d. Insulin can most probably be discontinued if the individual adheres to the walking program.
b. The walking regimen needs to be done on a regularly scheduled basis.
After an acute exacerbation of chronic obstructive pulmonary disease (COPD), the nurse prepares an older adult for discharge to home. Which is the most important patient teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD? a. Ease breathing by sitting upright. b. Use low-flow oxygen for dyspnea. c. Avoid sick people and wash hands. d. Eat nutrient- and calorie-dense foods.
c. Avoid sick people and wash hands.
An older man in a cardiac rehabilitation exercise class refuses to participate in the cool-down phase of the activity; consequently, 2 minutes later, he passes out but quickly regains consciousness. Which instruction does the nurse include in patient teaching to reinforce the importance of cooling down after exercising to this man? a. Cardiac output diminishes with age. b. Mobility capacity decreases with age. c. Baroreceptor function diminishes with age. d. Sensory perception diminishes with age.
c. Baroreceptor function diminishes with age.
Which of the following nursing interventions are suitable for a patient who has gout? a. Nonsteroidal anti-inflammatory drugs (NSAIDs) b. Liquid paraffin hand baths c. Colchicine (Colsalide) by mouth d. Hyaluronic acid injections
c. Colchicine (Colsalide) by mouth
Which classic sign of an acute myocardial infarction (AMI) can be absent in an older man with an AMI? a. Vague complaints b. Epigastric burning c. Crushing chest pain d. Dyspnea and fatigue
c. Crushing chest pain
The nurse recognized which of the following as symptoms of wet age-related macular degeneration (AMD)? (Select all that apply.) a. Rarely causes severe visual impairment b. Yellow deposits under the retina c. Decrease in central vision d. Visual distortion
c. Decrease in central vision d. Visual distortion
The nurse in a rehabilitation center is caring for a patient who has new-onset stroke with right-side hemiparesis. Which intervention should the nurse implement when caring for this patient? a. Orders a two-person assist with a transfer b. May need to incorporate repetition c. Gives the patient a dry erase board d. Raises all four side rails
c. Gives the patient a dry erase board
which laboratory results are goals for reducing a person's risk for diabetes and heart disease? a. Triglyceride value greater than 150 mg/dL b. Cholesterol value 250 mg/dL c. High-density lipoprotein (HDL) level greater than 40 mg/dL d. Fasting blood glucose value less than 150 mg/dL
c. High-density lipoprotein (HDL) level greater than 40 mg/dL
A nurse is caring for an older adult who is diagnosed with type 2 diabetes. The patient is prescribed oral medication for diabetes. The nurse can expect that which of the following medications is prescribed as a first line therapy? a. Insulin b. Sulfonureas c. Metformin d. Chlorpropamide
c. Metformin
An older client who was recently admitted to the subacute setting after having a knee replacement, is very anxious and refuses to get out of bed, stating that it is too painful. Which intervention will the nurse implement? a. Share with the patient that it's important to get out of bed and that there is pain medication available if it does hurt. b. Use the Hoyer lift to get her out of bed so that the knee will not experience much movement and so there will be little pain. c. Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed. d. Allow the patient to remain in bed but share that getting up will be required at least twice a day starting the next morning.
c. Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed.
When educating a client on the use of an adjuvant medication, which statement best demonstrates the nurse's understanding of this therapy? a. "These medications are used instead of opioids to decrease the likelihood of addiction." b. "Adjuvant medications are prescribed because they seldom cause any significant side effects." c. "These types of medications are used to eliminate the side effects of opioid medications." d. "These drugs are used in combination with analgesics to increase the effect of the analgesics."
d. "These drugs are used in combination with analgesics to increase the effect of the analgesics."
Compared with acute pain, which of the following statements is true of persistent pain? a. Leads to significantly altered vital signs b. Is usually described as a burning pain c. Is generally gone within 4 months d. Can bring about long-term changes in lifestyle
d. Can bring about long-term changes in lifestyle
The nurse is caring for a patient who has had a stroke. The nurse is concerned the patient will develop contractures. Which intervention should the nurse implement? a. Use tennis shoes while in bed. b. Turn the patient onto the affected side, resting on the shoulder. c. Use paraffin wax for hand soaks. d. Conduct passive range-of-motion movements to the affected extremities.
d. Conduct passive range-of-motion movements to the affected extremities.
An older woman seeks advice from the nurse about preventing further bone loss after being diagnosed with osteopenia. To achieve the woman's goal, which of the following patient teachings should the nurse provide to enhance the activity of the osteoblasts? a. Limit sodium intake. b. Refrain from alcohol use. c. Eat high-fiber foods. d. Exercise with weights.
d. Exercise with weights.
An older Hispanic man states that he is not having pain, but he had knee replacement surgery 2 days ago. Which is the best pain assessment tool as recommended by the Hartford Institute for Geriatric Nursing (HIGN) from "Try This" for the nurse to apply for this man? a. Numeric Rating Scale b. Verbal Descriptor Scale c. Iowa Pain Thermometer d. Faces Pain Scale-revised (FPS-R)
d. Faces Pain Scale-revised (FPS-R)
Which of the following statements is true about Parkinson's disease (PD)? a. Drinking large amounts of alcohol can relieve symptoms of essential tremor. b. Motor tremors and slow movement accompany severe cognitive impairment. c. Lewy body dementia (LBD) is the most common form of dementia. d. Older adults taking levodopa-carbidopa (Sinemet) must take it on an empty stomach.
d. Older adults taking levodopa-carbidopa (Sinemet) must take it on an empty stomach.
Which of the following pain sensations are associated with neuropathic pain? (Select all that apply.) a. Infection b. Obstruction c. Inflammation d. Postamputation
d. Postamputation
An older adult complains about experiencing dry eyes daily. Which of the following should the nurse assess to help determine the cause of the patient's complaint? a. Vitamin B deficiency b. Use of a humidifier at home c. History of diabetes mellitus d. Prescription antihistamine use
d. Prescription antihistamine use
After living with osteoporosis for 2 years, an older woman's bone density scan shows no improvement, despite consistent bisphosphonate therapy. Which intervention should the nurse implement to reduce bone loss for this older adult? a. Add Tai Chi or yoga exercises. b. Instruct her to drink fortified milk. c. Increase weight-bearing exercises. d. Review her daily nutritional habits.
d. Review her daily nutritional habits.
Which of the following statements is true about the mental health of older adults? a. Nurses should discourage denial and regression so older adults can directly face underlying causes of anxiety. b. Anxiety is easily distinguished from depression, dementia, and the effects of disease or medication. c. Compulsive rituals surrounding toileting and sleep are signs of a serious mental disorder. d. The nurse avoids antianxiety medications without an assessment for factors associated with anxiety.
d. The nurse avoids antianxiety medications without an assessment for factors associated with anxiety.
A medical illustration shows a man with the blunt end of a tuning fork pressed to the center of his forehead. The man is being tested for which of the following? a. Sensorineural hearing loss b. Presbycusis c. Tinnitus d. Unilateral conductive hearing loss
d. Unilateral conductive hearing loss
An older female resident lowers her voice and tells the nurse that another female resident is looking at her behind her back and is going to make her move tonight with a male staff member. Which ideas should the nurse include in the response to this individual? a. The staff receives training in ethics. b. Validate the woman's impression. c. Avoid suspicious, paranoid thinking. d. Use the call bell if she becomes frightened.
d. Use the call bell if she becomes frightened.
Which of the following is a true statement about heart disease in older men and women? a. More women than men die from MIs. b. Cardiac care for men and women is equally aggressive. c. Cardiac medications have been tested on men and women equally. d. Women generally receive less aggressive treatment than men do.
d. Women generally receive less aggressive treatment than men do.
An older patient is diagnosed with sensorineural hearing loss. The nurse knows that causes of sensorineural hearing loss include (Select all that apply.) a. tumors of the middle ear. b. cerumen impaction. c. infections of the external and middle ear. d. age-related hearing impairment. e. excessive and loud noise.
d. age-related hearing impairment. e. excessive and loud noise.
