Gero Exam 3
You are taking care of a female older adult client with a loss of height and kyphosis. She is also postmenopausal. Which one of the following diagnostic tools would you order?
-Dual-energy x-ray absorptiometry (DEXA) scan
As a nurse, you understand that several specific types of disorders fall under the umbrella of COPD. After assessing an older adult client who has been diagnosed with COPD, you note that his skin color is pink and that he has little sputum production. As a result, you determine that he has which one of the following disorders?
-Emphysema
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?
-Examine her mood and functional status
Your client has been complaining of headaches, poor vision in dim lighting, sensitivity to glare, and impaired peripheral vision, and he has a fixed and dilated pupil. He probably has which one of the following disorders?
-Glaucoma
An older man comes to a primary care setting, and his reason for seeking health care is to get a prescription for sildenafil (Viagra). Which of the following lab reports can help explain why this individual needs sildenafil?
-Glycosylated hemoglobin (Hgb A1c) over 8%
When an older adult client complains of itching and pain and several days later shows you a rash, you realize she has what?
-Herpes zoster
You realize that an older adult client is having a TIA when what happens?
-His symptoms begin to resolve within minutes
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?
-Holds abdomen tightly
Diminished tear production that occurs with age is the definition of what?
-Keratoconjunctivitis sclera
Which is a healthy practice recommended for a person at risk for OA?
-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 of the following is a true statement about tb in older adults?
-Older persons, particularly those in nursing homes, are at risk for tb
Your client has a history of arthritis. After assessing her condition and finding stiffness wth inactivity, pain relieved by rest, and crepitus, you realize she has which type of arthritis?
-Osteoarthritis (OA)
As a nurse, you realize the symptoms that normally occur in younger adults are often absent in older adults. When visiting an older adult client, you note that he has been falling, has some signs of confusion, is anorexic, and has rapid pulse and respirations rates. You realize that immediate treatment must be instituted for which one of the following conditions?
-Pneumonia
Which of the following describes the nurse's role for an older patient with a chronic illness?
-Provide care to help the patient live at the optimal level of health and wellness
What is an important consideration about the skin go an older adult person?
-Skin becomes more vulnerable to damage
A nurse will be conducting an educational session on preventing skin cancer at a local senior citizens center. Which should the nurse include in the session?
-Squamous cell cancer may appear similar to a wart.
The best gerontological nursing care is that in which:
-The key person in the assessment of pain is the nurse
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?
-Unilateral conductive hearing loss
An older patient complains of dry skin and asks for advice. What advice should the nurse offer for improving dry skin?
-Use tepid bath water
Myxedema can be described as what?
-a serious complication of untreated hypothyroidism in the older adult
Which of the following interventions should the nurse use when communicating with a hearing impaired older patient.
-always clearly identify yourself and others with you
the overall temperature in your unit is 62 degrees F during the evening shift. In documenting this concern to the administration, which factor is the most important for the health and well-being of older adults?
-an ambient temp of 62 degrees F is unsuitable for older people because they have impaired thermoregulation
Older persons with HTN have a higher risk for all the following events except what? A) Acute renal insufficiency B) Atrial fibrillation C) Heart failure D) Myocardial Infarction
A) Acute renal insufficiency
Which of the following is a true statement about impaired skin integrity? A) Stage III pressure ulcer cannot regress to stage II because the subcutaneous tissues regenerate B) Stasis ulcer is another term for pressure ulcer C) Muscle and fat cannot regenerate D) Weight reduction is recommended to help prevent pressure ulcers
C) Muscle and fat cannot regenerate
Which of the following is a true statement about assistive devices to aid older adults with impaired mobility? A) A walker can be used when climbing the stairs b) Cane tips should be smooth C) Older adults save money by adapting assistive devices from their friends D) A cane is most useful for unilateral disabilities but not bilateral problems
D) A cane is most useful for unilateral disabilities but not bilateral problems
Which of the following statements is true about RA? A) Strikes unilaterally B) Affects more men than women C) Can affect body systems other than the joints D) Glucosamine can be helpful for patients in the first 2 years of RA
-C) can affect body systems other than the joints
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?
-Call 911
OLDCART Pain scale
-Onset -Location -Duration -Characteristics -Aggravating Factors -Relieving Factors -Treatment
In assessing an older adult client, you notice symptoms that include bradykinesia, a reduction in facial muscle movement, and pin-rolling. You realize that this client possible has what?
-Parkinson disease
The nurse determines that an older adult who has chronic bronchitis is at high risk for falls, but he repeatedly tries to ambulate without assistance. Which alternative measure to restraints is contraindicated for this older adult?
-Place a concave mattress on the bed
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?
-Prescription antihistamine use
chronic illness
-a condition that lasts 1 year or longer and requires ongoing medical attention and/or limits activities of daily living
adjuvant
-a drug that has a primary use other than pain but also is used to enhance the effects of traditional pain medication
Verbal apraxia
-a motor speech disorder that affects the ability to plan and sequence voluntary muscle movement
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?
-analyze sputum for color, texture, and volume
types of drugs that are effective adjuvants
-anticonvulsants- Neurontin -SSRIs (cymbalta and Effexor)
After an acute exacerbation of 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?
-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?
-baroreceptor function diminishes with age
An older woman who has COPD wants to perform self-care activities. Which instruction should the nurse include in patient teaching to help her achieve this goal?
-bathe and eat slowly with periodic rest
An older woman has severe ischemic heart disease, hypertension, and low cardiac output. Which medication does the nurse administer to counteract the neurohormonal activation of this patient's cardiovascular status?
-beta-adrenegeric blocker
lab results that should be maintained in a diabetic patient
-bp < or + 130/80 -cholesterol <200 -LDL< 100 -HDL >40 -triglycerides <150 -fasting bg <126
An older female patient is diagnosed with a chronic illness. Which of the following principles should the nurse apply when answering her questions?
-chronic illness is unending and coping can be influenced by the perception of uncertainty
A new nurse in a long-term care facility is caring for a patient with PD. The nurse should note which one of the following actions related to PD that is observed during the assessment?
-cogwheel rigidity
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?
-conduct passive ROM movements to the affected extremities
Which classic sign of an acute MI can be absent in an older man?
-crushing chest pain
what medications should not be used with geriatric patients?
-demerol -talwin -methadone
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?
-determine symptom onset or when he fell at home
An older woman who receives intravenous (IV) fluids is making wide gesticulations with her arms and loudly insulting the nursing staff. Which intervention should the nurse implement to maintain safe, effective nursing care initially?
-determine the patient's needs
The nurse sees an older woman with 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?
-direct her to report temporal or scalp pain
what are the influences of chronic illness?
-education -income -gender -ethnicity
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?
-exercise with weights
lipofuscin
-fatty brown pigment found in the tissues related to aging
diabetes, dementia, parkinson's disease, stroke, and vitamin B deficiencies may cause neurological damage leading to what?
-gait disturbances
You realize your client has suffered a hemorrhagic stroke when or because of what?
-he is complaining of an explosive, severe headache with no other neurological manifestations
An older man who has osteoarthritis (OA) tells the nurse that he has experienced fatigue for the past 2 weeks. Which nursing intervention should the nurse implement to help him manage his fatigue?
-help him plan exercise and rest
Which laboratory results are goals for reducing a person's risk for diabetes and heart disease?
-high-density lipoprotein (HDL) over 40 mg/d
Which co-morbidity commonly associated with type 2 diabetes mellitus enhances the development of the microvascular complications of diabetes mellitus?
-hyperlipidemia
Over 50% of the population ages 65 and older suffers from which one of the following chronic health conditions?
-hypertension
The nurse cares for an older man who has a malignant melanoma. Which intervention should the nurse implement for this man to prevent a recurrence or advancement of this condition in the future?
-instruct him to wear sun-protective clothing and a hat at all times
An older woman has severe osteoporosis in the long bones, impaired mobility, and chronic pain. Which acute illness or condition is this woman most likely to experience as a result of osteoporosis?
-intertrochanteric fracture
An older adult who has OA receives a prescription for alendronate (Fosamax). Which instruction should the nurse include in patient teaching?
-is available for oral use
Which of the following statements is true about cardiopulmonary disease in older adults? A) COPD can be relieved 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 should receive pneumovax annually D) mouth hygiene is essential to prevent and treat pneumonia
-mouth hygiene is essential to prevent and treat pneumonia
Which assessment is typical for a patient with OA?
-narrow joint spaces with crepitus
glaucoma
-natural fluids of the eye are blocked by ciliary muscle rigidity -pressure builds and damage to the optic nerve occurs -more common unilaterally
funduscopy
-opthalmoscopic examination of the fundus of the eye
Nonfluent aphasia
-people can usually understand others but speak very slowly and use a minimal number of words
An African-American 58-year-old 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?
-prevent CVD
The nurse prepares an older man who has OA for discharge. Which instruction does the nurse include in patient teaching to maintain safety for this man?
-report joint instability to the health care provider
After living with OA 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?
-review her daily nutritional habits
The most common chronic condition for all ages is what?
-sinusitis
what 2 things, if the older adult patient is on them, makes them more susceptible to hypoglycemia
-sliding scale insulin -glipizide (sulfonureas)
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 one day?
-supplement caloric intake
titration
-the adjustment of the dosage of a given medication until the desired effect is produced
equianalgesic
-the dosage and route administration of one drug that produces approximately the same degree of effect as the dosage of another drug
tonometry
-the procedure used by eye care professionals to determine the ICP of the eye
Fluent aphasia
-the result of a lesion in the part of the brain adjacent to the primary auditory cortex
Which nursing intervention is most likely to prevent the creation of an environment conducive to fungal growth?
-use mild skin cleansing agents and blot dry
NSAIDs in patients over 75
-use with extreme caution
Trajectory Model of Chronic Illness
-views chronic illness from a life course perspective and as an integral part of lives, not as a single event
Shifting Perspectives Model of Chronic Illness
-views living with chronic illness as ongoing and focusing on the emotional, spiritual, and social aspects of life
Which of the following is a true statement about heart disease in older men and women?
-women generally receive less aggressive treatment than men do
drusen
-yellow deposits under the retina, often found in people over 60
Which condition is a COPD? A) Bronchial asthma B) Bacterial pneumonia C) Histoplasmosis D) Tuberculosis
A) Bronchial asthma
with which one of the following theoretical frameworks is living with a chronic illness viewed as a progression of phases after a predictable trajectory? A) Chronic Illness Trajectory Model B) Return to Wellness Perspective Model C) The Shifting Perspectives Model of Chronic Illness D) Dual Kingdom Model
A) Chronic Illness Trajectory Model
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
Which of the following is a true statement about Medicare for older adults? A) Eighty percent of Medicare's annual expenditures are for individuals with chronic illnesses. B) Medicare enrollees spend under $1500 annually for out-of-pocket expenses related to chronic illnesses. C) Complementary and alternative medicines (CAM) are not covered by Medicare. D) Medicare covers care for those who have trouble with activities of daily living.
A) Eighty percent of Medicare's annual expenditures are for individuals with chronic illnesses.
The nurse plans care to protect the skin covering an older adults greater trochanter. Which of the following interventions is the nurses priority when the older adult is positioned on the side? A) Implement a turning schedule. B) Place a cushion between the knees. C) Keep the skin clean and dry. D) Use the Sims position.
A) Implement a turning schedule
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
After working with older adults, you know that the following skin problems are common: (Select all that apply) A) Xerosis B) Pruritus C) Seborrheic keratosis D) Pressure ulcers E) Eschar F) Hyperemia
A) Xerosis B) Pruritus C) Seborrheic keratosis
Acute illness is to chronic illness as to which of the following comparisons? A) an ED is to a nursing home B) A hospital staff nurse is to an NP C) Health insurance is to medicare for older adults D) Inpatient surgical care is to outpatient medical care
A) an ED is to a nursing home
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) Prevent deconditioning C) control blood pressure D) Maintain patient safety
A) control fluid balance
Persons with normal age-related sensory changes are likely to have the most difficulty distinguishing which of the following? A) Spoken pairs of phrases like "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 like "she's praised" and fees raised
Which of the following statements is the most suitable for establishing goals when teaching an older adult with a chronic illness about potential changes in the health maintenance regimen? A)Management of the patient's chronic disease rests on the patient and the caregiver; therefore the goals should be collaboratively set. B) The patient will be able to make needed changes in his or her life if the nurse provides accurate, written instructions. C) Psychological functioning is usually impaired only to a small extent in a patient with a chronic illness. D) The patient's values, culture, and beliefs will have little to do with the types of changes he or she will be able to make.
A)Management of the patient's chronic disease rests on the patient and the caregiver; therefore the goals should be collaboratively set.
An OA-related fall necessitated hip replacement surgery for an older woman who is entering a rehabilitation facility. Which of the following is the nurse's priority goal during this woman's rehabilitation? A) Incorporate whole grains into her diet. B) Recapture preoperative mobility status. C) Keep the surgical wound clean and dry. D) Tell her to take two steps into the walker.
B) Recapture preoperative mobility status.
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 bp D) Increase physical Activity
B) Stop smoking C) Control bp D) increase physical activity
Which of the following is a true statement about joints in older adults? A) 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
The nurse is caring for a patient diagnosed with PD. Which tool should the nurse use to gather information from the patient's perspective? A) The Geriatric Depression Tool B) The Sickness Impact Profile (SIP) C) The Mini-Mental State Exam- 2nd edition D) The Montreal Cognitive Assessment Tool
B) The Sickness Impact Profile (SIP)
which of the following statements is true about Parkinson disease? 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 rasagiline (Azilect) must avoid eating foods containing tyramine.
D) Older adults taking rasagiline (Azilect) must avoid eating foods containing tyramine.
Which of the following characteristics of RA are unlike those of OA? A) Myalgia and stiffness B) Crepitus and instability C) Joint pain that is curable D) Systemic and symmetrical
D) Systemic and symmetrical
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) Thrombosis C) Decreased Cardiac Output D) Uncontrolled hypertension
D) Uncontrolled hypertension
After assessing the older man in his bed, the nurse determines that he is at high risk for falls. The nurse leaves the room to get a fall risk sign and returns to find him on the floor pleading for help. Which of the following was the most important intervention the nurse should have implemented to prevent this event? A) Call for someone to bring the sign. B) Show the older man how to use the call bell. C) Provide a urinal and drinking water D) Instruct the patient to call for help.
D) instruct the patient to call for help
what is hypoglycemia?
-BG less than 60
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 2x the strength B) Has difficulty hearing in crowded rooms C) Enjoys spicy food more than bland food D) Awakens with periodic left-food numbness
B) Has difficulty hearing in crowded rooms
After completing an admission assessment on a patient who recently suffered a stroke, the nurse should choose which of the following nursing diagnoses as a priority? A) risk for injury b) altered cerebral perfusion C) altered thought process D) decreased mobility
B) Altered cerebral perfusion
When teaching a patient about foods that do not increase blood glucose, which should the nurse include? A) White bread B) Broccoli C) Baked beans D) Corn
B) Broccoli
An older man who is right-handed works as a carpenter, but he has been left with a flaccid right arm after a thrombus occluded a cerebral artery. Which is the most important goal for the plan of care to help this man achieve his optimal state of health and wellness? A)Maintain skin integrity of right arm. B) Collaborate with occupational therapy (OT). C) Promote plaque-reversing strategies. D) Support effective coping mechanisms.
B) Collaborate with OT
Which of the following are common side effects of PD and the medications used to treat it? (Select all that apply.) A) Skin irritation B) Dystonia C) Dyskinesias D) Nausea
B) Dystonia C) Dyskinesias
Which of the following nursing interventions are suitable for a patient who has gout? A) NSAIDS B) Liquid paraffin hand baths C) Colchicine (Colsalide) by mouth D) Hyaluronic acid injections
C) Colchicine (Colsalide) by mouth
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 2 person assist with a transfer B) May need to incorporate repetition C) Gives the patient a dry erase board D) Raises all 4 side rails
C) Gives the patient a dry erase board
Which is the best goal when planning nursing care for an older patient with diabetes mellitus? A) Stabilize the serum glucose B) Set walking distance goals C) Prevent disease progression D) Plan for consistent exercise
C) Prevent disease progression
Which of the following statements is true about rehabilitation and restorative care for older adults? A) The purpose of rehabilitation and restorative care is to regain specific abilities lost because of a condition. B) Rehabilitation consists primarily of regular physical therapy sessions. C) A person can learn skills and gain abilities that enable functioning. D) The patient's capabilities are recognized at the time of admission.
C) a person can learn skills and gain abilities than enable functioning
Which of the following qualities does the nurse need to provide caring? A) Sensitivity to the needs of other nurses B) Longing to help others live a healthy life C) Desire to have a stable career and income D) Ability to create a trusting environment
D) Ability to create a trusting environment
which of the following statements is true about Parkinson's disease? 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 rasagiline (Azilect) must avoid eating foods containing tyramine
D) Older adults taking rasagiline (Azilect) must avoid eating foods containing tyramine
An older woman has severe osteoporosis in the long bones, impaired mobility, and chronic pain. Which acute illness or condition is the woman most likely to experience as a result of osteoporosis?
-Depression
An older man who is a non-Hispanic Caucasian 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?
-68 years of age
The nurse is conducting an admission assessment on an older adult and notes a small lesion with a multicolor appearance. Which assessment approach should the nurse use?
-ABCD (asymmetry, border, color, diameter) rule
Which is the most important medication the nurse administers to a patient with diabetes mellitus to attenuate a metabolic disorder that is closely associated with diabetes mellitus and that accelerates the disease processes are associated with diabetes mellitus?
-Atorvastatin (Lipitor)
The nurse assesses the quality of which of the following patient characteristics when applying the Get-Up-and-Go test from the Hendrich II Fall Risk Model?
-Balance
Of all the following malignant skin cancers, which one is the most common?
-Basal cell carcinoma
What is a true statement about heart disease in older adults?
-Both excessive urination at night and decreased urination can be signs of heart failure
An older adult client is having some vision problems. Which of the following disorders is caused by oxidative damage to the lens?
-Cataracts
The most detrimental illness or condition that an older adult with deafness that occurred at birth can experience is which one of the following?
-Cataracts
You suspect an older adult client is having trouble hearing what you say. It is important to first check for which of the following interferences in hearing?
-Cerumen impaction
Herpes zoster develops in individuals who have had which of the following disorders in the past?
-Chickenpox
The nurse monitors for which clinical indicator when the older adult complains of pruritus?
-Coarse skin
Which infection-control practice should the nurse implement when caring for an older adult who has active herpes zoster?
-Cover ruptured skin lesions with a nonabsorbent dressing.
An older adult woman complains of foot pain from a corn. After assessing her feet, what intervention should the nurse implement to alleviate her discomfort safely?
-Cut out an oval corn pad to make a U shape
Which one 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 the 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 per minute (bpm); respiration rate (R), 20 breaths per minute; 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 bpm; R, 26 breaths per minute; and BP, 164/90 mm Hg; and he denies pain. Which intervention should the nurse implement?
-ask if he has discomfort at the surgical site or any other location
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?
-assess for modifiable risk factors
which one of the following terms proposes that premature death will be minimized and disease and functional decline will be compressed into a period of 3-5 years before death?
-compressed morbidity
which one of the following is a true statement about mobility and safety for older adult patients?
-lowering the bed and fluorescent tapes are interventions to increase safety
Which of the following diseases affects the eyesight of an older adult by damaging the central part of the retina?
-macular degeneration
postprandial hypotension
-occurs after the consumption of a carbohydrate-filled meal
the health care provider has not ordered the use of a restraint for an alert patient at high risk for falling. The nurse should implement which side rail use?
-one 1/2 length rail
9. An older adult is vitamin deficient. Which of the following does the nurse offer to the older adult to provide the important missing vitamin for maintaining healthy skin and enhancing tissue repair?
-orange slices
Loss of bone mineral density and structure describes what?
-osteopenia
The nurse wants to use exercise according to the recommendations of the American Geriatrics Society (AGS) for an older woman who lost her balance and fell. Which nursing intervention is suitable for this older adult according to the AGS?
-provide information on group exercises for balance training
proprioception
-sensations from within the body regarding spatial position and muscular activity
The nurse is discharging an older woman who uses a walker from rehabilitative care. Which observation does the nurse use to determine whether the patient is prepared for discharge?
-she takes the walker to the elevator
The nurse is teaching older adults about maintaining health and wellness. Which recommendation should the nurse include in the teaching to maintain optimal vision?
-wear sunglasses that block sun rays
The safest opioid analgesic choice for an older patient who has severe acute pain is which of the following? A) Meperidine (Demerol) B) Pentazocine (Talwin) C) Morphine sulfate (Morphine) D) Safe opioids do not exist
C) Morphine sulfate (Morphine)
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 2 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
you realize your client does not understand her diagnosis of osteoporosis when she makes which of the following statements? A) I have removed all the throw rugs in my house so I will not trip and fall B) I am going to have to quit smoking sometime C) I have signed up at the YMCA to do water exercises twice a week D) I have asked my son to put grab bars in my bathtub and handrails in the hallway
B) I am going to have to quit smoking sometime
Pressure ulcers are defined as an injury to the skin and/or underlying tissue resulting from pressure or in combination with shear, usually over a bony prominence. To prevent pressure ulcers, you know that you must perform all of the following except for what? A) Turning immobile clients every 2 hours off of bony prominences B) Keep the skin moist C) Use lift or draw sheets to move clients in bed D) Ensure that your client maintains a healthy nutritional status
B) Keep the skin moist
A dermatologist should promptly evaluate which one of the following skin lesions? A) Circumscribed, raised area resembling a blob of brown wax B) Multicolored raised lesion with a fuzzy border C) Bright red, glazed area with satellite lesions on it D) Brown spot on the skin with no raised area
B) Multicolored, raised lesion with a fuzzy border
Which of the following statements is true about medications taken by individuals with diabetes mellitus? A) Sitagliptin (Januvia) is indicated to treat type 1 diabetes mellitus. B) Nateglinide (Starlix) increases the secretion of insulin. C) Metformin (Glucophage) increases the secretion of insulin. D) Rosiglitazone (Avandia) decreases glucose absorption
B) Nateglinide (Starlix) increases the secretion of insulin.
The nurse can place an older adult into one of four patient rooms. Which is the most suitable room for an older adult? A) Brightly lit, blue room with cozy throw rugs B) Room with orange carpeting and soft lighting C) Brightly lit, blue room with waxed vinyl floors D) Room for television and children's playtime
B) Room with orange carpeting and soft lighting
A female older adult client is complaining of mild and localized back and shoulder pain and some nausea and heartburn. Your immediate concern might be that she is experiencing which one of the following events? A) Coronary heart disease B) Silent MI C) Acute MI D) Heart failure
B) Silent MI
An older man was oriented and responded appropriately in the hospital, but he is now disoriented and confused in his home after discharge. Which of the following issues is the first that the home nurse should examine to determine whether an environmental issue is contributing to the patient's condition at home? A) complaints of shivering B) Temperatures of the household C) Types of food prep D) Presence of radon
B) Temperature of the household
An older adult client has been issued a cane to use while ambulatory. Your instructions would include all of the following except for what? A) Place your cane firmly on the ground B) The size and shape of the cane handle is not a priority C) Wear low-heeled, nonskid shoes D) Adjust the cane to your height
B) The size and shape of the cane handle is not a priority
Which of the following statements is true about a safe, effective care environment for older adults? A) Cold beer with steak and potatoes is a good meal for an older adult on a hot day. B) Older drivers are more likely to be in a fatal motor vehicle accident than younger drivers. C) Barrier-free buses and low fares make public transit a safe transportation option. D) A nurse's perception of temperature is a useful guide for patient thermal needs.
B)Older drivers are more likely to be in a fatal motor vehicle accident than younger drivers.
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
You notice that your older client frequently knocks his arm or hand against door frames or chair backs and develops a purpura. You advise your client to do all of the following except what? A) Wear a long sleeved shirt B) Protect the skin from trauma C) Tape a nonadherent dressing over the site of a skin tear D) Remind the healthcare personnel to be careful when handling this client's skin
C) Tape a nonadherent dressing over the site of a skin tear
As a nurse, you will be responsible for teaching self-management skills to an older adult client. Which one of the following skills would not be something that you would teach your client? A) What to do during periods of other illnesses B) How to use a personal glucose monitor C) The importance of eating fats and carbohydrates D) How to take care of his or her feet
C) The importance of eating fats and carbohydrates
An older woman who has diabetes mellitus takes glipizide (Glucotrol) and tells the nurse that her blood sugar levels have been higher than normal since she began using a vaginal cream for hot flashes. Which one of the following interventions is the best for the nurse to implement? A) Ask the patient if she has had a fever or infection recently. B) Verify the expiration date of the meds C) Review her diet for increased carbohydrates D) Ascertain whether the vaginal cream contains estrogen
D) Ascertain whether the vaginal cream contains estrogen
Which topical agent is safe to apply? A) Cornstarch to absorb moisture in the groin area B) Betadine to disinfect a healing pressure ulcer C) A over-the-counter preparation to dissolve a corn D) Light mineral oil to moisten skin after bathing
D) Light mineral oil to moisten skin after bathing
Which of the following is a true statement about skin care for older adults? A) An LPN is qualified to care for the feet of a patient with diabetes B) Onychomycosis is quickly eradicated with anti fungal creams or powders C) A rams-horn nail should be cut to give a smooth, rounded edge D) Maintaining oral hydration may reduce incidence of xerosis
D) Maintaining oral hydration may reduce incidence of xerosis
Which of the following therapies would not be beneficial for an older adult client with Parkinson? A) Range of motion and balance exercises B) Adaptive equipment for eating and self care C) Facial exercises and swallowing techniques D) Nonparticipation in activities as a result of slowed movements and tremors
D) Nonparticipation in activities as a result go slowed movements and tremors
during an assessment, an older client reports that he fell the night before. You should follow up with all of the following except who? A) Ask about frequency of falls B) Ask about the circumstances behind the falls C) Evaluate the client for gait and balance D) Perform a complete head-to-toe assessment
D) Perform a complete head-to-toe assessment
Your older adult client has recently been diagnosed with gout. You will need to teach him all of the following except what? A) Side effects of medications B) How to decrease the likelihood of another attack C) Care of the joint D) Reassurance that this is a one-time occurrence
D) Reassurance that this is a one-time occurrence
When teaching a client about taking his thyroid medication, the nurse needs to ensure that he follows all of the following except what? (Select all that apply) A) Take the medication at the same time every day B) Always take the same brand of medication C) Do not take mineral products (e.g., calcium) at the same time D) Take an extra dose if you feel any fluttering in the chest
D) Take an extra dose if you feel any fluttering in the chest
Your client has severe hearing loss and you are finding it increasingly difficult to talk with hum. During your visit, you spend time with him to discuss options to assist him with his hearing. Which of the following would not benefit your client? A) Hearing aids B) Personal listening systems C) Alerting devices D) Talking clocks, large print books, or software that converts text into artificial voice output
D) Talking clocks, large print books, or software that converts text into artificial voice output
When taking care of an older adult client, you realize that when assessing his pain level that all of the following considerations would apply except for what? A) He might not be able to express pain B) He might be depressed C) Sedation will affect how he expresses his pain D) You will have to take his culture into consideration E) You realize that because he is older, he does not feel pain as much
E) You realize that because he is older, he does not feel pain as much
