Gero Questions PrepU

An older client admits that the thought of dying is not pleasant, because it is an expectation that life eventually ends. What should this client's statement suggest to the nurse? A. The client is delusional. B. The client is not ready to accept that death occurs. C. The client has had previous experiences with death. D. The client intends to avoid talking about death in the future.

C. The client has had previous experiences with death. Clients' reactions to dying are influenced by previous experiences with death, age, health status, philosophy of life, and religious, spiritual, and cultural beliefs. The client's statement does not indicate that the client is delusional, is not ready to accept that death occurs, or will avoid talking about death in the future.

The nurse suspects that an older adult client is experiencing the effects of a sleep disturbance. What finding(s) did the nurse use to come to this conclusion? Select all that apply. A. Weakness B. Frequent yawning C. Disturbance in cognition D. Hypoactive bowel sounds E. Dark circles under the eyes

A, B, C, E A disruption in sleep pattern exists when the quantity or quality of sleep causes disruption to daily function. This disturbance can be displayed by problems falling or staying asleep, nighttime sleep of less than 4 hours, daytime drowsiness, frequent yawning, lack of energy or motivation to engage in activities, dark circles under eyes, weakness, and disturbances in mood or cognition. Hypoactive bowel sounds are not identified as an indication of a sleep disturbance.

The nurse is educating an older adult client about nutritional needs. The client asks, "What should I include in my diet to keep my mind healthy?" Which statements will the nurse include in the response? Select all that apply. A. "The Mediterranean-style diet is considered the 'gold standard' for healthy aging, including preventing brain atrophy, or deterioration." B. "Increasing plant-based and unprocessed foods is important for reducing risk for neurodegenerative diseases such as Alzheimer and Parkinson disease." C. "Fiber is critical for maintaining clear thinking, and preventing dysfunction in cognition and memory." D. "Folate is important for cognitive function, but supplements should be used with caution as they may mask vitamin B12 insufficiency." E. "Potassium is considered a 'nutrient of public health concern' because of its critical roles in cognitive function."

A, B, D Fiber is colonic and potassium is cardiac.

An older adult client arrives to be x-rayed after losing balance while tripping over an area rug at home and falling. The client's adult child reports finding the parent on the side in great pain. Which area(s) of the body will the nurse assess in preparation for a radiologic examination? Select all that apply. A. hip B. foot C. knee D. wrist E. ankle

A, D Fractures rated most likely due to low bone density found in older adults are the femoral neck, pathologic fractures of the vertebrae, as well as lumbar and thoracic vertebral fractures. Colles' fracture (break at the distal radius) is one of the most frequent upper extremity fractures and often occurs when attempting to stop a fall with an outstretched hand. The foot, knee, and ankle are not sites that are most at risk for a fracture from a fall.

The nurse in the emergency department assesses a 76-year-old female client. The client's bladder is visibly distended and the client has not voided since the previous evening. Which assessment question would be most important to determine the source of the client's condition? A. "When was your last bowel movement?" B. "Have you been receiving hormone replacement therapy?" C. "What did you have to eat yesterday?" D. "Do you have a history of kidney disease?"

A. "When was your last bowel movement?" Given that fecal impaction is the most common cause of urinary retention in women, questions relating to the client's recent bowel pattern are most important. Hormone replacement therapy would not be a factor in the client's current condition. Eating the day prior and kidney disease are unrelated to urinary retention.

The nurse assesses an older adult client for malnutrition. Which assessment finding indicates an increased risk for malnutrition in this client? A. Client reports no bowel movement in 3 days B. Concentrated and malodorous urine D. Client reports a mild headache D. Decreased skin turgor

A. Client reports no bowel movement in 3 days Constipation is considered a risk factor for malnutrition in older adults clients. Concentrated and malodorous urine, headache, and decreased skin turgor are not considered risk factors for malnutrition.

The nurse is caring for a client who vomits what looks like coffee grounds. Which intervention does the nurse perform next? A. Perform occult blood testing. B. Measure vital signs. C. Notify the health care provider. D. Assess for abdominal pain.

A. Perform occult blood testing. Coffee-ground emesis occurs with gastric or esophageal bleeding. The nurse will first test for occult bleeding. Then the nurse will complete data collections with measurement of vital signs and assessment of abdominal pain. Lastly, the nurse will report the results to the health care provider.

A client reports deep abdominal pain generating from a surgical wound. To determine a plan of care for pain management, which step would the nurse take first? A. Inspect the surgical wound. B. Ask the client to describe and rate the pain. C. Administer oral pain medications as prescribed. D. Refer to medication record for pain medication history.

B. Ask the client to describe and rate the pain. The first step, especially in older adult clients, is to ask the client open-ended questions regarding the level and type of pain the client is experiencing. This will allow the nurse to determine cognition and understanding of the client's view of the pain as well as type of pain, somatic or visceral. Once pain assessment has been made, then the nurse will evaluate the wound, review medication records, and offer medication as prescribed by the health care provider.

The nurse notes that an older adult client experiencing weight loss has several missing teeth and the remaining teeth have evidence of gum erosion. Which intervention will the nurse include in the plan of care? A. Use lemon glycerin swabs for oral care. B. Order a soft diet. C. Weigh monthly. D. Limit sugars.

B. Order a soft diet. The nurse will order a soft diet so the client can eat nutritious food that is easily on the mouth. Oral care is important but lemon glycerin swabs may cause burning in the mouth. Limiting sugar is not a requirement but the client should eat nutritious meals, due to weight loss the client should be weighed at least weekly to determine progress to goals.

After completing an assessment of an older adult client, the nurse interprets which finding as a pathological process rather than age-related respiratory changes? A. Posture is slightly kyphotic B. Slight wheeze on exhalation C. Uses accessory muscles on expiration D. Mucous membranes drier than younger clients'

B. Slight wheeze on exhalation The others are normal aging, wheeze is pathological.

An older client is experiencing nociceptive pain in the shoulder. Which potential consequence(s) of pain should the nurse assess the client? Select all that apply. A. Anemia B. Dementia C. Depression D. Decreased oral intake E. Immobility

C, D, E Unresolved pain can result in malnutrition, depression, or a decrease in mobility that can precipitate skin breakdown. It is not noted to play a direct role in anemia or dementia.

The nurse is caring for an older client who is confused and wanders the halls. What intervention is appropriate? A. Assist the client into a geriatric chair B. Apply a seat belt when the client is in a wheelchair C. Raise two of the client's four siderails when in bed D. Administer sedatives on a PRN basis

C. Raise two of the client's four siderails when in bed A restraint is anything that restricts freedom of movement. Two long, bed-length siderails or all four siderails up is considered restraining. Two out of four siderails up is not considered to restrict movement, but rather provides a safeguard. Sedatives, geriatric chairs, and seat belts are all considered restraint devices.

A client with a diagnosis of lung cancer has recently developed metastases to the bone, which is causing severe pain. The nurse would characterize the client's pain as which type? A. Chronic B. Neuropathic C. Somatic D. Visceral

C. Somatic Pain that originates from the bones is classified as somatic nociceptive pain. Chronic pain has been present for 3 months or longer. Neuropathic pain occurs from abnormal processing of sensory stimuli. Visceral pain is associated with disorders that can cause generalized or referred pain and is deep and aching.

An older adult client who spends most of the time in bed because of impaired mobility reports not getting enough sleep. Which area is a cause for concern by the nurse if this client were prescribed sleep sedatives? A. promotion of incontinence B. depression of some vital body functions C. decreased body movements during sleep D. decreased susceptibility to adverse reactions

C. decreased body movements during sleep The client already has compromised body movements. All sedatives may decrease body movements during sleep and predispose the older person to many complications of reduced mobility. It is not known if the sleep sedative would promote incontinence, depress vital body functions, or decrease susceptibility to adverse reactions of the sleep medications.

An adult child caring for an older adult parent calls the nurse, stating concern about the parent's chronic bad breath and stubborn plaque on the teeth. Which teeth-cleaning measure should the nurse recommend for this older adult? A. "Use a soft swab to clean the teeth as well as gums." B. "Lemon-glycerin swabs should be used to clean around the gumline." C. "An alcohol-based mouthwash will kill bacteria causing the odor." D. "An manual toothbrush is most effective when giving oral hygiene."

D. "An manual toothbrush is most effective when giving oral hygiene." The use of a toothbrush is more effective than swabs or other soft devices in improving gingival tissues and removing soft debris from the teeth. Lemon-glycerin swabs dry the oral mucosa and contribute to tooth enamel erosion. Mouthwashes with high alcohol content can be too harsh for the mouths of older adults.

The nurse is educating an older adult client about guidelines for daily food intake. Which statement by the client requires additional follow up by the nurse? A. "I should include at least three servings of fruits a day." B. "It is acceptable to include cooked greens and canned fruits in my diet." C. "Whole grains should make up a large portion of my daily food intake." D. "I need to omit fats and oils from my diet to reduce calories."

D. "I need to omit fats and oils from my diet to reduce calories." The statement, "I need to omit fats and oils from my diet to reduce calories," is inaccurate and requires further follow up by the nurse. Dietary recommendations do not include the omission of fats and oils, but instead includes replacing solid fats with oils, including those in fish, nuts, and seeds.

An older adult client comes to the clinic for a routine follow-up visit. During the visit, the client asks the nurse, "What foods would be best to eat so that I can stay as healthy and active as possible and prevent any muscle or bone problems?" The nurse would encourage a balanced diet, emphasizing the intake of which foods? A. Whole grains and starchy vegetables B. Organic and genetically-unmodified (non-GMO) foods C. Fruits and leafy green vegetables D. Dairy products and lean meats

D. Dairy products and lean meats Calcium 1500 mg recommended for older men & women not taking estrogen (1000 mg if they are). Diet rich in proteins & minerals helps maintain muscle & bone.

A 70-year-old client tells the nurse, "I have been taking a laxative every day for years." For which sign/symptom does the nurse assess, because it is often related to laxative abuse? A. nausea B. peptic ulcers C. anal fissures D. dehydration

D. dehydration The safe use of laxatives should be emphasized to prevent laxative abuse. The nurse should be aware that diarrhea resulting from laxative abuse may cause dehydration, a serious threat to life. Nausea and ulcers are not associated with laxative abuse. Anal fissures are prevalent in clients who practice anal intercourse, clients who are constipated, those with chronic diarrhea, and/or those with anal cancer. Anal fissures, however, are not associated with laxative abuse.

An older adult client with controlled chronic illnesses has no interest in eating and is losing weight. What should the nurse assess first? A. finances B. dentition C. ability to swallow D. reason for no interest in eating

D. reason for no interest in eating First step in anorexia is identifying the causes.