Gerontological ch. 15, 16, 20,28

The nurse assesses the quality of which of the following patient characteristics when applying the get up and go test from the Hendricks 2 fall risk model?

Balance

A nurse in a long term care facility notes that there has been an increase in falls on one unit and that many of the falls are occurring immediately after mealtime. The nurse recommends that the nursing home conduct a trail of six smaller meals instead of the three traditional meals. The nurse makes this recommendation on the understanding that

Postprandial hypotension occurs after ingestion of a carbohydrate meal and may be related to the release of a vasodilatory peptide

The nurse can place an older adult into one of four patient rooms. Which is the most suitable room for an older adult?

Room with orange carpeting and soft lighting

Which of the following are assessed in a fall prevention assessment of an older adult? Select all that apply

1. Environment 2. Physical status 3. Functional status 4. Medical history

Which attempt by the family to prevent an older frail adult from falling causes the home health nurse concern?

Keeping the side rails up on the clients bed at night

Which of the following is a true statement about mobility and safety for older adults?

Lowering the bed and fluorescent tapes are interventions to increase safety

A home care nurse in an area of the country that is prone to tornadoes routinely discusses disaster preparedness with older adult clients. What is the primary rationale for this intervention?

Older adults are less likely to seek formal and informal help when affected by natural disasters

Which of the following statements is true about a safe, effective care environment for older adults?

Older drivers are more likely to be in a fetal motor vehicle accident than younger drivers

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

The nurse wants to use exercise according to the recommendations of the America. Geriatrics society 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 improves

A nurse is admitting and orienting an older adult to the hospital unit. She discusses fall prevention and demonstrates the use of the call bell to the patient. The patients daughter asks: why don't you just put up all the side rails to prevent my mother from getting out of bed by herself and falling? That should work right? The best response by the nurse is

There is no evidence that side rail use decreases falls, and in fact there is a greater risk of injury

The daughter of an older patient states the following to a nurse: " I am so concerned that my dad is still driving. He is dangerous! He has had a couple of accidents, and I am worried that he is going to kill himself, or worse, somebody else. What can I do?" The nurse recommends which of the following involved type action strategies for driving cessation? Select all apply

1. Hold a family meeting with the person to discuss the situation and come to a mutual agreement of the problem 2. Arrange for alternate transportation for the person

A home health nurse is making a home visit to an older patient. A nurse conducts a home safety assessment and screens the environment for potential hazards for fall. The nurse recommends that the patient eliminate which of the following?

1. Loose carpeting on the floors 2. Excess clutter

Which factors in the patient care environment should be routinely assessed to decrease the risk of falls? Select all that apply

1. Outdoor grounds 2. Appropriate footwear 3. Grab bars in place

Benefits of telehealth include that it select all that apply

1. Promotes self management of illness in rural and underserved areas 2. Facilitates remote physical assessment and monitoring of chronic conditions 3. Decreases costs by reducing hospital readmissions

Which assessment findings is a contributor to an older clients risk for falls?

1. The client is awaiting cataracts surgery on right eye 2. The client type 2 diabetes is poorly controlled with diet and exercise alone 3. The client reports a fall in the past year

A homecare nurse visits a client in the home to conduct a fall risk assessment. The nurse assesses the the client and the home for extrinsic risk factors for falls. Which of the following are extrinsic risk factors? Select all that apply

1. The client uses a cane but the cane is not appropriate size for the client 2. The clients home is cluttered 3. There are no grab bars in the clients bathroom

The nurse will be educating a group of senior citizens on adaptations for safer driving. Which adaptations should the nurse include? Select all that apply

1.Wide rear view mirrors 2. Pedal extensions 3. Global Positioning System device

A group of older women in an assisted living facility are talking about one of the residents who fell and fractured her hip. The women asks a nurse the following: "it seems like so many of us fall and break our hips, and then it is downhill from there. Is this really true?" In formulating a response, the nurse considers which of the following? Select all that apply

1.hip fractures are a leading cause of hospitalization for older ppl 2. The major cause of hip fractures is fall 3. Hip fractures are associated with very high morbidity and mortality rates

Which of the following is a true statement about assistive devices to aid older adults with impaired mobility?

A cane is most useful for unilateral disabilities but not bilateral problems

The overall temp in your gerontological unit is 62 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 is unsuitable for older ppl because they have impaired thermoregulation

The nurse recommends that a client diagnosed with moderate stage Alzheimer's disease attend a support group when he becomes defensive about not driving his automobile and the effects it will have on being stuck at home. Which is the priority outcome expected for this client when attending the group sessions?

Helps with minimizing the loss as a factor in causing depression

After assessing an 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 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?

Instruct the patient to call for help