HESI EAQ gerontology

Which finding in older adult clients is associated with aging?

Correct 1 Decrease in height 2 Decreased neck rigidity 3 Increased fine-motor dexterity 4 Increased range of motion (ROM)

The nurse is performing a male reproductive system assessment of an older adult client. The nurse expects which age-related finding?

1 Asymmetrical testes Correct 2 Reduced size of testes 3 Absence of pubic hair 4 Foreskin that is difficult to retract A reduction in the size of the testes is a characteristic of aging. The testes are symmetrical in shape and length; any change in their symmetry denotes an abnormality. Pubic hair is normally present. For uncircumcised males, a foreskin will be present and should be easily retractable.

Which age-related skin change occurs in older adult clients and increases their potential for developing pressure ulcers?

1 Atrophy of the sweat glands Correct 2 Decreased subcutaneous fat 3 Stiffening of the collagen fibers 4 Degeneration of the elastic fibers

Which theory proposes that older adults experience a shift from a materialistic to cosmic view of the world?

1 Activity theory 2 Continuity theory 3 Disengagement theory Correct 4 Gerotranscendence theory

A 90-year-old resident fell and fractured the proximal end of the right femur. The surgeon plans to reduce the fracture with an internal fixation device. Which general fact about the older adult would the nurse consider when caring for this client?

1 Aging causes a lower pain threshold. Correct 2 Aging reduces the physiological coping defenses. 3 Most confused states result from dementia. 4 Older adults psychologically tolerate changes well. Aging causes a lowering of the physiological coping reserve of various systems of the body. The pain threshold increases with aging. There are many etiologies for confusion (e.g., medication intolerance, altered metabolic state, unfamiliar surroundings). As individuals age they become more entrenched in ideas, environment, and objects that are familiar, and thus do not tolerate change well.

Which action would the nurse take for an older client with Alzheimer disease who has laid out several outfits on the bed to wear to a recreational session but is still wearing nightclothes?

1 Assist the client to dress and explain when residents are expected at the activity. 2 Prompt the client to dress more quickly to avoid delaying the other residents. Correct 3 Help the client select appropriate attire and offer to help the client get dressed. 4 Allow the client time to dress but explain that the client has missed the opportunity to attend the activity. Helping the client select appropriate attire and offering help in getting dressed is the action the nurse would take. This aids the client in decision-making; new situations may be stressful and may lead to ambivalent feelings. Assisting the client to dress and explaining when residents are expected at the activity is not sharing decision-making; the client may not remember this explanation in the future. Reminding the client to dress more quickly to avoid delaying the other residents may make the client more anxious and frustrated. Because of Alzheimer disease, the client needs help, not punishment, for getting dressed to attend an activity.

Which is the most important nursing intervention when working with an older adult client?

1 Encouraging frequent naps 2 Strengthening the concept of ageism Correct 3 Reinforcing the client's strengths and promoting reminiscing 4 Teaching the client to increase calories and focusing on a high-carbohydrate diet

Which type of bone tumor occurs most commonly in elderly clients?

1 Endochroma 2 Osteosarcoma Correct 3 Chondrosarcoma 4 Osteochondroma Chondrosarcoma occurs most commonly in cartilage in the arm, leg, and pelvic bones of older adults in the age group of 50 to 70 years old. Endochroma occurs in clients in the age group of 10 to 20 years old. Osteosarcoma and osteochondroma occur in the age group of 10 to 25 years old.

Which intervention would the nurse include when developing a plan of care for an older client with dementia?

1 Explain to the client the details of the regimen. 2 Demonstrate interest in the client's various likes and dislikes. 3 Be firm when dealing with the client's attitudes and behaviors. Correct 4 Provide consistency in carrying out nursing activities for the client.

Which are extrinsic factors responsible for falls in older adults? Select all that apply. One, some, or all responses may be correct.

1 Impaired vision 2 Cognitive impairment Correct 3 Environmental hazards Correct 4 Inappropriate footwear Correct 5 Improper use of assistive devices

Which action would the nurse take when caring for an older adult with a history of recent memory loss?

1 Instruct the client to move slowly when changing positions. 2 Remind the client to look where he or she places the feet while walking. 3 Adjust the daily schedule to accommodate sleep pattern. Correct 4 Employ electronic devices that provide alerts.

Which initial nursing intervention would the nurse take for an older adult with delirium who begins acting out while in the dayroom?

1 Instructing the client to be quiet 2 Allowing the client to act out until fatigue sets in 3 Guiding the client from the room by gently holding the client's arm Correct 4 Giving the client one simple direction at a time in a firm, low-pitched voice

Which intervention would the nurse include in the nursing home plan of care for an older adult with Alzheimer disease who has nighttime wandering?

1 Order a vest restraint for the client to be applied at night. 2 Obtain a prescription for a sedative so the client will sleep better at night. 3 Request that the family provide a companion to stay with the client at night. Correct 4 Assign the client to a room near the nurses' station for closer supervision at night.

Which guideline would the nurse consider when planning care for a hospitalized older client with Alzheimer disease?

1 Physical contact will increase dependency needs. Correct 2 Routines provide stability for clients with neurocognitive disorders. 3 Regressive behavior should be interrupted immediately. 4 Procedures do not have to be explained to clients with neurocognitive disorders.

Which psychosocial health concern involves accepting descriptive statements stated by a confused older client?

1 Reminiscence 2 Reality orientation Correct 3 Validation therapy 4 Therapeutic communication

Which action would the nurse take for an older client with Alzheimer disease who sleeps very little and becomes more disoriented from sleep deprivation?

1 Shut the client's door during the night. 2 Apply a vest restraint when the client is in bed. Correct 3 Leave a dim light on in the client's room at night. 4 Administer the client's prescribed as-needed sedative medication. The nurse would leave a dim light on in the client's room at night. A small light in the room may prevent misinterpretation of shadows, which can heighten fear and alter the client's perception of the environment. A disoriented and confused client should be closely observed, not isolated by closing the door. Restraints are a last resort; less restrictive interventions should be used first. Sedatives should be used sparingly in older adults, because they may cause further confusion and agitation.

Which intrinsic factor is associated with the fall of an older adult?

1 Wet floors 2 Poor lighting Correct 3 Lack of exercise 4 Inappropriate footwear

Which gerontologic assessment findings of the auditory system are related to the inner ear? Select all that apply. One, some, or all responses may be correct.

Correct 1 Hair cell degeneration Correct 2 Reduced blood supply to the cochlea 3 Atrophic changes of the tympanic membrane 4 Decline in the ability to filter out unwanted sounds Correct 5 Less effective vestibular apparatus in the semicircular canals Hair cell degeneration, reduced blood supply to the cochlea, and less effective vestibular apparatus in the semicircular canals are assessment findings related to the inner ear. Atrophic changes of the tympanic membrane is an assessment finding associated with the middle ear. A decline in an ability to filter out unwanted sounds is an assessment finding related to the brain.

Which age-related effects on the immune system occur in the older client?

Correct 1 Increased autoantibodies 2 Increased expression of IL-2 receptors 3 Increased delayed hypersensitivity reaction 4 Increased primary and secondary antibody responses The effects of aging on the immune system include increased autoantibodies. Expression of IL-2 receptors, delayed hypersensitivity reaction, and primary and secondary antibody responses decrease in older adults because of the effects of aging on the immune system.

While caring for an older adult client, which symptom would require an immediate reassessment of the client's needs and plan of care?

Correct 1 Memory loss or confusion 2 Neglect of self-care 3 Increased daily fatigue 4 Withdrawal from usual activities

An older client with Alzheimer type dementia, consistently sleeps in a semi-Fowler position in bed. Which area of the client's body would the nurse consider a high risk for developing a pressure injury?

Correct 1 Sacrum 2 Scapulae 3 Ischial spine 4 Greater trochanter

Which assessment finding is associated with depression?

Correct 1 The client has islands of intact memory. 2 The client has impaired recent and remote memory. 3 The client has impaired recent and immediate memory. 4 The client needs step-by-step instructions for simple tasks.

The nurse is preparing to teach a community health program for senior citizens. Which physical findings would the nurse include that are typical in older adults?

1 Increased skin elasticity and an increase in testosterone production 2 Impaired fat digestion and an increase in pepsin production Correct 3 Increased blood pressure and decreased cardiac output 4 An increase in body warmth and some swallowing difficulties With aging, narrowing of the arteries causes some increase in the systolic and diastolic blood pressures. Decreases occur in diastolic pressure, diastolic filling, and beta-adrenergic stimulation; increases occur in arterial pressure, systolic pressure, wave velocity, and left ventricular end diastolic pressure. Decreased cardiac output and cardiac reserve decrease the older adult's response to stress. Changes in libido may occur. Testosterone appears to influence the frequency of nocturnal erections; however, low testosterone levels do not affect erections produced by erotic stimuli. There is a loss of skin elasticity. By the age of 60, gastric secretions decrease 70% to 80% of those of the average adult. A decrease in pepsin may hinder protein digestion. There may be a decrease in subcutaneous fat and decreasing body warmth. Some swallowing difficulties occur because older people are susceptible to fluid loss and electrolyte imbalance. This results from decreased thirst sensation, difficulty swallowing, chronic disease, reduced kidney function, diminished cognition, or adverse medication reactions.

The nurse recognizes which mental process is associated with deterioration that accompanies aging?

1 Judgment 2 Intelligence 3 Creative thinking Correct 4 Short-term memory During the aging process there is a progressive atrophy of the convolutions of the brain with a decrease in its blood supply, which may produce a tendency to become forgetful, a reduction in short-term memory, and susceptibility to personality changes. There should be little or no change in judgment. There is little or no intellectual deterioration; intelligence scores show no decline. Creativity is not affected by aging; many people remain creative until very late in life.

Which condition is due to decreased elasticity of the ocular lens?

1 Myopia 2 Hyperopia Correct 3 Presbyopia 4 Astigmatism

Which characteristic of a therapeutic milieu would the nurse consider important for a confused older adult with socially aggressive behavior?

Correct 1 Sets limits 2 Has variety 3 Is group oriented 4 Allows freedom of expression The therapeutic milieu characteristic would be to set limits. Because clients with socially aggressive behavior have poor control, these individuals require a therapeutic environment in which appropriate limits for behavior are set for them. Variety will increase anxiety. The daily routine should be structured and repetitive. A group-oriented environment is too stimulating for a person with socially aggressive behavior. Freedom of expression may result in injury to the client or others, because the client may be unable to control impulses.

Which is the purpose of block and parish nursing?

Correct 1 To provide services to older clients 2 To promote health throughout a school curriculum 3 To provide nursing services with a focus on health promotion and education 4 To deliver primary care to a client population living in a community In block and parish nursing, nurses living within a neighborhood provide services to older clients or those unable to leave their homes. Health promotion throughout a school curriculum is provided by school health. Nurse-managed clinics provide nursing services with a focus on health promotion and education, chronic disease assessment management, and support for self-care and caregivers. Community health centers are outpatient clinics that provide primary care to a client population living in a community.

Which characteristic about confusion would the nurse keep in mind when an older client with Alzheimer disease is admitted to a long-term care facility?

Correct 1 Occurs with a transfer to new surroundings 2 Will be unchanged despite reality orientation 3 Is a common finding and expected with normal aging 4 Results from brain changes that make interventions futile