NUR 303 - Older Adults

An older adult client is being discharged from the hospital on several medications. Which intervention best reinforces medication teaching for this client? a. Have the client actively participate in drug administration during hospitalization. b. Include the client's children in discussions regarding medication administration. c. Give the client a pamphlet with the actions, side effects, and doses of all drugs. d. Make a chart showing which drugs should be taken at specified times during the day.

A have the client actively participate in drug administration during hospitalization

The nurse is assessing several clients. Which clients does the nurse identify as being at high risk for falls? (Select all that apply.) The client: a. With visual impairment such as presbyopia b. Who is reluctant to use a cane while walking c. Who performs Tai Chi exercise daily d. Who wears a hearing aid and glasses e. Who has difficulty arising from a sitting position f. Who is male and over 55 years of age

A, B, E

An older adult client has been admitted to a skilled nursing facility following surgery. What interventions should the nurse add to this client's care plan to assist with adjusting to this situation? ((Select all that apply.) a. Make sure the client has hearing aids and glasses. b. Offer the anxiolytic that the physician has prescribed. c. Encourage the family to bring in favorite pictures. d. Ask where the client wants the room furnishings placed. e. Encourage the client to eat meals alone in his or her room. f. Set a daily schedule for the client that includes group activities.

A, C, D

A nurse manager is planning a comprehensive care plan for older clients admitted to the medical-surgical unit. To decrease hospital stays and lessen the pain that older clients experience, which standard intervention should the manager include in the care bundle for this population? a. Assess all clients for depression. b. Obtain a dietary consult for nutrition assessment. c. Perform medication reconciliation on admission. d. Screen all clients for alcohol and drug use.

A. assess all clients for depression

Which behavior exhibited by an older adult client alerts the nurse to the possibility that the client is experiencing delirium? a. Becoming confused within 24 hours after hospital admission b. Displaying a cheerful attitude despite a poor prognosis c. Becoming withdrawn and sleeping most of the day d. Beginning to use slurred speech and losing coordination

A. becoming confused within 24 hours after hospital admission

An older client is agitated and develops new-onset confusion on admission to the long-term care unit. What is the best action for the nurse to take to minimize relocation stress syndrome for this client? a. Provide reorientation during hourly rounding. b. Obtain a certified sitter to remain with the client. c. Speak to the client as little as possible to avoid overstimulation. d. Provide adequate sedation to lessen fear-provoking situations.

A. provide reorientation during hourly rounding

What is a priority nursing intervention to prevent falls for an older adult client with multiple chronic diseases? a. Providing assistance to the client in getting out of the bed or chair b. Placing the client in restraints to prevent movement without assistance c. Keeping all four siderails up while the client is in bed d. Requesting that a family member remain with the client to assist in ambulation

A. providing assistance to the client in getting out of the bed or chair

What interventions can the nurse apply to help an older adult client who is having trouble sleeping while in the hospital? (Select all that apply.) a. Changing the client's sheets each night before sleep b. Decreasing the level of light surrounding the client's bed c. Attempting to keep the client awake during the daytime d. Keeping staff conversations as quiet as possible e. Administering sleeping pills at night f. Administering pain medication before bedtime g. Asking the client if he or she would like to pray

B, C, D, F

An older adult client is in physical restraints. Which intervention by the nurse is the priority? a. Assess the client hourly while keeping the restraints in place. b. Assess the client every 30 to 60 minutes, releasing restraints every 2 hours. c. Assess the client once each shift, releasing the restraints for feeding. d. Assess the client twice each shift while keeping the restraints in place.

B. assess the client every 30 to 60 minutes, releasing restraints every 2 hours

An older adult client has become agitated and combative toward health care personnel on the unit. What is the first action that the nurse will take? a. Obtain an order for a sedative-hypnotic medication to reduce combative behavior. b. Attempt to soothe the client's fears and reorient the client to surroundings. c. Obtain an order to place the client's arms in restraints to protect personnel. d. Arrange for the client to be transferred to a mental health facility.

B. attempt to soothe the client's fears and reorient the client to surroundings

An older adult recently had a hysterectomy and has requested some medication for pain. The physician leaves an order for meperidine (Demerol). Which action by the nurse is most appropriate? a. Assess the client's pain 1 hour after giving the medication. b. Call the physician and request a different pain medication. c. Assess the client's respiratory rate often after administering the Demerol. d. Ensure that the client does not receive iron supplements at the same time.

B. call the physician and request a different pain medication

An older adult client presents with signs and symptoms related to digoxin toxicity. Which age-related change may have contributed to this problem? a. Increased total body water b. Decreased renal blood flow c. Increased gastrointestinal motility d. Decreased ratio of adipose tissue to lean body mass

B. decreased renal blood flow

An older adult client's spouse has died, and the family expresses concern that the client has lost weight recently and now refuses to attend the annual family reunion. The nurse should assess this client further for what clinical condition? a. Psychosis b. Depression c. Dementia d. Delirium

B. depression

Which intervention would best support a client who relates a feeling of "loss of control" after having a mild stroke? a. Explain that such feelings are normal, but that expectations for rehabilitation must be realistic. b. Encourage the client to perform as many tasks as possible and to participate in decision making. c. Further assess the client's mental status for other signs of denial or psychopathology. d. Obtain an order for physical and occupational therapy evaluations.

B. encourage the client to perform as many tasks as possible and to participate in decision making

A client with Alzheimer's disease has been hospitalized for dehydration. In making an assessment, the nurse notes the presence of a cluster of bruises on the client's buttocks. What is the nurse's priority action? a. Call the local police to report a crime. b. Notify the client's physician and social worker. c. Confront the client's caregiver with the suspicions. d. Alert security to prevent visits by the client's caregiver.

B. notify the client's physician and social worker

An 89-year-old is admitted to the medical-surgical floor. The nurse is formulating the client's plan of care. In assessing the client, which findings would be considered part of the clinical syndrome of frailty? (Select all that apply.) a. Increased appetite b. Weight loss c. Weakness d. Decreased sleep e. Slowed gait

B., C, E

What conditions predispose an older adult client to acute confusion or delirium? (Select all that apply.) a. Alcoholism b. Chronic pain c. Acute infection d. Electrolyte imbalances e. Multi-infarct cerebrovascular disease f. Change in drug regimen

C, D, F

A nurse is assessing a client's understanding of medication therapy. Which statement indicates that the client needs further instruction? a. "My husband is on the same medication, so we always take our medications together in the morning." b. "I prepare all my medication for the week and place the pills in a container labeled for each day." c. "When I don't sleep well at night, I take two thyroid pills the next day instead of just one." d. "I take my Coumadin every day when the noon news comes on the television."

C. "When I don't sleep well at night, I take two thyroid pills the next day instead of just one."

An older adult client is suspected of being neglected by the caregiver. What assessment provides the nurse with the best information about this possibility? a. Inspect skin in the "bathing suit zone" for bruises. b. Assess the client for orientation to person, place, and time. c. Compare the client's current weight with prior recorded weights. d. Perform orthostatic pulse and blood pressure readings.

C. compare the client's current weight with prior recorded weights

An older adult client is in the hospital. To what government resource would the nurse refer the client to help meet the cost of health care? a. Preferred provider organizations b. Health maintenance organizations c. Medicare Part A d. Medicare Part B

C. medicare part A

A nurse is caring for an older adult client who lives alone. Which economic situation presents the most serious problem for this client? a. Stock market fluctuations b. Increased provider benefits c. Social Security as the basis of income d. Costs of creating a living will

C. social security as the basis of income

A nurse is assessing a client at risk for dehydration. Which statement by the client indicates that more education by the nurse is required? a. "I try to limit coffee to one cup in the morning and one cup in the early evening." b. "During the day I drink at least six to seven glasses of water." c. "Alcohol causes me to frequently urinate so I cut it out of my diet." d. "I stop drinking fluids in the afternoon to avoid bathroom trips at night."

D. "I stop drinking fluids in the afternoon to avoid bathroom trips at night."

What will the nurse teach the older client with hypertension who complains that "food does not taste good without salt"? a. Salt can be used as long as blood pressure remains controlled. b. All salt should be removed from the diet to preserve kidney function. c. Table salt can be used in small amounts in conjunction with diuretics. d. Herbs and spices can be substituted to season food.

D. herbs and spices can be substituted to season food