Older Adults- Exam 3
Which one of the following statements about elder abuse is most accurate? A) Elder abuse is a problem that is under recognized and underreported. B) It is more common for elderly men to be abused rather than elderly women. C) If there is long-term domestic violence in an elderly couple, it is not considered elder abuse for the perpetrator to continue to abuse the victim. D) Self-neglect is not considered to be a form of mistreatment.
A Feedback: Elder abuse is a problem that is under recognized and underreported. It is more common for elderly women to be abused rather than elderly men. The most common perpetrators of elder abuse are spouses or partners of elders, often in a relationship with long-term domestic violence. In some states, self-neglect is also considered a form of mistreatment.
Which of the following are characteristics of healthy older adults? A) They are able to perform functional activities of daily living. B) They are able to adapt, to continue to handle stress, and to be active in life and living. C) They maintain the maximum degree of physical, mental, and social vigor. D) They are likely to be dependent on others. E) They reside in institutions.
A Feedback: Healthy older adults' ability to function is a key indicator of health and wellness and is an important factor in understanding healthy aging. They are able to adapt, to continue to handle stress, and to be active in life and living. They maintain the maximum degree of physical, mental, and social vigor. The vast majority of older adults, even those with chronic diseases or other disabilities, are living outside institutions and are relatively independent.
When describing the changes occurring in the older adult population globally, which of the following would be most accurate? A) The over-80 years age group is the fastest growing segment of the group. B) Males have a longer projected life expectancy when compared with females. C) Most countries have adequate numbers of social programs for older adults. D) Adults over age 65 are expected to account for about 25% of the population by 2050.
A Feedback: In most of the world, the population of those over 80 years of age is growing faster than any other population age group. A higher life expectancy at birth for females compared with males is almost universal. Many countries have few or no social programs available for older adults. By the year 2050, one tenth of the population is expected to be over the age of 65 years.
When working with the older adult population in the community, which of the following would be most important for the community health nurse to do? A) Develop case management programs to channel clients to appropriate services B) Place the older adult in skilled nursing facilities for the best care available C) Raise funds to support the needs of the older adults in the community D) Emphasize tertiary prevention at this stage in the lives of the older adult
A Feedback: Services for the older adult should be proactive. Nurses should design interventions that maximize nursing resources and provide the greatest benefit to elderly clients. Skilled nursing facilities are for people with skilled needs, not for older adults managing chronic diseases independently. One's own home is most often the best place for elders and where they want to be. This is not something that is always needed or possible for a community health nurse to become involved in. Nurses can identify the needs for additional funding, advocate for more funding, and facilitate a community group's efforts to raise funds. This is how a nurse can best serve the elderly and support their needs rather than by actually raising the funds. Prevention should be proactive and focus on primary prevention regardless of the client's age.
Which of the following comprise the primary criteria for effective programs for older adults? A) Coordination B) Accessibility C) Comprehensive D) Complex E) Quality
A, B, C, E Feedback: The primary criteria for effective programs for older adults include coordination, accessibility, comprehensive, and quality.
Which of the following are included in a comprehensive set of services? Select all that apply. A) Adequate financial support B) Health education C) Encouragement to spend much time alone D) Adult day care programs E) Access to high quality health care services F) In-home services
A, B, D, E, F Feedback: A comprehensive set of services for senior citizens should include the following: adequate financial support, adult day care programs, access to high quality health care services, health education, in-home services, recreation and activity programs that promote socialization (not encouragement to spend much time alone), and specialized transportation services.
Which of the following statements are common misconceptions about older adults? Select all that apply. A) It is normal for older adults to become more confused and childlike, forgetful, and lose contact with reality as they age. They become "senile." B) As older adults age, they become more different and less alike other older adults. C) Older people are very capable of learning new things. D) As age increases, older adults withdraw, become inactive, and cease being productive.
A, D Feedback: The misconceptions or myths about older adults include the following: It is normal for older adults to become more confused and childlike, forgetful, and lose contact with reality as they age. They become "senile"; As age increases, older adults withdraw, become inactive, and cease being productive; As older adults age, they lose their individual differences and become progressively more alike; older adults are forgetful, unable to learn new things, and set in their old ways of doing things.
A community health nurse meets with a group of adults at the local senior center. They range in age from 65 to 70 years. The nurse would recommend vision screening at which frequency? A) Every year B) Every 2 years C) Every 5 years D) Every 10 years
B Feedback: Currently, vision screening is recommended every 2 years for adults aged 65 years and older. Blood pressure screening should occur yearly, and total cholesterol evaluation should occur every 5 years. Tetanus and diphtheria immunizations should be administered every 10 years.
An older adult interested in nutrition asks the community health nurse about the number of calories that he or she should eat every day. Which of the following would be most appropriate? A) 800 to 1,200 calories B) 1,200 to 1,600 calories C) 1,600 to 2,000 calories D) 2,000 to 2,400 calories
B Feedback: It is generally believed that older people need to maintain their optimal weight by eating a diet that is low in fats, moderate in carbohydrates, and high in proteins with a daily calorie count of 1,200 to 1,600.
An older adult comes to the community health center for a checkup. During the visit, he or she mentions that he or she is somewhat constipated. Which of the following suggestions would be most appropriate? A) Use a laxative about once or twice a week B) Increase your intake of fresh fruits and vegetables C) Drink about four 8-oz. glasses of fluid each day D) Walk around the block once a week
B Feedback: Older adults should add more fiber and bulk to their diet with fresh fruits and vegetables instead of relying on the habitual use of laxatives. Also inadequate fluid intake can contribute to bowel and bladder problems. Consuming a diet that includes eight or more 8-oz. glasses of fluid (water, juices, tea) each day assists the gastrointestinal and genitourinary system in their functions. Increased physical activity and exercise, such as a daily walk, help keep an older adult's bowel patterns regular.
A community health nurse is assessing an older adult's ability to perform activities such as shopping, doing the laundry, using the telephone, and handling finances. Which assessment tool would be most appropriate for the nurse to use? A) Barthel Index B) Instrumental Activities of Daily Living Scale C) Katz Index of Activities of Daily Living D) Modified Rankin Scale
B Feedback: The Instrumental Activities of Daily Living Scale looks at an older adult's ability to perform such activities as using the telephone, shopping, doing laundry, and handling finances. The Barthel Index assesses functional independence and is often used to determine levels of disability or dependence of stroke victims in respect to ADLs. The Modified Rankin Scale (MRS) is another common tool used for this purpose. The Katz Index of Activities of Daily Living is based on an evaluation of the functional independence or dependence of clients with respect to bathing, dressing, toileting, and related tasks.
When describing elder abuse to the families of older adults who are attending a local community presentation, which of the following would the community health nurse identify most commonly as the perpetrator? A) Elder's adult child B) Elder's partner C) Elder's neighbor D) Elder's grandchild
B Feedback: The most common perpetrators of elder abuse are spouses or partners of elders. The next most frequent abuser is the adult child of the elder. Although it may be possible that the perpetrator is the elder's neighbor or grandchild, this situation would be quite rare.
A community health nurse is working with an older adult population ranging in age from 75 to 85 years. The nurse correctly classifies this group as which of the following? A) Young-old B) Old-old C) Oldest-old D) Elite-old
B Feedback: Those between the ages of 65 and 75 are classified as "young-old," while those between 75 and 85 are labeled "old-old." The number of people living into "older" old age (75 years and older) is increasing. Forty percent of elderly people in the United States are among the "oldest-old" (85 to 100 years), while more than 200,000 are among the elite-old, or centenarians.
After teaching a group of students about the most common health problems affecting older adults in the community, which of the following if identified by the students would alert the instructor to the need for additional teaching? A) Arthritis B) Hypertension C) Emphysema D) Peripheral vascular disease
C Feedback: Emphysema is not considered a common health problem of older adults. The most common health problems of older people in the community are arthritis, reduced vision, hearing loss, heart disease, peripheral vascular disease, and hypertension.
When visiting a local senior center, a community health nurse engages several of the older adults in a discussion about immunizations. Which statement best reflects the importance of older adult immunization? A) "We're at greater risk of dying from the flu or pneumonia." B) "You don't get the flu from the flu shot." C) "The doctor told us that we should get it." D) "Many of us get the shot here at the center for free."
C Feedback: Older adults are at risk of not only contracting influenza or pneumonia but of dying from them, underscoring the importance of obtaining the immunizations. The statement about not getting the flu from the shot addresses one of the common reasons for not getting it, the belief that the flu shot will give them the flu. The statement about the doctor telling them to get it indirectly reflects another reason for not getting it, lack of knowledge about the need. The statement about getting the shot for free suggests that finances may be a barrier to obtaining the shot but not why it is important.
A community health nurse is preparing a teaching program that addresses chronic diseases common among older adults. Which of the following would be most appropriate to include? A) Forty percent of older adults are diagnosed with diabetes. B) Weight-bearing exercises are related to increased cases of osteoporosis. C) Postural hypotension can be related to falls in elders. D) Older White men have the highest rates of hypertension.
C Feedback: Older adults need to have sufficient cerebral circulation to avoid dizziness. Dizziness can lead to falling. A normal to high-normal blood pressure for the elder should be maintained. Based on the most current statistics, 15.1% of men and 13.0% of women report having diabetes. Weight-bearing exercises are a way to prevent osteoporosis. Older African American men have the highest rates of hypertension.
A community health nurse is teaching a group of older adults at a senior center about strategies for successful aging. Which of the following would the nurse include? A) "Limit drinking alcohol to once or twice a month" B) "Avoid eating too many fruits and vegetables" C) "Keep in touch with friends and family" D) "Get up early in the morning"
C Feedback: Strategies for successful aging include maintaining contacts with family and friends and staying active through work, recreation, and the community. Moderation in drinking is key. The older adult should eat a healthy diet of fruits, whole grains, vegetables, and lean meat. They also should get as much sleep and rest as needed. Getting up early in the morning may or may not be appropriate.
While working with another group of community health nurses, a nurse overhears one of the nurses saying, "That older man should just retire. He's 70 years old. How productive can he be?" The nurse interprets this statement as reflecting which of the following? A) Prejudice B) Bias C) Ageism D) Insight
C Feedback: The one nurse's statement reflects stereotyping and a negative image of an older adult. This is called ageism. It may be due to negative personal experiences, myths, or a general lack of information. It is not reflective of prejudice or bias. Insight would reflect an understanding of the older adult, which this statement does not do.
After teaching a group of older adult women about preventing osteoporosis, which of the following if stated by the group indicates the need for additional teaching? A) "We should eat foods that are high in calcium and vitamin D." B) "We need to get bone density screenings regularly." C) "We should avoid activities that involve weight bearing." D) "We need to make sure that maintain a healthy weight."
C Feedback: Weight-bearing activities are encouraged to promote strong bones. In addition, individuals should be encouraged to eat diets that are rich in vitamin D and calcium, and include calcium supplements as needed. Not smoking, maintaining a healthy weight, and receiving ongoing bone density screenings are positive health behaviors that can contribute to strong bones throughout life.
A community health nurse is making a home visit to a family who is providing care to an older adult member with Alzheimer's disease for the past 6 months. During the visit, which of the following would be most important for the nurse to assess? A) Cognitive status B) Medication regimen C) Personality changes D) Caregiver's status
D Feedback: Although assessment of the various aspects of the patient's status is important, that of the caregiver is even more important. Often, the person with AD is cared for at home until very late in the disease course. The intense care given to these clients can be a constant drain on the emotional and physical reserves of their families. The stress of providing care puts the caregiver's health at risk, as well.
Which of the following care options would be most appropriate for an older adult who experiences confusion, requires daily insulin injections and blood glucose monitoring, and needs assistance with bathing, dressing, and feeding? A) Personal care home B) Respite care C) Intermediate care facility D) Skilled nursing facility
D Feedback: Based on the situation, a skilled nursing facility would be most appropriate. A skilled nursing facility provides skilled nursing care, such as injections and blood glucose monitoring, along with personal care that is considered nonskilled such as bathing, dressing, and feeding. A personal care home offers 24 hours basic custodial care but no skilled services. Respite care provides time off for caregivers and can take place in a variety of settings. An intermediate care facility provides health care, but the amount and type of skilled care is less than that provided in skilled nursing facilities.
A group of community health nurses who work in continuing care retirement centers are asked to talk to a group of seniors about what they do. Which of the following would the nurses identify as unique for this setting? A) Accept clients who primarily need skilled nursing services B) Are similar to board and care homes C) Are respite centers for family members of older adults D) Provide a variety of housing and care options that elders need as they age
D Feedback: Continuing care retirement centers are comprehensive centers and have become the last place an older adult needs to live, meeting independent to dependent needs, including skilled nursing and Alzheimer's disease services. They can age in place without moving to another location as their needs increase. They accept residents at all stages of need, from totally independent living to assisted living to skilled nursing care. In some settings, residents cannot enter the residence at the skilled nursing level. These beds are filled by residents with increasing needs as they move from independent living, to assisted living, to skilled nursing care. Skilled nursing facilities provide skilled nursing care along with personal care that is considered nonskilled. Board and care or personal care homes offer 24 hours basic custodial care but provide no skilled nursing services. Respite care centers provide time off for caregivers. It can take place in an adult day center, home, or residential setting.
The nurse educator is aware that the nursing student has a grasp of the primary prevention needs of older adults when the nursing student makes which of the following comments? A) It is unnecessary for older adults to receive immunizations. B) All older adults must restrict their sodium intake. C) Older adults don't need to drink as much fluid as they are often less thirsty. D) The oral health of older adults is often neglected and so it is important that they see a dentist regularly.
D Feedback: The oral health of older adults is often neglected, and so it is important that they see a dentist regularly. It is necessary for older adults to receive immunizations. Neither of these statements is true: All older adults must restrict their sodium intake and older adults don't need to drink as much fluid as they are often less thirsty.
