Prep U chapter 19

The hospice nurse is visiting the older adult wife of a client 4 weeks after the client died. Which comment by the wife concerns the hospice nurse the most?

"Eating alone is so lonely. I just lose my appetite when I think about it."

A nurse is teaching an elderly client's family about the causes of mental impairment. The nurse sees that the teaching has been effective when the family says which of the following?

"Sundowning is a common problem of dementia."

An older adult client's daughter asks if the doctor can prescribe an antipsychotic medication for her father because he is so confused and agitated much of the time. The nurse is aware that the client should only be prescribed this medication when which strategy has failed? Select all that apply.

- Behavioral - Environmental -Social

The unit manager at a long-term care facility is concerned with the recent weight loss of several residents. The nurse plans a staff in-service to discuss weight loss in older adults, including identifying what possible causes? Select all that apply.

-decreased thirst and smell -alterations in taste -early satiation (feeling full) -anorexia -decline in physical activity

The nurse is caring for an older adult client who is confused and agitated. When the client's family comes to visit the nurse asks how long the client has been confused. The family states that the client has been confused for a long time and the confusion is getting worse. The client is subsequently diagnosed with dementia. What is the most common cause of dementia in an older adult client?

Alzheimer's disease

One of the greatest causes of death in the United States and Canada is colon cancer. The nurse instructs the community on which of the following factors?

Annual screening after the age of 50

Which factor contributes to sleep disturbances in older adults?

Beta-blockers

When educating the middle-age adult, it is important to discuss which of the following?

Calcium replacement

The nurse is providing care to an older adult client. Which assessment finding would necessitate the inclusion of interventions in the nursing plan of care to decrease the risk for disability?

Client's current body mass index (BMI) is 40.

What term is used to describe various disorders that progressively affect cognitive function?

Dementia

A 78-year-old woman is status post right hip fracture after a fall. She has stopped going to her church over the past few months. She has also asked her neighbor to help her and do her gardening, an activity she previously loved. The client tells the nurse "I just don't enjoy gardening like I used to. I am always worried about falling." What would most concern the nurse regarding the client?

Depression

A group of nursing students is reviewing information about the older adult and mobility. The students demonstrate a need for additional study when they identify which statement as accurate?

Falls are the leading cause of death due to injury in individuals who are over the age of 75 years

A 77-year-old woman is on the nurse's unit s/p left knee replacement. The client typically stools every morning but has not had a bowel movement in 3 days. The nurse knows that which medication places the client at increased risk for constipation?

Hydromorphone

When assessing a client during the middle adult years, the nurse recognizes which of the following as a normal physical change?

Increased loss of calcium from the bones

An 80-year-old woman has had abdominal surgery following a bowel obstruction. The nurse is aware that the recuperation period for this patient will most likely be prolonged due to what common condition found in the elderly?

Increased time for healing

The nurse practitioner is examining a 55-year-old female client. Which of the following findings would be uncommon for this age group?

Lower extremity pulses are weak

The nurse is preparing a presentation on chronic pain management to a group of older adult members of a community senior citizens center. Which chronic disease should the nurse focus on in her presentation?

Osteoarthritis

A healthy 52-year-old client asks the nurse what she can do to maintain her health. Which of the following does the nurse recommend?

Perform self-examination of the skin every month

An client 81 years of age is in a long-term-care facility. His family could no longer cope with his progressing senile dementia, including wandering away and unpredictable behavior. Late one night the nurse finds the client wandering in the hall. He says he is looking for his wife. What should the nursing approach should be?

Remind him of where he is and assess why he is having difficulty sleeping.

In a report, the night nurse tells the incoming nurse that one client with dementia has sundowning syndrome. Which of the following nursing diagnoses would be most appropriate for this client?

Sleep deprivation

A nurse has attended an inservice workshop that addressed the phenomenon of ageism in the health care system. Which of the following practices is indicative of ageism?

Speaking to older adults with the presumption that they have mild cognitive deficits

A 90-year-old woman is admitted to a nurse's unit status post CVA. The client is alert and oriented to person, place, and time but has limited mobility and hemiparesis of the left side of her body. She is experiencing urinary incontinence. What is the most appropriate nursing action?

Use the Braden scale to assess for pressure ulcers.

A 76-year-old man is recovering from a myocardial infarction. In regards to his recovery, it is important for the nurse to:

address any questions about sexuality.

Changes in T-cell function in older adults will result in:

risk of infection.

Coping with chronic illness is common for older adults. How they adapt to living with chronic illness will determine:

whether they are ill or healthy.

The nurse is caring for an older adult with hypertension. Based on the nurse's understanding of inappropriate medications for use in the older adult, the nurse would question an order for which drug as initial treatment for hypertension? Select all that apply.

-Clonidine -Methyldopa -Prazosin

A nurse is caring for an older adult client who fell and sustained a hip fracture. Which intervention needs to be included in the nursing care plan? Select all that apply.

-Cough and deep breathe every 2 hours. -Avoid massaging over bony prominences. - Auscultate breath sounds every 1-2 hours.

An older adult client comes to the senior center for a check-up. During the visit, the client tells the nurse that he knows he should be more active than he is. The nurse reinforces the client's statement, explaining that physical activity helps to lower the risk of which condition? Select all that apply.

-Heart disease -Stroke -Diabetes

Which of the following health promotion measures should occur most frequently in older adult women?

Fecal occult blood test

A nurse is working with an older adult population at a local community senior center. Based on information from the Association of Aging, the nurse would anticipate needing to address which condition as most common?

Hypertension

A nurse encourages residents of a long-term care facility to continue a similar pattern of behavior and activity that existed in their middle adulthood years to ensure healthy aging. This intervention is based on which aging theory?

Identity-continuity theory

A nurse caring for older adults in a long-term care facility is teaching a novice nurse characteristic behaviors of older adults. Which statement is not considered ageism?

Personality is not changed by chronologic aging.

An 80-year-old client tells the nurse that he has been dizzy since starting to take an herbal remedy for arthritis in addition to prescribed medications. The nurse recognizes that the client may be experiencing the effects of which of the following?

Polypharmacy

After graduation, if you especially want to care for the aged population, you would consider the nursing specialty that focuses on the health and illnesses of the aging. This specialty is:

gerontologic nursing.

After obtaining the health history from an older adult client, the nurse develops a plan of care and identifies a nursing diagnosis of Risk for Impaired Physical Mobility. A history of which condition would support this nursing diagnosis? Select all that apply.

-Hip fracture -Arthritis -Stroke

Nurses who care for diverse populations must be aware of patterns of disease that are more likely to affect certain ethnic or racial groups. Which examples accurately reflect these profiles? (Select all that apply.)

-Hispanics have higher rates of obesity than non-Hispanic Caucasians. -Black Americans have the highest mortality rate of any minority for most major cancers. -Tuberculosis is 11 times more common in Asian Americans than the white population. Black American men are 30% more likely to die from heart disease than non-Hispanic white men.

A nurse is screening for Alzheimer's disease (AD) in patients in a long-term care facility. Which facts regarding AD are accurate? (Select all that apply.)

-Nearly half of 85-year-old adults have A -AD affects brain cells and is characterized by patchy areas of the brain that degenerate. -Scientists estimate that more than 5 million people have AD.

A 92-year-old is admitted to a nurse's unit with a community-acquired pneumonia requiring 14 days of intravenous antibiotic treatment. The client asks why this happened to her. The nurse knows which to be true of immunity in older adults? Select all that apply.

-Older adults are more susceptible to pneumonia following respiratory infections. -Humoral immunity declines.

A nurse is reviewing the medical records of clients at a long-term care facility who are experiencing weight loss. The clients' medical conditions have been ruled out as a cause. The nurse understands that which situation would most likely be a factor? Select all that apply.

-evidence of depression -use of appetite-suppressing drugs -need for staff to assist with meals

When describing the older adult's risk for infection, which aspect would the nurse most likely address? Select all that apply.

-inadequate nutrition -lowered antibody responses - decline in humoral immunity

A nurse is preparing for a discussion with a group of older adults about the need for adequate nutrition. Which factor would the nurse address as placing an older adult at risk for decreased food intake? Select all that apply.

-reduced thirst sensation -early satiety -reduced level of physical activity -decreased number of taste buds

In 2008, what percentage of older adults resided in nursing homes?

4.1%

In regard to lifespan considerations, the most important functional health pattern to assess in the elderly client is

Cognition-perception

A nurse is developing a plan of care for a client who recently lost his spouse. Which of the following would be most appropriate for the nurse to suggest to help the client cope with his loss?

seeking support from his faith

An older adult is admitted to the health care facility with a diagnosis of depression. The nurse would be especially alert for:

suicidal thoughts