Aging NCLEX

44. An elderly postoperative pt is demonstrating lethargy confusion, and a resp rate of 8 per minute. The nurse sees that the last dose of pain medication administered via a patient controlled anesthesia (PCA) pump was within 30minutes. Which of the following acid-base disorders might this patient be experiencing?

1 Respiratory acidosis 2 Metabolic acidosis 3 Respiratory alkalosis 4 Metabolic alkalosis

41. A 78 yo female client with Meniere's disease is experiencing severe vertigo. Which instruction should the nurse give to the client to assist in controlling the vertigo?

1. Increase sodium in the diet 2. Avoid sudden head movements 3. Lie still and watch the television 4. Increase fluid intake to 3000 mL a day.

33. Which person is at greatest risk for developing a community-acquired pneumonia?

C. An older adult with exercise-induced wheezing

40. The nurse notes that the health care provider has documented a diagnosis of Ménière's disease on a client's chart. The nurse understands what is not one of the possible causes of this condition?

a) Hypothyroidism b) Diabetes mellitus c) Hyperthyroidism d) Neurosyphilis

38. You are caring for a 75 year old patient who just had general elective surgery with a PMHx of COPD and a R knee replacement who reports that she uses a walker to get around. While caring for your patient what is the most important nursing care strategy?

a. Ensure patient is receiving adequate nutrition b. Encourage vigorous pulmonary hygiene c. Monitor patient's LOC (levels of consciousness) d."Get up and Go" test

15. You are caring for a 78 year-old female cardiac patient. In preconference your clinical instructor asks you what is an age-related change in the cardiac system of the older adult? Your best response would be

b)Decreased cardiac output

16. A 76-year-old patient has made an appointment for a routine physical. What is the most appropriate statement for the nurse to assess hearing impairment?

b. "Are you experiencing any pain or ringing of the ears?"

9. The nurse is performing an assessment on an elderly client experiencing sudden hearing loss and balance issues. Which assessment finding is most specific to these deficits?

b. Client is taking Keflex for a skin infection

20. An older client recently has been taking cimetidine (Tagamet) for heartburn. The nurse monitors the client for which most frequent central nervous system side effect of this medication?

1. Tremors 2. Dizziness 3. Confusion 4. Hallucinations

6. What is a clinical manifestation of age-related changes in the GI system that the nurse may find in an older patient?

D. Reflux of gastric contents into the esophagus

8. The nurse plans care for a client with acute glaucoma who reports severe pain in the eyes and rainbow colors (halos) around lights. Which action should the nurse take first?

d) assess the client's visual status

30. What statement is a sign that your 85-year-old female patient still needs more patient teaching?

----1) "Sudden incontinence or a change in ability to hold urine in the bladder is a sign I may have a urinary tract infection." -----2) "Urinary tract infections are much more common in the elderly due to the thinning and weakening of the urethra." 3) "Practicing proper perineal care and staying well hydrated are both ways to help prevent frequent urinary tract infection." 4) "Signs and symptoms of a urinary tract infection are frequent urination, the strong urge to urinate, and burning while urinating."

14. A nurse is caring for an older adult with a hearing loss secondary to aging. What can the nurse expect to identify when assessing this client? Select all that apply.

1 Dry cerumen 2 Tears in the tympanic membrane 3 Difficulty hearing high-pitched voices 4 Decrease of hair in the auditory canal 5 Overgrowth of the epithelial auditory lining

32. A new nurse completes an assessment on a 75 year old patient. Which statement to the patient reveals a lack of knowledge regarding normal changes in vision for the aging patient?

1"Don't be alarmed at difficulty in focusing on near-in objects." 2"Your eyes should adjust to light when you walk out of a dark movie as well as when you were 30. We'd better refer you to a specialist." 3"You're not alone in this mild development of glaucoma. An ophthalmologist may be able to offer some strategies to control or limit these changes." 4"Your cataract development probably has a variety of causes. I know this is troubling you and we may be able to slow or remedy this normal aging condition."

50. The clinical nurse prepares to perform a focused assessment on an elderly client who is complaining of symptoms of constipation. Which should the nurse include for this type of assessment? (Select all that apply)

1) Ask about chronic laxative use 2) Check for risks of polypharmacy 3) Assess the client's daily fluid intake 4) Ask if the client often experiences dyspnea on exertion

27. A long term care nurse is performing an assessment on a 76 year old resident. Which of the following normal age related physiologic changes in vision should the nurse expect to note? Select all that apply:

1)Decreased visual acuity 2)Presbyopia and cataract formation 3)Decreased accommodation in eyes 4)Decreased peripheral vision 5)Decreased sensitivity to glare 6)Decreased adjustment time to changes in light

23. A 72 year old male patient has benign prostate hyperplasia. Which nursing intervention is most important when treating this patient?

1. Encourage the patient to take medications that increase urinary retention. 4. Maintain sodium levels below 130 mEq/L

49. A nurse who is caring for an older client is aware that the client is at risk for prolonged medication effects as a result of the normal aging process. The nurse would be most concerned with this effect if the client had a history of disease of which organ?

1. Liver 2. Pancreas 3. Stomach 4. Gallbladder

3. The nurse observes a 74-year-old man with Parkinson's disease rocking side to side while sitting in the chair. Which action by the nurse is most appropriate?

2 Document the activity in the patient's health record.

29. A 76-year-old client with hypertension type 2 diabetes, and a known allergy to seafood is scheduled for a cardiac catheterization. Which orders should a nurse recognize as appropriate for this client? Select all that apply.

2. Draw blood for a liver panel. 3. Draw blood for a renal panel. 4. Start NS IV at 125 mL/hr. 5. Hold metformin (Glucophage).

34. The nurse is providing instructions to the unlicensed assistive personnel (UAP) regarding care of an older client with hearing loss. Which should the nurse tell the UAP about older clients with hearing loss?

3. They respond to low-pitched tones

12. The nurse is providing medication instructions to an older client who is taking digoxin (Lanoxin) daily. The nurse notes that which age-related body change could place the client at risk for digoxin toxicity?

4. Decreased lean body mass and decreased glomerular filtration rate

28. Which of the following should be suspected in elderly or demented patients who exhibit an acute or subacute deterioration in behavior cognition, or function?

A) Delirium B) Depression C) Infection D) All of the above

11. An older client reported to the ER that he fell and hit his head after that he started getting headaches, vision problems, and started to breath abnormally. After VS were taken it was noted that his BP was high and that his PP was widening. It was found that all his symptoms were caused by increased intracranial pressure (ICP). What can the nurse do to help keep the ICP from increasing and causing more damage?

A) The nurse can help by keeping an open airway. B) The nurse can help the client by maintain a normal body temperature. C) The nurse can position the client in the Trendelenburg's position to increased blood flow to the brain. D) The nurse can give an Aspiring to the client to help with inflammation and pain.

19. A 90-year-old healthy man is suffering from dysphagia. The nurse explains what age-related change of the GI tract is the most likely cause of his difficulty?

A- Xerostomia

42.The primary reason an older adult client is more likely to develop a pressure ulcer on the elbow as compared to a middle-age adult is:

A. A reduced skin elasticity is common in the older adult B. The attachment between the epidermis and dermis is weaker C. The older client has less subcutaneous padding on the elbows D. Older adults have a poor diet that increases risk for pressure ulcers

37. A nurse received an elderly patient in the hospital who was admitted for dyspnea. Their blood work reveals that their mixed venous O2 saturation was 55%. What is the nurse's first action?

A. Call the Health Care Provider B. Administer O2 to the patient stat! C. Monitor level for the next 3-4 hours for any changes D. Administer antibiotics stat!

45. In reviewing changes in the older adult the nurse recognizes that which of the following statements related to cognitive functioning in the older client is true?

A. Delirium is usually easily distinguished from irreversible dementia. B. Therapeutic drug intoxication is a common cause of senile dementia. C. Reversible systemic disorders are often implicated as a cause of delirium. D. Cognitive deterioration is an inevitable outcome of the human aging process.

10. When caring for an older adult patient the nurse uses the following interventions to accommodate visual changes with age:

A. Eye glasses in the bedside table. B. Adequate lighting and uncluttered walkways. ??

47. When caring for a 78 year old patient you will note the following age-related GI changes except:

A. Increased risk for maldigestion B. Decreased thirst C. Increased sodium bicarbonate levels D. Decreased drug metabolism

2. When you are teaching an elderly client how to best prevent constipation which of the following instructions should the nurse include?

A. Make sure to add 30 minutes of exercise to your daily routine at least 4 times a week

46. The nurse caring for a 78-year-old female patient understands that the primary reason her patient is at an increased risk for pressure ulcers is because:

A. Older patients generally have poor eating habits, which decreases nutritional intake B. Older patients tend to be less mobile than middle-age or young adult patients C. Older patients have less subcutaneous fat covering their body D. Older patients are more likely to be incontinent, thus causing increased moisture in high risk areas

39. Which of the following is true of the immunological theory of aging?

A. Views aging a predetermined, genetically programmed events caused by cellular damage B. Elders have an increased susceptibility to disease C. Immune functions decrease which results in an inability of the body to recognize its own cells D. All of the above

36. Age-related changes in the skin include (select all that apply)

A. oily scalp B. a loss of collagen C. thicker, brittle nails D. thinner, fragile nails E. improved blood supply

4. The 75-year-old patient has normal age-related changes in his ear that include all of the following except:

A: Dry and wrinkled skin on the auricle C: Dry cerumen D: Hair in the ear canal

31. In the aging adult many age-related changes can be noted within the cardiovascular system. Of those changes, which of the following is a common age-related morphology change of the heart?

D) Heart size remains the same and left ventricular wall thickening occurs

13. A nurse is assessing a 74-year-old patient for delirium who is experiencing confusion and agitation after being admitted to the hospital a day ago with pneumonia. All of the following information from the nurse's assessment would indicate delirium EXCEPT:

D. Increasing confusion over several years

7. A nurse reports to a health care provider that a client has decreased peripheral vision. An ophthalmologist consult is ordered and the client is diagnosed with chronic open-angle glaucoma. The client cries when told the diagnosis. A nurse identifies the following nursing diagnoses. In which priority order should the nurse plan to address the nursing diagnoses?

B. Anxiety related to fear of vision loss and changes in quality of life

25. Which one of the following patient education and interventions is not appropriate for a patient with a diagnosis of psoriasis that's affecting the patient's face and all four extremities?

B. Help patient identify possible triggers such as stress and ways to manage it.

18. In performing a physical assessment for an older adult the nurse anticipates finding which of the following normal physiological changes of aging?

B. Increased airway resistance

24. A 75-year-old client is seen in the clinic for urinary incontinence. The nurse explains to the patient that urinary incontinence can be caused by: Select all that apply.

B. Leading a stressful life C. Neurological conditions F. Urinary tract infections

26. The 67 yr old female obese client comes into the clinic with the complaint that she urinates whenever her hilarious father-in-law comes to visit. She said this has been going on for some time without a big concern but it has been getting increasingly worse with time. Recently, she states that she is unable to do her daily exercise routine without feeling self-conscious and embarrassed that others will notice. Based on these findings, the nurse would suspect which of the following age-related conditions?

B. Stress Incontinence

17. A 68- year-old man reports chronic constipation. To promote bowel evacuation the nurse will suggest that the patient attempt defecation

B. after eating breakfast

43.A client with age-related macular degeneration asks a nurse about treatment measures to correct visual deficits related to this condition. What is the best response by the nurse?

a) contact lenses may be prescribed to correct your vision b) surgical removal of the cloudy eye lens can help restore vision c) eye drops that reduce intraocular pressure should slow down the progression of this disorder d) it is not possible to restore vision that has already been lost but measures to maximize existing vision are used

48. What is the most common cause of urinary incontinence in an elderly patient?

a. Functional b. Infection c. Drugs d. Dementia e. Constipation

22. An older adult client mentions they have had trouble hearing high-frequency sounds especially when background noise is present and that the problem has gradually gotten worse. After performing a watch test the nurse determines that the hearing loss is bilateral. What condition is likely present?

a. conductive hearing loss b. presbycusis c. tinnitus d. Meniere's Disease

35. The nurse is performing an assessment on an older adult client. Which assessment data would indicate a potential complication associated with the skin of this client?

a. crusting b. wrinkling c. deepening of expression lines d. thinning and loss of elasticity in the skin

21. After a right hemicolectomy for treatment of colon cancer a 70-year old client is reluctant to turn while on bed rest. Which action by the nurse would be appropriate?

b)Explaining to the client why turning is important

5. An older female client confides to the visiting nurse that she is afraid she will fall while going to the bathroom at night. Which suggestion if made by the nurse, indicates that the nurse understands the visual changes affecting the older client?

c) keep a red light on the bathroom at night

1. An elderly female client has been admitted to the hospital with a diagnosis of severe anemia. The nurse knows that older adults can develop anemia due to what expected age-related change?

c. malabsorption related to decreased small intestine motility