ATI Gerontology Final Questions

The nurse is assisting in the planning of an immunization clinic for older adults. At which of the following times should an older adult client receive the influenza vaccine?

Annually in the fall the nurse should recommend that older adult clients receive the influenza vaccine annually. influenza outbreaks occur annually, and the influenza virus changes constantly. consequently, an influenza vaccine from a previous year will not protect a client exposed to this year's influenza strain. influenza in older adults can result in the development of primary viral influenza pneumonia, which causes several deaths a year. an influenza vaccine given in the fall, prior to the onset of flu season, will be most effective in preventing influenza in this target population

A nurse is reinforcing teaching with an older adult client about methods to improve sleep. Which of the following statements should the nurse include in the teaching?

Go to the bed at the same time everynight the nurse should recommend that the client keep consistent sleep and wake times even on the weekends. having a regular sleep schedule will help minimize the alterations to the circadian rhythm that occurs in the older adult client

A nurse at a long term care facility is reinforcing teaching with an older adult client about ambulating with a quad cane. Which one of the following statements should the nurse include in the teaching?

Hold the cane on the stronger side of your body the client should hold the cane with the hand on the stronger side of her body so that she can move the cane to support the weaker leg. this action allows for a more normal gait, with the ipsilateral arm and weaker leg moving at the same time

A nurse is reinforcing teaching with a client who is to start taking finasteride. Which of the following statements by the client indicates an understanding of the teaching?

I should see a decrease in my PSA levels the nurse should emphasize that the decreased in PSA levels with this medication will be measured 6 month after starting treatment. the expected decline is 30% to 50% in the psa level

A nurse is collecting data from an older adult client who has chronic pain. Which of the following effects of unrelieved pan should the nurse identify as a priority finding to report?

Impaired mobility

a nurse is reinforcing teaching with an older adult client who is healthy and has chronic constipation about establishing a bowel retraining program. which of the following statements should the nurse include in the teaching?

Increase the fiber content of your diet

A nurse is reinforcing teaching with an older adult client who is to start taking warfarin. Which of the following statement indicates the client understands the teaching

i can continue to eat green salads the client should have a diet that is consistent in foods containing vitamin k, such as green, leafy vegetables. sudden increases or decreases in this consumption will alter the coagulation effects of the warfarin. the nurse should report any alterations in consumption of foods containing vitamin k

a nurse at a long term care facility is contributing to a plan for an older adult client who has dementia. which of the following interventions should the nurse include in the plan?

use photographs as memory triggers

A nurse is reinforcing teaching to a client with COPD and has been losing weight about ways to improve his nutritional intake. which of the following statements by the client indicate and understanding of the teaching?

i should add grated cheese to sauces and vegetables the nurse should reinforce that adding cheese to side dishes will increase his protein and calcium intake, as will assist increase calories. this will assist the client in regaining weight and stamina

A nurse is reinforcing teaching with an older adult client who had total hip athroplasty abut ambulating with a standard walker. Which of the following action by the client indicates understanding?

The client moves the walker ahead 15.24 cm (6in) and then steps with the walker the correct technique for using a walker is to balance on both feet; lift the walker and place it in front; walk into the walker, using it for support when standing on the affected lin=mbl and then balance on both feet before repeating the sequence this provides maximum support for the client

A nurse is caring for an older adult client who has a hip fracture and is rating her pain at 8 on a 0 to 10 scale. Which of the following medications should the nurse adminster?

oxycodone/acetaminophen 7.5/325 tablet PO a client who rates his pain as an 8 is experiencing severe pain nurse should administer an opioid for this pain.

A nurse is collecting data from an older female client. Which of the following findings should the nurse identify as a priority?

Rales heard in the bases of the lungs

A nurse in an assisted living facility is assisting in the care of an older adult client who moved in 3 months ago following the death of his partner. The client reports awakening in the morning and admits to feeling very sad. The nurse should identify then the client is experiencing which of the following types of grief.

Acute grief the client experiencing acute grief will have both somatic and psychological manifestations of distress, such as the inability to sleep well profound sadness. the nurse should identify that this client is experiencing acute grief and further evaluate his support system, concurrent stressors in his life, and his ability to manage stress

A nurse is reinforcing teaching about skin changes in the older adult client with a newly licensed nurse. Which of he following findings should the nurse identify as benign, age related change commonly seen in older adult clients?

Liver spots liver spots, also known as age spots or lentigines, are flat brownish-black macules that usually occur in sun exposed areas of the body. aging and exposure to sunlight, or other forms of ultraviolet light, can result in increased pigmentation. liver spots are extremely common after 40 years of age; they occur most often on the forearms, shoulders, face, forehead, and backs of the hands, which are also the areas of highest sun exposure. they are harmless and painless, but they can affect the client's cosmetic appearance.

A nurse is caring for a client who has aphasia following a stroke. Which of the following actions should the nurse take?

Present one idea at a time the nurse should present on idea or thought in a sentence to avoid creating frustration for the client. additionally, the nurse should allow time for the client to process and respond to the nurse quality of life. the nurse should identify that anxiety is a common factor that interferes with sleep; however the nurse needs additional information in order to fully understand the scope of the problem

A nurse in an adult day care is contributing to the development of treatment plans for older adult clients. Which of the following therapeutic strategies should the nurse use to help clients achieve ericksons developmental task for this age group?

Reminiscence therapy

A nurse is reinforcing teaching with an older adult client about osteoporosis. Which of the following statements should the nurse include in the teaching?

Brisk walking will help prevent bones loss

A nurse is reviewing the basic need of older adult clients with a group of assistive personnel, which of the following statements should he nurse include?

Deep Sleep is decrease

A nurse at a long term care facility is contributing to the plan of care for a client who has Alzheimer's disease and wanders at night. Which of the following interventions should the nurse include in the plan?

Assign the client to a room closer to the nurses station the nurse should place the client who wanders in a room that allows for close observation. the nurse should provide clients who wander a safe place to walk and supervision when the client is ambulating

A nurse is caring for a patient who is using a CPM device following a right knee replacement. Which of the following actions should the nurse take when applying the CPM device?

Line up the frame s=joints of the CPM to the clients knee.

A nurse us reinforcing teaching with a client who is to start taking alendronate sodium. Which of the following recommendation should the nurse include in the teaching?

Discontinue the medication if you develop heartburn

A nurse is transferring an older adult client who has right sided weakness from bed to a wheelchair. Which of the following action should t nurse take to provide a safe transfer?

Maintain a straight back and bend at the knees the nurse should maintain a straight back and bend at the hips and knees when transferring a client in order to allow the larger muscles of the thighs to do the lifting. good body mechanics are essential in preventing injury to the nurse

A nurse is reinforcing teaching with a group of older adults clients about dietary needs. Which of the following dietary recommendations should the nurse include in the teaching?

You should consume 1200 milligrams of calcium a day

A nurse is completing medication reconciliation for an older adult client who is receiving multiple medications which of the following action should the nurse take first?

Ask the client about over the counter medications the nurse should apply the nursing process priority-setting framework. the nurse can use the nursing process to plan client care and prioritize nursing actions. each step of the nursing process builds on the previous step, beginning with assessment or data collection. before the nurse can formulate a plan of action, implement a nursing intervention, or notify the provider of a change in the client's status, she must first collect adequate data from the client. assessing or collecting additional data will provide the nurse with knowledge to make an appropriate decision. when performing medication reconciliation, it is important that the nurse collect a list of all the medications the client takes in order to compare the full list of medications against any new medications the client will take the list should include prescriptions, over the counter medications, and herbal and nutritional supplements.

A nurse is caring for a client and is using a fentanyl transdermal patch for pain control. Which of the following actions should the nurse take when caring for this client?

Avoid using heating patch

A nurse is caring for an older adult client who has a terminal illness. the client tells the nurse " I just want to live one more month so i can see my grand child get married" which of the following in Kubler-ross stages of grief should the nurse identify the client is experiencing?

Bargaining bargaining is the third stage of grief according to kubler-ross. bargaining represents a last effort at overcoming death by earning longer life. trying to put off death for on last major celebration in the client's life, like the marriage of a grandchild, is a form of bargaining

A nurse is reinforcing teaching with a group of healthy, older adult clients about age related changes and sexual response. Which of the following changes should the nurse include as an age related change?

Decreased vaginal lubrication the nurse should inform the clients that a decreased in baginal secreations is an expected age-related change in older adult female clients. vaginal dryness might result in painful intercourse, which clients can manage with the use of water soluble lubricants during intercourse.

A nurse is collecting data from an older adult client who lives alone. Although the client is able to answer all questions appropriately, the nurse notes that the client has a decreased attentions span, expresses feelings of overwhelming sadness, and has low energy level. The nurse should identify that the client is exhibiting manifestations of which of the following disorders?

Depression

A nurse is collecting data afrom an older adult client who reports feeling anxious about financial concerns and having difficulty sleeping for several months. Which of the following actions should the nurse take?

Determine the client's usual sleep habits the nurse should collect further data from the client regarding usual bedtime rituals, the difficulties he is currently expereiencing, and the impact the current sleep pattern has had on his

A nurse is collecting data from an 85 yr old client. Which of the following findings should the nurse report to the provider?

Differences in pulse strength between lower extremities a difference in pulse strength can indicate a vascular complication. assessment of the peripheral vascular system should also include temperature, color, sensation, edema, and skin integrity of both the upper and lower extremities. the nurse should identify any differences in symmetry of these findings and report them.

A nurse is caring for an older adult client who reports that she has just retired and expresses feelings of loneliness due to the of daily interactions with coworkers. Which of the following responses should the nurse make?

Do you know about the local senior group? the nurse should assist the client in the resocialization process by using the therapeutic communication technique of giving information. becoming involved in an organization might assist the client in resocialization, which is beneficial to clients who have depended upon their employment for social interaction

A nurse is reviewing the medical record of an older client. For which of the following medications should the nurse request a hearing assessment of the client?

Furosemide

A nurse is collecting data from an older adult client who had a right sided stroke two days ago. For which of the following findings should he nurse notify the provider immediately?

Increased restlessness the nurse should apply the urgent versus non urgent priority setting framework. using this framework, the nurse should consider urgent needs to be the priority need because they pose more of a threat to the client. the nurse might also need to us maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. the nurse should check the client's level of consciousness to evaluate for increases in intracranial pressure that might have occurred. the nurse should identify increased restlessness a a sign of possible increases in intracranial pressure, which requires immediate intervention

A nurse is assisting with the admission of an older adult client who has urinary incontinence and smells strongly of urine. The clients partner who has been caring for her a home, states the he is sorry and embarrassed about the unpleasant smell. Which of the following responses should the nurse make?

It must be difficult to care for someone who is incontinence the nurse should use therapeutic responses such as acknowledgement and empathy when addressing the client's partner. this response is nonjudgmental and acknowledges the effort the client's partner has made, the use of therapeutic communication also encourages further discussion and provides the nurse with an opportunity to teach and to evaluate the need for assistance in the home

A nurse is caring for an older adult client who is expressing feelings of grief and longing for his earlier life. Which of the following actions should the nurse take?

Listen attentively and allow the client to talk about the past the nurse should encourage the client to reminisce as a means of dealing with his feelings of grief and longing. this is the therapeutic technique of offering self. listening to the client allows for venting of the client's feelings about the loss of a healthy, active life. according to erikson's theory, reminiscence is a necessary activity for older adults, who are in the stage of integrity vs despair

A nurse is reviewing the records of a group of older adults. Which of the following findings should the nurse identify as an unexpected manifestation of the aging process

Obesity the nurse should recognize that although obesity is found among a large percentage of the older adult population, this is an unexpected finding and can lead to cardiovascular disease, diabetes and stroke

A Nurse is caring for an older adult client who has moderate hearing loss. Which of the following action should the nurse take to enhance communication?

Speak at a moderate rate

A nurse is caring for an adult older client who is on bed rest. Which of the following foods should the nurse plan to include on the clients breakfast tray to prevent constipation?

Stewed prunes the nurse should include foods that are high in dietary fiber, such as stewed prunes, to help prevent constipation for the client is on bed rest

A nurse is caring for an older adult client who is unresponsive following a stroke. Which of the following actions should the nurse take while providing mouth care.

Turning the client in the side before starting oral care. the nurse should place the client in a lateral position to allow excess fluids to run out of his mouth into a basin, which reduces the risk of aspiration of fluids and secretions

A nurse collecting data from an older adult who has right sided heart failure. Which of the following findings is the nurse's priority to report?

Weight has increased 0.91 kg (2 lb) in 24 hr. the nurse should apply the urgent versus non urgent priority-setting framework. using this framework, the nurse should consider urgent needs to be the priority need because they pose more of a threat to the client. the nurse might also need to use maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. the nurse should evaluate daily weight of client's experiencing heart failure. a weight gain of .45 to .91 overnight or 1.36 kg within one week is an indication of worsening heart failure.