Ch. 77. Primary Care of Older Adults

What should be suggested to a patient to aid with the pain of claudication? a. Rest b. Exercise c. Cross legs d. Stand

ANS: A A nursing intervention to relieve pain is to recommend the patient rest periodically until the pain subsides. Exercise and standing for long periods of time can exacerbate the pain. Crossing the legs can limit blood flow to the extremities and increase pain.

The nurse recommends a breathing technique to help a patient with chronic obstructive pulmonary disease (COPD) to empty the lungs of used air and to promote inhalation of adequate oxygen. What is this method of breathing called? a. Pursed-lip breathing b. Increased inspiration c. Vital capacity d. Decreased expiration

ANS: A Pursed-lip breathing can help empty the lungs of used air and promote inhalation of additional oxygen.

What is the best test to identify the risk of osteoporosis in postmenopausal women? a. Skeletal x-ray b. Bone density scan c. Calcium blood level d. CAT scan

ANS: B Bone density testing can identify women at risk for fractures.

The patient complains to the nurse about a newly developed intolerance to milk. What should the nurse suggest to fulfill calcium needs? a. Rye bread b. Yogurt c. Apples d. Raisins

ANS: B Lactose, primarily found in milk, is a common source of food intolerance. Dairy products are an important source of calcium, which is needed to prevent osteoporosis. Lactose-intolerant individuals need to replace milk with cheese and yogurt, which are processed and digested more easily.

When discussing aging, to whom does the term older adulthood apply? a. Age 55 and above b. Age 65 and above c. Age 70 and above d. Age 75 and above

ANS: B Older adulthood begins at about age 65.

The nurse is assisting an older adult patient out of bed when suddenly the patient begins to fall. What is the likely cause of the fall? a. Fever b. Orthostatic hypotension c. Dehydration d. A decrease in venous return

ANS: B Orthostatic hypotension occurs when the patient changes position. In the older adult, the loss of elasticity in the vessels slows the vascular accommodation to sudden postural changes to a standing position.

The older adult female patient is concerned about incontinence when she sneezes. What is the correct terminology for this type of incontinence? a. Urge incontinence b. Stress incontinence c. Overflow incontinence d. Functional incontinence

ANS: B Stress incontinence results from increased abdominal pressure, which occurs with coughing or sneezing. Urge incontinence occurs after a sudden urge to void and is associated with cystitis, tumors, stones, and CNS disorders. Overflow incontinence is associated with diabetic neuropathy and spinal cord injuries. Functional incontinence results from unwillingness or inability to get to the toilet.

What is age-related vision change caused by the loss of elasticity of the lens called? a. Nearsightedness b. Cataracts c. Presbyopia d. Blepharitis

ANS: C Age-related changes include presbyopia and farsightedness resulting from a loss of elasticity of the lens. Cataracts are due to opacity of the lens.

What is the most common cause of dementia? a. Multi-infarct b. Medications c. Alzheimer disease d. Parkinson disease

ANS: C Alzheimer disease is the most common cause of dementia.

When assessing the skin of an older adult patient who is complaining of pruritus, what should the nurse advise the patient to avoid to reduce further drying of her skin? a. Perfumed soap b. Hard-milled soap c. Antibacterial soap d. Lotion soap

ANS: C Antibacterial soap is very drying.

To help prevent falls related to muscle weakness, what type of exercises should be selected for the aging patient? a. Daily b. Running c. Weight-bearing d. Aerobic

ANS: C Appropriate interventions to increase muscle strength begin with weight-bearing exercises. They do not have to be done daily to be effective. Running and aerobic exercise would not be appropriate or effective for the aging patient.

The older adult patient complains to the nurse about nocturia. This problem is most likely related to: a. loss of bladder tone. b. decrease in testosterone. c. decrease in bladder capacity. d. intake of caffeine.

ANS: C At least 50% of older men and 70% of older women must get up two or more times during the night to empty their bladders, a condition known as nocturia (excessive urination at night). The most significant age-related change is the decrease in bladder capacity.

The nurse reminds the 80-year-old patient that her respiratory system has decreased resistance to respiratory infections. For what is this patient at increased risk? a. COPD b. Bronchitis c. Pneumonia d. Atelectasis

ANS: C Decreased resistance to respiratory infections places older adults at higher risk for pneumonia.

The nurse recognizes that an older adult patient with COPD has a higher incidence of developing which age-related skeletal change that will alter the ability to exchange air effectively? a. Osteoporosis b. Arthritis c. Kyphosis d. Osteomyelitis

ANS: C Kyphosis, usually caused by osteoporosis, is a curvature of the spine that alters respiration and air exchange.

What is one positive aspect of Parkinson disease? a. The disease does not alter ability to communicate b. Anti-Parkinson drugs have few side effects c. Intellectual function is not impaired d. Involuntary movements can be controlled

ANS: C Parkinson disease does not impair the intellect. The disease does alter the ability to communicate. Anti-Parkinson drugs have many side effects. The involuntary movements associated with the disease cannot be controlled.

When the nurse discusses prevention of cardiac disease, falls, and depression with a group of older adults, the benefits of what are important to stress? a. Nutrition b. Medications c. Exercise d. Sleep

ANS: C Primary prevention stresses exercise for the prevention of cardiac disease, falls, and depression.

A change of aging related to the circulatory system includes decreased blood vessel elasticity. For what should the nurse assess? a. Confusion b. Tachycardia c. Hypertension d. Retained secretions

ANS: C The blood vessels become less elastic because of aging and may lead to increased blood pressure.

When communicating with an older adult patient, the nurse becomes aware of the fact that the patient is well satisfied with his accomplishments over a lifetime and has no regrets concerning aging. Which of Eriksons developmental stages has the patient achieved? a. Acceptance b. Withdrawal c. Ego integrity d. Interaction

ANS: C The last stage of life is acceptance of life and it results in ego integrity.

At mealtime, the older adult seems to be eating less food than would be adequate. Compared to the younger adult, what is a requirement for the older adult? a. More fluids b. Less calcium c. Fewer calories d. More vitamins

ANS: C The older adult requires 30 calories per kilogram of body weight, whereas the younger adult requires 40 calories.

An older adult is having difficulty swallowing. What position should the nurse recommend to aid in swallowing? a. Chin parallel b. Chin upward c. Chin down d. Chin to the side

ANS: C The upright position, leaning slightly forward with the chin down, improves swallowing with the assistance of gravity.

When communicating with an older adult patient who has difficulty hearing, how should the nurse change her speech? a. Speak very loudly b. Speak rapidly c. Lower the tone of the voice d. Raise the tone of the voice

ANS: C To communicate with a patient with a hearing loss, the nurse should lower the tone of the voice.

For what is the older adult patient at increased risk because of age-related changes in the musculoskeletal system? a. Fractures due to poor uptake of calcium b. Heart attacks due to increased effort to ambulate c. Respiratory failure due to kyphosis d. Falls related to posture changes

ANS: D Falls are the leading cause of accidental death in individuals over 65, in part because of posture changes brought on by aging.

The older patient informs the nurse that food has no taste and therefore the patient has no appetite. What is this most likely caused by? a. Tasteless food b. Overuse of salt c. Lack of variety d. Loss of taste buds

ANS: D Older adults may experience a loss of appetite. Change in taste as a result of decreased saliva production and a decreased number of taste buds may make food unappealing.

Because thin skin and lack of subcutaneous fat predisposes the older adult to pressure ulcers, the nurse alters the care plan to include turning the bedfast patient how often? a. Once every shift b. Every 4 hours c. Each evening d. Every 2 hours

ANS: D Pressure ulcers can be avoided by repositioning the patient every 2 hours.

When an older female patient complains of painful sexual intercourse, what should the nurse recognize as the probable cause? a. Urinary incontinence b. Arthritic joints c. Kyphosis d. Mucosal drying

ANS: D Sexual intercourse may be uncomfortable because of drying of the mucosa of the vagina.