Chapter 11 PrepU AH1
A patient with Alzheimer's disease is prescribed donepezil (Aricept). When teaching the patient and family about this drug, which of the following would the nurse include?
It can help treat symptoms of the disease
Why are IV solutions usually given at a slower rate to older adults?
Older adults may have cardiac or renal impairments
An older adult develops sudden onset of confusion and is hospitalized. The family expresses concern that their loved one is developing Alzheimer disease. What response by the nurse is most appropriate?
"Several possible underlying factors could be causing the confusion. Alzheimer's usually does not present with sudden confusion."
Which actions by the nurse will assist in promoting an older adult's adherence to medication therapy? Select all that apply.
*Encourage the client to keep a list of medications and review it frequently for updates. *Use easy-to-open lids. *Provide a written medication schedule.
The nurse is assisting an older adult patient with dietary planning. The nurse emphasizes the importance of adequate intake of fruits, vegetables, and fish. What should the patient's daily carbohydrate intake be?
55-60%
A nurse is teaching nursing assistants in an extended-care facility measures to protect the skin of elderly clients. Which of the following measures is the nurse likely to recommend?
Encourage clients to avoid cigarette smoking
Older adults, who are more subject to falls, may fracture one or more ribs and be more susceptible to which condition after a rib fracture?
Pneumonia
Which neurotransmitter is implicated in depression?
Serotonin
Which are leading causes of death among the elderly? Select all that apply.
Heart disease
A client in a nursing home is diagnosed with Alzheimer's disease. He exhibits the following symptoms: difficulty with recent and remote memory, irritability, depression, restlessness, difficulty swallowing, and occasional incontinence. This client is in what stage of Alzheimer's disease?
II (Stage 2)
Students are reviewing information about visual changes and conditions associated with aging. The group demonstrates understanding of the information when they identify which condition as the major cause of vision loss in the elderly?
Macular degeneration
A nurse is assessing an older adult for depression using the Geriatric Depression Scale. Which question would the nurse ask first?
Are you basically satisfied with your life?
A nurse is obtaining the health history of a 72-year-old woman who has come to the ambulatory care center for an evaluation. When obtaining information about the woman's sleep patterns, which of the following would the nurse expect to assess?
Complaints about frequently waking up during the night
Which factor alters urinary elimination patterns in older adults?
Decrease in muscle tone
A nurse is assessing an elderly client with senile dementia. Which neurotransmitter condition is most likely to contribute to this client's cognitive changes?
Decreased acetylcholine levels
An age-related change associated with the cardiovascular system is
Decreased cardiac output
A client has recently brought her elderly mother home to live with her family. The client states that her mother has moderate Alzheimer's disease and asks about appropriate activities for her mother. The nurse tells the client to
Ensure that the mother doesn't have access to car keys or drive an automobile
After teaching a group of nursing students about living arrangements for older adults, the instructor determines that the teaching was successful when the group identifies which housing option as used by most older adults?
The client's own home
The following information is documented on the assessment form for an older adult: Kyphosis Dry mucous membranes Decreased respiratory excursion Urinary incontinence The nurse is reviewing the information and reports which finding to the physician?
Urinary incontinence
An older adult patient has just been admitted to a long-term care facility. Which of the following would be most important to reduce the risk for infection?
Use the PPD test to evaluate for TB
A nurse is providing a fall prevention clinic for a group of older adults. What information should the nurse include? Select all that apply.
*Have routine vision and hearing screenings *Place grab bars in the shower and tub *Wear nonslip shoes or socks when walking *Review medications routinely for side effects
When performing a respiratory assessment on an older adult patient, what changes associated with aging does the nurse expect to find?
*Increased residual volume *Loss of elastic tissue surrounding the alveoli *Reduced vital capacity
The nurse is preparing an elderly hospitalized client for discharge to home within the hour. What should be the priority for the nurse?
Assess the need for pneumococcal & influenza vaccines
A nursing instructor is preparing a class about age-related changes in the cardiovascular system that occur in the older adult. Which of the following would the instructor most likely include?
Increased BP
An elderly client exhibits blood pressure of 110/76 while prone, 100/72 sitting, and 92/64 standing. The nurse instructs the client to
Ingest 5-6 small meals a day
What is a nurse's role in providing home care for a client with Alzheimer disease?
Providing emotional and physical report
The nurse is assessing sleep habits of an elderly client who reports difficulty falling asleep and staying asleep. The nurse intervenes when the client reports he
Reads in bed before going to sleep
A nurse is caring for a client with dementia. A family member of the client asks what the most common cause of dementia is. Which response by the nurse is most appropriate?
The most common cause of dementia is alzheimer's disease
A client reports to the nurse that her grandmother with Alzheimer's disease recently moved in with her and her two school-aged children. The client states the grandmother becomes agitated and starts yelling and crying frequently. The woman asks, "What can I do?" The nurse first responds:
What precipitates the outbursts?
Ageism refers to
bias against older people based solely on chronological age.
An elderly female client tells the nurse she has trouble holding her "water." A nursing intervention is informing the client to
have adequate fluid intake
An elderly client is hospitalized for treatment related to leukemia. Family members want to visit with a toddler who has a cold. It would be best for the nurse to
Instruct the family to remove the toddler from the room for the protection of the client.
A nurse is working with the family of a patient with Alzheimer's disease to develop an appropriate plan of care. Which of the following would the nurse suggest to foster socialization?
Limiting visitors to 1 or 2 at a time
After teaching students about age-related changes in the sense of taste in older adults, the instructor determines that teaching was successful when the students identify which taste as being most affected?
Sweet
A client who is elderly reports difficulty with reading and seeing faces. The nurse assesses the client for the following risk factors associated with age-related macular degeneration (select all options that apply):
*Sunlight exposure *Cigarette smoking *Family Hx
The nurse brings the older adult patient a dinner tray and observes the patient placing excess amounts of salt on the food. What suggestions for flavoring can the nurse provide to decrease the amount of salt the patient is placing on her food? (Select all that apply.)
*Use low-sodium herbs and spices. *Use pepper instead of salt. *Use lemon instead of salt to flavor food.
Approximately what percentage of home care required by elderly people with Alzheimer disease is provided by informal caregivers?
80[%]
A client with Alzheimer's disease is being treated for malnutrition and dehydration. The nurse decides to place him closer to the nurses' station because of his tendency to:
wander
An older adult female patient tells the nurse, "I have lost an inch [2.5 cm] of height and have a hump on my back. What can I do about this?" What is the best response by the nurse?
"In order to prevent further bone loss, eat a diet high in calcium and low in phosphorus."
A client reports to the nurse that her elderly mother has become increasingly angry and responds inappropriately to conversations within the past few months. She notes that her mother does not respond when the mother's back is turned. The best intervention of the nurse is to
Ask if the mother could come in for a hearing evaluation
Family members report to the nurse that their elderly grandmother has had a sudden onset of confusion and that they are having difficulty providing care for her. What is the nurse's best response?
Assess for adventitious lung sounds
An elderly client is contemplating a move to a continuing care retirement community (CCRC). The nurse assesses that the client requires assistance with food preparation and recommends placement in
Assisted living apartment
Which is an age-related change in the respiratory system?
Decreased gas exchange
Students are reviewing information about age-related changes in the older adult. They demonstrate a need for additional study when they identify which of the following as an age-related change in the respiratory system?
Decreased residual lung volume
Which condition is characterized by a decline in intellectual functioning?
Dementia
A family of a patient with Alzheimer's disease asks the nurse what causes this condition? Which response by the nurse would be most appropriate?
Evidence shows that there are changes in nerve cells and brain chemicals
When assessing an older adult's gastrointestinal system, the nurse would identify an increase in which of the following as normal?
Feeling of fullness
After teaching an older adult about measures to relieve constipation, which statement by the client indicates a need for additional teaching?
I should use a laxative every other day
An elderly client experienced a cerebrovascular accident (CVA) and was unable to ambulate following his CVA. The client was transferred from a hospital and is now at a subacute care facility. For continuation of Medicare coverage, the nurse evaluates that the client must demonstrate
Improvement in ambulation
The reason that federal and state governments carefully regulate treatment given in licensed health care facilities, particularly long-term care facilities, is expressed by which statement?
Older adults are more vulnerable
A client with moderate Alzheimer's disease has been eating poorly, losing weight, and playing with food at meals. The nurse best intervenes by
Placing one food at a time in front of the client during meals
Which refers to the decrease in lens flexibility that occurs with age, resulting in the near point of focus getting farther away?
Presbyopia
The nurse is attempting to take vital signs of an older adult hospitalized following knee surgery. The client continuously yells, "It's 1999 and you are going to hurt me!" What action should the nurse do first?
Reorient the patient.
A nurse is preparing a health promotion class for a group of seniors at a local community center. As one part of the presentation, the nurse is planning to address sexuality and sexual function. Which statement would be least appropriate to include?
Sexual desire typically becomes progressively less
An elderly client is hospitalized. To maintain the client's mobility, the best nursing intervention is
Sit the client in a chair for meals
Which is an age-related change associated with the nervous system?
postural hypotension
A female elderly client tells the nurse she experiences vague pain during sexual intercourse with her spouse. It is best for the nurse to
refer the client to a gynecologist for eval
When assessing an older adult, the nurse anticipates an increase in which component of respiratory status?
residual lung volume
