Chapter 19

An older adult client comes to the health center reporting difficulty sleeping. Which statement by the client would the nurse need to address? "I go to bed around 10:30 pm every night." "I try not to be too active once I've eaten dinner." "I don't drink coffee or alcohol." "I find myself napping on and off throughout the day."

"I find myself napping on and off throughout the day."

The charge nurse in an extended-care facility knows that the new nurse understands ageism when she says which of the following? "Older adults have incontinence." "Most older adults are lonely." "Older adults don't mind how they look." "Neither intelligence nor personality normally decline because of aging."

"Neither intelligence nor personality normally decline because of aging."

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? "Delirium progressively affects cognitive function and is a chronic process." "Dementia is an acute process and develops suddenly." "Sundowning is a common problem of dementia." "Alzheimer's disease (AD) is a reversible neurologic illness."

"Sundowning is a common problem of dementia."

A nursing student is studying depression in the elderly adult. Faculty members knows the student has mastered the information when she states which of the following? "Sadness is most often associated with suicidal intent." "Depression is usually not accompanied by changes in behavior." "Depression can resolve without treatment." "Treatment of depression includes counseling."

"Treatment of depression includes counseling."

A nursing student is looking at the demographics related to the older adult and finds that what percentage of the older adult population that is institutionalized falls into the age range of 85+ years? 15.4% 2.4% 3.8% 1.3%

15.4%

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? Excessive drug use Delirium Depression Alzheimer's disease

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? Endoscopic exam every year after 30 <20 g of fiber intake per day Annual screening after the age of 50 Administration of a stool softener daily

Annual screening after the age of 50

The nurse practitioner is examining a 55-year-old female client. Which of the following findings would be uncommon for this age group? Agility gradually decreases Menopause occurs Lower extremity pulses are weak Presbyopia occurs

Answer: Lower extremity pulses are weak. Rationale: Normal physiologic changes of the middle-aged adult do not include peripheral pulses becoming weak and not always palpable. The other options can be seen in a middle-aged adult.

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. Diverticulitis Stroke Glaucoma Hip fracture Arthritis

Arthritis Hip fracture Stroke

The nurse is evaluating a 42-year-old client who says that he is feeling stressed. Which of the following does the nurse know that could be a cause of stress for this age group? Losing driving privileges Retirement Being caught in the sandwich generation Social isolation

Being caught in the sandwich generation

A gerontologic nurse practitioner has a large client population with heart disease problems. This nurse practitioner is aware that heart disease is the leading cause of death in the aging adult. What is the cause of this trend? The cardiac output is increased with age. Resting heart rate decreases with age. Blood vessels lose their elasticity with age. Systolic blood pressure decreases with age.

Blood vessels lose their elasticity with age.

When educating the middle-age adult, it is important to discuss which of the following? Drug abuse Dysuria Calcium replacement Hypothyroidism

Calcium replacement

A nurse is providing care to an older adult with moderate cognitive impairment. When interacting with the client, which actions would be most appropriate? Select all that apply. Speak in a loud tone of voice. Use short, simple words when conversing with the client. Ask the client "Do you remember me?" when interacting Call the client by name. Avoid identifying yourself each time.

Call the client by name. Use short, simple words when conversing with the client.

In regard to lifespan considerations, the most important functional health pattern to assess in the elderly client is Cognition-perception Sexuality-reproduction Coping-stress tolerance Values-belief

Cognition-perception

What term is used to describe various disorders that progressively affect cognitive function? Ageism Reminiscence Dementia Delirium

Dementia

A nurse is assisting an older adult who is experiencing pain. Which intervention would be appropriate for the nurse to suggest? Select all that apply. Distraction Recreational therapies Massage Meditation Limited participation in physical activity

Distraction Massage Meditation Recreational therapies

Gould viewed the middle years as a time when adults increase their feelings of self-satisfaction, value their spouse as a companion, and become more concerned with health. Which nursing action best facilitates this process? Counseling a client who complains of being depressed Encouraging a client to have regular checkups Providing entertainment for a client on bedrest Arranging for social services to assist with meals for a homebound client

Encouraging a client to have regular checkups

An elderly client is becoming progressively confused due to Alzheimer's disease. The family can no longer manage the client at home due to wandering. Which of the following living arrangements could the nurse recommend? Naturally occurring retirement communities (NORCs) Respite care Accessory apartment Extended-care facility

Extended-care facility

A 78-year-old woman is on a nurse's rehabilitation unit status post a cerebrovascular accident (CVA). As the nurse assess her gait, the nurse notices that the client's left foot is dragging and she is not bending her left knee nor swinging her left arm. How would the nurse best describe the client's gait? Hemiparesis Spastic Ataxic Festinating

Hemiparesis

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? Furosemide Psyllium Hydromorphone Acetaminophen

Hydromorphone

When completing an assessment of the middle-aged adult, the nurse makes note of the client's cognitive development. Then nurse would expect to find what? Decreasing ability to focus and solve problems. Client wants to appear competent. Increased motivation to learn. Memory processing is quickly reviewed.

Increased motivation to learn.

A nurse is assessing middle-age adults living in a retirement community. What behavior would the nurse typically see in the middle-age adult? Looks forward but also looks back and begins to reflect on his or her life Believes in establishment of self but fears being pulled back into the family Looks inward, accepts life span as having definite boundaries, and has special interest in spouse, friends, and community Usually substitutes new roles for old roles and perhaps continues formal roles in a new context

Looks inward, accepts life span as having definite boundaries, and has special interest in spouse, friends, and community

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 Have a physical examination every 3 years Obtain the zoster vaccine Have a colonoscopy every 10 years

Perform self-examination of the skin every month

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. Intelligence declines with age. Old age begins at age 65. Most older adults are ill and institutionalized.

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? Fluid volume overload Cascade iatrogenesis Sleep disorder Polypharmacy

Polypharmacy

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? Grieving Social isolation Sleep deprivation Noncompliance

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? Providing slightly smaller servings of food for clients who are elderly Assessing the skin turgor of an older adult differently than that of a younger adult Speaking to older adults with the presumption that they have mild cognitive deficits Implementing falls prevention measures in a setting where older adults receive care

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

An older adult female client tells the nurse, "Whenever I sneeze or cough, I urinate a little bit. It's very embarrassing." The nurse interprets the client's statement as indicating which type of incontinence? Functional Overflow Stress Urge

Stress

A nurse is providing discharge instructions to an elderly client and his daughter. The daughter asks for suggestions to help keep her father healthy. Which of the following could the nurse suggest? The client should limit carbohydrates in his diet. The daughter can talk to the client's physician about taking a vitamin B supplement. The client should have a physical examination every 3 years. The client should have his eyes examined every year for glaucoma.

The client should have his eyes examined every year for glaucoma.

When providing nursing care to the elderly, it is most important to provide comfort due to which of the following changes? Thermoregulation Dementia Sexuality Isolation

Thermoregulation

An older adult client tells his home care nurse that he doesn't seem to sleep as well as he used to. The nurse is aware that the sleep changes that occur in the older adult client which cause a less restful sleep include: a decrease in stage I of the sleep cycle. a decrease in the deep sleep stage of the sleep cycle. a change in the normal progression of the sleep cycle. an increase in stage II of the sleep cycle.

a decrease in the deep sleep stage of the sleep cycle.

When describing the older adult's risk for infection, which aspect would the nurse most likely address? Select all that apply. enhanced immune function inadequate nutrition maintenance of T-cell function decline in humoral immunity lowered antibody responses

decline in humoral immunity lowered antibody responses inadequate nutrition

A nurse is preparing a presentation for a group of families who are providing care to their older adult parents. One of the family members asks the nurse, "How common is Alzheimer's disease?" The nurse responds by telling the group that after age 65, the prevalence of Alzheimer's disease: decreases by 10 for every year. doubles every 5 years. triples every year. declines but the rate is unknown.

doubles every 5 years.

The nurse is caring for an older adult client on the medical unit admitted for diagnostic testing. He is alert and oriented and lives independently in his own home. Which nursing intervention will be most effective in the prevention of falls for this client? moving him to a room close to the nurse's station ensuring his glasses are close by his bed using a gait belt each time he ambulates placing a bed alarm on his bed

ensuring his glasses are close by his bed

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. long-term care. hospice nursing. geriatrics.

gerontologic nursing. Gerontologic nursing combines the knowledge and skills of nursing with specialized focus on the aging in both health and illness. Hospice is end-of-life care, long-term care is a type of care facility, and geriatrics is a branch of medicine.

An older adult client is prescribed a sleep medication. When explaining the medication to the client, the nurse would emphasize which aspect of therapy? rare occurrences of confusion greatest effectiveness with short term use need for follow-up laboratory tests minimal risk of adverse effects

greatest effectiveness with short term use

A home care nurse is making a home visit to a 78-year-old client being cared for by his son and daughter-in-law. The client has missed several follow up visits to the health care provider over the past several months. The client states, "My son is so busy. I don't want to bother him." When the nurse asks the son about the missed visits, the son replies, "He just saw the doctor a couple months ago. He doesn't need to see him again. Besides, it costs too much money." The nurse would suspect: exploitation. neglect. abandonment. physical abuse.

neglect

The nurse is assessing an older adult client who has suffered injury to his nervous system. The client has a history of chronic pain and currently reports pain on a scale of 8 out of 10. The nurse identifies this type of pain as most likely: postherpetic neuralgia. neuropathic pain. central pain. phantom limb pain.

neuropathic pain.

An older adult client being cared for at home has developed a decubitus ulcer. The nurse would instruct the family caregiver to institute measures to: promote bowel elimination. control incontinence. relieve sustained pressure. improve nutrition.

relieve sustained pressure.

Based on an understanding of the cognitive changes that normally occur with aging, what might the nurse expect a newly hospitalized older adult to do? talk rapidly but be confused withdraw from strangers take longer to respond and react interrupt with frequent questions

take longer to respond and react