Chapter 32

The nurse transfers from an acute care facility to a long-term care facility. The nurse manager will make sure to tell the new nurse to refer to those who live in the facility are referred to as ___________________.

residents

The nurse is providing care in an acute care setting to an older adult patient. Which comment by the nurse indicates an attitude of ageism?

"I am certain that I will need to repeat the discharge instructions over and over."

The nurse is aware that the population of the elite old is growing. The 2010 U.S. Census identified more than 50,000 people over the age of 100 years. Which reason does the nurse recognize as the cause for this longevity?

Better medical management of chronic conditions

The nurse is talking to a group of middle-old adults. Which statement indicates to the nurse that a patient is having a psychosocial problem related to aging?

"I don't socialize much. I hate to get too close to people."

The nurse in a long-term care facility understands the division of responsibilities to the residents. Which reply will the nurse make to an unlicensed assistive personnel (UAP) who states, "I think that we should plan some activities for the residents."?

"The facility provides opportunities for activities and entertainment."

The nurse works in a long-term care facility. A new nurse expresses a lack of understanding about how older patients should be treated. Which comment by the experienced nurse reflects ageism?

"You know how old people are, think about how your grandmother behaved."

Which patient would be classified as old-old?

87 year-old

The nurse is aware that patients may experience some psychosocial issues as they age. Which causes of psychosocial issues does the nurse recognize? Select all that apply.

A fear of dying related to struggles about spiritual belief Loss and grief over the deaths of family members and friends Concern about the increased need to depend on others for care

The actual performance of physical nursing actions will change when caring for residents in a long-term care facility. Which provision of nursing care is incorrect?

A head-to-toe assessment is performed weekly.

The nurse is interviewing a young-old patient for a first-time office visit. The patient's medical record reveals prehypertension, a total cholesterol level of 205, and a recent diagnosis of adult onset diabetes mellitus. Which factor does the nurse identify as the least likely contributor to the patient's medical history?

A job that requires long working hours.

The nurse provides care and evaluation for multiple older adults in a clinic setting. Which patient will the nurse identify as being at greatest risk for cardiovascular problems?

A middle-old male patient with hypertension and hypercholesterolemia.

The nurse works in a gerontology physician's office and is responsible for reviewing medication information with each patient. Which information does the nurse include in the review sessions? Select all that apply.

The amount and timing of each medication Any substances that may interact with the medication Indications of medication effectiveness or side effects Safety precautions to be taken with each medication

The nurse is interviewing an old-old adult patient. The patient expresses concern over xerostomia. Which reason for the condition does the nurse provide?

The cells in the salivary glands diminish in size and number.

The nurse is performing screening for older adult patients at a community center. One patient demonstrates the ability to see the letters on a Snellen chart only by looking at the chart sideways. Which condition does the nurse suspect?

Age-related macular degeneration

The nurse is providing care for a young-old patient hospitalized after a cerebrovascular accident (CVA). The nurse notes left-sided weakness and difficulty speaking. Which nursing intervention will the nurse use to promote communication?

Allow plenty of time for the patient to reply to the nurse's questions.

The nurse in a general care office assists with an old-old patient who exhibits severe dementia. The family member asks if the nurse thinks the patient has Alzheimer's disease. Which information does the nurse provide?

Alzheimer's disease can only be accurately diagnosed with an autopsy.

The nurse is visiting the home of an old-old patient who lives in the home of an adult child's family. Which situation would cause the nurse to suspect elder abuse or neglect? Select all that apply.

An adult family member says, "I am surprised at how many bruises she can get." The daughter shares, "Mom doesn't eat with us anymore, she is so slow." A family friend states, "I think she has fallen recently and may have broken something." The patient tells the nurse, "I can't find my teeth and I need new glasses."

The nurse is aware that the activities director plans and manages activities and entertainment for the residents in a long-term care facility. Which activities would the nurse consider to be inappropriate? Select all that apply.

Charades Creative writing classes.

The nurse is providing care for a middle-old adult patient who is recently diagnosed with type 2 diabetes mellitus. The nurse recognizes that age has decreased the function of the patient's pancreas. Which additional factor related to age is associated with the management of diabetes mellitus?

Impaired mobility can interfere with the ability to exercise.

The nurse works in a long-term care facility. An unlicensed assistive personnel (UAP) tells the nurse that a couple of residents are having sexual intercourse in a room occupied by a single resident. Which action will the nurse take first?

Inquire if the resident's door was closed.

The nurse provides care for a young-old adult patient who has been hospitalized three times for recurrent respiratory infections. The nurse is attempting to provide the patient with an explanation for the recurrent illness. Which information will the nurse exclude?

The condition has become chronic.

The nurse is having a conversation with a middle-old patient. The patient states, "My last childhood friend just died. I feel so sad and alone." Which action should the nurse take to help the patient deal with loss and grief? Select all that apply.

Suggest the patient attend meetings with a support group. Encourage the patient to express feelings about the recent losses.

The nurse works in a church clinic and once a week sees older adult patients. Which physiological changes does the nurse expect to see in patients between the ages of 65 and 75 years?

Elevated blood pressure and high cholesterol.

The nurse is providing care to a middle-old patient following a cardiovascular accident (CVA). The spouse expresses concern that the patient cries and pounds a fist on the mattress. Which action by the nurse is best?

Explain that the patient may have personality changes following a CVA.

The nurse has transferred from an acute care setting to a long-term care facility. Which additional assessments will the nurse make on the residents beyond the monthly head-to-toe physical assessment? Select all that apply.

General eating habits Ability and methods of communication Bowel and bladder elimination status and habits

The nurse in a long-term care facility is aware that residents should not be isolated from the outside community. Which interventions will promote a sense of community with the residents? Select all that apply.

Have local churches provide services for the residents. Invite local children to come for holiday celebrations. Host a girl or boy scouting troop at the facility.

The nurse is interviewing an older adult patient in the health-care provider's office. The patient states, "I don't get this aging thing, some of us do it so well and others really struggle." Which factor will the nurse exclude from an explanation to the patient?

Having a positive outlook on life will significantly slow the aging process.

The nurse works in a clinic that provides care for older adult patients. A patient tells the nurse, "I am so upset. Money is disappearing from my investment accounts." Which initial information will the nurse attempt to learn from the patient?

If someone recently solicited personal information over the telephone

The nurse is providing care for a middle-old patient experiencing confusion after anesthesia. The patient calls out that someone is watching her through the window. The nurse notices that the nurse's reflection in a picture glass is the cause of the patient's reaction. Which specific symptom does the nurse identify?

Illusions.

The nurse in a long-term care facility is planning a program for unlicensed assistive personnel (UAPs) about promoting patient nutrition. Which suggestions will the nurse pass along to the UAPs? Select all that apply.

Make sure that residents have dentures inserted. Feed or assist residents to eat as needed.

The residents in a long-term care facility are in the dining room. Which primary benefit to the residents does the nurse recognize? *PIC*

Meal times are enhanced by social interactions.

The nurse works in a long-term care facility and is contemplating a transfer to a memory care unit in the same facility. Which differences will the nurse encounter in memory care unit? Select all that apply.

Objects and cues are used to trigger comforting memories for the residents. Hallways are often in circular patterns to promote safe wandering. A calm, quiet atmosphere is maintained to decrease stimulation.

The nurse in a long-term care facility is aware that many older adult patients experience constipation, or worry about bowel function. Which cause related to aging does the nurse recognize?

Peristalsis naturally slows down over time.

The nurse is preparing to present information to a group of older adult patients about home safety. The nurse plans to focus on the incidences of crime related to the elderly. Which topic is the nurse likely to emphasize the least?

Persons representing themselves as contractors may do shoddy work.

The nurse is evaluating older adult residents in a long-term care facility. The nurse is concerned about preventing impaired immobility in residents. In which activities will the nurse encourage residents to participate? Select all that apply.

Scheduled exercise sessions Outdoor walks and activities Leading residents in chair exercises Tending flower gardens

The nurse works in a health-care provider's office and is interviewing an older adult patient who is seeking medical care for an acute upper respiratory condition. Which other body system will the nurse be able to easily evaluate during the interviewing process?

Sensory and neurological processes.

The nurse in an acute care facility is interviewing an old-old patient with a hearing deficit. Which action is the nurse performing to accommodate the patient?

Sitting to be visible so that the patient can lip read

The nurse is providing care for an older adult patient who experiences presbycusis. Which nursing action is inappropriate when communicating with this patient?

Speak to the patient in a very loud voice to promote hearing.

The nurse working in a hospital is providing care for an old-old patient with dementia who often forgets to take his medications consistently. The nurse begins teaching the patient and the patient's family during discharge about at-home care options. Which factor does the nurse expect will most influence this family's decision regarding the care of the patient?

The culture of the patient's family.

The nurse in a long-term care facility is aware that older adult patients experience changes in genitourinary functioning. Which change causes the nurse the greatest concern for patient safety?

The development of nocturia

The nurse is interviewing a middle-old adult patient. The nurse understands that this patient is at increased risk for the development of a psychosocial disorder. Which factor does the nurse recognize as the greatest cause of this disorder?

The loss of a spouse, family members, or friends to death.

The nurse receives an assignment to care for a patient who is 64 years old. The nurse places the patient in which age category?

Young-old

The nurse works in a long-term care facility in the unit designated for residents with dementia. Which function by the nurse will be different for residents in this unit?

The nurse may need to maintain the resident's room for safety reasons.

The nurse is moving from an acute care facility position to a long-term care facility. Which adjustment will the nurse need to make when referencing Maslow's hierarchy of needs?

The nurse will have a longer time frame to address the resident's needs.

The nurse is seeing a patient that is considered to be old-old. The patient is cared for in an adult child's home. Which finding causes the nurse to suspect elder abuse?

The patient has lacerations in varying stages of healing.

The nurse in a clinic is reviewing prescribed medications with an older adult patient. The nurse notes some medications that are duplicated in action and purpose and that some medications are contraindicated because of possible interactions. Which reason does the nurse recognize as the most likely contributing factor to the patient's medications?

The patient is under the care of several different health-care providers.

The nurse works at a community clinic. Which older adult patient exhibits the positive aspects of aging to the nurse?

The patient who volunteers services as a small business advisor.

Nurses are aware of shortages in the profession. Which social situation will place the number of nurses at one million below the number needed by the year 2020?

The projection that by 2050, 17% of the population will be over the age of 65 years.

The nurse in a long-term care facility notices that an old-old female resident is having difficulty moving about. Which factor related to age will prompt the nurse to suggest that the resident use a wheelchair?

The resident has decreased bone density and muscle mass.

The nurse is providing care in an acute care setting for a middle-old patient admitted for neurological monitoring and testing. The patient fell after feeling dizzy and is experiencing right side numbness. The patient currently has no symptoms. Which diagnosis does the nurse expect?

Transient ischemic attack (TIA).