Final 241 - MedSurg

A nurse is discussing culturally comprehend care at a nursing staff inservice. Which of the information should the nurse include when discussing clients culture?

Nurses should expect clients to adapt to the care provided regardless of culture

a nurse is teaching a client who has a history of falls about home safety. Which of the following statements should the nurse identify as an indication that the client understands the instructions? -I will place a bath seat in my shower to use when I bathe -I will keep the fluorescent ceiling light on in my room at night -I will place an area rug at the entry of my bathroom -I will keep my walker at the end of my bed

" I will place a bath seat in my shower to use when I bathe?" Rationale: a bath seat can help reducing slipping and falling in the bathtub or shower

A nurse is teaching the family of an older adult client who has a new diagnosis of dementia. Which of the following statements should the nurse include in the teaching?

"The signs of dementia is a progressive disorder that is irreversible."

a nurse is teaching a client about the uses of cranberry juice. Which of the following information should the nurse include in the teaching? -drinking cranberry juice daily can prevent recurrent urinary tract infection -cranberry juice can cause bad breath -you may experience bloating -cranberry juice can lower cholesterol

"drinking cranberry juice daily can prevent recurrent urinary tract infections." Rationale: the client can decrease the risk of having recurrent urinary tract infections by consuming cranberry juice daily, because cranberry juice contains proanthocyanidins a compound that prevents bacteria from adhering to the urinary tract mucosa

which precaution would be beneficial in minimizing an older adults risk of being a victim of fraud? (SATA) - do not allow uninvited salespersons into your home -keep your bank account and credit card numbers with you at all times -rely on advice of people who only friends have recommended -never provide personal information to telephone sales solicitors

- do not allow uninvited salespersons into your home -never provide personal information to telephone sales solicitors

a nurse working for a home health agency is teaching a client who has diabetes mellitus about disease management. Which of the following glycosylated hemoglobin (HbA1c) values should the nurse include in the teaching as an indicator that the client is appropriately controlling his glucose levels? -8.5% -6.3% -7.8% -10%

-6.3%

which technique is most effective when communicating with a client who is positioned in bed? -standing at the foot of the bed -sitting in a chair at the foot of the bed -sitting in a chair at the bedside facing the client -standing near the clients head on his or her dominant side

-sitting in a chair at the bedside facing the client

A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following laboratory values? A) free T4 B) thyroid stimulating hormone (TSH) C) serum T3 D) serum T4

B

The most significant etiology for COPD a. emphysema b. chronic bronchitis c. tobacco use d. exposure to carinogens in the workplace

C) tobacco use

A nurse is assessing a client who has hyper thyroidism. The nurse should expect the client to report which of the following manifestations? A) constipation B) weight gain of 4.5kg (10 lbs) in 3 weeks C) sensitivity to cold D) frequent mood changes

D

A nurse is assessing an older adult client who has osteoporosis. Which of the following spinal deformities should the nurse expect to find in this client? A) lordosis B) ankylosis C) scoliosis D) kyphosis

D

A nurse is caring for a client who has rheumatoid arthritis and is experiencing difficulty feeding herself using adaptive devices. The nurse should initiate a referral with which of the following members of the inter-professional health care team? A) speech pathologist B) social worker C) registered dietitian D) occupational therapist

D

A client who reported "a problem sleeping" shows an understanding of good sleep hygiene by: A) seldom eating a bedtime snack B) doing 10 pushups before bed to encourage a "pleasant tiredness" C) engaging in computer games as a pre-bed activity D) avoiding daytime napping

D) avoiding daytime napping

A paper on culture and illness would be likely to include the statement that

Ethnicity involves recognized traditions, symbols, and literature

Define Health Literacy?

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

An older patient learns that he has metastatic cancer. The patient states: "I must have angered God." This is an example of which type of belief?

Magico-religious

A nurse measures an older adult's blood pressure on the right arm and notes a reading of 150/100. The nurse waits 5 minutes and measures the blood pressure again in the right arm and obtains a reading of 152/100. What is the next action by the nurse?

Obtain a second set of measurements at a different time. Rational: Diagnosis of hypertension requires two measurements. A second set is done at a different time for the diagnosis to be confirmed. Doing orthostatic measurements is not indicated in this situation. A blood pressure reading above 140/90 is considered abnormal for an older adult.

A nurse is teaching a class on Health promotion and illness prevention. The nurse should include in that which of the following is an example of secondary prevention?

Performing monthly breast self-examinations.

Which technique is most effective when communicating with a client who is positioned in bed?

Sitting in a chair at the bedside facing the client

a nurse is teaching a group of clients about st. johns wort. Which of the following information should the nurse include in the teaching? -st johns wort can reduce the effectiveness of oral contraceptives -st johns wort increases estrogen levels in the body -st johns wort can lower prostate specific antigen levels -st johns wort can be used to treat mild depression

St johns wort can be used to treat mild depression rationale: the nurse should teach that st johns wort increased the serotonin level of serotonin-enhancing antidepressants, which may place the client at risk for serotonin syndrome

A nurse is assessing a family as a system. Which of the following factors should the nurse include when assessing sociocultural context

The family's religious practices

A nurse is caring for a client who has COPD. The client tells the nurse, "I can feel the congestion in my lungs, and I certainly cough a lot, but I can't seem to bring anything up." Which of the following actions should the nurse take to help this client with tenacious bronchial secretions? a. encouraging the client to drink 2 to 3 L of water daily b.administering oxygen via nasal cannula at 2L/min c. maintaining a semi-fowlers position as often as possible d. helping the client select a low-salt diet

a. encouraging the client to drink 2 to 3 L of water daily

A nurse is providing teaching to a client who has a new diagnosis of Parkinson's disease. On which of the following medications should the nurse prepare to instruct the client? a. levodopa/carbidopa b. piperacillin/tazobactam c. carbamazepine d. levothyroxine

a. levadopa/carbidopa

a nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. the nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin? -the client follows a low-fat diet to reduce cholesterol -the client uses garlic to lower cholesterol levels -the clients drinks a glass of grapefruit juice every day -the client sprinkles flax seeds on food 1 hr before taking the anticoagulant

the client uses garlic to lower cholesterol levels Rationale: the nurse recognize the garlic can potentiate the action of the warfarin.

a nurse is assessing a client who has insomnia. Which of the following questions is the highest priority for the nurse to ask the client? -Can you describe your bedtime routine to me? -when did you begin to have trouble sleeping? -are there any specific factors that you think are affecting your ability to sleep? -do you have difficulty staying awake when you are driving?

-do you have difficulty staying awake when you are driving?

the area in which nurses have the greatest effect on the safe, effective medication therapy of an older client is -educating the client to all aspects of the medication -monitoring overall health of the client as it is affected by the medication -assessing for adverse reactions to the medication -evaluating the outcomes resulting from the medication

-educating the client to all aspects of the medication

the FANCAPES assessment tool focuses on the older adults -ability to meet personal needs to identify the amount of assistance needed -ability to perform instrumental activities of daily living -cognitive abilities -level of dementia present

-ability to perform instrumental activities of daily living

a client who reported a problem sleeping shows an understanding of good sleep hygiene by -avoiding daytime napping -seldom eating a bedtime snack -doing 10 pushups before bed to encourage a pleasant tiredness -engaging in computer games as a pre bed activity

-avoiding daytime napping

a nurse is preparing a presentation about black cohosh to a group of clients. Which of the following information should the nurse include in the teaching? -black cohosh is used to treat the common cold -black cohosh helps relieve nocturia -black cohosh can help to reduce arthritis pain -black cohosh is used to alleviate menopausal symptoms

-black cohosh is used to alleviate menopausal symptoms

when performing the initial assessment on a new client in a geriatric outpatients practice, the most effective method the nurse can implement to elicit an accurate medication assessment is to ask that the client -make a list of all her current medication -work with a family member to make a list of her medications -bring in all of the medications that she is currently taking -allow her previous primary care provider to provide a list of medications

-bring in all of the medications that she is currently taking

a nurse is reviewing a client's laboratory results and finds the hemoglobin is 10 g/dL and the hematocrit is 30%. The nurse recognizes that the client is at risk for which of the following? -prolonged bleeding -cellular hypoxia -impaired immunity -fluid retention

-cellular hypoxia

a nurse is presenting a class about fall prevention to a group of assisted-living residents. Which of the following statements by a resident best indicates an understanding of the teaching? -I should place a throw rug over electrical cords -I should get a longer cord for my telephone -it is a good idea to use the handrails in the bathroom -I should use chairs without armrests

-it is a good idea to use the handrails in the bathroom

a nurse is teaching a class on health promotion and illness prevention. The nurse should include that which of the following is an example of secondary prevention? -teaching foot care to a client who has diabetes -providing a community program on stress reduction -performing monthly breast self-examinations -referring a client who has had a mastectomy to a support group

-performing monthly breast self-examinations

a home health nurse is conducting a home safety assessment for an older adult client. Which of the following findings should the nurse identify as a safety risk for the client? -throw rugs -bathtub with rails -electric cords behind the furniture -raised toilet seats

Throw rugs Rationale: the nurse should recommend removing or securing any rugs or mats that could move and cause the client to slip, slide or trip.

A nurse in a clinic is assessing a client. Which of the following findings should the nurse identify as a risk factor for osteoporosis? A) smokes 1 pack of cigarettes per day B) drinks one alcoholic beverage per day C) history of bone fracture during childhood D) large body stature

A

A nurse is performing a pain assessment for a client who is alert. The nurse should recognize that which of the following measures is the most reliable indicator of pain? A) self-report of pain B) non-verbal behavior C) severity of the condition D) vital signs

A

A nurse is teaching a client who has a new diagnosis of gout about managing the disorder. Which of the following instructions should the nurse include in the teaching? A) eat less liver, sardines, and shrimp B) have a glass of red wine with dinner each day C) drink 1 to 1.5 L of fluid each day D) use aspirin for management of gout pain

A

A nurse is teaching a client who has diabetes mellitus about foot care. Which of the following statements by the client indicates an understanding of the teaching? A) "I'll check my feet every day for sores and bruises" B) "I'll wear sandals in warm weather" C) "I'll soak my feet in cool water every night before I go to bed" D) "I'll put lotion between my toes after drying my feet"

A

A nurse working for a home health agency is teaching a client who has diabetes mellitus about disease management. Which of the following glycosylated hemoglobin (HbA1c) values should the nurse include in the teaching as an indicator that the client is appropriately controlling is glucose levels? A) 6.3% B) 8.5% C) 7.8% D) 10%

A

A nurse is caring for a group of older clients. Which of the following manifestations indicates one of the clients is experiencing delirium?

A client attempts to climb out of bed and repeatedly states she must get home. Rationale: Delirium is characterized by a change in cognition that occurs over a short period of time. It results from a secondary physiological condition(e.g., infection, surgery, prolonged hospitalization, hypoxia, fever, medications) and is a transient disorder. Although delirium can occur with any age, it is more common in older adults. It frequently progresses in the evening hours and is sometimes called "sundown syndrome."Delirium is characterized by alterations in memory, agitation, restlessness, illusions, or hallucinations. A client who becomes acutely confused and agitated may be showing manifestations of delirium.

A nurse is caring for a client who asks about the functions of the thymus, spleen, and lymph nodes. Which of the following responses should the nurse make? A) these organs are used in digestion B) these organs support immunity C) these organs regulate electrolyte balance D) these organs assist vitamin absorption

B

A nurse is working with an older individual who has recently started an exercise program. The individual tells the nurse, "this exercise thing is really hard, and I absolutely hate walking on a treadmill going nowhere. I think I am going to call it quits." Which of the following responses by the nurse will be most effective in encouraging the individual to remain in the program? A) "most older people hate exercising, but they do it anyways" B) "what types of exercise do you enjoy doing?" C) "I will have to report that to your physician" D) "if you stop exercising you will reverse all the good effects that the exercise accomplished"

B

A nurse is instructing a young adult client about healthful sleep habits. Which of the following statements should the nurse identify as an indication that the client needs further teaching? A) "I go to bed and get up routinely at the same time each day" B) "I watch television until I fall asleep at night C) "I have a small snack and take a bath before going to bed each day" D) "I don't take naps throughout the day"

B) "I watch television until I fall asleep at night"

A nurse is caring for a client who is at risk for falls. Which of the following actions should the nurse take? (Select all that apply) A) keep the clients room dark at night B) place a fall-risk identification band on the client's wrist C) keep the clients bed in the lowest position D) assess the client every 4hrs

B) place a fall-risk identification band on the client's wrist C) keep the clients bed in the lowest position

A client who has type 2 diabetes mellitus asks the nurse, "why did I develop diabetes?" Which of the following responses should the nurse make? A) your kidneys are not able to reabsorb water which leads to type 2 diabetes mellitus B) an infection in your pancreas destroyed the cells that make insulin C) your body has insulin resistance and decreased insulin secretion D) your body is destroying the cells that secrete insulin

C

A nurse is admitting a client who has a partial hearing loss. Which of the following is a priority action by the nurse? A) speak using his usual tone of voice B) rephrase statements the client does not hear C) stand directly in front of the client D) determine if the client uses hearing aids

D) Determine if the client uses hearing aids

A nurse is caring for an older client who states, "I am afraid that I may fall while walking to the bathroom during the night." Which of the following action should the nurse take? A) obtain a bedside commode for the clients use B) limit the clients fluid intake in the evening C) put the side rails up and tell the client to call the nurse before voiding D) Leave a nightlight on the client's room

D) Leave a nightlight on the client's room

A nurse assessing a client notes that the client has a constant leakage of small amounts of urine and a bladder that is distended and palpable. The nurse should associate these findings with which of the following types of urinary incontinence? A) stress incontinence B) reflex incontinence C) urge incontinence D) overflow incontinence

D) Overflow incontinence

A nurse in the emergency department is implementing a plan of care for an older adult client who is experiencing delirium tremens, with increased psychomotor activity. Which of the following actions should the nurse take first? A. administer diazepam b. start intravenous fluids c. obtain a medical history d. raise the side rails of the bed

D. raise the side rails of the bed

A community health nurse is reviewing levels of disease prevention. Which of the following activities is an example of tertiary population?

Providing rehabilitation for clients who have chronic obstructive pulmonary disease

Primary prevention strategies for older adults include which of the following?

A smoking cessation program

A nurse is preparing a presentation at a nursing home about osteoarthritis. The nurse should plan to include which of the following information? (Select all that apply) A) causes joint stiffness B) causes joint pain C) affects bilateral, symmetrical joints D) crepitus can occur in affected joints

A, B, D

A home health nurse is making a home visit to an older patient. A nurse conducts a home safety assessment and screens the environment for potential hazards for falls. The nurse recommends that the patient eliminate which of the following? (Select all that apply) A) loose carpeting on the floors B) night lights C) railings on the stairway D) excess clutter

A, D

A nurse is caring for a client who reports difficulty sleeping while in the hospital. Which of the following actions taken by the assistive personnel (AP) while the client is sleeping should prompt the nurse to intervene? A) closes the door to the clients room B) Flushes the client's toilet after emptying the urinary catheter's drainage bag C) asks a group of nurses in the hall to speak quietly D) measures the clients vital signs routinely

B) Flushes the client's toilet after emptying the urinary catheter's drainage bag

A nurse is caring for an older adult client who is at risk for skin breakdown. Which of the following should the nurse use to help maintain the integrity of the client's skin? A) reposition the client every 3 hours B) provide the client with a diet high in protein C) apply cornstarch to keep the skin dry D) massage bony prominences to promote circulation

B) Provide the client with a diet high in protein.

A nurse is assessing an older client who has a pressure ulcer. The nurse should recognize which of the following findings is a manifestation of a stage 3 pressure ulcer? A) partial thickness skin loss B) subcutaneous tissue C) exposed bone D) blood filled blisters

B) Subcutaneous tissue

A nurse is assessing four older female clients for obesity. Which of the following clients have manifestations of obesity? A) a client who has a BMI of 28 B) a client who weighs 28% above ideal body weight C) a client who has a body fat of 22% D) a client who has a waist circumference of 81.3 cm (32 in)

B) a client who weighs 28% above ideal body weight

A nurse is teaching a client about hypertension. Which of the following information should the nurse include in the teaching? a. limit your alcohol consumption to three drinks a day b. diuretics are the first type of medication to control hypertension c. plan to lower saturated fats to 10 percent of your daily calorie intake d. reaching your goal blood pressure will occur within 2 months

B) diuretics are the first type of medication to control hypertension

A nurse is teaching a client who has constipation. Which of the following should the nurse discuss as cause of constipation? (Select all that apply) A) increased activity B) excessive laxative use C) increased fiber in the diet D) inadequate fluid intake

B) excessive laxative use C) inadequate fluid intake

An older person has a sudden onset of a severe headache, left-sided facial drooping, and left arm numbness. The person's daughter calls 911 and the person is transported to the emergency department. The first diagnostic test that will likely be performed is a(n): a. international normalized ratio to determine level of anticoagulation b.computed tomography (CT) scan to differentiate hemorrhagic from ischemic stroke c. electrocardiogram (ECG) to assess for atrial fibrillation d. lumbar puncture to assess for infection

B. CT scan to differentiate hemorrhagic from ischemic stroke

A nurse is providing teaching for a client who has a recent diagnosis of depression. Which of the following should the nurse identify as a primary risk factor for this disorder? A. Recent history of stressful, positive life events B. Past history of childhood trauma C. Having elevated levels of serotonin D. Being an only child

B. Past history of childhood trauma

A nurse is assessing an older adult's risk for falls. One of the questions that she asks is whether the older adult had fallen in the past year. She asks this because individuals who have fallen: A) are most likely to have a balanced disorder as compared to persons who did not fall in the past year B) have most likely developed a fear of falling as compared to persons who did not fall in the past year C) have a higher risk of falling again than the persons who did not fall in the past year D) are more likely to sustain injuries if they fall again than persons who did not fall in the past year

C

A nurse is proving teaching to a client who has a new diagnosis of hypothyroidism. On which of the following medications should the nurse prepare to instruct the client? A) sumatriptan B) levofloxacin C) Levothyroxine D) radioactive iodine

C

A nurse is talking with a client whose thyroid-stimulating hormone (TSH) level will be measured. Which of the following statements by the nurse explains the purpose of this test? A) "this test measures the amount of thyroid hormone that attaches to a protein in your blood" B) "this test measures the absorption of iodine and how it relates to the thyroid gland" C) "this test determines whether your thyroid gland is overactive, appropriately active, or under active " D) "this test detects antithyroid antibodies in your blood"

C

A nurse is teaching a client who has gout about dietary recommendations. The nurse should teach the client that which of the following beverages can trigger an attack? A) coffee B) orange juice C) alcohol D) milk

C

A 75-years old female asks a nurse "I know I should be moving, but how much is the right amount of exercise for me? The best response of the nurse is: A) "there are no specific recommendations for someone of your age; just keep moving" B) "since you are 75, the recommendations are 30 minutes of moderate exercise three times a week" C) "you need to engage in 30min of moderate intensity exercise at least 5 days a week" D) "you need to engage in at least 30 minutes of moderate intensity exercise everyday of the week"

C) "You need to engage in 30min of moderate intensity exercise at least 5 days a week"

A nurse is caring for a client who has herpes zoster. Which of the following findings should the nurse expect? A) multiple furuncles located on the clients back B) patches scattered across the torso C) painful lesions following a nerve pathway D) different sized papules in the genital area

C) Painful lesions following a nerve pathway

A nurse is teaching a client about risk factors for osteoarthritis. Which of the following factors should the nurse include in the teaching (select all that apply) A) bacteria B) diuretics C) obesity D) aging

C, D

A nurse identifies that an older adult needs more education on nutritional needs when the older adult states the following -even though I am an older adult, I still need the same amount of nutrients in order to be healthy -since I am an older person, I need fewer calories since my metabolic rate is slower -since I am an older person. I need more calories because my metabolic rate is slower -even though I am an older person, I still need to pay attention to my diet and activity levels

-since I am an older person. I need more calories because my metabolic rate is slower

When conducting an admissions interview with an older client, the nurse observes that the client pauses for a period of time before responding to the questions. The nurse responds to this client based on the assumption that the client is: A) sorting through his or her vast life experiences in order to answer appropriately B) reluctant to share information with someone whom he or she has no relationship C) exhibiting signs of mild cognitive impairment

A) Sorting through his or her vast life experiences in order to answer appropriately

A nurse is assisting an older client who is sedentary plan a new exercise regimen. Which of the following activities should the nurse recommend? A) walking B) running C) tennis D) jumping rope

A) Walking

A nurse is monitoring a client who is postoperative and unable to respond to questions. Which of the following nonverbal behaviors should the nurse identify as an indication that the client has pain? (Select all that apply) A) restlessness B) grimacing C) clenching D) drowsiness

A, B, C

A nurse is teaching a client about risk factors for osteoporosis. Which of the following risk factors should the nurse include in the teaching? (Select all that apply) A) sedentary lifestyle B) smoking C) aging D) obesity

A, B, C

The nurse includes education on when not to exercise. Which of the following should the nurse include in the education? (Select all that apply) A) do not exercise if your BP is greater than 200 systolic and 100 diastolic B) it is important to wait 30 min after a big meal before engaging in exercise C) do not exercise if your resting heart rate is over 70 D) do not exercise if a joint that you are using to exercise is red, warm, and painful

A, D

A diagnosis of Parkinson's disease is made based on the presence of which of the following symptoms? a. rigidity b.progressive decline in cognitive function c. resting tremor d. bradykinesia

A,C,D

A nurse is assessing an older patient with a new onset confusion. The nurse understands that in order to have a diagnosis of delirium, the patient. must exhibit which of the following? A. flat affect B. altered level of consciousness c. disorganized thinking d. acute onset of symptoms or fluctuating course

B. altered level of consciousness c. disorganized thinking d. acute onset of symptoms or fluctuating course

A nurse is preparing a community health program for adults at risk for cardiovascular disease. Which of the following should the nurse include as a modifiable risk factor? A.increasing age B. Cigarette smoking c. diagnosis of diabetes mellitus d. family history of cardiac disease

B. cigarette smoking

An older adult with suspected Parkinson's disease has a "challenge test" performed in order to confirm the diagnosis. The nurse understands that a "challenge test" will demonstrate which of the following? a. immediate reversal of all symptoms of Parkinson's disease after administration of levodopa b. dramatic improvement of symptoms of Parkinson's disease after administration of levodopa c. dramatic improvement in tremor only after administration of levodopa d. dramatic improvement in gait only after administration of levodopa

B. dramatic improvement of symptoms of Parkinsons after administration of levodopa

a nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease. The nurse should expect which of the following findings? -BUN 10 mg/dL and creatinine 0.3 mg/dL -BUN 45 mg/dL and creatinine 8 mg/dL -BUN 23 mg/dL and creatinine 1.0 mg/dL -BUN 8mg/dL and creatinine 0.7 mg/dL

BUN 45mg/dL and creatinine 8mg/dL A BUN that is decreased combined with a creatinine level that is within the expected reference range is not an expected finding of chronic kidney disease

A nurse is caring for a client 3 days after admission for treatment of depression. The client leaves her current activity, approaches the nurse and states, "There's no reason to go on living. I just want to end it all." Which of the following actions should the nurse take? A. Recognize the attempt at manipulation and escort the client back to her activity B. Assist the client to her room and allow her to rest before resuming activity C. ask the client if she has a plan to commit suicide D. Notify the clients family and request a visitor to stay with the client until thoughts of suicide are gone

C. ask the client if she has a plan to commit suicide

A nurse is assessing a client who has Parkinson's disease. Which of the following manifestations should the nurse expect? A. xerostomia B.pruritis C. Bradykinesia D. hypertension

C. bradykinesia

A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestations should the nurse tell the family to expect? A. decreased auditory and visual acuity B. decreased display of emotions c. forgetfulness gradually progressing to disorientation d. personality traits that are opposite of original traits

C. forgetfulness gradually progressing to disorientation

An older adult is admitted to the hospital after a serious fall. When noting that the client has been prescribed meperidine (Demerol) for muscle pain, the nurse: A) conducts a pain assessment and determines the client's need for an analgesic medication B) administers the medication so as to prevent the client from developing the fear of pain C) questions the client and family concerning any allergies to analgesic medication D) calls the physician to question the appropriateness of this medication order

D

An older adult with gastric cancer with bone metastases is being discharged from the hospital after beginning a regimen of opioid analgesics to control the metastatic pain. What should be included in the discharge planning? A) increasing calories in the diet B) preventing pressure ulcers C) benefits of grief counseling D) the development of a plan to prevent constipation

D

A nurse is presenting a class about fall prevention to a group of assisted-living residents. Which of the following statements by a resident best indicates an understanding of the teaching? A) "I should get a longer cord for my telephone" B) "I should use chairs without armrests" C) "I should place a throw rug over electrical cords" D) "It is a good idea to use the handrails in the bathroom."

D) "It is a good idea to use the handrails in the bathroom."

A nurse is teaching a group of older adults about nutrition. The nurse should include which of the following amounts as an appropriate daily intake of fiber? A) 40-50g B) 10-15g C) 5-10g D) 20-35g

D) 20-35g

A nurse at a health fair is assessing the weight status of four older clients. Which of the following clients are classified as overweight? A) a female client who has a body mass index of 24 B) a male client who has a waist circumference of 96.52 cm (38 in) C) a female client who has a waist circumference of 101.6 cm (40 in) D) a male client who has a body max index of 29

D) A male client who has a body max index of 29

A nurse is educating a client who is experiencing sleep disturbances and desires to decrease caffeine intake. Which of the following beverages should the nurse recommend? A) chocolate milk B) brewed ice tea C) diet cola D) lemon-lime soda

D) Lemon-lime soda

a nurse is reviewing a clients laboratory values and discovers the clients has a serum potassium of 6.2 mEq/L. Which of the following interventions should the nurse anticipate? -administering a potassium-sparing diuretic -administering sodium polystyrene sulfonate (kayexalate) -initiating an IV potassium infusion -encouraging the client to eat bananas

administer sodium polystyrene sulfonate (kayexalate) rationale: the nurse should expect to administer sodium polystyrene sulfonate, which absorbs excessive potassium and excretes it through the stool. Other treatments include hemodialysis and IV glucose and insulin.

when discussing pharmacological considerations, a 68 year old client asks, " why do medications seem to act differently than they did when I was younger?" The nurse bases the response on the concept that: -older adults may need larger doses of medication to bring about the desired effects -age-related changes affect the way drugs are metabolized by other adults -adverse drug reactions occur with similar frequency in older adults as the general population -over the counter drugs have standardized dosages that are appropriate for all ages

age related changes affect the way drugs are metabolized by older adults rationale: age related pharmokinetic and pharmodynalic changes explain why older adults react differently to medications. OTC drugs can result in altered drug outcomes since that related to the individuals response to the medications. Age related changes may require smaller doses of medication in older patients that in younger patients. The rule is to start slow and go slow. The older the person is, the more likely he or she is to have an adverse drug reaction

An older client admitted to the hospital after having sustained a fall at home is diagnosed with a right hip fracture and experienced a surgical reduction of the fracture. At 2:30 AM, she awakens from sleep insisting that her daughter is in the other room and wants to see her. Attempts to reorient her to the surroundings are unsuccessful. In reviewing the client's record, what data would be considered a primary risk factor for the delirium? A. history of cardiac disease B. death of the clients husband last month C. history of dementia d. the clients age

c. history of dementia

A nurse is developing a plan of care for a client who has COPD. The nurse should include which of the following interventions in the plan? a. have the client use the early-morning hours for exercise and activity b. restrict the clients fluid intake to less than 2 L/day c.d instruct the client to use pursed lip breathing d. provide the client with a low-protein diet.

c. instruct the client to use pursed-lip breathing

a nurse is assessing an older patient and notes a cluster of fluid-filled vesicles on the right thoracic area. The nurse suspects herpes zoster. The patient asks the nurse, I really dont understand how I got shingles. I dont even know anyone who has this infection. The nurse includes which of the following in formulating a response to the patient? -HZ is caused by the same virus as chickenpox and requires exposure to an individual with active chickenpox -HZ is caused by the varicella zoster virus and occurs only in individuals who were never previously exposed to the virus -HZ is caused by a reactivation of dormant varicella zoster virus within the sensory neuron of the dorsal root ganglion -HZ is caused by the same virus as chickenpox and requires direct contact with an individual with HZ

-HZ is caused by a reactivation of dormant varicella zoster virus within the sensory neuron of the dorsal root ganglion

a nurse is instructing a young adult client about healthful sleep habits. Which of the following statements should the nurse identify as an indication that the client needs further teaching? -I dont take naps throughout the day -I watch television until I fall asleep at night -I go to bed and get up routinely at the same time each day -I have a small snack and take a bath before going to bed each day

-I watch television until I fall asleep at night

a nurse is teaching a client who report insomnia about promoting rest and sleep. Which of the following statements should the nurse identify as an indication that the client understands the instructions? -I will no longer have a glass of wine before bedtime -I will do my muscle relaxation techniques each afternoon -I will have a cup of hot cocoa immediately before bedtime -I will walk briskly for 30 minutes before bedtime

-I will no longer have a glass of wine before bedtime

a nurse is teaching a client who has a history of falls about home safety. Which of the following statements should the nurse identify as an indications that the client understands the instructions? -I will place a bath seat in my shower to use when I bathe -I will place an area rug at the entry of my bathroom -I will keep the fluorescent ceiling light on in my room at night -I will keep my walker at the end of my bed

-I will place a bath seat in my shower to use when I bathe

A nurse in the ambulatory care setting is preparing to do an interview with a non-English-speaking client. The nurse secures an interpreter. To have the most effective interview, the nurse should do which of the following? (Select all that apply.)

-Watch the client's nonverbal communication. -Through the interpreter, check whether the client understands the communication.

a nurse identifies a need to assess a patients cognitive status. The nurse chooses to use the clock-drawing test. The nurse knows that the patient must have which of the following abilities (SATA) -ability to hear and see -ability to sit up for 10 minutes -number fluency -familiarity with analog clocks

-ability to hear and see -number fluency -familiarity with analog clocks

A nurse completes a cultural assessment of an older adult who is being admitted to an assisted living facility. Reasons for completing a cultural assessment include (Select all that apply.)

-culture guides decision making about health, illness, and preventive care. -culture provides direction for individuals on how to interact during health care encounters. -culture impacts attitudes toward aging.

a nurse completes a cultural assessment of an older adult who is being admitted to an assisted living facility. Reasons for completing a cultural assessment include (SATA) -culture provides direction for individuals on how to interact during health care encounters -all members of a culture react in the same way in similar situations -culture impacts attitudes toward aging -knowledge of culture eliminates health care disparities

-culture provides direction for individuals on how to interact during health care encounters -culture impacts attitudes toward aging

a nurse is admitting a client who has a partial hearing loss. Which of the following is the priority action by the nurse? -stand directly in front of the client -speak using his usual tone of voice -determine if the client uses hearing aids -rephrase statements that client does not hear

-determine if the client uses hearing aids

a nurse is providing teaching to a client about preventing skin cancer. Which of the following client statements indicates a need for further teaching? -I should use sunscreen even on cloudy days -eating a high fiber diet will reduce my risk for developing skin cancer -I should avoid the use of tanning booths -I should check my skin monthly for any changes

-eating a high fiber diet will reduce my risk for developing skin cancer

a long term care facility has selected sleep promotion as its quality improvement project. Which of the following interventions would be appropriate to implement on this unit? (SATA) -waking residents for routine care during the night -limiting caffeine and fluids before bedtime -instituting quiet time (keep noise down, speak in hushed tones, no overhead paging) between 10:00 PM and 6:00 AM -ensuring that all resident receive evening care and are in bed by 8:00 PM

-limiting caffeine and fluids before bedtime -instituting quiet time (keep noise down, speak in hushed tones, no overhead paging) between 10:00 PM and 6:00 AM

An antihypertensive medication has been prescribed for an older patient with hypertension. The patient tells a clinic nurse that he would like to take an herbal substance to help lower his BP instead of the prescription medication. Which of the following should the nurse do? (SATA) -instruct the patient not to take herbal substance, as it is dangerous -encourage the patient to discuss the use of an herbal substance with his primary care provider -educate the patient on possible interactions of the herbal substance with his other medications -explore with the patient which herbal substance his is planning on taking -tell the patient that herbal substances are less effective than prescription medications

-encourage the patient to discuss the use of an herbal substance with his primary care provider -educate the patient on possible interactions of the herbal substance with his other medications -explore with the patient which herbal substance he is planning on taking rationale: the popularity of medicinal herbs and supplements continues to rise. A major concern with the use of herbs and supplements is the potential interactions with prescribed medications. it is important that the patient share his or her use of herbs and substances with all providers and that the provider review the herbs and the prescribed medications to ensure compatibility

an older nursing home resident reports that her hearing loss is getting worse. What is the first action of the nurse? -examine the resident ears for cerumen impaction -raise her voice when speaking to the resident -teach the resident to read lips -refer the resident for an evaluation for a hearing aid

-examine the resident ears for cerumen impaction

which intervention has priority before touching a clients consent zone? -draping the area to minimize exposure -explaining why the area will be touched while asking permission -assuring the client that the touch Is absolutely necessary -having another nurse present

-explaining why the area will be touched while asking permission

the Beers criteria is an effective tool for health care professionals prescribing and/or managing the medication therapy of older adults since it identifies medications that for this population -generally cause allergic reactions -have a higher than usual risk for injury -are not typically covered by drug benefit plans -are likely to be abused

-have a higher than usual risk for injury

A nurse in the ambulatory care setting is preparing to do an interview with a non- English speaking client. The nurse secures an interpreter. In order to have the most effective interview, the nurse should do which of the following? (SATA) -use technical terminology to ensure accuracy -look and speak to the interpreter -have the interpreter check whether the client understands the communications -watch the clients nonverbal communications

-have the interpreter check whether the client understands the communications -watch the clients nonverbal communications

a nurse in ophthalmology clinic is interviewing a client who as referred by his primary care provider for suspicion of cataracts. The nurse should expect the client to report -having a lose of peripheral vision -loss of central vision -seeing bright flashing of light and floaters -having a decreased ability to perceive colors

-having a decreased ability to perceive colors

a nurse is planning health education on chronic illnesses for a group of seniors in the comminity. When deciding upon which illnesses to focus on, the nurse knows that which of the following are the most common diseases in the US? (SATA) -heart disease -cancer -asthma -diabetes

-heart disease -cancer -diabetes

a home care nurse is caring for an older patient from a different culture who is bed-bound and high risk for development of a pressure ulcer. the nurse discusses the plan of care with the patients daughter, emphasizing the importance of turning every 2 hours and posts a turning clock on the wall. When the nurse returns later in the week, the turning clock has been removed, and the patients daughter reports that she turns her mother occasionally. She states, I am taking very good care of my mother. You just dont understand, our ways do not involve doing things on schedules. the best response by the nurse is -how can we best work together to provide the best care for your mother -I understand that you value your culture, but culture cannot stop you from providing good care to your mother -you must follow my guidelines and turn her every 2 hours, or I will not be able to take care of her -I understand that you care very much for your mother. Perhaps caring for her is too much for you

-how can we best work together to provide the best care for your mother

a nurse is teaching a client who has constipation. Which of the following should the nurse discuss as causes of constipation? (SATA) -increased fiber in the diet -ignoring the urge to defecate -increased activity -inadequate fluid intake

-ignoring the urge to defecate -inadequate fluid intake

which statement by the person preparing for retirement indicates they may need specialized counseling and targeted education? -im waiting until im eligible for medicare so I can be sure to continue treatment for my heart failure -im so glad ill have a pension to draw from -im really looking forward to quitting this government job -I dont know what im going to do since practicing law has always filled my days

-im waiting until im eligible for medicare so I can be sure to continue treatment for my heart failure

which outcome regarding the effects of therapeutic touch on the skin is inaccurate? -helps relieve physical and psychosocial pain -is known to reduce anxiety and tension -brings about sensory stimulation -improves skin integrity

-improves skin integrity

a nurse implements a nursing care plan for a patient with constipation. Which of the following should the nurse include in the plan? -increasing fiber in the diet -administering aluminum hydroxide antacids -bed rest -restricting fluids

-increasing fiber in the diet

an older patient is prescribed warfarin for stroke prevention. A nurse is providing patient education. Which of the following foods should the patient be taught to avoid? (SATA) -kale -spinach -milk -red meats -whole grains

-kale -spinach rationale: it is important to avoid leafy green vegetables when taking coumadin

an older adult who is within a normal weight range asks a nurse, I have heard that it is important to limit the amount of fats in my diet, but I dont know how much I should be taking in daily. Can you help me? The best response by the nurse is -someone of your age needs to limit fats -fat intake will depend on the presence of any cardiac issues -less than 10% of calories per day should come form saturated fats -read food labels well and focus your diet on low fat foods

-less than 10% of calories per day should come form saturated fats

a nurse is teaching a group of older adults about healthy aging. The nurse discusses global lifestyle risk factors for chronic disease. The nurse includes which of the following in the education? (SATA) -maintenance of high levels of physical activity -maintenance of blood pressure readings at a level of 120/80 or lower -smoking cessation and avoidance of tobacco -development of advance directives

-maintenance of high levels of physical activity -smoking cessation and avoidance of tobacco

a nurse is caring for a client who is menopausal and asks the nurse about the use of herbal therapies to reduce the discomfort. Which of the following statements should the nurse take? -many herbal products have not undergone long-term testing for safety and efficacy -herbal therapies have no benefits and will not help your discomfort -you should begin immediately as they will help you -there are no ill effects associated with the use of herbal therapies

-many herbal products have not undergone long-term testing for safety and efficacy

a nurse is admitting an oder adult client who has a suspected cognitive disorder. Which of the following inventories should be included as part of the admission assessment? -mental status examination -brief patient health questionnaire -abnormal involuntary movements scale -scale for assessment of negative symptoms

-mental status examination

an older widow who is a newly admitted resident of a long-term care facility develops a romantic relationship with a male resident. When the residents daughter demands that the staff put a stop to this sexual behavior right now, the nurses response is based on the understanding that: -sexual activity can be dangerous for older adults with chronic illnesses -such activity in a long term facility is inappropriate -sexual desire is usually absent in older adults -older adults need to express love and intimacy

-older adults need to express love andintimacy

a nurse in a dermatologists office is planning an educational session about skin cancer. Which of the following should the nurse include as risk factors for skin cancer (SATA) -dark skin -overexposure to ultraviolet light -under 40 years of age -genetic predisposition

-overexposure to ultraviolet light -genetic predisposition

an 88 year old woman is admitted to the hospital with a diagnosis of pneumonia. She has a history of hypertension and congestive heart failure and is on a total of five different medications for these chronic conditions. The nurse caring for the woman develops a care plan that includes the diagnoses risk for falls. A priority intervention for this client is -assess the clients dietary intake for calcium adequacy -perform a fall assessment -place the client on bed rest so that she does not fall -keep all of the side rails up on the clients bed at nighttime

-perform a fall assessment

the major focus regarding nursing education for the older adult regarding the use of herbal supplements is the -expense of the herbal supplements since they are seldom covered by insurance -high risk of herbal overdose since the manufacturing process lacks effective controls -likelihood that the client will substitute herbals for more expensive prescribed medications -possibility of dangerous interactions between herbals and the clients prescription medications

-possibility of dangerous interactions between herbals and the clients prescription medications

factors that complicate assessment of older adults include (SATA) -lack of assessment instruments specific for the older adult population -presence of multiple comorbid conditions -difficulty in differentiating symptoms of disease from normal age related changes -atypical presentation of illness

-presence of multiple comorbid conditions -difficulty in differentiating symptoms of disease from normal age related changes -atypical presentation of illness

a nurse is evaluating a clients laboratory results. the nurse should recognize that an increase in the clients prostate specific antigen (PSA) laboratory values is indicative of which of the following diagnoses? -prostatic cancer -liver cancer -breast cancer -colon cancer

-prostatic cancer

a nurse is teaching a class at the skilled nursing facility about medication reconciliation. Which of the following information should the nurse include in the teaching? -do not include over the counter medications in the medication reconciliation report -do not perform reconciliation for a client at discharge from a health care facility -provide a list of the clients current medications during admission to a health care facility -provide a list of the clients current medications during the change of shift report

-provide a list of the clients current medications during admission to a health care facility

two older residents of a long term care facility are engaged in a romantic relationship. The residents are both cognitively intact. A nurse finds that two residents engaging in sexual activity. the response of the nurse includes which of the following? -contact the family members of the residents in order to get consent form them -inform the residents that they cannot engage in a sexual relationship while they are residents of the facility -provide a safe private area where the residents can engage in sexual activity -ignore the residents activity

-provide a safe private area where the residents can engage in sexual activity

a community health nurse is reviewing the levels of disease prevention. Which of the following activities is an example of tertiary prevention? -providing treatment for clients who have chronic obstructive pulmonary disease -administering influenza immunizations at a local health fair -performing screening for sexually transmitted infections -testing new nurses for exposure to tuberculosis

-providing treatment for clients who have chronic obstructive pulmonary disease

which of the following statements describing oral care for the older population is correct? -regular dental examinations can prevent tooth loss and improve the ability to chew healthful foods -losing ones teeth is considered a normal part of the aging process -oral malignancies seldom occur in older adults so oral examinations are of low priority -preventative dental care is covered under medicare

-regular dental examinations can prevent tooth loss and improve the ability to chew healthful foods

a nurse is developing a plan of care for a client who has a stage 3 pressure ulcer. Which of the following interventions should th nurse include int the plan? -massage reddened areas with dressing changes -reposition the client at least every 2 hours -clean the wound with hydrogen peroxide solution -apply a heat lamp twice a day

-reposition the client at least every 2 hours

an older person is admitted to the hospital with an exacerbation of congestive heart failure. The nurse noted that the patient complains of severe itching at night and has a red rash on her torso. the patient is diagnosed with scabies. the patient asks the nurse, How did I get something like this? The best response by the nurse is -scabies is commonly seen in older adults due to normal age related changes in the skin -scabies is highly contagious and spreads easily through physical contact -scabies is only seen in older adults who have multiple chronic illnesses -certain medications can make you more susceptible to contracting scabies

-scabies is highly contagious and spreads easily through physical contact

a nurse cares for an older adult who is described as being frail. The nurse understands that in order to be characterized as frail an individual must possess which of the following characteristics: (SATA) -slow walking speed -low activity level -taking at least 5 prescribed medications -a diagnosis of at least 2 chronic conditions

-slow walking speed -low activity level

health literacy is defined as: -the capacity to read and write in order to access health care -the capacity to read basic health information in order to make appropriate health decisions -the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions -the capacity to read and execute health care documents

-the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions

a nurse is making a home visit to a client who has alzheimers disease and the clients partner. Which of the following observations indicates to the nurse that the partner is experiencing caregiver role strain -the partner redirects the client when the client is frustrated -the partner has lost 20 lbs in the past 2 months -the partner has placed locks at the top of the doors leading to the outside -the partner has hired a house cleaner

-the partner has lost 20 lbs in the past 2 months

a nurse is assessing a patients activities of daily living. The nurse will assess which of the following? (SATA) -driving -self-medication administration -toileting -eating

-toileting -eating

a nurse is caring for a client who has a stage I pressure ulcer. Which of the following dressings should thenurse plan to apply? -alginate dressing -hydrogel dressing -transparent dressing -wet-to-dry gauze dressing

-transparent dressing

when counseling an older adult, the nurse discusses the major global lifestyle risk factors for the development of chronic diseases. Which of the following should be included? -unhealthy diet -tobacco use -sleep patterns -physical inactivity

-unhealthy diet -tobacco use -physical inactivity

a nurse is providing education for a client who has glaucoma. Which of the following statements should the nurse include in the teaching? -double vision is a common symptom of glaucoma -without treatment, glaucoma can cause blindness -glaucoma is caused by inadequate production of fluid within the eye -use of eye drops will improve vision over time

-without treatment, glaucoma can cause blindness

a 75 year old female asks a nurse I know I should be moving, but how much is the right amount of exercise for me? The best response is: -since you are 75, the recommendation are 30 minutes of moderate exercise three times a week -you need to engage in at least 30 minutes of moderate intensity exercise every day of the week -there are no specific recommendations for someone of your age; just keep moving -you need to engage in 30 minutes of moderate intensity exercise five days a week

-you need to engage in 30 minutes of moderate intensity exercise five days a week

An older adult asks the nurse, "I hear about getting enough fruits and vegetables in my diet and eating a balanced diet. It is confusing. Can you help me understand what a balanced diet for me would be?" The nurse bases a response on which of the following? A) "daily intake should consist of 50% fruits and vegetables; 25% grains; and 25% protein rich foods" B) "daily intake should consist of 25% fruits and vegetables; 25% grains; and 50% protein-rich foods" C) "daily intake should consist of 33% fruits and vegetables; 33% grains; and 33% protein-rich foods" D) "daily intake should consist of 40% fruits and vegetables; 30% grains; 30% protein-rich foods"

A) "Daily intake should consist of 50% fruits and vegetables; 25% grains; and 25% protein rich foods"

An older adult who is within a normal weight range asks a nurse, "I have heard that it is important to limit the amount of fats in my diet, but I don't know how much I should be taking in daily. Can you help me?" The best response for the nurse is: A) "less than 10% of calories per day should come from saturated fats" B) "someone of your age needs to limit fats" C) "read food labels well and focus your diet on low-fat foods" D) "fat intake will depend on the presence of any cardiac issues."

A) "Less than 10% of calories per day should come from saturated fats"

A nurse is caring for a client whose partner is requesting to bring the client food from home that is not allowed in the client's dietary plan. Which of the following responses should the nurse take? A) "Let's try to find ways to incorporate your partner's favorite food into her diet plan" B) "everyone likes food from home, but it can delay your partners recovery" C) "why would you want to put your partners health at further risk?" D) "you will need to discuss your concerns about your partners diet with the provider"

A) "Let's try to find ways to incorporate your partner's favorite food into her diet plan"

During a routine physical examination, a nurse observed a 1-cm (0.4 in) lesion on a clients chest. The lesion is raised and flesh-colored with pearly white borders. The nurse should recognize that this finding is suggestive of which of the following types of skin cancer? A) basal cell carcinoma B) malignant melanoma C) squamous cell carcinoma D) actinic keratosis

A) Basal Cell Carcinoma

A nurse is caring for an older client who has depression and is discussing activities of daily living (ADL's) with his family. The nurse should identify that the client can perform which of the following activities prior to discharge? A) hygiene B) house cleaning C) driving D) grocery shopping

A) Hygiene

A nurse teaching a client about nutritional requirements necessary to promote wound healing. Which of the following nutrients should the nurse include in the teaching? A) protein B) vitamin D C) vitamin B1 D) calcium

A) Protein

a 79- year-old client resides independently in the community. The visiting home health nurse finds that despite it being 90 degrees outside, the windows are closed and the client is wearing a sweater. The nurse initially recognizes that this behavior may be related to: -a Delirium related acute illness is affecting body heat production -age-related motor deficiencies that result in self-neglect -cognitive changes that diminish the individual's awareness of temperature changes -age-related neurosensory changes that diminish awareness of temperature changes

age-related neurosensory changes that diminish awareness of temperature changes rationale: neurosensory changes related to aging tend to delay or diminish the individuals awareness of temperature changes and may impair behavior or thermoregulatory responses to dangerously high or low temperatures. There is no evidence in this scenario that the client has cognitive changes, an acute illness, or is incapable of self-care, and such assumptions should not be routinely made based on age alone

A nurse assesses an older patient for asthma. The nurse knows is the strongest risk factor for asthma is: A. positive family history of asthma b. genetic predisposition to severe allergies c. airway inflammation caused by allergic reaction to inhaled substances d. history of smoking

c. airway inflammation caused by allergic reaction to inhaled substances

an older resident in a long term care facility reports to the nurse that she has been noticing changes in her vision, including the appearance of halos around objects and a yellow tint to most objects. the nurse knows that these complaints are most often associated with -diabetic retinopathy -cataracts -age related macular degeneration -glaucoma

cataracts

a nurse is preparing to administer potassium chloride to a client who is receiving diuretic therapy. The nurse reviews the client's serum potassium level results and discovers the client's potassium level is 3.2 mEq/L. Which of the following actions should the nurse take? -give the ordered KCL as prescribed -omit the LCK dose and document that it was not given -call the lab to verify the clients results -hold the prescribed dose and notify the provider of the serum potassium level

give the ordered KCL as prescribed rationale: the clients serum potassium level is below the recommended reference range. the nurse should administer the KCL as prescribed

a nurse in a public clinic is planning a health fair for older adults clients in the community. In teaching medication safety, which of the following foods should the nurse advise the clients to avoid when taking prescriptions? -orange juice -grapefruit juice -carbonated beverage -milk

grapefruit juice Rationale: there is a high rate of food-drug interactions between grapefruit juice and many medications frequently taken by older adults, especially lowering agents. It is thought that one or more of the chemicals (most likely flavonoids) in grapefruit juice alter the activity of specific enzymes. These enzymes decrease the rate at which medications enter the systemic circulation. This could allow a larger amount of these drugs to reach the bloodstream, resulting in increased drug levels and possibly toxicity

what factor is an important contribution to polypharmacy in older adults? -increasing popularity of dietary and herbal supplements -implementation of medicare part D prescription drug benefit -inadequate communication among medical care providers -use of generic medications

inadequate communication among medical care providers rationale: when communication amount patients, nurses, other HCP, and caregivers becomes fragmented, the risk for duplicative medications, inappropriate medication, potentially unsafe dosages, and potentially preventable interactions is heightened.

an older adult client is being seen for the first time at the outpatient geriatric clinic. As a component of the nursing admission history, the nurse inquires about the use of herbs and supplements. The basis for the inquiry is that such herbal therapy: -replaces the need for prescription medications -causes excessive sedation in older adults -is hazardous when used by other adults -may interact with prescription medications

may interact with prescription medications

The major focus regarding nursing education for the older adult regarding the use of herbal supplements is the : -expense of the herbal supplements since they are seldom covered by insurance -likelihood that the client will substitute herbals for more expensive prescribed medications -high risk of herbal overdose since the manufacturing process lacks effective control -possibility of dangerous interactions between herbals and the clients prescription medications

possibility of dangerous interactions between herbals and the clients prescription medications

a home health nurse is planning care for a client who has alzheimers disease. The clients partner is her primary caregiver and reports not having enough time to complete his errands. Which of the following referrals should the nurse plan to make? -restorative care -mental health care -respite care -hospice care

respite care

A home health nurse is assessing an older adult client in the home who has decreased vision due to a history of glaucoma. Which of the following findings should the nurse identify as a safety risk? -scatter rugs are present in the kitchen -handrails are present in the bathroom -electrical cords are placed along the walls -uses a microwave for cooking

scatter rugs are present in the kitchen rationale: scatter rugs un the kitchen are a safety hazard. The client could trip on one of the rugs and fall due to impaired vision.

a nurse is reviewing a clients CBC findings and discovers that the clients platelet count is 9,000/mm3. The nurse should monitor the client for which of the following conditions? -oliguria -infection -spontaneous bleeding -hyperactive deep tendon reflexes

spontaneous bleeding rationale: the nurse should consider the risk for spontaneous bleeding that can occur in clients who have low platelets. Low platelet levels cause clotting time to increase

a patient tells the nurse, every time I laugh or cough, I wet myself. Which type of urinary incontinence is this patient describing -mixed -stress -urge -function

stress

the nurse suspects that a client is experiencing tardive dyskinesia when observing that -the client can't seem to stop moving -the clients facial muscles are twisting involuntarily -the client not able to get up out of a chair -the clients hand tremors so much that the drinking from a cup is difficult

the clients facial muscles are twisting involuntary