GERI- Nclex questions: test 2
The healthcare provider is performing an assessment on a patient who is taking propranolol (Inderal) for supraventricular tachycardia. Which assessment finding is an indication the patient is experiencing an adverse effect of this drug? a) Dry mouth b) Bradycardia c) Urinary retention d) Paresthesia
b) Bradycardia Propranolol is a nonselective beta-adrenergic antagonist
You are caring for a 78 year-old female cardiac patient. In preconference, your clinical instructor asks you what is an age-related change in the cardiac system of the older adult? Your best response would be Student Response Value Correct Answer Feedback 1. Decreased blood pressure 2. Decreased cardiac output 3. Increase ability to respond to stress 4. Increased heart recovery rate
2. Decreased cardiac output
Your patient assigned to you has pneumonia. You are reviewing the age-related changed involved with the older adult. Select all age-related changes of the respiratory system that apply. 1. Decreased in residual lung volume 2. Decreased gas exchange 3. Decreased cough efficiency 4. Increased gas exchange
2. Decreased gas exchange 3. Decreased cough efficiency
Which manifestation(s) indicate(s) serious heat-related problems? (Select all that apply) 1. Cramps in the leg 2. Vomiting 3. Heavy perspiration 4. Profound weakness 5. Mental changes 6. Throbbing headache
2. Vomiting 4. Profound weakness 5. Mental changes 6. Throbbing headache Rationale: Symptoms of hyperthermia are progressive. Mild, early signs of heat stress include feeling hot, listless, or uncomfortable. Cramps in the legs, arms, and abdomen are early indicators of elevated body temperature. Serious indications of heat-related problems include hot, dry skin without perspiration; tachycardia; chest pain; breathing problems; throbbing headache; dizziness; profound weakness; mental or perceptual changes; vomiting; abdominal cramps; nausea; and diarrhea.Page reference: 174
Which interventions would be appropriate to use when teaching a client who has presbycusis? (select all that apply) 1. Stand on the affected side 2. Speak much more loudly 3. Use simple statements 4. Provide audiovisual tapes 5. Repeat information 6. Face the client when talking 7. Ensure adequate lighting
3, 4, 5, 6 and 7
Which physiological change occurs in older adults and warrants the nurse teaching the client about safety tips to prevent falls? A. Slowed movement B. Cartilage degeneration C. Decreased bone density D. Decreased range of motion
C
Which physiological change occurs in older adults and warrants the nurse teaching the client about safety tips to prevent falls? A. Slowed movement B. Cartilage degeneration C. Decreased bone density D. Decreased range of motion
C. Decreased bone density
An 80 year-old- client is admitted to the hospital with severe dehydration. The client's daughter asks the nurse how her mother could have become dehydrated. Which response by the nurse is correct? A. The body's fluid needs decrease with age because of tissue changes. B. Access to fluid may be insufficient to meet the daily needs of the older adult. C. Memory declines with age, and the older adult may forget to ingest adequate amounts of fluids. D. The thirst reflex diminishes with age, and the recognition of the need for fluid is decreased.
D.
What eye changes occur as a part of the normal aging process?
Increased Dryness and irritation (eye drops), increased light refractions (avoid glare/shiny hospital floors), decreased accommodation, presbyopia (reading glasses at 40 have to put arm out to read), and decreased color discrimination (blue green violet spectrum).
What type of skin spots are normal with aging? Which are not?
Skin tags/brown spots=normal, leukoplasia (white spots)= abnormal
A 85 year old patient living in a nursing home has generalized weakness and dementia. Knowing this patient is at risk for a pressure injury, what are some interventions the nurse should implement to prevent a pressure ulcer? Select all that apply. A. Turn & reposition the patient regularly B. Tell the patient he should get up and walk around every hour C. Place a pressure relief mattress under the patient D. Ensuring the patient maintains proper nutrition and hydration
a c d
What is the best way to prevent pressure ulcers? a.) The Dodgers beating the Cubs b.) Pillows and alternating pressure mattresses c.) Frequent position changes d.) Answers B&C
d.) Answers B&C
The nurse is advising an older adult client to apply moisturizer when the skin is moist. Which physical change in the client is associated with this advice? A. Thinning subcutaneous layer B. Degeneration of elastic fibers C. Decreased dermal blood flow D. Benign proliferation of capillaries
C
The nurse is assessing an older adult during a regular checkup. Which finding(s) during the assessment is/are normal? Select all that apply A. Loss of turgor B. Urinary incontinence C. Decreased night vision D. Decreased mobility of ribs E. Increased sensitivity to smells
A. Loss of turgor C. Decreased night vision D. Decreased mobility of ribs
What musculoskeletal changes occur as a part of normal aging?
Increased incidence of fractures, OSTEOARTHRITIS AND OSTEOPOROSIS (wt bearing), and decreased lean muscle mass.
What lung changes occur as part of the normal aging process?
Increased residual volume ( A BARREL CHEST-AP DIAMETER- IS COMMON), increased chance of infection (symptoms may be atypical-lethargy, anorexia, confusion, poor functional ability), and decreased ability to respond to increased O2 demands.
A nurse is teaching a patient about the risk factors of cataracts. Which is not a risk factor for cataracts? a.) Increasing age b.) Exposure to large amounts of UVB rays c.) Diabetes d.) Race
d.) Race
The nurse should instruct the nursing assistant who is caring for a client who is receiving antihypertensive medication to: 1. Have at least two people assist with ambulation 2. Allow them to stand up slowly from sitting or lying position 3. Take the blood pressure if they complain of diplopia 4. Provide additional salt with meals
2. Allow them to stand up slowly from sitting or lying position Rationale: Medications often contribute to falls, and because older adults commonly take one or more medications, their risk for untoward effects is increased. Common types of hazardous medications include sedatives, hypnotics, tranquilizers, diuretics, antihypertensives, and antihistamines. Antihypertensive medications can cause dizziness or fainting with position changes due to a sudden drop in blood pressure (orthostatic hypotension). Therefore the client receiving an antihypertensive should be encouraged to change to a standing position slowly to avoid symptoms of orthostatic hypotension.Page reference: 168, 175
An older, sedentary adult may not respond to emotional or physical stress as well as a younger individual because of: a. Left ventricular atrophy b. Irregular heartbeats c. Peripheral vascular occlusion d. Pacemaker placement
A. Left ventricular atrophy a. In older adults who are less active and do not exercise the heart muscle, atrophy can result. Disuse or deconditioning can lead to abnormal changes in the myocardium of the older adult. As a result, under sudden emotional or physical stress, the left ventricle is less able to respond to the increased demands on the myocardial muscle. Decreased cardiac output, cardiac hypertrophy, and heart failure are examples of the chronic conditions that may develop in response to inactivity, rather than in response to the aging process. Irregular heartbeats are generally not associated with an older sedentary adult's lifestyle. Peripheral vascular occlusion or pacemaker placement should not affect response to stress.
A nurse is performing a musculoskeletal assessment on an older adult living independently. What normal physiologic changes of aging does the nurse expect? Select all that apply. A. Muscle atrophy B. Slowed movement C. Scoliosis D. Arthritis E. Widened gait.
A. Muscle atrophy B. Slowed movement D. Arthritis E. Widened gait.
While bathing an elderly client who has limited abilities for self-care, the nurse notices several patches of dry skin on the clients heels, elbows, and coccyx. The nurse cleans and dries all the areas well and applies a moisturizing lotion. The most appropriate immediate follow-up by the nurse to ensure appropriate nursing care for this clients skin is to: A. Revise the client's care plan to show the need for the application of moisturizing lotion B. Assume personal responsibility to apply the moisturizing lotion daily to the client's skin C. Encourage the client to tell whomever bathes her to apply the moisturizing lotion to her areas of dry skin D. Inform the staff that the client's skin is showing signs of breakdown and moisturizing lotion needs to be applied daily
A. Revise the client's care plan to show the need for the application of moisturizing lotion.
Which physiological changes of the m/s system would the nurse associate with aging? SATA. A. Slowed movement B. Cartilage degeneration C. Increased bond density D. Increased range of motion E. Increased bone prominence
A. Slowed movement B. Cartilage degeneration E. Increased bone prominence
Which intervention would the nurse implement with a healthy older adult client who has decreased bone density? A. Teaching the client to do isometric exercises B. Encouraging the client to do weight-bearing exercises C. Instructing the client to sit in supportive chairs with arms D. Providing moist heat such as a shower or moist compress
B
Which nursing interventions would the nurse provide to an older client with hypertension? Select all that apply A. Provide skin care B. Advise the client to limit salt intake C. Teach stress management D. Instruct the client to quit smoking E. Advise the client to eat finger foods.
B, C, D
A nurse is reinforcing teaching about ways to improve nutritional intake with a client who has chronic obstructive pulmonary disease and has been losing weight. Which of the following statements by the client indicates an understanding of the teaching? A. "I will choose hot foods to decrease the sense of fullness when eating." B. "I should add grated cheese to sauces and vegetables." C. "I will eat my largest meal of the day in the evening." D. "I should consume a diet high in carbohydrates."
B. "I should add grated cheese to sauces and vegetables."
Which of the following statements made by a nurse reflects the best understanding of the health value of conducting a blood pressure (BP) screening at a senior citizens centers health fair? A. "This is a high risk group, so assessing BP allows us to identify clients at risk and send them for treatment." B. "Older adults enjoy health fairs, so it's a good place to screen substantial numbers of clients for hypertension." C. "Hypertension doesn't present symptoms early on, so screening elder adults is a wonderful preventive measure." D. "Blood pressure problems are common among this group, so it's a good way to monitor the effectiveness of their medications."
B. "Older adults enjoy health fairs, so it's a good place to screen substantial numbers of clients for hypertension."
When caring for an older adult patient, the nurse uses the following interventions to accommodate visual changes with age: A. Eye glasses in the bedside table. B. Adequate lighting and uncluttered walkways. C. Draw drapes in room to prevent glare. D. Keep bedside rails down.
B. Adequate lighting and uncluttered walkways
What age related skin change occurs in older adults and increases their risk for developing pressure ulcers? A. Atrophy of the sweat glands B. Decreased subcutaneous fat C. Stiffening of the collagen fibers D. Degeneration of the elastic fibers
B. Decreased subcutaneous fat
An 85-year-old client has just been admitted to the nursing home. When designing a plan of care for this older adult, the nurse recalls which expected sensory losses associated with aging? Select all that apply: A. Difficulty in swallowing B. Diminished sensation of pain C. Heightened response to stimuli D. Impaired hearing of high frequency sounds E. Increased ability to tolerate environmental heat
B. Diminished sensation of pain D. Impaired hearing of high frequency sounds
Which intervention would the nurse implement with a healthy older adult client who has decreased bone density? A. Teaching the client to do isometric exercises B. Encouraging the client to do weight-bearing exercises C. Instructing the client to sit in supportive chairs with arms D. Providing moist heat, such as shower or moist compress
B. Encouraging the client to do weight-bearing exercises
The registered nurse is teaching isometric exercises to an 80-year-old client. Which change as a result of aging requires this intervention? A. Kyphotic posture B. Muscular atrophy C. Decreased bone density D. Cartilaginous Degeneration
B. Muscular atrophy
A nurse is reinforcing teaching with an older adult client about osteoporosis. Which of the following statements should the nurse include in the teaching? A. "Cottage cheese is a good source of calcium." B. "Increase your caffeine intake." C. "Brisk walking will help prevent bone loss." D. "Hormone replacement therapy with estrogen will increase your risk of osteoporosis."
C. "Brisk walking will help prevent bone loss."
A nurse is collecting data from an 85-year-old client. Which of the following findings should the nurse report to the provider? A. A widened anterior-posterior chest diameter B. Presence of an S4 heart sound C. Differences in pulse strength between lower extremities D. Post-void residual of 75 mL
C. Differences in pulse strength between lower extremities
When performing a comprehensive geriatric assessment of an older adult, focus of the nursing assessment is on the patient's: A. Physical signs of aging. B. Immunological function. C. Functional abilities. D. Chronic illness.
C. Functional abilities
A patient with dysphagia is: A. fed only for pleasure. B. at low risk for nutritional deficits. C. at higher risk for pneumonia. D. able to drink thin liquids.
C. at higher risk for pneumonia
A nurse is preparing to admit an older adult client to the postsurgical unit. The nurse anticipates that the client will most likely require supplemental oxygen. The nurse should understand that hypoxemia occurs in older adult clients as a result of which of the following physiologic change normally associated with aging? A. Decreased anterior-posterior diameter B. Increased diameter of the small airways C. Increased number of cilia D. Decreased alveolar surface area
D. Decreased alveolar surface area
A nurse is collecting data from an older adult client who reports feeling anxious about financial concerns and having difficulty sleeping for several months. Which of the following actions should the nurse take? A. Encourage exercise 1 hr prior to the client's bedtime B. Inquire into the client's financial concerns C. Refer the client to the facility's chief financial officer D. Determine the client's usual sleep habits
D. Determine the client's usual sleep habits
A nurse is reviewing the medical record of an older adult client. For which of the following medications should the nurse request a hearing assessment of the client? A. Omeprazole B. Ferrous sulfate C. Digoxin D. Furosemide
D. Furosemide
You are a nurse working on a medical-surgical floor, upon arriving for your shift you receive report on 5 patients, which of these patient is at risk for pressure wounds? Select all that apply :A. A 35 year old patient who has type 1 diabetes and has ambulated 4 times today B. A 87 year old patient with pneumonia and generalized weakness C. A 66 year old patient with a BMI of 38 and just had a total hip replacement surgery D. A 50 year old patient who had a GERD flare up and is not a fall risk E. A 73 year old veteran who is a paraplegic
b,c,e
What ear changes occur as part of the normal aging process?
Sensorineural hearing loss, increased cerumen (q-tips conductive hearing loss from impaction), sensorineural presbycusis= high pitched noises hard to hear, decreased speech discrimination (decrease bckgrd noise, face patients, speak slowly, and avoid high pitched speech).
The nurse working on a diabetic medical floor is teaching an orienting nurse about the difference between nonproliferative and proliferative diabetic retinopathy. Which statement made by the orienting nurse is correct. a.) Proliferative DR can lead to retinal detachment and blindness b.) Neovascularization occurs in nonproliferative DR c.) Proliferative DR is characterized by retinal edema and hard exudates d.) Nonproliferative DR is rare, but severe leading to blindness in 50% of patient if left untreated
a.) Proliferative DR can lead to retinal detachment and blindness
What skin changes occur as part of normal aging?
THINNING/DRYING/FRAGILITY OF EPIDERMIS (PREVENTION OF TRAUMA, AKA XEROSIS, TX NO MORE THAN 2 BATHS PER WEEK, CHECK HYDRATION, FURROWED TONGUE).
What diet would be best for a patient with pressure ulcers? a.) Quinoa, eggs, spinach and dark chocolate b.) Hamburger, fries, and strawberry milkshake c.) Pizza, ice cream, and ranch. d.) Tator tots, pasta, and diet Pepsi
a.) Quinoa, eggs, spinach and dark chocolate
The nurse is performing an assessment on an older adult client. Which assessment data would indicate a potential complication associated with the skin? a) Crusting b) Wrinkling c) Deepening of expression lines d) Thinning and loss of elasticity in the skin
a) Crusting The normal physiological changes that occur in the skin of older adults include thinning of the skin, loss of elasticity, deepening of expression lines, and wrinkling. Crusting noted on the skin would indicate a potential complication.
Which medication will decrease the heart rate and prolong the action potential and refractory period? a) Potassium channel blocker b) Adrenergic agonist c) Sodium channel blocker d) Sympathomimetic
a) Potassium channel blocker
A nurse is teaching a new graduate about how to prevent complications from occurring in older adults on a med-surg floor. Which of the following should she include? SATA a. Closely monitor I&O b. Avoid urinary catheterization if possible c. Do not allow the family in the room while the nurse is educating the patient d. Frequently reposition the client
a,b,d
An 82 year old male is immobile and is in the left lateral recumbent position. Which sites should the nurse check for pressure injury while in this position? Select all that apply. A.Patella B.Ankle C.Wrist D.Shoulder E.Hip F.Sacral
a. Patella b. Ankle d. Shoulder e. Hip
When planning care for a client receiving treatment for cardiac dysrhythmias, an appropriate client outcome would be: a. The client will avoid use of caffeine during therapy. b. The client will maintain heart rate below 60 beats per minute. c. The client will limit fluid intake to 1000 ml/day. d. The client will limit cigarettes to 15/day.
a. The client will avoid use of caffeine during therapy. Causes of dysrhythmias include electrolyte imbalance, hyperthyroidism, anxiety, caffeine ingestion, and tobacco use. The client should be taught to avoid caffeine and tobacco.
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: a. cataracts. b. glaucoma. c. diabetic retinopathy. d. age-related macular degeneration.
a. cataracts.
If an older patient is taking aspirin as a blood thinner, what would you warn them about that could occur with their ears? a.) Inflammation b.) Build up of wax c.) Bleeding in the ears d.) Tinnitus
d.) Tinnitus
A nurse is performing preoperative teaching for an older adult who is scheduled to have a cataract extraction and lens implant. The nurse includes which of the following in the teaching plan? (Select all that apply.) a. Avoid lifting heavy objects after the surgery b. Avoid bending from the waist after the surgery c. Take stool softeners as needed d. Maintain strict control of your blood sugar and blood pressure e. Maintain a dry sterile dressing over the eye for 10 days
A, B, C
An older patient is diagnosed with diabetic retinopathy. The patient asks a nurse: "Is there anything that I can do to prevent progression of this disease and blindness?" The nurse includes which of the following into the response? (Select all that apply.) a. Strict control of blood glucose levels is important in slowing disease progression b. Laser photocoagulation treatments can stop progression of the disease c. Control of blood pressure and cholesterol levels are important steps slowing disease progression d. Wearing sunglasses to protect the eyes from ultraviolet light can stop disease progression e. Eating a diet high in beta-carotene can stop disease progression
A, B, C
A nurse is providing glaucoma education for a group of older adults in a senior center. The nurse knows that the following groups are most likely to develop glaucoma. (Select all that apply.) a. African Americans b. Mexican Americans c. Individuals with a family history of glaucoma d. Individuals with diabetes e. Asian Americans
A, B, C, D
A nurse is conducting an assessment of an older patient's eyes. The nurse expects to see which of the following normal age-related changes of the external eye? (Select all that apply.) a. The eyelids are less elastic and droopy b. The eyes are very dry c. The eyelids may not close completely d. There is a loss of eyelashes e. The lower lid may be turned outward
A, B, C, E
Which gerentologic assessment findings of the auditory system are related to the inner ear? Select all that apply: A. Hair cell degeneration B. Reduced blood supply to the cochlea C. Atrophic changes of the tympanic membrane D. Decline in the ability to filter out unwanted sounds E. Less effective vestibular apparatus in the semicircular canals
A, B, E
While assessing the skin of an older adult, the nurse finds redundant flesh around the eyes. Which changes in the skin are responsible for this condition? Select all that apply: A. Decrease in muscle laxity B. Increase in capillary fragility C. Decrease of subcutaneous fat D. Decrease of extracellular water E. Increase in focal melanocytes in the basil layer.
A, C
Which intervention would the nurse provide while caring for an older adult client who is reported to have decreased estrogen production? A. Use minimal tape on client's skin B. Cover the client with warm clothing C. Perform blood glucose test for the client D. Monitor for bradycardia
A.
A nurse is reinforcing teaching with an older adult client about methods to improve sleep. Which of the following statements should the nurse include in the teaching? A. "Go to bed at the same time every night." B. "Watch television in bed until you are sleepy." C. "Drink a glass of wine before going to bed." D. "Engage in physical activity in the evenings."
A. "Go to bed at the same time every night."
Which instruction from the nurse to an 80-year-old client with thinning of a subcutaneous layer would be beneficial? A. Dress warmly in cold weather B. Use soaps with high fat content C. Change the position of the bed once every 5 hours D. Apply moisturizer 2 hours after bathing.
A. Dress warmly in cold weather
Which gerontologic assessment findings of the auditory system are related to the inner ear? Select all that apply. A. Hair cell degeneration B. Reduced blood supply to the cochlea C. Atrophic changes of the tympanic membrane D. Decline in the ability to filter out unwanted sounds E. Less effective vestibular apparatus in the semicircular canals
A. Hair cell degeneration B. Reduced blood supply to the cochlea E. Less effective vestibular apparatus in the semicircular canals. These 3 are related to the INNER ear.
A nurse at an ophthalmology clinic is caring for a client. The nurse is interviewing a client who was referred by her primary care provider for suspicion of cataract. Which of the following client reports should the nurse recognize is consistent with the primary care provider's suspicion? A. Halos and rainbows when looking at lights B. Loss of peripheral vision C. Bright flashes of light and floaters D. Eyestrain and headache with close work
A. Halos and rainbows when looking at lights
You have four rooms to choose from for your older client to be admitted this afternoon. Which room would you choose? a. A brightly lit, blue room with cozy throw rugs b. An orange-carpeted room with soft lighting and yellow walls c. A brightly lit, blue room with an EZ-Glide wax floor d. A fluorescent-lighted room with green walls and a glossy, tiled floor
ANS: B
A factor that contributes to the development of hypothermia in older adults is decreased: 1. Activity level 2. Sensory perception of cold 3. Percentage of body fat 4. Nutritional and fluid intake
Answer:2. Sensory perception of cold Rationale: Older adults are highly susceptible to hypothermia for several reasons. Normal changes that occur with aging affect the body's ability to regulate temperature. Changes in the skin reduce the older person's ability to perceive dangerously hot or cold environments. Decreased muscle tissue, diminished peripheral circulation, reduced subcutaneous fat, and decreased metabolic rate affect the amount of heat produced and retained by the body.Page reference: 173
An 85-year-old client has just been admitted to a nursing home. When designing a plan of care for this older adult, the nurse recalls which expected sensory losses associated with aging? Select all that apply: A. Difficulty in swallowing B. Diminished sensation of pain C. Heightened response to stimuli D. Impaired hearing of high frequency sounds E. Increased ability to tolerate environmental heat
B, D
In performing a physical assessment for an older adult, the nurse anticipates finding which of the following normal physiological changes of aging? A. Increased perspiration B. Increased airway resistance C. Increased salivary secretions D. Increased pitch discrimination
B. Increased airway resistance Rational: Normal physiological changes of aging include increased airway resistance in the older adult. The older adult would be expected to have decreased perspiration and drier skin as they experience glandular atrophy (oil, moisture, sweat glands) in the integumentary system. The older adult would be expected to have a decrease in saliva. A normal physiological change of the older adult related to hearing is a loss of acuity for high-frequency tones (presbycusis).
A nurse is caring for an older adult client who has moderate hearing loss. Which of the following actions should the nurse take to enhance communication? A. Speak with exaggerated lip movement B. Speak at a moderate rate C. Speak in a louder voice D. Speak using a higher pitch
B. Speak at a moderate rate
Which step listed by the nursing student indicates a need for additional training regarding communicating with older adults with hearing problems? A. Refrain from speaking very slowly B. Speak clearly by exaggerating his or her lip movements C. Allow the client to ask questions when necessary D. Ensure that the client knows that the nurse is talking.
B. Speak clearly by exaggerating his or her lip movements
A nurse is assessing an older adult client for signs of dehydration. Which of the following findings should the nurse consider a normal part of the aging process? A. Elevation of urine specific gravity B. Thin skin and spidery veins of the hands C. Dry oral mucous membranes D. Poor turgor over the sternum
B. Thin skin and spidery veins of the hands
Age-related eye changes may include: A. increased visual accommodation. B. macular degeneration. C. non-preventable blindness as a result of glaucoma. D. decreased ability of pupil to respond to light changes.
B. macular degeneration
What are normal changes in dark skinned patients as they age?
Blue line on gums, blue/purple spots on body, gray palms, yellow sclera (check soft palate for jaundice), hyperpigmentation of knees/ knuckles/ elbows, to check for inflammation feel for warmth.
The nurse is preparing to teach a community health program for senior citizens. Which physical findings would the nurse include that are typical in older adults. A. Increased skin elasticity and an increase in testosterone production. B. Impaired fat digestion and an increase in pepsin production. C. Increased blood pressure and decreased cardiac output. D. An increase is body warmth and some swallowing difficulties
C. Increased blood pressure and decreased cardiac output.
The nurse is preparing to teach a community health program for senior citizens. Which physical findings would the nurse include that are typical in older adults? A. Increased skin elasticity and an increase in testosterone production. B. Impaired fat digestion and an increase in pepsin production. C. Increased blood pressure and decreased cardiac output. D. An increase in body warmth and some swallowing difficulties.
C. Increased blood pressure and decreased cardiac output.
Which action would be used to decrease risk for postoperative respiratory complications in an older adult with decreased vital capacity? A. Give prescribed intravenous antibiotics B. Administer oxygen via non-rebreather mask C. Teach the client coughing and deep-breathing exercises. D. Keep the client on mechanical ventilation for several days.
C. Teach the client coughing and deep-breathing exercises.
The primary reason an older adult client is more likely to develop a pressure ulcer on the elbow as compared to a middle-age adult is: A. A reduced skin elasticity is common in the older adult B. The attachment between the epidermis and dermis is weaker C. The older client has less subcutaneous padding on the elbows D. Older adults have a poor diet that increases risk for pressure ulcers
C. The older client has less subcutaneous padding on the elbows
A nurse is collecting data from an older adult client who has right-sided heart failure. Which of the following findings is the nurse's priority to report? A. Oxygen saturation is 92% on room air B. The client consumes 20% of meals C. Weight has increased 0.91 kg in 24 hr D. The client has 1+ edema in the lower extremities
C. Weight has increased 0.91 kg in 24 hr
A 70-year-old client asks the nurse to explain to her about hypertension. An appropriate response by the nurse as to why older clients often have hypertension is due to: A. Myocardial muscle damage B. Reduction in physical activity C. Ingestion of foods high in sodium D. Accumulation of plaque on arterial walls
D. Accumulation of plaque on arterial walls
Which change in the joint may result in joint pain in older adults? A. Dehydration of discs B. Loss of muscle mass C. Decreased elasticity in the ligaments D. Increased cartilage erosion
D. Increased cartilage erosion
An 82-year-old retired school teach is admitted to the nursing home. During the physical assessment, the nurse would identify which ocular problem common to persons at this client's developmental level? A. Tropia B. Myopia C. Hyperopia D. Presbyopia
D. Presbyopia
A debilitated older client who has glaucoma places great value on independence. What would the nurse encourage the client to do after discharge from the hospital? A. Prevent stressful events that can increase symptoms B. Conserve eyesight by not watching tv or reading C. Perform household chores and shopping without assistance D. Self-administer eye medications using appropriate techniques
D. Self-administer eye medications using appropriate techniques
A nurse is caring for an older adult client who has osteoarthritis of the right hip and lower lumbar vertebrae. Which of the following client statements should indicate to the nurse that further instruction is necessary? A. "A warm shower will help me to relieve morning stiffness when I first get up out of bed." B."To relieve the pressure on my back and spine I can use a cane while ambulating." C."I will take my NSAID every 6 hours, as prescribed, to help control my pain." D."I will remain consistently active throughout the day to prevent stiffness in my joints."
D."I will remain consistently active throughout the day to prevent stiffness in my joints."
What taste and smell changes are part of the normal aging process?
Decreased or altered taste (at risk for food poisoning, watch for excessive salt and seasoning), and decreased sense of smell (at risk bc unable to smell smoke or gas leak in home).
What heart changes occur as part of the normal aging process?
Decreased response to stressors and decreased CO, HR (at rest and with exercise- takes a second for it to elevate), increased systolic pressure (140/160 expected), and increased systolic murmurs.
An older adult client shares with the nurse that, "I don't know what it is but it seems that I need more light for reading or even watching television as I get older." The nurse explains that aging may cause this change due to the: a. slower ability of the pupil to adjust to changes in lighting. b. impact arcus senilis has on visual acuity c. flattening and thinning of the cornea. d. retinal changes that begin to occur with aging.
a. slower ability of the pupil to adjust to changes in lighting.
A 77-year-old client being treated for glaucoma asks the nurse what causes glaucoma. The nurse's response is: a. the exact etiology of glaucoma is variable and often unknown. b. spasms of the orbicular muscle. c. changes to the suspensory ligaments, ciliary muscles, and parasympathetic nerves. d. bits of broken coalesced vitreous from the peripheral or central part of the retina.
a. the exact etiology of glaucoma is variable and often unknown.
An older man tells a nurse, "The doctor says I have something wrong with my eyes, something called presbyopia. Can you explain why I have this? I was always fortunate to have good eyesight." The nurse formulates a response based on the knowledge that: a. the lens of the eye loses elasticity causing a loss of focus for near objects. b. the cornea of the eye becomes thicker and less curved causing an increase in astigmatism. c. the lens of the eye increases in opacity causing a decrease in light refraction. d. the cornea of the eye forms a gray ring at the edges.
a. the lens of the eye loses elasticity causing a loss of focus for near objects.
A patient is being discharged after the insertion of a permanent pacemaker. Which statement made by the patient indicates an understanding regarding appropriate self-care? a) Every morning I will perform arm and shoulder stretches b) Each day I'll take my pulse and record it in a log c) I'll have to get rid of my microwave oven d) I won't be able to use my electrical blanket anymore
b) Each day I'll take my pulse and record it in a log
In caring for the patient with age-related, dry macular degeneration, it is important for the nurse to: a) teach the patient how to use topical eye drops b) emphasize the use of low-vision aids c) encourage the patient to wear eye patches d) prepare the patient for sudden onset of blindness
b) emphasize the use of low-vision aids
Presbyopia occurs in older adults because a) the eyeball elongates b) the lens becomes inflexible c) the corneal curve curvature becomes irregular d) light rays are focusing in front of the retina
b) the lens becomes inflexible
Myopia is when: a) you can only see far (farsightedness) b) you can only see near (nearsightedness) c) distorted vision occurs at all distances d) nearsightedness occurs due to aging
b) you can only see near (nearsightedness)
The nurse has completed an assessment on a client with a decreased cardiac output. Which findings should receive highest priority? a. BP 110/62, atrial fibrillation with HR 82, bibasilar crackles b. Confusion, urine output 15mL over the last 2 hours, orthopnea. c. SpO2 92 on 2 liters nasal cannula, respirations 20, 1+ edema of lower extremities. d. Weight gain of 1kg in 3 days, BP 130/80, mild dyspnea with exercise.
b. A low urine output and confusion are signs of decreased tissue perfusion. Orthopnea is a sign of left-sided heart failure. Crackles, edema and weight gain should be monitored closely, but the levels are not as high a priority. With atrial fibrillation there is a loss of atrial kick, but the blood pressure and heart rate are stable
An older patient reports the following symptoms to a nurse during a routine visit to the geriatric clinic: blurry vision, the need for more light when reading, and blind spots in the middle of his visual field. He also states, "Strangely enough my peripheral vision continues to be pretty good." The nurse suspects that the patient has which of the following? a. Glaucoma b. Age related macular degeneration c. Diabetic retinopathy d. Cataracts
b. Age related macular degeneration
A nurse is caring for a client with a new diagnosis of Type 2 diabetes mellitus. The nurse is educating the client about diabetic retinopathy screening. Which statements made by the client are correct: (select all that apply) a.) "I don't have to be screened since I just got diagnosed." b.) "I should make an appointment for an eye exam before I leave today" c.) "I will need to have dilated eye exams every 5 years" d.) "Screening is only for patients who take insulin" e.) "I will need to have dilated eye exams annually"
b.) "I should make an appointment for an eye exam before I leave today" e.) "I will need to have dilated eye exams annually"
Which patient(s) are most at risk for developing Macular Degeneration? Select all that apply. a.) 50 year old who exercises 3 times per week for 30 minutes a day and eats a balanced diet. b.) 60 year old who has a BMI of 29.9 and has a family history of AMD. c.) 65 year old caucasian male who smokes daily. d.) 55 year old who maintains a normal blood pressure and cholesterol level.
b.) 60 year old who has a BMI of 29.9 and has a family history of AMD. c.) 65 year old caucasian male who smokes daily.
A patient is being prepared for outpatient cataract surgery. The nurse would expect the patient to report a history of: a) a painless, sudden, severe loss of vision b) blurred vision, colored halos around lights and eye pain c) a gradual loss of vision with abnormal color perception and glare d) light flashes, floaters, and a "cobweb" in the field of vision
c) a gradual loss of vision with abnormal color perception and glare
The nurse is assessing clients at a health fair. Which client is at greatest risk for coronary artery disease? a. a 32-year-old female with mitral valve prolapse who quit smoking 10 years ago. b. a 43-year-old male with a family history of CAD and cholesterol level of 158 c. A 56-year-old male with an HDL of 60 who takes atorvastatin (Lipitor) d. A 65-year-old female who is obese with an LDL of 188
d. The woman who is 65-years-old, over weight and has an elevated LDL is at greatest risk. Total cholesterol >200, LDL >100, HDL <40 in men, HDL <50 in women, men 45-years and older, women 55-years and older, smoking and obesity increase the risk of CAD. Atorvastatin is a medication to reduce LDL and decrease risk of CAD. The combination of postmenopausal, obesity and high LDL cholesterol places this client at greatest risk.
A nurse is teaching a a class about management and treatment of diabetic retinopathy. All of the following statements are correct EXCEPT: a.) Laser photocoagulation is used to destroy leaking blood vessels b.) Medications called vascular endothelial growth factor inhibitors (anti-VEGF) are injected intravitreally c.) Proper control of diabetes mellitus is critical d.) Treatments are aimed at restoring lost vision
d.) Treatments are aimed at restoring lost vision
What reason puts elderly patients at a higher risk for pressure ulcers?a.) Fragile skin that damages easy b.) Poor nutritional state c.) Reduced sensation of pressure and pain d.) Frequently more affected by immobile and edematous conditions e.) All of the above
e.) All of the above
