Gerontology

Which skin damage is caused by chronic exposure to ultraviolet rays? Select all that apply. One, some, or all responses may be correct. A. Dryness B. Photoaging C. Vascular lesions D. Wrinkling of skin E. Benign neoplasm

Answer: B, D. Photoaging and wrinkling of skin Rationale: The skin damages that happen from chronic exposure to ultraviolet rays are photoaging and skin wrinkling. Dryness, vascular lesions, and benign neoplasm are changes related to aging.

Which gerontologic assessment findings of the auditory system are related to the inner ear? Select all that apply. One, some, or all responses may be correct. 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

Answer: A, B, E Hair cell degeneration, Reduced blood supply to the cochlea, Less effective vestibular apparatus in the semicircular canals Rationale: Hair cell degeneration, reduced blood supply to the cochlea, and less effective vestibular apparatus in the semicircular are assessment findings related to the inner ear. Atrophic changes of the tympanic membrane is an assessment finding associated with the middle ear. A decline in an ability to filter out unwanted is an assessment finding of the brain.

Which characteristic of a therapeutic milieu would the nurse consider important for a confused older adult with socially aggressive behavior? A. Sets limits B. Has variety C. Is group oriented D. Allows freedom of expression

Answer: A. Sets limits Rationale: The therapeutic milieu characteristic would be to set limits. Because clients with socially aggressive behavior have poor control, these individuals require a therapeutic environment in which appropriate limits for behavior are set for them.

Which type of bone tumor occurs most commonly in elderly clients? A. Endochroma B. Osteosarcoma C. Chondrosarcoma D. Osteochondroma

Answer: C. Chondrosarcoma Rationale: Chondrosarcoma occurs most commonly in cartilage in the arm, leg, and pelvic bones of older adults in the age group of 50 to 70 years old. Endochroma occurs in clients in the age group of 10 to 20 years old. Osteosarcoma and osteochondroma occur in the age group of 10 to 25 years old.

Which age-related effects on the immune system occur in the older client? A. Increased autoantibodies. B. Increased expression of IL-2 receptors. C. Increased delayed hypersensitivity reaction. D. Increased primary and secondary antibody responses.

Answer: A. Increased autoantibodies Rationale: The effects of aging on the immune system include increased autoantibodies. Expression of IL-2 receptors, delayed hypersensitivity reaction, and primary and secondary antibody responses decrease in older adults because of the effects of aging on the immune system.

An older client with Alzheimer type dementia, consistently sleeps in a semi-Fowler position in bed. Which area of the client's body would the nurse consider a high risk for developing a pressure injury? A. Sacrum B. Scapulae C. Ischial spine D. Greater trochanter

Answer: A. Sacrum Rationale: The sacrum is the center of the greatest body mass; an elevated torso exerts pressure toward this area. Although the scapulae are at risk, they do not bear the greatest body weight as when the client is in the semi-Fowler position. The ischial spine bears the greatest pressure when the client is in an upright sitting position. Greater trochanter is at risk when the client is in a side-lying position.

The nurse is caring for an older adult who was admitted to the hospital to be treated for dehydration. While the nurse is providing discharge teaching, the client asks what to do about itchy, dry skin. Which response by the nurse is appropriate? A. "Wear plenty of warm clothes to keep moisture in the skin." B. "Use a moisturizer on the skin daily to help reduce itching." C. "Take hot tub baths only twice a week to reduce drying of the skin." D. "Expose the skin to the air to help reduce the sensation of itching."

Answer: B. "Use a moisturizer on the skin daily to help reduce itching." Rationale: Lubricating the skin with a moisturizer effectively relieves dryness and, thus, the pruritus (itching). Wearing warm clothing will not lubricate the skin or relieve pruritus. Warm or cool, not hot, tub baths will reduce itching. Exposing the skin to the air causes further drying and will not relieve pruritus.

Which guidelines would the nurse consider when planning care for a hospitalized older client with Alzeimer disease? A. Physical contact will increase dependency needs. B. Routines provide stability for clients with neurocognitive disorders. C. Regressive behavior should be interrupted immediately. D. Procedures do not have to be explained to clients with neurocognitive disorders.

Answer: B. Routines provide stability for clients with neurocognitive disorders. Rationale: Routines provide stability for clients with neurocognitive disorders. Rituals and routines in activities of daily living provide a framework and structure for client with Alzheimer disease, adding to their sense of safety and security.

Which action would the nurse take for an older client with Alzheimer disease who sleeps very little and becomes more disoriented from sleep deprivation? A. Shut the client's door during the night. B. Apply a vest restraint when the client is in bed. C. Leave a dim light on in the client's room at night. D. Administer the client's prescribed as-needed sedative medication.

Answer: C. Leave a dim light on in the client's room at night. Rationale: The nurse would leave a dim light on in the client's room at night. A small light in the room may prevent misinterpretation of shadows, which can heighten fear and alter the client's perception of the environment.

Which condition is due to decreased elasticity of the ocular lens? A. Myopia B. Hyperopia C. Presbyopia D. Astigmatism

Answer: C. Presbyopia Rationale: Presbyopia is an age-related problem in which the lens loses its elasticity and is less able to change its shape to focus the eye for close work. As a result, images fall behind the retina. Myopia, or nearsightedness, is a condition in which the eye over-refracts the light and the bent images fall in front of, not on, the retina. Hyperopia, also called hypermetropia or farsightedness, is a condition in which refraction is too weak, causing images to be focused behind the retina. Astigmatism occurs when the curve of the cornea is uneven. Because light rays are not refracted equally ion all directions, the image does not focus on the retina.

Which activity would the nurse ask an older adult client to do when testing short-term memory? A. Subtract serial sevens from 100. B. Copy one simple geometric figure. C. State three random words mentioned earlier in the examination. D. Name two common objects when the nurse points to them.

Answer: C. State three random words mentioned earlier in the examination. Rationale: Stating three random words mentioned earlier in the examination is a test of the client's ability to recall from short-term memory.

Which action would the nurse take when caring for an older adult with a history of recent memory loss? A. Instruct the client to move slowly when changing positions. B. Remind the client to look where he or she places the feet while walking. C. Adjust the daily schedule to accommodate sleep pattern. D. Employ electronic devices that provide alerts.

Answer: D. Employ electronic devices that provide alerts. Rationale: Providing electronic devices that give alerts can help an older who has developed recent memory loss.

Which initial nursing intervention would the nurse take for an older adult delirium who begins acting out while in the dayroom? A. Instructing the client to be quiet B. Allowing the client to act out until fatigue sets in C. Guiding the client from the room by gently holding the client's arm D. Giving the client one simple direction at a time in a firm, low-pitched voice

Answer: D. Giving the client one simple direction at a time in a firm, low-pitched voice Rationale: Clients with delirium typically respond to simple directions stated one at a time in a firm, low-pitched voice.

Which intervention would the nurse include when developing a plan of care for an older client with dementia? A. Explain to the client the details of the regimen. B. Demonstrate interest in the client's various likes and dislikes. C. Be firm when dealing with the client's attitudes and behaviors. D. Provide consistency in carrying out nursing activities for the client.

Answer: D. Provide consistency in carrying out nursing activities for the client. Rationale: The nurse would include providing consistency in carrying out nursing activities for the client. Familiarity with situations and continuity add to the client's sense of security and foster trust in the relationship.