ALL QUESTIONS

A nurse at a long term care facility is contributing to the plan of care for a client who has Alzheimer's disease and wanders at night. Which of the following interventions should the nurse include in the plan?

Assign the client to a room closer to the nurses station.

A nurse is reinforcing teaching with a group of healthy, older adult clients about age related changes and sexual response. Which of the following changes should the nurse include as an age related change?

Decreased vaginal lubrication

A nurse is reviewing the basic need of older adult clients with a group of assistive personnel, which of the following statements should he nurse include?

Deep Sleep is decrease

A nurse in an adult day care is contributing to the development of treatment plans for older adult clients. Which of the following therapeutic strategies should the nurse use to help clients achieve ericksons developmental task for this age group?

Reminiscence therapy

A nurse is caring for an older adult client who is unresponsive following a stroke. Which of the following actions should the nurse take while providing mouth care.

Turning the client in the side before starting oral care.

A nurse is teaching an older adult who has osteoarthritis in right hip and low lumbar vertebrae. Which statement by the patient indicates an understanding of teaching? a. I should avoid use of a heating pad on my back b. To relieve pressure on my hip, I can use a cane while ambulating c. I will have steroid injections to my joints d. I will exercise even when it causes pain

b. To relieve pressure on my hip, I can use a cane while ambulating Using a cane as an assistive device enables the client to compensate for weakness in the spine by providing some relief of hip pressure. Use of a cane can provide joint support and safety for self-care activities.

For an admission assessment, what action should the nurse take to collect subjective data? a. leave client written questionnaire to fill out in private b. allow sufficient time for client to respond c. talk to family to obtain client's hx d. obtain health hx from client's medical record

b. allow sufficient time for client to respond

Nurse developing plan of care for client who had recent stroke and history of GERD. Which following disorders should nurse plan to monitor? a. duodenal ulcer disease b. aspiration pneumonia c. viral pneumonia d. esophageal varices

b. aspiration pneumonia GERD results in reflux of gastric secretions from the stomach into the lower esophagus. When regurgitation occurs, the client is at high risk for pneumonia. Pneumonia occurs due to aspiration of gastric contents into the airway. This client is at increased risk for dysphagia due to the stroke and history of GERD; therefore, the nurse should monitor closely for aspiration pneumonia.

Which of the following physiologic changes associated with aging can affect medication dosage in an older patient? a. increased GFR b. decreased body fat c. decreased gastric motility d. decreased gastric pH

c. decreased gastric motility Decreased gastric motility results in medications remaining in the digestive tract for longer periods of time, leading to slow absorption of the medication. The provider might have to allow for a longer time for medication onset and peak by extending the length of time between doses.

A nurse in a LTC facility is promoting reminiscence in older adults. Which of the actions should the nurse take? a. establish a weekly pet therapy visitation program b. place a calendar and clock in each resident's room c. institute a daily storytelling hour d. encourage all clients to eat their meals in the dining room

c. institute a daily storytelling hour A storytelling hour is an example of reminiscence therapy, which allows clients to share stories of their past and reminisce with others who might have similar or shared memories. According to Erikson's psychosocial theory, reminiscence is an important action for older adult clients.

A nurse is part of a committee that is developing age-appropriate care standards. Which of the following should the nurse know is the focus for older adult clients, based on Erikson's developmental tasks? a. intimacy b. identity c. integrity d. initiative

c. integrity

a nurse at a long term care facility is contributing to a plan for an older adult client who has dementia. which of the following interventions should the nurse include in the plan?

use photographs as memory triggers

A nurse in an assisted living facility is assessing an older adult client who moved in 3 months ago following the death of his partner. The client reports awakening in the morning and admits to feeling very sad. The nurse should identify then the client is experiencing which of the following types of grief.

Acute grief The client experiencing acute grief will have both somatic and psychological manifestations of distress, such as the inability to sleep well or profound sadness. The nurse should identify that this client is experiencing acute grief and further assess his support system, concurrent stressors in his life, and his ability to manage stress.

The nurse is assisting in the planning of an immunization clinic for older adults. At which of the following times should an older adult client receive the influenza vaccine?

Annually in the fall

A nurse is completing medication reconciliation for an older adult client who is receiving multiple medications which of the following action should the nurse take first?

Ask the client about over the counter medications

A nurse is caring for a client and is using a fentanyl transdermal patch for pain control. Which of the following actions should the nurse take when caring for this client?

Avoid using heating patch

A nurse is caring for an older adult client who has a terminal illness. the client tells the nurse " I just want to live one more month so i can see my grand child get married" which of the following in Kubler-ross stages of grief should the nurse identify the client is experiencing?

Bargaining

A nurse is reinforcing teaching with an older adult client about osteoporosis. Which of the following statements should the nurse include in the teaching?

Brisk walking will help prevent bones loss

A nurse is collecting data from an older adult client who lives alone. Although the client is able to answer all questions appropriately, the nurse notes that the client has a decreased attentions span, expresses feelings of overwhelming sadness, and has low energy level. The nurse should identify that the client is exhibiting manifestations of which of the following disorders?

Depression

A nurse is collecting data afrom 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?

Determine the client's usual sleep habits

A nurse at a long term care facility is reinforcing teaching with an older adult client about ambulating with a quad cane. Which one of the following statements should the nurse include in the teaching? a. adjust height of can so you can flex elbow at 45 degrees b. hold the cane on the stronger side of your body c. place flat side of cane away from your foot d. move cane and your stronger leg at same time

Hold the cane on the stronger side of your body

A nurse is reinforcing teaching with a client who is to start taking finasteride. Which of the following statements by the client indicates an understanding of the teaching?

I should see a decrease in my PSA levels

A nurse is collecting data from an older adult client who has chronic pain. Which of the following effects of unrelieved pan should the nurse identify as a priority finding to report?

Impaired mobility

a nurse is reinforcing teaching with an older adult client who is healthy and has chronic constipation about establishing a bowel retraining program. which of the following statements should the nurse include in the teaching?

Increase the fiber content of your diet

A nurse is collecting data from an older adult client who had a right sided stroke two days ago. For which of the following findings should he nurse notify the provider immediately?

Increased restlessness

A nurse is assisting with the admission of an older adult client who has urinary incontinence and smells strongly of urine. The clients partner who has been caring for her a home, states the he is sorry and embarrassed about the unpleasant smell. Which of the following responses should the nurse make?

It must be difficult to care for someone who is incontinence

A nurse is caring for a patient who is using a CPM device following a right knee replacement. Which of the following actions should the nurse take when applying the CPM device?

Line up the frame s=joints of the CPM to the clients knee.

A nurse is caring for an older adult client who is expressing feelings of grief and longing for his earlier life. Which of the following actions should the nurse take?

Listen attentively and allow the client to talk about the past

A nurse is reinforcing teaching about skin changes in the older adult client with a newly licensed nurse. Which of he following findings should the nurse identify as benign, age related change commonly seen in older adult clients?

Liver spots

A nurse is transferring an older adult client who has right sided weakness from bed to a wheelchair. Which of the following action should t nurse take to provide a safe transfer?

Maintain a straight back and bend at the knees

A nurse is reviewing the records of a group of older adults. Which of the following findings should the nurse identify as an unexpected manifestation of the aging process

Obesity

A nurse is caring for a client who has aphasia following a stroke. Which of the following actions should the nurse take?

Present on idea at a time

A nurse is collecting data from an older female client. Which of the following findings should the nurse identify as a priority?

Rales heard in the bases of the lungs

A Nurse is caring for an older adult client who has moderate hearing loss. Which of the following action should the nurse take to enhance communication?

Speak at a moderate rate

A nurse is caring for an adult older client who is on bed rest. Which of the following foods should the nurse plan to include on the clients breakfast tray to prevent constipation?

Stewed prunes

A nurse collecting data from an older adult who has right sided heart failure. Which of the following findings is the nurse's priority to report?

Weight has increased 0.91 kg (2 lb) in 24 hr.

A nurse is reinforcing teaching with a group of older adults clients about dietary needs. Which of the following dietary recommendations should the nurse include in the teaching?

You should consume 1200 milligrams of calcium a day

A nurse at an ophthalmology clinic is assessing a client referred by the provider for a potential cataract. Which of the following client reports should the nurse recognize is consistent with cataracts? a. halos 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 when looking at lights A cataract is a cloudy or opaque area in the lens of the client's eye. Cataracts in adults usually develop with advancing age and can be hereditary. Cataracts develop slowly and painlessly with a gradual onset of difficulty with vision. Visual problems include difficulty seeing at night, halos around lights or glare sensitivity, and decreased visual acuity, even in daylight. Cataracts are accelerated by environmental factors, such as cigarette smoke or other toxic substances, or in response to metabolic diseases, such as diabetes mellitus.

A nurse caring for an older patient who has gout and refuses to eat. The client's provider has approved the family to bring food from home. Which food should the nurse recommend the client not eat? a. lentil soup b. cheese sandwich c. yogurt d. raisins

a. lentil soup The nurse should encourage the client to eat a purine-restricted diet to decrease elevated uric acid levels. The diet is used for clients who have gout, renal calculi, or both in conjunction with medication therapy. Whole grain breads and cereals, oatmeal, wheat germ, wheat bran, meat gravies, fresh and saltwater fish, beans, organ meats, mushrooms, green peas, spinach, asparagus, cauliflower, and baker's and brewer's yeast are all high in purine. Lentils, which are legumes, are a rich source of purines.

A nurse at an assisted living center is conducting an orientation session for a group of newly hired AP. Which instructions should the nurse include regarding clients who are hearing impaired? a. maintain eye contact with clients b. stand to one side of the clients and speak into their good ears c. speak loudly with exaggerated enunciation d. ask only questions with yes or no answers

a. maintain eye contact with clients

A nurse is teaching a newly hired AP about her role in helping older clients with activities of daily living (ADLs). The nurse should explain that which of the following is the most common factor that affects a client's performance of ADLs? a. social withdrawal b. chronic physical disability c. emotional impairment d. cognitive dysfunction

b. chronic physical disability Physical disability is the most common reason older adult clients have difficulty performing ADLs. Self-care deficit, the nursing diagnosis that describes the inability of the client to perform self-care activities necessary for optimum health and function, is associated with several physical etiologic factors: activity intolerance, pain, neuromuscular impairment, sensory-perceptual impairment, musculoskeletal impairment, and cognitive impairment.

Nurse admitting older client who fell 3 days ago and presents with a fractured hip, malnutrition, and dehydration. Which lab value represents malnutrition? a. increased sodium b. decreased albumin c. increased BUN d. decreased blood glucose

b. decreased albumin Decreased albumin is indicative of inadequate protein intake, which is a common finding in a client who has prolonged malnutrition.

A nurse assessing an older adult for signs of dehydration. Which finding is an expected part of the aging process. a. elevation of urine specific gravity b. decreased creatinine clearance c. dry oral mucous membranes d. poor skin turgor over sternum

b. decreased creatinine clearance

A nurse is caring for an older adult with new onset Type 2 DM. What physiologic change contributes to development of Type 2 DM? a. increased production of insulin by pancreas b. decreased sensitivity to circulating insulin c. increased rate of glucose metabolism d. decreased release of glycogen by liver

b. decreased sensitivity to circulating insulin

A nurse is assessing an older patient during an annual physical. What finding should the nurse report to the provider? a. BP 118/76 mm Hg b. fasting blood glucose level 160mg/dl c. report of waking to void two to three times per night d. report of bowel movement every other day

b. fasting blood glucose level 160mg/dl nurse should recognize that a fasting blood glucose level of 160 mg/dL is elevated. The nurse should report this value to the provider for further evaluation, as the client might be showing early signs of a tendency for diabetes mellitus.

A nurse who is caring for an older patient with pneumonia. Which of the following physiologic change associated with aging places the client at risk for pneumonia a. decreased anterior-posterior diameter b. increased diameter of small airways c. decreased number of cilia d. increased alveolar surface area

c. decreased number of cilia A physiologic change associated with aging is a decreased number of cilia. This, along with a less effective cough, leads to diminished efficiency of the normal defense mechanisms for clearing the airway, putting the client at increased risk for infection, such as pneumonia.

A nurse is assessing an older adult who is homeless. What findings should the nurse associate with co-morbidity? a. inadequate shelter and clothing for weather b. malnutrition and poverty c. dementia and TB d. lack of preventive

c. dementia and TB The term comorbidity refers to medical conditions known to co-exist in a client. The number of comorbid conditions present in a client is used to provide an indication of his health status and risk of death. Dementia and tuberculosis occurring in an individual client is an example of comorbidity and increases the client's risk.

A nurse in a clinic is assessing older adult client for 2nd time in week. Client reports decreased energy level, insomnia, anorexia. Diagnostic tests WNL. Which condition should nurse screen client? a. sarcopenia b. dementia c. depression d. diabetes

c. depression

A nurse is reviewing a medical record who is post-menopausal and has osteoporosis. The client has a new Rx for alendronate sodium. Which finding in the history should the nurse recognize as a contraindication for this medication? a. glaucoma b. paget's disease c. esophageal achalasia d. long-term corticosteroid use

c. esophageal achalasia Clients who have a history of esophageal abnormalities, such as stricture or achalasia, have delayed esophageal emptying, which greatly increases the client's risk for esophageal erosion, bleeding, and perforation. Alendronate sodium is a bisphosphonate, which prevents or slows weakening of bone. It is used to prevent and treat postmenopausal osteoporosis. The nurse should instruct the client to wait at least 30 min after taking alendronate sodium before eating, drinking, or taking other medications, and caution her not to lie down for at least 30 min after taking the medication. Standing or sitting upright ensures that the client gets the full dose and decreases heartburn or the risk of injury to the esophagus.

An older adult says to the nurse: "I am always forgetting things. I can't remember where I parked my car. Do you think I have Alzheimer's?" The correct therapeutic response by the nurse would be: a. perhaps you should discuss your concerns with your doctor b. I am forgetful too. I can't remember where I parked my car either!" c. You're probably just having senior moments. Everyone has memory lapses. d. That must be very upsetting. Can you tell me about your forgetfulness?

d. That must be very upsetting. Can you tell me about your forgetfulness?

A client has Alzheimer's, refuses to take antihypertensive medication, is oriented to time and place, and is able to perform ADLs with minimal supervision. What action should the nurse take? a. crush pills and feed them to client in applesauce b. insist client comply by informing her of possible implications of missing a dose c. notify the provider of need for further evaluation of client's level of competence d. ask client to express her reasons for refusing the medication and document the event

d. ask client to express her reasons for refusing the medication and document the event

A nurse is caring for an older adult client who has a hip fracture and is rating her pain at 8 on a 0 to 10 scale. Which of the following medications should the nurse adminster?

oxycodone/acetaminophen 7.5/325 tablet PO

A nurse is collecting data from an 85 yr old client. Which of the following findings should the nurse report to the provider?

Differences in pulse strength between lower extremities

A nurse us reinforcing teaching with a client who is to start taking alendronate sodium. Which of the following recommendation should the nurse include in the teaching?

Discontinue the medication if you develop heartburn

A nurse is caring for an older adult client who reports that she has just retired and expresses feelings of loneliness due to the of daily interactions with coworkers. Which of the following responses should the nurse make?

Do you know about the local senior group?

A nurse is reviewing the medical record of an older client. For which of the following medications should the nurse request a hearing assessment of the client?

Furosemide

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?

Go to the bed at the same time everynight

A nurse is reinforcing teaching with an older adult client who had total hip athroplasty abut ambulating with a standard walker. Which of the following action by the client indicates understanding?

The client moves the walker ahead 15.24 cm (6in) and then steps with the walker

A nurse is teaching an older client on bedrest following a DVT about methods to increase peristalsis. Which of the following high-fiber food choices should the nurse recommend? a. navy bean soup b. canned fruit soup c. white rice pudding d. soy milk

a. navy bean soup An older adult client who is on bedrest has an increased risk for constipation due to the decreased peristalsis associated with the aging process. Increasing dietary fiber by adding foods like legumes to the diet, as well as ensuring adequate fluid intake, will promote bowel regularity.

A nurse is caring for an older client who has dementia. The client becomes confused and agitated at night, and wanders into the hallway at night. Which of the following actions should the nurse take? a. place client mattress on the floor b. restrain client during nighttime hours c. provide continuous orientation to client d. turn out lights in client's room at night

a. place client mattress on the floor

A nurse is administering diphenhydramine hydrochloride to an older adult client. Which actions should nurse take prior to administration? a. review medical record for client hx glaucoma b. plan to administer med 30 min prior to meal c. explain to client he will need to restrict fluid intake once he takes med d. remind client his appetite might increase when starting the med

a. review medical record for client hx glaucoma The nurse should review the medical record for a history of glaucoma prior to administration of the medication. Diphenhydramine is contraindicated for clients who have narrow-angle glaucoma because diphenhydramine can dilate the pupils. Clients who have glaucoma are administered medication to constrict the pupils, which improves circulation of the aqueous humor for absorption.

A nurse at a long-term care facility is teaching new volunteers. The nurse should explain that older adults are most likely to exhibit a decrease in what? a. short-term memory b. creative ability c. decision-making skills d. cognitive capacity

a. short-term memory

Discharge instructions about calcium supplements to older adult female who has osteoporosis and recent repair of fracture in right hip. Which instructions should nurse include? a. you should take your calcium supplement with large glass of water b. you should increase your intake of grain cereals while taking calcium supplements c. you should take at least 2600 mg calcium supplements daily d. you will not need to take vitamin D with your calcium supplement after menopause

a. you should take your calcium supplement with large glass of water

A nurse is teaching a group of older female adults about postmenopausal dietary requirements. Which statement about should the nurse make about folic acid? a. clients who are postmenopausal need to limit intake of folic acid to reduce risk of stroke b. dietary folic acid is not significant importance after childbearing years c. healthy clients who are postmenopausal require a daily folic acid supplement d. adequate folic acid intake is associated with a reduced risk for heart disease

d. adequate folic acid intake is associated with a reduced risk for heart disease Clients who are postmenopausal and consume the recommended daily intake of 400 mcg of folic acid have significantly lower levels of homocysteine, a risk factor for heart disease, than those who do not. Older adult female clients need to improve their daily folic acid intake, which can be accomplished by increasing daily dietary intake of foods such as orange juice, beans, legumes, and green leafy vegetables, as well as foods enriched with folic acid, such as breads and pastas.

A nurse is planning care for a client who had a stroke. Which of the following goals should the nurse identify as a major priority for this client a. client's skin will remain intact during hospitalization b. client will verbalize one new word each week c. client will begin to help turn himself in bed, indicating improved mobility d. client's airway will remain clear, as evidenced by clear breath sounds

d. client's airway will remain clear, as evidenced by clear breath sounds

A nurse is caring for a patient with anemia. Which food should the nurse recommend to increase iron? a. greek yogurt b. bran muffin c. peanut butter sandwich d. dried fruit

d. dried fruit

Nurse is planning care for an older adult client following abdominal surgery for a bowel obstruction. What about pain management should the nurse consider when planning care? a. diminished capacity to perceive pain b. should not take narcotics for pain control c. increased pain as a normal part of aging d. sensitive to analgesic effect of opiates

d. sensitive to analgesic effect of opiates An older adult client is likely to require a decreased dose of opiates to provide the same level of analgesia as a younger client, with a reduced risk of side effects.

A nurse is teaching a group of healthy older adults about health screenings after age 50. Which health screening should the nurse recommend that client's complete annually? a. cholesterol b. colonoscopy c. diabetes mellitus d. visual acuity

d. visual acuity

A nurse is reinforcing teaching with an older adult client who is to start taking warfarin. Which of the following statement indicates the client understands the teaching

i can continue to eat green salads

A nurse is reinforcing teaching to a client with COPD and has been losing weight about ways to improve his nutritional intake. which of the following statements by the client indicate and understanding of the teaching?

i should add grated cheese to sauces and vegetables