COA Exam 1 Questions

The nurse is planning an educational event for the nurses on a subacute medical unit on the topic of normal, age-related physiologic changes. What phenomenon should the nurse address?

A decrease in muscle mass and bone density

The nurse is caring for a 65-year-old client who has previously been diagnosed with hypertension. What blood pressure reading represents the threshold between high-normal blood pressure and hypertension?

140/90 mm Hg

The nurse is caring for a 91-year-old client who reports urge incontinence and says that he sometimes falls when he tries to get to the bathroom in his home. The nurse identifies the nursing diagnosis of Risk for Falls related to impaired mobility and urinary incontinence. The older adult's risk for falls is considered to be which of the following?

A geriatric syndrome

A gerontologic nurse is aware of the demographic changes that affect the provision of health care. Which of the following phenomena is currently undergoing the most rapid and profound change?

A growing number of people live to a very old age

Which clinical manifestation would be most significant and require further investigation when assessing the skin of an 85 year old?

Ecchymoses (bruises) on both forearms

The admissions department at a local hospital is registering a male older adult for an outpatient diagnostic test. The admissions nurse asks the man if he has an advanced directive. The man responds that he does not want to complete an advance directive because he does not want anyone controlling his finances. What would be appropriate information for the nurse to share with this client?

Advance directives are limited only to health care instructions and directives

An occupational health nurse overhears an employee talking to his manager about a 65-year-old coworker. What phenomenon should the nurse identify when hearing the employee state, He should just retire and make way for some new blood.?

Ageism

A nurse will conduct an influenza vaccination campaign at an extended care facility. The nurse will be administering intramuscular (IM) doses of the vaccine. Of what age-related change should the nurse be aware when planning the appropriate administration of this drug?

An older client has less subcutaneous tissue and less muscle mass than a younger client

A gerontologic nurse is overseeing a large, long-term care facility. The nurse is educating staff about the threat posed by influenza in older, frail adults. What action should the nurse prioritize to reduce the incidence and prevalence of influenza in the facility?

Ensure that residents receive influenza vaccinations in the fall of each year

The nurse is caring for an 85-year-old client who has been hospitalized for a fractured radius. The client's daughter has accompanied the client to the hospital and asks the nurse what her father can do for his very dry skin, which has become susceptible to cracking and shearing. What is the nurse's best response?

He should likely take showers rather than baths, if possible

The nurse is providing care for an 82-year-old man whose signs and symptoms of Parkinson disease have worsened over the past several months. The man states that he can no longer do as many things for himself as he used to be able to. What factor should the nurse recognize as impacting the client's life most significantly?

Loss of independence

After a sudden decline in cognition, a 77-year-old man who has been diagnosed with vascular dementia is receiving care in his home. To reduce this man's risk of future infarcts, what action should the nurse most strongly encourage?

Rigorous control of the client's blood pressure and serum lipid levels

Based on a client's vague explanations for recurring injuries, the nurse suspects that a community-dwelling older adult may be the victim of abuse. What is the nurse's primary responsibility?

Report the findings to adult protective services

For several years, a community health nurse has been working with a 78-year-old man who requires a wheelchair for mobility. The nurse is aware that the interactions between disabilities and aging are not yet clearly understood. This interaction varies, depending on what variable?

Socioeconomics

The nurse is caring for an elderly client with cardiovascular disease. The client comes to the clinic with a suspected respiratory infection and is diagnosed with pneumonia. What should the nurse recognize about the altered responses of older adults?

The altered responses of older adults reinforce the need for the nurse to monitor all body systems to identify possible systemic complications

What data regarding the family history of an adult is most important for the nurse to obtain during an initial interview? a. Major disease of close family members b. Dates of immunizations and vaccines received c. Quality of emotional support provided by family d. Number and ages of client's siblings

a. Major disease of close family members

A client on complete bed rest is at risk for disuse syndrome. The nurse should consider which client goal as appropriate? a. The client remains free of contractures in lower extremities b. The nurse performs passive ROM to lower extremities every 4 hours c. The nurse turns the client every 2 hours d. The client has shorter periods of immobility

a. The client remains free of contractures in lower extremities

The nurse must apply an elastic bandage to support a client's sprained ankle. Which action should the nurse take during this procedure? a. Maintain a tight stretch with each wrap of the bandage b. Moderately stretch the bandage and wrap it from distal extremity to proximal c. Wrap the extremity loosely enough to insert two fingers beneath the bandage d. Start proximal to the injury site and work distally

b. Moderately stretch the bandage and wrap it from distal extremity t proximal

The nurse would take which action as a high priority during a routine health assessment? a. Identify all areas of pathology b. Teach the client about ways to maintain health and wellness c. Use humor if the client is anxious d. Explore the client's family relationships

b. Teach the client about ways to maintain health and wellness

What statement made by a client indicates to the nurse an understanding of genetic testing? Select all that apply a. "My nutritional intake will be recorded." b. "I need to keep a diary of my activities during the week of the screening." c. "Counseling will be provided at a follow-up appointment." d. "Medicine will be prescribed for me." e. "Blood may be drawn from my spouse and I, as well as our children."

c. "Counseling will be provided at a follow-up appointment." e. "Blood may be drawn from my spouse and I, as well as our children."

The nurse plans to do which of the following using the skill of inspection during the health assessment on an adult? Spend a significant amount of time completing this portion of the exam b. Leave all prepared supplies on a nearby table c. Use eyes, ears, and sense of smell to make observations d. Look at one side of the body first, then the other

c. Use eyes, ears, and sense of smell to make observations

The nurse should interpret that which client is most at risk for developing skin cancer? a. A 20 year old lifeguard who wears sunscreen b. A teenager who wears a ski outfit when skiing c. A baby underneath a large beach umbrella d. An 80 year old farmer who wears a cap when working

d. An 80 year old farmer who wears a cap when working