Fundi's Ch. 23 Prep U

A nurse is conducting an education session about appropriate measures to promote sleep with an older adult who is experiencing frequent awakenings at night and then awakening early in the morning. The nurse determines that the education was successful when the client states: A. "I need to try and go to bed and get up at the same time each night." B. "I should avoid coffee, but tea is okay to drink before bed." C. "I should do some mild exercises about 2 hours before bedtime." D. "I should continue to take my sleep medication for as long as I need to."

A. "I need to try and go to bed and get up at the same time each night."

A nursing student is studying depression in older adults. Faculty members knows the student has mastered the information when she states which of the following? A. "Treatment of depression includes counseling." B. "Sadness is most often associated with suicidal intent." C. "Depression can resolve without treatment." D. "Depression is usually not accompanied by changes in behavior."

A. "Treatment of depression includes counseling."

One of the greatest causes of death in the United States and Canada is colon cancer. The nurse instructs the community on which of the following factors? A. Annual screening after the age of 50 B. Endoscopic exam every year after 30 C. Administration of a stool softener daily D. <20 g of fiber intake per day

A. Annual screening after the age of 50

A nurse is assessing a 55-year-old female client. What is a normal physical change in the middle adult? Select all that apply. A. Cardiac output begins to decrease. B. There is a loss of calcium from bones. C. Skin moisture increases. D. Cognitive ability diminishes. E. Hearing acuity diminishes. F. Hormone production increases.

A. Cardiac output begins to decrease. B. There is a loss of calcium from bones. E. Hearing acuity diminishes.

The nurse is assessing a middle-aged adult age 48 years in the clinic. The nurse recalls the changes that occur in middle age as they complete the physical and cognitive examination. Changes that occur include what? A. Cardiac output decreases. B. Low-pitched sounds are more difficult. C. Visual acuity changes with myopia. D. Loss of fatty tissue

A. Cardiac output decreases.

An older adult client enjoys good overall health, but has just been diagnosed with pneumonia and has begun receiving an intravenous (IV) antibiotic. Shortly after being administered the first dose, the client pulled out his IV line and is now attempting to scale his bed rails. Which of the following phenomena most likely underlies this change in the client's cognition? A. Delirium B. Disorientation C. Depression D. Dementia

A. Delirium

Gould viewed the middle years as a time when adults increase their feelings of self-satisfaction, value their spouse as a companion, and become more concerned with health. Which nursing action best facilitates this process? A. Encouraging a client to have regular checkups B. Counseling a client who complains of being depressed C. Arranging for social services to assist with meals for a homebound client D. Providing entertainment for a client on bedrest

A. Encouraging a client to have regular checkups

An older adult client is becoming progressively confused due to Alzheimer's disease. The family can no longer manage the client at home due to wandering. Which of the following living arrangements could the nurse recommend? A. Extended-care facility B. Accessory apartment C. Naturally occurring retirement communities (NORCs) D. Respite care

A. Extended-care facility

The nurse is assigned to care for a client age 87 years admitted to the medical unit for congestive heart failure. It is the fourth hospital day, and the response to treatment has been good. The client is no longer short of breath and the lung sounds are clearing. There is still a diet restriction of decreased sodium and fluids are limited to no more than 1000 mL per day. The nurse is preparing the client and family for discharge. The nurse's discharge education, in order to promote the older client's health, will include which instructions? Select all that apply. A. Gradually increase activities as tolerated. B. Increased stress may interfere with recovery. C. Take several naps during the day. D. Do not use the salt shaker at meals.

A. Gradually increase activities as tolerated. B. Increased stress may interfere with recovery. D. Do not use the salt shaker at meals.

Mrs. Jimenez, age 79, became a widow earlier this year and now resides alone in the house that she and her husband shared for 30 years. Her children have encouraged her to move, but she expresses a desire to remain in her home, despite some slight mobility challenges. The nurse who provides occasional home healthcare for Mrs. Jimenez should first propose which of the following? A. Home modification B. Homesharing C. A nursing home D. Assisted living

A. Home modification

A nurse has attended an inservice workshop that addressed the phenomenon of ageism in the health care system. Which of the following practices is indicative of ageism? A. Speaking to older adults with the presumption that they have mild cognitive deficits B. Providing slightly smaller servings of food for clients who are older adults C. Assessing the skin turgor of an older adult differently than that of a younger adult D. Implementing falls prevention measures in a setting where older adults receive care

A. Speaking to older adults with the presumption that they have mild cognitive deficits

Which situation would lead the client's family to suspect onset of dementia? A. The client has increasingly experienced disorientation to familiar surroundings. B. The client has experienced confusion with two new medications. C. The client's air-conditioning is broken and he has not reported it. D. The client has not attended church services in a month.

A. The client has increasingly experienced disorientation to familiar surroundings.

Which of the following assessment findings of a male client age 77 years should signal the nurse to a potentially pathologic finding, rather than a normal age-related change? A. The client is oriented to person and place but is unsure of the month. B. The client's gait is slow and his posture appears stooped. C. The client claims to hear high-pitched sounds less clearly than earlier in life. D. The client states that his urine stream is less strong than in the past.

A. The client is oriented to person and place but is unsure of the month.

A nurse is preparing a presentation for a group of older adults about health promotion. Which statistic would the nurse need to keep in mind about this group? A. The group experiencing the largest growth is those 85 years of age and older. B. The older adult population appears to be younger than in the past. C. Life expectancy has increased for men but not for women. D. The number of older adults has begun to plateau since the year 2000.

A. The group experiencing the largest growth is those 85 years of age and older.

Nurses who care for diverse populations must be aware of patterns of disease that are more likely to affect certain ethnic or racial groups. Which examples accurately reflect these profiles? Select all that apply. A. Tuberculosis is 11 times more common in Asians in America than Whites. B. Black men in America are 30% more likely to die from heart disease than non-Hispanic White men. C. Black adults are diagnosed with diabetes and die from diabetes almost three times as often as White adults. D. Hispanics have higher rates of obesity than non-Hispanic Whites. E. Black adults in America have the highest mortality rate of any minority for most major cancers. F. American Indian/Alaska Natives have an infant mortality rate 75% higher than that of Whites.

A. Tuberculosis is 11 times more common in Asians in America than Whites. B. Black men in America are 30% more likely to die from heart disease than non-Hispanic White men. D. Hispanics have higher rates of obesity than non-Hispanic Whites. E. Black adults in America have the highest mortality rate of any minority for most major cancers.

When providing care to a client with dementia, which interventions would be most appropriate? Select all that apply. A. ensuring the use of assistive sensory devices B. using validation therapy C. maintain levels of sensory stimulation that are tolerable D. continually correcting the client for mistakes E. employing reality orientation

A. ensuring the use of assistive sensory devices B. using validation therapy C. maintain levels of sensory stimulation that are tolerable

An older adult client comes to the health center reporting difficulty sleeping. Which statement by the client would the nurse need to address? A. "I try not to be too active once I've eaten dinner." B. "I find myself napping on and off throughout the day." C. "I go to bed around 10:30 pm every night." D. "I don't drink coffee or alcohol."

B. "I find myself napping on and off throughout the day."

A 79-year-old female is admitted to a long-term care facility. She is incontinent of urine and feces and has impaired cognition. What is the best nursing intervention to prevent skin breakdown for this resident? A. Ask her to call the nurse when she feels the need for elimination B. Assist her to the toilet every 2 hours and after meals C. Turn her every hour when in bed D. Insert an indwelling catheter to prevent urine from causing skin breakdown

B. Assist her to the toilet every 2 hours and after meals

The nurse is evaluating a 42-year-old client who says that he is feeling stressed. Which of the following does the nurse know that could be a cause of stress for this age group? A. Retirement B. Being caught in the sandwich generation C. Losing driving privileges D. Social isolation

B. Being caught in the sandwich generation

A 78-year-old woman is status post right hip fracture after a fall. She has stopped going to her church over the past few months. She has also asked her neighbor to help her and do her gardening, an activity she previously loved. The client tells the nurse "I just don't enjoy gardening like I used to. I am always worried about falling." What would most concern the nurse regarding the client? A. Generalized anxiety disorder B. Depression C. Realistic caution D. Bipolar disorder

B. Depression

A nurse is assessing an older adult with impaired thinking, mood and communication. The nurse would expect to find that the client is most likely experiencing problems with which activity initially? Select all that apply. A. Feeding B. Managing finances C. Cooking D. Bathing E. Ambulating F. Shopping

B. Managing finances C. Cooking F. Shopping

A nurse is providing discharge instructions to an older adult client and his daughter. The daughter asks for suggestions to help keep her father healthy. Which of the following could the nurse suggest? A. The client should limit carbohydrates in his diet. B. The client should have his eyes examined every year for glaucoma. C. The daughter can talk to the client's physician about taking a vitamin B supplement. D. The client should have a physical examination every 3 years.

B. The client should have his eyes examined every year for glaucoma.

When providing nursing care to older adults, it is most important to provide comfort due to which of the following changes? A. Dementia B. Thermoregulation C. Sexuality D. Isolation

B. Thermoregulation

When describing the older adult's risk for infection, which aspect would the nurse most likely address? Select all that apply. A. enhanced immune function B. inadequate nutrition C. maintenance of T-cell function D. decline in humoral immunity E. lowered antibody responses

B. inadequate nutrition D. decline in humoral immunity E. lowered antibody responses

An adult child accompanies an older adult client to the clinic and states, "I am not sure what is going on with my parent but I think it is depression." What questions should the nurse ask the client to determine if he or she is depressed? Select all that apply. A. "What foods do you like to eat?" B. "Have you been seeing things that no one else seems to see?" C. "Have you had any changes in weight recently such as a gain or loss?" D. "Can you tell me what your sleep patterns are?" E. "Have you lost interest in things you previously found pleasurable?"

C. "Have you had any changes in weight recently such as a gain or loss?" D. "Can you tell me what your sleep patterns are?" E. "Have you lost interest in things you previously found pleasurable?"

A nurse is teaching an older adult client's family about the causes of mental impairment. The nurse sees that the teaching has been effective when the family says which of the following? A. "Dementia is an acute process and develops suddenly." B. "Alzheimer's disease (AD) is a reversible neurologic illness." C. "Sundowning is a common problem of dementia." D. "Delirium progressively affects cognitive function and is a chronic process."

C. "Sundowning is a common problem of dementia."

A gerontologic nurse practitioner has a large client population with heart disease problems. This nurse practitioner is aware that heart disease is the leading cause of death in the aging adult. What is the cause of this trend? A. Resting heart rate decreases with age. B. The cardiac output is increased with age. C. Blood vessels lose their elasticity with age. D. Systolic blood pressure decreases with age.

C. Blood vessels lose their elasticity with age.

A nurse is making a home visit to an older adult with multiple chronic health problems. The client is alert and oriented and cognition is intact. While talking with the client, the client reveals a belief that the adult child is stealing the client's social security checks to buy beer and eat out all the time. What action should the nurse first do regarding the possible elder abuse to keep the client safe? A. Immediately report the abuse to the state authorities. B. Educate the client on how to recognize and prevent elder abuse. C. Complete an elder abuse assessment by using an elder abuse screening tool. D. Educate the adult child on how to recognize and prevent elder abuse.

C. Complete an elder abuse assessment by using an elder abuse screening tool.

A nurse is preparing to medicate an older adult client with an opioid analgesic. Which information will the nurse obtain first to decide about administering the medication? A. Taking the clients vital signs to determine if indicative of pain B. Obtaining family feedback about client's pain level C. Determining if the client is able to communicate pain verbally or nonverbally D. Observing client behavior to determine if coincides with report of pain

C. Determining if the client is able to communicate pain verbally or nonverbally

The middle adult is sometimes called the "sandwich generation". According to Erikson, the developmental task of the middle adult is what? A. Initiative versus guilt B. Ego-integrity versus despair C. Generativity versus stagnation D. Goal attainment versus crisis

C. Generativity versus stagnation

In a report, the night nurse tells the incoming nurse that one client with dementia has sundowning syndrome. Which of the following nursing diagnoses would be most appropriate for this client? A. Social isolation B. Grieving C. Sleep deprivation D. Noncompliance

C. Sleep deprivation

A nurse arrives at the home of an older adult client. The agency was called because a neighbor noticed that the client was home alone. The nurse finds the client alone in the living room. When asked about the client's daughter who lives there and has been caring for her, the client says, "She went on vacation for about a month. She'll be back soon." Further assessment reveals that there are no other family members or services currently involved. The nurse would identify this situation as: A. emotional abuse. B. exploitation. C. abandonment. D. neglect.

C. abandonment.

An older adult client is prescribed a sleep medication. When explaining the medication to the client, the nurse would emphasize which aspect of therapy? A. minimal risk of adverse effects B. need for follow-up laboratory tests C. greatest effectiveness with short term use D. rare occurrences of confusion

C. greatest effectiveness with short term use

A nurse is preparing a presentation for a group of older adults about promoting safety while maintaining their mobility. Based on the nurse's understanding of factors placing the older adult at risk for falls, which area would the nurse most likely address? Select all that apply. A. hearing loss B. changes in bowel function C. medication use D. environmental hazards E. diminished strength

C. medication use D. environmental hazards E. diminished strength

Based on an understanding of the cognitive changes that normally occur with aging, what might the nurse expect a newly hospitalized older adult to do? A. talk rapidly but be confused B. interrupt with frequent questions C. take longer to respond and react D. withdraw from strangers

C. take longer to respond and react

When assessing an older adult client's home for safety, the nurse should recommend what? A. Avoiding air conditioning in summer B. Taking tub baths C. Using low lighting D. Eliminating throw rugs

D. Eliminating throw rugs

The nurse is reminiscing with a 72-year-old client with early onset dementia while providing care in a long-term care facility. How does the nurse implement this form of therapy to maximize the therapeutic value? A. Encourage the client to talk about special life experiences so discussions regarding death and dying can be easier and can prepare the client for declining health. B. Ask questions about the client's childhood and any unresolved relationship issues that may be preventing the client's peace and acceptance of the aging process. C. Ask family members to participate in activities that help the client remember important aspects of life and health so he/she can move through the final stages of aging. D. Listen to the client's stories and ask questions to facilitate ego integrity and provide companionship.

D. Listen to the client's stories and ask questions to facilitate ego integrity and provide companionship.

A nurse is assessing middle-age adults living in a retirement community. What behavior would the nurse typically see in the middle-age adult? A. Believes in establishment of self but fears being pulled back into the family B. Usually substitutes new roles for old roles and perhaps continues formal roles in a new context C. Looks forward but also looks back and begins to reflect on his or her life D. Looks inward, accepts life span as having definite boundaries, and has special interest in spouse, friends, and community

D. Looks inward, accepts life span as having definite boundaries, and has special interest in spouse, friends, and community

The nurse practitioner is examining a 55-year-old female client. Which of the following findings would be uncommon for this age group? A. Menopause occurs B. Agility gradually decreases C. Presbyopia occurs D. Lower extremity pulses are weak

D. Lower extremity pulses are weak

A nurse caring for older adults in a long-term care facility is teaching a novice nurse characteristic behaviors of older adults. Which statement is not considered ageism? A. Old age begins at age 65. B. Intelligence declines with age. C. Most older adults are ill and institutionalized. D. Personality is not changed by chronologic aging.

D. Personality is not changed by chronologic aging.

The home care nurse is visiting an older adult client in the home to assess a leg wound and change the dressings. The nurse is aware that the client receives money monthly but there is no food in the house, no adequate heat, and the client states, "My sister takes my check and cashes it every month." What is the correct action by the nurse? A. Tell the client to talk with the sister and have her replace the money she has stolen. B. Call the police and tell them to swear a warrant for the arrest of the sister. C. Take the client to the local hospital Emergency Department. D. Report the incident to social service informing them the client has no food or heat.

D. Report the incident to social service informing them the client has no food or heat.

An older adult is admitted to the health care facility with a diagnosis of depression. The nurse would be especially alert for: A. lack of initiative. B. sleep problems. C. poor cognitive performance. D. suicidal thoughts.

D. suicidal thoughts.

Based on an understanding of the cognitive changes that normally occur with aging, what might the nurse expect a newly hospitalized older adult to do? A. withdraw from strangers B. talk rapidly but be confused C. interrupt with frequent questions D. take longer to respond and react

D. take longer to respond and react