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What is Presbyphagia?

slowed swallowing in older adults

A nurse educator teaches about theories of late-life depression. Which of the following statements by a student shows that the material is understood?

"Older adults with depression and chronic illness have more serious negative functional consequences."

nurse assess an older adult' insight regarding the care plan. What questions may the nurse ask to gauge the client's insight?

"Why do you think that your doctor admitted you to the hospital?"

A nurse monitors for depression in the older adult population. Which of the following are a risk factor and a functional consequence of depression in the older adult? (select all that apply.)

- Chronic pain - Functional impairment - Nutritional deficiencies

Barriers for the elderly in effective health care:

- Missed appointments- Non-compliance with medication - Miss identifying pills, looking at the pills not reading labels - Not asking questions or asking few questions - Mismatched communication

What are risk factors that affect cognition wellness? Select all that apply

- Socioeconomic status - lifestyle factors (nutrition and physical exercise) - Length of formal education

Education for an older adult patient with postprandial hypotension should be:

-Avoid sitting for long periods -Engage in regular, but not excessive exercise -Limit alcohol - Drink non caffeinated beverages

Which older adult is most at risk to develop osteoporosis?

65 year old white woman with chronic obstructive pulmonary disease who takes corticosteroids

A nurse monitors older adults in a long-term care facility. Which of the following symptoms would require follow-up by the nurse to assess for depression in the older adult?

Anorexia

A hospice nurse admits an older adult after the metastasis of malignant melanoma. Which of the following health problems should the nurse anticipate? A) Necrosis of extremities B) Hemoptysis C) Hyperglycemia D) Dyspnea

Ans D Dyspnea is a common accompaniment to the dying process. Hyperglycemia, hemoptysis, and tissue necrosis are less common.

A nurse monitors older adults in a long-term care facility. Which of the following symptoms would require follow-up by the nurse to assess for depression in the older adult? A) Anorexia B) Weakness C) Labile affect D) Impaired perceptions

Ans: A Appetite disturbances, particularly anorexia, are among the most common physical complaints of depressed older adults. Individuals with dementia have the following symptoms: vague fatigue, labile affect, and physical complaints that are easily forgotten

While discussing sexual behavior at a sex and aging seminar, one older adult states, "No condoms for me, I can't get pregnant!" Which of the following responses is most appropriate? A) "Condoms protect you from sexually transmitted diseases including HIV." B) "How freeing to not have to be concerned about unwanted pregnancies anymore." C) "The youth of society have so much to be concerned with, what with AIDS killing people." D) "Your generation is soon going to have the largest population of HIVinfected persons."

Ans: A Condoms are an important protection for sexually active adults who are sexual with anyone other than a long-term monogamous partner. Condoms protect from many sexually transmitted diseases. Acquired immunodeficiency syndrome is considered a chronic disease. Eleven percent of new human immunodeficiency virus (HIV) infections occur in adults aged 50 years, and by 2015, 50% of HIV-infected individuals will be 50 and older. This is true, but doesn't answer the question.

A nurse is participating in a health fair that is being sponsored by a local seniors' center, discussing healthy skin and aging. Which of the following teaching points should the nurse emphasize? A) "You should limit your sun exposure to a small amount each day and keep your skin protected from direct sunlight for the remainder." B) "Many drugs can have an effect on your skin, so it's important to avoid most over-the-counter medications." C) "The health of your skin is primarily determined by your genes, so all you can do is try to maintain your overall level of health." D) "Even if you find it difficult to do, it's important to bathe once a day."

Ans: A Current recommendations emphasize the importance of a balanced approach that encourages small amounts of sun exposure each day for adequate vitamin D synthesis, but not so much that would lead to increased skin cancer risk. Many medications affect the skin, but it would be inappropriate for the nurse to recommend that older adults refrain from all over-the-counter medications. Genetic factors influence integumentary health, but this does not mean that other risk factors are irrelevant or nonmodifiable. It is unnecessary for most older adults to bathe every day

A diabetes nurse is providing care for a 73-year-old client who is a regular client of the hospital's out-client diabetes clinic. What assessment question most clearly addresses this client's potential for optimal function? A) "What are some goals that you have for maximizing your level of wellness?" B) "How can we help you to take ownership of your own health?" C) "Is there anything that you're doing that might be exacerbating your diabetes?" D) "How long do you think that you'll be able to live independently?"

Ans: A Eliciting an older adult's goals for wellness and high functioning can help promote these outcomes. Questions about a client's living situation, disease management, and personal responsibility may or may not promote wellness.

The child of an 81-year-old client asks the nurse about vitamins, antioxidants, and age-related macular degeneration. Which of the following theories of aging is most appropriate to this topic? A) Free radicals theory B) Immunosenescence theory C) Program theory D) Wear-and-tear theory

Ans: A Free radical theory focuses on interventions to modify or prevent the age-related accumulation of free radicals or to diminish the formation of free radicals. Antioxidants, beta-carotene, and vitamins C and E provide defense mechanisms against oxidative damage from free radicals. Immunosenescence (age-related decline of the immune system) theory focuses on the increased susceptibility of older people to diseases, such as cancer and infections. The immune system may even attack healthy cells, leading to autoimmune conditions, such as rheumatoid arthritis. Program theory postulates the life span of about 110 years in humans. Abnormal cells, such as cancer cells, are not subject to this predictable program and can proliferate an indefinite number of times. Wear-and-tear theory postulates that the longevity of the human body is affected by the care it receives, as well as by its genetic components.

A nurse cares for an older adult who is nonresponsive and surrounded by family. Which of the following statements by the nurse is most appropriate? A) "I am here for you, how can I be helpful?" B) "I know just how you feel, my mother died last month." C) "I'll leave you alone so that you can grieve in private." D) "She was a really nice lady; she did a good job raising you."

Ans: A Nurses can help people who are dying and their caregivers express their needs by using open, honest, direct, and empathetic communication. Nurses use ongoing assessment to meet the needs of their clients. The statements by the nurse should center on the client and not the nurse. Presence is an appropriate intervention; the nurse should not assume that they desire to be alone

A 76-year-old Hispanic woman has been admitted to the hospital. There are no advance directives in the chart. Which of the following questions will best prepare the nurse to begin a dialogue with this client about advance directives? A) "With whom do you talk to about your health care decisions?" B) "I see that you have no advanced directives on your chart, could you tell me about that?" C) "Is there someone we should call to join us while we discuss your care?" D) "Tell me about your living arrangements; do you live alone or with others?"

Ans: A Nurses need to identify patterns of culturally influenced decision making in order to ask questions and obtain relevant information from clients of different cultures. Why there are no advance directives on the chart is not the place to start to open the conversation. Whether or not she lives with someone, inviting family to join reflects an emphasis on family caregiving consistent with the Hispanic culture.

A nurse plans care for a frail older adult in long-term care. Which of the following interventions should be included in the plan of care to reduce the risk of respiratory infections? A) Oral care B) Oxygen administration C) Pulmonary function testing D) Tracheal suctioning

Ans: A Poor oral care in long-term care residents increases the risk for pneumonia. Tracheal suctioning should be limited to those who are intubated. Neither testing nor oxygen would decrease risk of pneumonia

Which of the following is the most important remediable risk factor for cardiovascular disease in older adults? A) Smoking B) Stress C) Sedentary lifestyle D) Aggressive personality

Ans: A Smoking is a major risk factor for cardiovascular disease. Benefits of smoking cessation as a secondary prevention intervention begin immediately and are as effective in older adults as they are in younger people. Additional lifestyle interventions that are effective for preventing cardiovascular disease include remaining physically active, managing stress, and maintaining ideal body weight

A nurse admits an 81-year-old man to the hospital with aspiration pneumonia. Which of the following risk factors should the nurse predict that the client has in his history? A) Cigarette smoking B) Lung cancer C) Dysphagia D) Sleep apnea

Ans: C Dysphagia creates a serious risk for aspiration pneumonia. Smoking, cancer, and sleep apnea do not have a direct correlation with aspiration pneumonia

An 80-year-old is seen in the emergency department for a fall. The client has bruises on the upper arms and appears depressed. The client is accompanied by a grandchild, who is unkempt, glassy-eyed, and whose breath smells of alcohol. Which of the following should be a priority with the nurse? A) Assess whether the older adult is safe in the home environment. B) Determine whether legal interventions are appropriate. C) Assess the client's degree of frailty and chronic health problems. D) Determine the mental capacity of the older adult.

Ans: A The first priority should be to see whether the older adult is safe and then determine his competency. Legal intervention can be pursued after safety and competency are determined. The degree of frailty and chronic health problems is assessed with safety issues and determination of competency.

Which of the following statements by the new nurse best conveys an understanding of diabetes in older adults? A) "A combination of lifestyle factors and age-related changes contributes to high rates of diabetes among older adults." B) "Development of diabetes later in life is considered a normal, age-related change." C) "Health care providers should avoid drawing conclusions about diabetes risk based on ethnicity." D) "The diagnosis of diabetes in older adults is complicated by subtle signs and symptoms."

Ans: A The high prevalence and incidence of diabetes among older adults is attributable to lifestyle, genetic, and age-related factors. Ethnicity is a valid variable that needs to be considered, given that some minority groups have significantly higher rates of diabetes. Some symptoms of hypoglycemia are subtle in the older adult, but diagnosis is based on laboratory data that do not change with aging. While age-related changes contribute to a susceptibility to diabetes, the development of the disease should not be considered a normal, age-related change in and of itself

A client is unresponsive, the skin is usually dry, confined to bed, with limited mobility and contractures, and the nutrition is less than adequate. Using the Braden score, which score will be assigned to this client's risk for pressure ulcers? A) 8, very high risk B) 8, at risk C) 18, high risk D) 18, moderate risk

Ans: A The nurse uses the Braden score to determine the plan of care. The lower the Braden score, the greater the risk. Scores of 9 or less are considered to be at very high risk, and additional pressure relieving surface and treatment of nutrition are important for this client

A nurse in a postoperative unit educates peers to overcome myths about pain in older adults. Which of the following statements by a peer most clearly warrants further teaching? A) "We have to be more conservative in the treatment of the older adults' pain than the younger clients." B) "Older adults have more health problems than younger people and this puts them at risk of experiencing pain." C) "The acute can turn into persistent pain if not treated thoroughly." D) "Older adults', even those with dementia, sense of pain is as strong as a younger person."

Ans: A The statement that warrants more teaching is that their pain should be treated more conservatively than younger clients. Studies have found no age-related difference in appropriate doses of postoperative morphine. Multimorbidities and chronic health problems are associated with pain. Recent studies focused on the development of persistent postoperative pain, finding that its incidence can be reduced with the use of aggressive and early analgesic therapy. It is true that older adults have no age-related change in the sensation of pain

A nurse provides education to an 82-year-old woman with postprandial hypotension. Which of the following interventions should be included? (Select all that apply.) A) Avoid sitting still for prolonged periods. B) Drink eight glasses of non-caffeinated beverages daily. C) Eat regularly scheduled meals with breakfast as the largest. D) Engage in regular, but not excessive, exercise.E) Limit alcohol consumption to one drink per evening.

Ans: A, B, D, E Health promotion measures specific to postprandial hypotension include the following: minimize the risk for postprandial hypotension by taking antihypertensive medications (if prescribed) 1 hour after meals rather than before meals; eat small, low-carbohydrate meals; avoid alcohol consumption; and avoid strenuous exercise, especially for 2 hours after meals

Which of the following methods can be used to informally assess an older adult's visual skills? (Select all that apply.) A) Ask the person to look out a window and describe certain details. B) Perform a standard confrontation test to assess central vision. C)Place good illumination and ask the person to read printed material with various type sizes. D)Perform a standard vision test, testing each eye separately and allowing the person to cover the other eye with a hand

Ans: A, C Nurses informally assess vision by asking the older adult to read printed material with various type sizes and describing details of a scene at a distance. A standard confrontation test is a gross measurement of peripheral vision fields. With standard vision tests, each eye is tested separately, and one should avoid using the hand as a cover

A nurse is conducting a medication assessment of an older adult client who will soon be receiving home care. Which of the following questions should the nurse include in this assessment? (Select all that apply.) A) "Are you a smoker?" B) "What is your typical diet?" C) "What over-the-counter drugs do you use?" D) "Do you use any herbs or dietary supplements?" E) "Do you drink alcohol?"

Ans: A, C, D, E Question relating to smoking, alcohol use, over-the-counter drugs, and herbs and dietary supplements should be included in a medication assessment. A client's diet, however, is not a common focus during a medication assessment.

A 72-year-old man's diagnostic testing and physical examination have resulted in a diagnosis of COPD. Which symptomatology is unexpected and will require follow-up? (Select all that apply.) A) Hemoptysis and orthostatic hypotension B) Chest pain and shortness of breath C) Cough and dyspnea D) Apneic spells and fatigue E) Wheezing and clubbing

Ans: A, D The most common manifestations of COPD are cough, dyspnea, wheezing, and increased sputum production. Hemoptysis and orthostatic hypotension are unexpected and require follow-up, as do apneic spells and fatigue. Chest pain and shortness of breath signal cardiac dysfunction and require immediate attention

The nurses who provide care in a long-term care setting are aware of the high prevalence and risks of cardiovascular disease among the older adults who live at the facility. Which of the following measures is most likely to prevent heart disease among older adults? A) Advocating for organic dietary choices for residents B) Establishing an exercise program C) Teaching about the relationships between family history and heart disease D) Teaching residents to reduce their stress levels

Ans: B Inactivity is among the most salient risk factors for heart disease, exceeding the effects of stress. Knowledge about the role of family history is unlikely to lower individuals' risks of heart disease. An organic diet is not necessary to prevent heart disease

An older adult client on a palliative care unit divulges to his nurse that he fears being in pain during the dying process. How can the nurse best respond to the client's admission? A) "It sounds like you're understandably anxious about this. How can I help you to relax?" B) "A lot of clients do have pain at the end, and we will do all we can to control it for you." C) "We will do all we can to address it, and you'll be able to have a peaceful passing." D) "Pain during the dying process actually is not nearly as common as many people believe."

Ans: B Acknowledging that a lot of clients do have pain at the end and that staff will do all they can to control it both acknowledges the client's specific concern and provides a realistic response that the pain will be treated as effectively as possible, but does not guarantee a pain-free dying process. Acknowledging the anxiety and offering relaxation assistance do not address the specific concern about pain. Stating that the client will have a peaceful passing makes a promise that is not possible to guarantee. Pain is a common accompaniment to the dying process

A nurse initiates an acute care for elders unit in a medical facility. Which of the following factors should the nurse include when teaching the nursing staff about delivering medications to the older adults on the unit? A) Drug metabolism shifts from the liver to the kidneys as individuals age. B) Older adults face an increased risk of adverse medication effects. C) Older adults tend to achieve clearance of medication faster than do younger patients. D) Older adults tend to need more frequent doses of a drug to achieve therapeutic effect.

Ans: B Age-related physiologic changes result in an overall increased risk of adverse drug effects. Drug clearance tends to be slower, so lower doses are normally required. There is no change in which organs are responsible for metabolism of drugs in older adults.

A nurse reviews the medication list of an older adult upon transfer from the hospital to an extended care facility. Which of the following methods is most likely to reduce the occurrence of adverse effects? A) Administer medications at the same time every day with meals. B) Compare the list to the Beers criteria list and notify the health care provider of any on the list. C) Request that the client's medications be put on hold and restarted one at a time. D) Stop the administration of GI and narcotic pain medications.

Ans: B An important theme of the Beers criteria and other guidelines is that medications are determined to be appropriate or inappropriate in relation to the patient's condition. Some medications should be given with meals, while others should not. There is no need to stop all medication

A nurse is discussing an older adult's recent diagnosis of rheumatoid arthritis with a colleague. Which of the nurse's statements reflects an accurate view of the relationship between aging and wellness? A. "It's important that the individual knows this is an expected part of growing older." B. We need to teach the older adult how he can keep living a fruitful life in spite of his diagnosis." C) "We need to make sure our teaching is not too detailed for someone of his age." D) "We need to ensure his expectations of continuing to live alone are realistic."

Ans: B Answer B reflects a desire to foster a fulfilling and productive life for the older adult despite his diagnosis, and reflects an understanding of wellness and aging. Option A implies that illness is an inevitability of aging. Option C suggests that older adults have a limited capacity to learn by virtue of their age, and option D implies pessimism about the health and functioning of the older adult.

A community health nurse is to create initiatives to foster the health of older adults in the community. Which of the following health promotion activities has the greatest potential to promote the respiratory health of older adult participants? A) A lung cancer screening program B) A smoking cessation program C) A tuberculosis screening program D) A bronchitis immunization program

Ans: B As with younger adults, smoking cessation confers a multitude of health benefits, especially with regard to respiratory and cardiovascular health. Lung cancer screening and tuberculosis screening are less likely to benefit large numbers of participants. Bronchitis is not a health problem that is amenable to immunization

A nurse who provides care in a clinic comes into contact with numerous older adults, many of whom have bruises of various sizes and stages on their body. What pattern of bruising is most suggestive of possible abuse? A) Significant bruising on the shin region of a client's leg B) Bruising on both ears and both sides of the neck C) Bruising on the back of a client's hands D) Bruising on both of a client's elbows

Ans: B Bruising on the neck and ears is not typically accidental. Conversely, bruising on the backs of the hands, elbows, and shins is more common and less likely to raise the suspicion of abuse

A nurse on an acute care unit is disturbed by the increasing incidence of pressure ulcers among older adults. Which of the following measures should the nurses on the unit prioritize in order to prevent the formation of pressure ulcers? A) Apply emollient lotions with baths B) Frequent repositioning of immobilized clients C) High-protein, high-calorie diet D) Massage bony prominences each shift

Ans: B Frequent repositioning is an important measure in prevention. Lotions should be applied; relief of pressure is the highest priority. Nurses should ensure that those at risk for pressure ulcers do receive enough calories, vitamins, and protein. Nurses do not massage bony prominences for concern of damage

A graduate nurse expresses an interest in focusing future study to healthy aging. Toward which of the following fields should the experienced nurse steer the graduate nurse? A) Palliative care B) Gerontological nursing C) Nursing home administration D) Social work

Ans: B Gerontological nurses are the health care professionals consistently responsible for the 24-hour care of older adults in all clinical settings.

A nurse manager of an intensive care unit develops plans to improve end-of-life care for clients in the unit. Which of the following actions is the priority? A) Create a script for nurses to use when discussing hospice and palliative care. B) Guide staff to improve communication with families about end-of-life decision making. C) Increase communication between professionals about end-of life decision making. D) Survey clients and families about their end-of-life needs.

Ans: B In recent years, nurses and other health care professionals raised concerns about the need to improve end-of-life care in hospitals. Much of this concern is associated with poor communication between professionals and families about end-of-life decision making. Creating a script can help with that specific need, but the clients continue to experience pain, indignity, social isolation, and uncomfortable symptoms related to ineffective and unwanted life-sustaining treatments, particularly in intensive care units. Interprofessional communication will also help; the priority is between staff and families.

An 84-year-old client has been living in an assisted living facility for several years but is now faced with the prospect of relocating to a nursing home. Which of the following characteristics of the client's current situation is most likely to prompt this move? A) The development of a severe, acute health problem B) A decrease in the client's level of function and activities of daily living (ADLs) C) Exacerbation of a chronic health problem that may require medical treatment D) A change in the level of the client's social support

Ans: B Nursing home settings are becoming increasingly diverse, but a common feature of older adults who are admitted to nursing homes is a decrease in function and ADLs. Acute health problems that require medical treatment necessitate hospital admission, and a change in social support would not necessarily prompt a move from assisted living.

Older adults experience a number of changes in the structure or function of their cardiovascular system. Which of the following changes is considered to be a normal, age-related change? A) Veins become thinner and more elastic B) Regulation of blood pressure and heart rate becomes less efficient. C) Heart valves become atrophied and regurgitation occurs. D) Heart rate becomes slower and ejection fraction increases

Ans: B Overall regulation of blood pressure and heart rate becomes less responsive and less efficient with age. Veins become thicker and stiffer. Heart rate does not typically slow with age and valvular regurgitation is considered a pathologic condition at any age

A nurse is working with a 79-year-old client newly diagnosed with osteoporosis. Which of the following interactions promotes achievement of wellness outcomes? A) The nurse performs strength and mobility training appropriate to the client's age and diagnosis. B) The nurse teaches the client about bone density in older women and the role of vitamin D and calcium intake. C) The nurse plans interventions in light of the body- mind-spirit interconnectedness of the client. D) The nurse teaches the client about how her risk factors are a consequence of age.

Ans: B Teaching about bone density and the role of vitamin D reflects an acknowledgment that the client's diagnosis is attributable to both the client's age-related changes and risk factors such as inadequate nutrient and mineral intake. Strength and mobility training may well be an appropriate intervention, but it does not necessarily acknowledge the interplay of risk factors and age in the client's diagnosis. The body-mind-spirit interconnectedness is a component of the Functional Consequences Theory, but it does not address the relationship between risk factors and age per se. Teaching about risk factors as a consequence of age implies that these factors are an inevitable consequence of age, which is not the case.

A nurse explores resources available to assist a client. Which of the following older adults meets the eligibility requirements for hospice care? A) A client who is immobilized and unable to afford specialized nursing care B) A client who has experienced a stroke and been given 3 months to live C) A client with cancer who is living with uncontrolled persistent pain D) A client with acquired immunodeficiency syndrome who lacks family support to provide needed care

Ans: B The eligibility requirements for hospice care include physician referral and a life expectancy of less than 6 months. Financial need, high pain levels, and lack of family support are not explicit qualifiers for hospice care

Which of the following statements best captures the typical character of health problems in the lives of older adults? A) Older adults' lives are dominated by the increasing number of acute health problems due to age-related changes. B) Most older adults experience an interplay between a number of chronic conditions and occasional acute health problems. C) Older adults can expect a relatively consistent decline in their health over time as a result of acute health problems. D) Chronic conditions account for the normal downward direction of an older adult's health status

Ans: B The interplay between chronic and occasional acute conditions is typical of the health trajectory of many older adults. The most salient factor is not acute problems alone, nor are health problems necessarily attributable to age-related changes. Changes in health status are rarely consistent and do not exclude chronic conditions or acute problems

After a scheduled trip to her optometrist, a 70-year-old has been told that the pressure in her eye is high and she needs to be monitored and treated to prevent damage to the optic nerve. What is this person's diagnosis? A) Cataracts B) Glaucoma C) AMD D) Presbyopia

Ans: B The term glaucoma refers to a group of eye diseases in which the ganglion cells of the optic nerve are damaged by an abnormal buildup of aqueous humor in the eye. Increased intraocular pressure is not implicated in the development of cataracts, AMD, or presbyopia

A nurse is teaching new graduates about the nature of palliative care on her unit. Which of the following statements by a new nurse indicates a need for further teaching? A) "I can see how important it is for us to educate patients and their families and friends on the unit." B) "It certainly requires a change in thinking to understand why we don't provide any medical interventions for patients." C) "I can see how comfort and psychosocial well-being take precedence over physical functioning." D) "Purpose in life and quality of life seem to be the overarching goals of palliative care."

Ans: B While the focus of palliative care is not on curing disease, this does not mean that treatments of all kinds are absent. Distressing symptoms are addressed from both a nursing perspective and a medical perspective. Education is a key component of palliative care, and comfort and psychosocial well-being trump physical functioning. Purpose in life and quality of life are similarly emphasized

A 65-year-old woman is speaking to her nurse at the primary care clinic. She states that it is very painful for her when she has sexual relations. She asks the nurse what she could do to alleviate the pain. Which of the following suggestions could the nurse make to the woman? A) Decrease the incidence of sexual relations. B) Use a water-soluble lubricant or estrogen cream. C) While engaging in intercourse, have your partner thrust his penis upward. D) Use a polyisoprene (non-latex) condom for intercourse

Ans: B With age, there is a thinning of the vaginal mucosa, which creates dryness and predisposes women to irritation and inflammation so using a water-soluble lubricant or estrogen cream may be helpful. The male partner should thrust downward instead of upward during sexual intercourse. Decreasing the incidence of sexual relations may lead to a "use it or lose it" principle. Use of a condom, latex or polyisoprene, will not decrease vaginal wall irritation.

Following a prolonged hospital stay due to an exacerbation of congestive heart failure, an older adult woman has returned to the nursing home where she normally resides. The woman became incontinent of urine during her time in the hospital, a problem that nursing staff wish to now resolve. What action should her caregivers take in performing continence training? A) Limit the woman's fluid intake to 750 mL daily, primarily before suppertime. B) Assist the woman with toileting at timed intervals throughout the day. C) Teach the woman about the functional and psychosocial benefits of restoring continence. D) Perform intermittent catheterization before each meal and before bedtime

Ans: B With caregiver-directed methods of continence training, the caregiver uses the initial assessment of voiding patterns to establish a schedule for assisting with voiding. The caregiver gradually increases the interval between voidings until the person can maintain continence for 2 to 4 hours. Fluid restriction to 750 mL per day is inadequate to maintain hydration, and intermittent catheterization does not promote continence. Education is a component of continence training, but individuals are not likely to need to be informed of the benefits of continence

Which of the following are crucial when assessing visual function in an older adult? (Select all that apply.) A) Asking the older adult to read the fine print on a medicine bottle without a magnifying aid B) Asking the older adult whether he or she can drive without difficulties at night C) Observing the older adult functioning in his or her normal environment D)Observing the older adult while he or she is reading a newspaper without glasses

Ans: B, C The nurse should observe the older adult's usual pattern of activities. These observations are best made in the person's usual environment and address the person's ability to carry out activities. Older adults who report difficulty driving at night may have cataracts or other visual impairments.

An older adult is admitted to the hospital with weight loss and cognitive impairment. To assist in the diagnosis of major depressive disorder, for which of the following should the nurse assess? (Select all that apply.) A) Decreased deep tendon reflexes B) Loss of interest or pleasure C) Psychomotor agitation D) Respiratory difficulty E) Sleep disturbances

Ans: B, C, E Diagnostic criterion for major depression includes depressed mood and/or loss of interest or pleasure along with at least five of the following signs and symptoms: weight loss, appetite change, sleep disturbances, observable, psychomotor agitation or retardation (i.e., slowness), fatigue or loss of energy, feeling worthless or excessively guilty, cognitive impairment, and recurrent thoughts of death or suicide. It does not include deep tendon reflexes or respiratory difficulty

A nurse administrator incorporates older adults' sexuality into the policies of a long-term care facility. Which of the following should be included in this plan? (Select all that apply.) A) Allow public masturbation. B) Ask permission to enter a room. C) House spouses separately. D) Knock on door before entering. E) Redirect inappropriate sexual behaviors.

Ans: B, D, E Masturbation is normal, but not appropriate for public places, assuring that the clients' rooms are their own personal space and assuring privacy while in those rooms are important to sexuality. Sexual behaviors that impinge on others' comfort should be redirected. Components of sexuality that are especially important for older adults include kissing, hugging, intimacy, fantasy, masturbation, oral sex, loving words, physical closeness, and expressions of affection

A nurse who works in a palliative setting is aware of the need to facilitate a "good death" for as many clients as possible. Which of the following interventions should be included? A) Discuss openly and explicitly the client's strengths and weaknesses. B) Ensure that a minimum of nursing interventions are performed. C) Empower the client and family to maintain as much control as possible. D) Emphasize spiritual needs rather than physical comfort and medical needs

Ans: C A "good death" is fostered by enabling a sense of control for the client and his or her family over a challenging situation. Nursing interventions are chosen carefully, but not necessarily minimized. A discussion of the client's strengths and weaknesses is inappropriate and spiritual needs are not mutually exclusive of comfort and appropriate biomedical interventions

A nurse manager of the long-term care facility develops plans to reduce nutritional deficits. Which of the following interventions is appropriate to include in the plan? A) Encourage residents to eat in their rooms to minimize distractions. B) Offer four to five small meals a day rather than three larger meals. C) Promote oral care for residents multiple times each day. D) Provide incentives for residents to eat all the food on their trays.

Ans: C Adequate oral care is important in the promotion of adequate food intake, because it enhances chewing, eating, and swallowing. Eating alone is associated with lower caloric intake. Offering incentives may be construed as coercive or patronizing. Frequent, small meals may be necessitated by certain medical conditions, but this is not a recognized strategy for the promotion of nutrition among a larger group of older adults

A nurse is conducting a study on the needs and living situations of older adults in the community. Which of the following statements should the nurse take into account? A) A majority of older Americans will live in a nursing home at some point. B) More older men live alone than older women. C) Assisted living arrangements have become increasingly common. D) Most older Americans reside in some form of institutional arrangement.

Ans: C Assisted living arrangements have become an increasingly common alternative to nursing homes. The number of Americans living in nursing homes has recently decreased, not increased, and more older women live alone than do older men. Ninety percent of older Americans live in an apartment or house, rather than in an institutional arrangement.

A nurse is aware that many health care providers prioritize the role of biology in the aging process. What is a weakness of biologic theories of aging as it applies to nursing? A) Biologic theories do not account for the differences in life expectancy between men and women. B) Biologic theories are unable to explain the role of cell division in life expectancy and the aging process. C) Biologic theories of aging do not adequately address issues of wellness and quality of life. D) Biologic theories of aging are unable to explain the significant increases in life expectancy that occurred in the 20th century.

Ans: C Biologic theories of aging do not address the significant influence of nursing, medical, and psychosocial interventions that can improve a person's functioning and life expectancy. More broadly, they do not address holistic questions surrounding wellness. They are generally able to account for increases in life expectancy and phenomena such as cell division.

An 81-year-old adult suffered an ischemic stroke 6 days ago. The client has failed to regain consciousness since the event. The care team has approached the client's family to obtain their views on inserting a feeding tube. Which of the following documents will allow the family to make a decision on the parent's behalf? A) A do not resuscitate (DNR) order B) A living will C) A durable power of attorney for health care D) A will

Ans: C Feedback: A durable power of attorney for health care is an advance directive that takes effect whenever someone cannot, for any reason, provide informed consent for health care treatment decisions. A will, a DNR order, or a living will do not confer this authority on the client's family member.

A 78-year-old client states, "I often have dry eyes, it is bothersome and irritating." What intervention should the nurse recommend? A) Daily rinses with tap water B) A medication vacation to determine if medications are the cause C) Use of over-the-counter artificial tears D) Keeping eyes closed for 3 to 5 minutes each hour

Ans: C For most older adults with dry eyes, the use of over-the-counter artificial tears or ocular lubricants usually will relieve symptoms. It would be inappropriate for the nurse to independently recommend a cessation of medication. Rinsing with tap water and keeping the eyes closed are not recommended interventions

A nurse is explaining to a new colleague the similarities and differences between gerontology and geriatrics. Which of the following situations would most likely be addressed by a geriatrician rather than a gerontologist? A) Teaching older adults techniques to identify and deal with age-related changes B) Organizing and leading exercise classes to facilitate mobility C) Identifying and treating a client's vascular dementia D) Rearranging an older adult's apartment to minimize the risk of falls

Ans: C Geriatricians are medical specialists concerned with the treatment of diseases and disabilities common among older adults. The focus of gerontologists is a multidisciplinary approach aimed at emphasizing healthy and successful aging. Options A, B, and D fall under the auspices of gerontology.

. An 81-year-old has been living for the past 2 years in a long-term care facility. However, financial pressures have required that the resident move in with the oldest child and spouse. Which of the following statements if made by the child's spouse should signal a potential risk for elder abuse? A) "I sure hope that we'll qualify for some home care because this seems pretty overwhelming." B) "This won't be easy for anyone. I think I might even end up having to juggle my work schedule." C) "He's used to being waited on here, but at our place he's going to have to fend for himself." D) "I'm probably going to even have to get some friends or neighbors to help out from time to time."

Ans: C It is normal and reasonable to be somewhat overwhelmed with the prospect of providing care for an older adult. However, a suggestion that the older adult may have to go without care is problematic and a potential precursor to elder abuse (neglect).

An older adult with pain is to be discharged home with a prescription for oral morphine (MSContin) daily for persistent pain. The client historically took an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) for pain. Which statement by the patient shows the nurse that the client understands the plan? A) "I will be careful to take an antacid with the morphine pill." B)"I will only take this morphine when the NSAID doesn't work." C) "I will take MiraLAX and a stool softener to reduce my constipation." D) "NSAID side effects are not as bad as a morphine pill."

Ans: C Long-term use of NSAIDs is associated with more severe and life-threatening adverse effects, whereas the most common adverse effect of opioids is constipation, which can be addressed by using laxatives (MiraLAX), stool softeners, fluid, and activity. While the client historically took an NSAID, the MSContin is an extended-release medication that should be taken daily.

A nurse identifies clients who are at risk for modifiable risk factors for cardiovascular disease. Which of the following clients should the nurse prioritize as having modifiable cardiovascular functional consequences? A) A 54-year-old admitted to the hospital with hepatitis A B) A 72-year-old after her second myocardial infarction. C) A 86-year-old obese woman who has type 2 diabetes D) A 94-year-old with a strong family history of myocardial infarctions at an early age

Ans: C Modifiable risk factors include obesity, and control of blood glucose levels. Hepatitis A is not a risk factor. Prior myocardial infarction and strong family history are not modifiable. However, those clients are at risk and other risk factors in their life may need to be modified.

A nurse identifies clients who are at risk for modifiable risk factors for cardiovascular disease. Which of the following clients should the nurse prioritize as having modifiable cardiovascular functional consequences?A) A 54-year-old admitted to the hospital with hepatitis A B) A 72-year-old after her second myocardial infarction. C) A 86-year-old obese woman who has type 2 diabetes D) A 94-year-old with a strong family history of myocardial infarctions at an early age

Ans: C Modifiable risk factors include obesity, and control of blood glucose levels. Hepatitis A is not a risk factor. Prior myocardial infarction and strong family history are not modifiable. However, those clients are at risk and other risk factors in their life may need to be modified.

A 79-year-old client recently experienced a syncopal (fainting) episode after standing up quickly while gardening. Which assessment is the nurse's priority? A) "Did you experience any fatigue or blurred vision?" B) "What did you doctor say about this?" C) "What medications do you take?" D) "When did you last eat a meal?"

Ans: C Risks for orthostatic hypotension include multiple medications. Orthostatic hypotension can be accompanied by symptoms such as fatigue, lightheadedness, blurred vision, and syncope upon standing or not. Whether orthostatic hypotension is symptomatic or asymptomatic, it can lead to negative functional consequences. Postprandial hypotension is not represented by this scenario. Asking what the primary health care provider said is passing the buck.

A nurse who works on a geriatric long-term care unit is aware that many of the older adult clients on the unit have a documented history of orthostatic hypotension. What measure should the nurse prioritize in order to ensure the safety of such clients? A) Mobilize clients within 2 hours of eating a meal. B) Have clients take several deep breaths before standing to their feet. C) Have clients sit on the edge of their beds for a minute or two before ambulating. D)Encourage clients to use a bedpan or incontinence brief to prevent falls while ambulating to the bathroom.

Ans: C Sitting at the edge of the bed before standing can significantly reduce the risk of falls in individuals with orthostatic hypotension. It is inappropriate to have clients use bedpans or briefs for the sole reason of preventing falls. Mobilizing after meals and deep breathing do not appreciably address orthostatic hypotension

A nurse educator teaches about theories of late-life depression. Which of the following statements by a student shows that the material is understood? A) "Adverse events impair your ability to evaluate yourself." B) "Depression is caused by decreased activity in the hypothalamic-pituitary-adrenal axis." C)"Older adults with depression and chronic illness have more serious negative functional consequences." D) "Researchers have identified a cause-and-effect relationship between depression and dementia."

Ans: C Studies consistently find that the co-occurrence of depression with chronic conditions in older adults is associated with more serious negative functional consequences. Cognitive theory says that distorted perceptions, not adverse (unfavorable) events, impair one's ability to appraise oneself and the event constructively. Increased plasma cortisol levels and increased activity of the hypothalamic-pituitary-adrenal axis can lead to depression. Researchers have identified neuropathologic changes but have not identified a specific cause-and-effect relationship between dementia and depression.

Which of the following are examples of appropriate communication techniques for dealing effectively with people with dementia? A) Ask open-ended questions so the person feels he or she can make choices. B) For people in the later stages of Alzheimer disease, talk as you would to a child. C) Maintain good eye contact and use a relaxed and smiling approach. D) When the person forgets something, remind him or her not to forget next time

Ans: C To facilitate communication with people who have dementia, the nurse uses a relaxed and smiling approach. The nurse should avoid infantilization of the older adult and not emphasize the person's memory or cognitive deficits

A nurse who works with the older population is aware that elder abuse takes many forms. Which of the following examples most clearly constitutes elder abuse? A) A paid caregiver cleans and assists with shopping for an older adult who lives alone. B) An older adult assists with child care in exchange for room and board at her niece's house. C) A daughter manages her mother's finances after the older adult granted her power of attorney. D) A daughter changes her mother's incontinence brief only after the urine has soaked through all her clothing because she wants to save money

Ans: D Allowing an older adult to remain in soiled clothing as a way of preserving financial assets is a form of elder abuse. Power of attorney confers legitimate financial control to an individual and this is not necessarily coercive or abusive. Fair exchanges of services for money or housing do not constitute abusive situations.

A 74-year-old client has recently begun integrating more fresh fruit and vitamin supplements in an effort to increase the levels of antioxidants. This client's actions indicate an understanding of what theory of aging? A) Cross-linkage theory B) Program theory of aging C) Immunosenescence D) Free radical theory

Ans: D Antioxidants, including beta-carotene and vitamins C and E, are one of the major defense mechanisms against oxidative damage from free radicals. The theory of immunosenescence, cross-linkage theory, and the program theory of aging do not directly prioritize a role for antioxidants in maintaining health.

A nurse administrator is involved in strategic planning for a large long-term care facility that has locations in numerous regions of the country. What trend should the nurse administrator anticipate? A) A decrease in the proportion of older adults who are members of minority groups B) A gradual decline in overall life expectancy C) Average longevity of men exceeding that of women D) Increased use of assisted living facilities by older adults

Ans: D Assisted living facilities have become a more common option for older adults; this trend is expected to continue. Life expectancy is continuing to increase, with women usually outliving men. An increasing proportion of the older adult population will be members of minority groups.

A 70-year-old client has been a regular cigarette smoker since late teens and has made several attempts to quit over the years. When the nurse encourages the client to again try to quit, the client responds, "At this point in my life, I think it's probably too late." How should the nurse best respond to the client's statement? A) "You'll be able to avoid having a future heart attack if you quit smoking now." B) "Three months after your quit, you'll have the same risk of heart disease as a lifetime nonsmoker." C) "In a way that's true, but you would feel much better about yourself if you managed to quit." D) "Actually, you'll start to enjoy some health benefits almost as soon as you quit."

Ans: D Benefits of smoking cessation exist at any age. Complete elimination of smoking-related health threats does not disappear after only 3 months, however. Smoking cessation is not a guarantee against future MI

An older adult is admitted to the emergency department with dyspnea and a sudden change in level of consciousness. The nurse should assess first for which of the following disorders? A) Myocarditis B) Aortic aneurysm C) Cor pulmonale D) Myocardial infarction

Ans: D Compared with younger adults, older adults experiencing a myocardial infarction are more likely to have dyspnea or neurologic symptoms, rather than chest discomfort. Older adults with angina and acute myocardial infarction are more likely to have subtle and unusual manifestations

A nurse is conducting a medication assessment of an older adult. Which of the statements by the older adult indicates a need for further education? A) "Overall, I much prefer to prevent getting sick than having to rely on different drugs to stay healthy." B) "I've made a reminder system for myself so that I don't miss any of my pills during the day." C) "My family doctor has me on so many different pills now, so I want to talk about whether they're all necessary." D) "I use a lot of herbs and supplements, but I'm careful to make sure that they're all natural."

Ans: D It is a common misconception that because herbs are natural, they have no potential for harm; the nurse should teach clients about the potential risks of herbal supplements. It is proactive to act in amanner that will prevent illness. Implementing a reminder system for drugs is prudent. Similarly, wanting to discuss the potential for polypharmacy with a care provider shows appropriate assertiveness and ownership of health.

A client has recently begun receiving Social Security benefits and is asking the nurse about what services might be included or excluded under Medicare. Which of the following services is most likely to be excluded from Medicare funding? A) Hospital care B) Hospice care C) Rehabilitation care D) Nursing home care

Ans: D Medicare was established as a means of funding some types of direct client medical care, hospice and rehabilitation care may be covered, but nursing home residence is not.

An elderly client with heart failure should be encouraged that

heart failure is a chronic condition that can be controlled with medication

A palliative care team has taken over primary responsibility for the care of an older adult who has recently experienced a stroke. A visitor asks, "What is palliative care?" Which of the following is the best response by the nurse? A) "Spiritual and psychosocial care that takes place near the end of life" B) "Nursing care and medical treatment that prioritizes the wishes of patients and families" C) "The prioritization of complementary and alternative measures over biomedical interventions" D) "The provision of holistic care to patients experiencing incurable health states"

Ans: D Palliative care is a holistic approach to care that may be applied during complex and/or declining health states. It is not necessarily limited to the end of life and does not involve a rejection of biomedical interventions. The wishes of patients and their families are prioritized, but this is not the defining feature of palliative care. It includes spiritual and psychosocial care, but is not limited to these domains

A nurse is conducting a health education class for older adults with arthritis that will address relevant issues of sexual function. Which of the following statements indicates that the nurse's teaching has been successful? A) "I will decrease the amount of time spent in foreplay before engaging in sexual intercourse." B) "I will avoid taking a warm bath before engaging in sexual activity." C) "I will avoid experimenting with different positions during sexual relations." D) "I will use a vibrator since my ability to massage is limited."

Ans: D People with arthritis will want to increase foreplay. Warm baths will decrease stiffness. People with arthritis should experiment with sexual positions for comfort and support. A vibrator may help if the ability to massage is limited for the person with arthritis

An older woman of Filipino heritage has been having rectal bleeding for several months. Her physician has told the woman and her daughters that she has advanced colon cancer. Her daughters want to obtain hospice services but the client is reluctant and does not want to discuss what she feels is "beyond her control." Which of the following concerns is this client most likely experiencing? A) Entrenched optimism in health care providers B) Individual autonomy regarding end of life C) Impaired cognition secondary to cancer D) Cultural taboo to discuss death

Ans: D Some members of the Filipino culture believe in fatalism and resist any discussion about or planning for events beyond one's control such as illness or death, because it is viewed as tempting fate and will likely bring the potential event into reality.

A nurse assesses an older adult in the assisted living facility who has presbyphagia. Which of the following systems should the nurse auscultate? A) Abdomen for bruit B) Bowel sounds C) Heart tones D) Lung sounds

Ans: D Swallowing difficulties create a risk of aspiration. Presbyphagia is unlikely to result in assessment changes to the abdomen or heart

A nurse is providing an educational program about age-related macular degeneration (AMD) to a group of older adults. Which of the following statements by an older adult indicates the need for further teaching? A) "Smoking is a risk factor for AMD." B) "Macular degeneration causes a loss of central vision." C)"People with macular degeneration should have any sudden changes evaluated." D) "The dry type of macular degeneration occurs rapidly."

Ans: D The dry type of AMD progresses slowly and does not cause total blindness. The wet type of macular degeneration develops rapidly and causes visual loss. Smoking is a risk factor for macular degeneration. As AMD progresses, it affects central vision. People with AMD should have any sudden changes evaluated

A nurse on a geriatric medical care unit consults hospice for a client. Which of the following nursing interventions should the nurse anticipate after the client begins hospice care? A) Administering chemotherapy to a client with a diagnosis of pancreatic cancer B) Assessing the deep tendon reflexes of a client with neurologic impairment C) Infusing total parenteral nutrition to a client with dysphagia D) Providing an opioid analgesic to a client with bone metastases

Ans: D The focus of hospice care is on the relief of suffering rather than cure of disease. Relief of suffering often encompasses providing pain relief to clients. Active curative treatments, such as chemotherapy, and parenteral feeding often are forgone. Health assessments that do not assess the client's comfort, such as the assessment of deep tendon reflexes, are not the priority of palliative/hospice care

A nurse assesses an 85-year-old client and finds bruises on the arms and shins and a skin tear on the right hand. Which action is the priority for further nursing assessment? A) Consider the family as a reliable source of information. B) Determine if the person is depressed. C) Follow the protocol for reporting elder abuse. D) Review the client's medications and medical diagnoses

Ans: D The nurse has not yet gathered enough data to determine whether elder abuse is a potential factor. The client/family may not know the source of the bruises, and in fact may provide inaccurate information if they contribute to an abusive situation. It is important to consider adverse medication effects and some medical conditions as potential causes of bruising.

A healthy 70-year-old has been using diphenhydramine (Benadryl) for allergic rhinitis. One week later, the client begins to exhibit signs of confusion and disorientation. The spouse calls the primary care facility to speak with the nurse. Which event should the nurse suspect first? A) The older adult has hyponatremia, leading to delirium. B) The older adult is having transient ischemic attacks. C) The older adult has an overwhelming infection. D) The older adult is experiencing an adverse drug effect

Ans: D The older adult has been taking diphenhydramine, which can have an anticholinergic effect. Anticholinergic drugs can lead to medication-induced cognitive impairment. There is no reason to think that the client has hyponatremia. Rhinitis does not generally cause delirium in older adults. The client is more likely to be having adverse reaction than transient ischemic attacks.

A nurse reviews the medication list of an older adult. Which of the following age-related changes leads to a slower drug clearance? A) Increase in sensitivity to bioactive substances B) Elimination half-time is likely to be faster. C) Increase in glomerular filtration rate D) Decrease in hepatic blood flow

Ans: D The older adult is not more sensitive to bioactive substances. Elimination is likely to be slower. There is an age-related decline in hepatic blood flow that impacts pharmacokinetics, as well as the glomerular filtration rate.

Which of the following is true about cognitive impairment and abuse of older adults? A) Older adults who live alone are always willing to acknowledge their impairments. B) Cognitively impaired older adults are usually able to meet minimum standards of care. C) When the older adult denies cognitive impairment, the risk for abuse declines. D) Older adults become more vulnerable to abuse because of cognitive impairment.

Ans: D When the older adult denies cognitive impairment, the risk for abuse increases. Older adults who are cognitively impaired are not able to meet minimal standards of care. Older adults who live alone may be afraid to acknowledge their impairments

A quality control nurse for a large group of long-term care facilities assesses the quality of care at the end of life for the residents. Which of the following measures indicate quality care? (Select all that apply.) A) Increase in the number of deaths in the hospital B) Increase in the number of residents who refuse treatments at the end of life C) Increase in the percent of residents with advanced dementia D) Increase in the use of hospice services E) Increasing number of staff trained in palliative care

Ans: D, E Studies confirm the need for staff education related to symptom management and other aspects of palliative care. Two measures of quality care at the end of life for nursing home residents are use of hospice services and avoiding death in the hospital. There are a large number of residents with advanced dementia (the desire is that more of these become clients of hospice)

A nurse in a long-term care facility assists several residents with bathing each day. What intervention should the nurse implement in order to promote and protect the residents' skin?

Apply moisturizing (emollient) products to maintain the moisture of the skin.

What does baroreceptors detect?

Blood pressure

Which of the following statements about depression and functional impairment is true?

Depression can lead to hip fracture and increase susceptibility to infection.

What are the symptoms of cataracts?

Dim or blurred vision, increased sensitivity to glare, decreased contrast sensitivity, double vision, seeing halos around bright lights, diminished color perception

An older adult client with osteoarthritis walked 2 miles last week. The client says since that time, "I haven't been doing very much; I'm afraid it will hurt like last time." Which action by the nurse is most appropriate?

Discuss moderation in activity, encouraging continued movement.

Which of the following is priority nursing intervention for the management of delirium?

Giving the client low-dose oxygenation and maintaining his or her fluid and electrolyte balance

A 70 year old woman has expressed interest in preventing osteoporosis as a result of the high prevalence of the disease in her peer group. What dietary measures should the nurse recommend?

High intake of calcium and vitamin D

A gerontological nurse has been providing ongoing care for an older adult who has a diagnosis of dementia. What goal should nurse prioritize when conducting ongoing assessment of this client?

Identifying factors affecting the client's functioning and quality of life.

What is Macular Degeneration?

loss of central vision

Which of the following interventions specifically facilitates performance of independent activities of daily living in an older adult with dementia?

Keeping the older person's environment free of clutter, and giving assistance with medications if needed.

Nurse cares for female Alzeimer patient remarks to an experienced nurse, "It's a real shame, but at least she'll never know what's happening to her." What fact triggers the experienced nurse response?

Many persons with dementia are acutely aware of the fact that they are experiencing a cognitive deficit.

To reduce the risk of respiratory infection in a dependent elderly patient

Oral care

An elderly patient admitted with mental status changes accompanied weakness. Which condition should be assessed

Pneumonia

Which of the following is accurate about functional consequences related to mobility and safety?

Range of motion may b limited in all joints, causing some difficulties in the performance of some activities of daily living (ADLs)

Older adult with ongoing problems with pain control best response by nurse

The increase prevalence of chronic conditions in older adults predisposes older adult to pain.

The nurse is wroking with a 79 year old female patient with a diagnosis of osteoporsis. Which of the following interactions best exemplifies the nurse's understandings of the relationship between age-related changes and risk factors?

The nurse teaches the patient about bone density in older women and the role of vitamin D and calcium intake.

Which findings suggest the presence of persistent pain of an older adult patient?

The patient rubs hands together

A nurse manager justifies the budget for education regarding cultural competency for the staff. Which of the following justifications will best support the need for this education?

The proportion of healthcare consumers who are minorities continues to increase.

Client diagnosed with cognitive impairment, the condition worsened over several months and culminated to his recent death. An autopsy revealed numerous infarcted brain regions resulting from vessel occlusions. This client suffers from what type of dementia?

Vascular dementia

A postmenopausal woman asks the nurse what she can do to reduce her risk for osteoporosis. What suggestion should the nurse make?

Walk 1.6 km (1 mile) each day.

Looking at Biological Theories of Aging. Which theory describes the human body as a machine?

Wear and Tear Theory

What diabetic assessment question address the patient's optimal function

What are some of the goals for advancing your well-being?

Phys. healthy aging adult w/Alzheimer disease expresses concern about the disease progression. Which statement by the nurse is most appropriate?

Yes, it is a progression disease, it is better to start making plans early.

Cataracts (pathophysiology, symptoms, risk factors, prevention)

association with malnutrition, cigarette smoking, and diabetes

What are the two types of Macular Degeneration?

wet and dry


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