Gero Practice Quiz

Bone is visible

Stage 4

Goal temp in hypothermia

>97

Phase: Active illness; requires hospitalization

Acute

Who may not be able to report UTI symptoms

Cognitively impaired

Phase: no signs or symptoms, before problem occurs

Preventative

If you suspect that a person is having trouble with eating or swallowing during a meal or drinking, what's the most important thing to do?

Stop feeding/fluids

Weak sphincter, increased intraabdominal pressure (laughing, coughing), leaking >50 mL

Stress

Beta blockers

-olol

Stimulant laxative

Bisacodyl

Phase: Controlled illness/symptoms

Stable

Last resort laxative

enemas

Thiazide diuretic

hydrochlorothiazide

What in urinalysis shows UTI

leukoesterase

Which specific sleep aid should older adults avoid?

melatonin

Most common cause of sepsis in older adults

UTI

Phase: Uncontrolled but not requiring hospitalization

Unstable

Eschar/ necrotic tissue

Unstageable

Overactive bladder, voiding >8/day, nocturia, urgency

Urge

Category with highest risk for dehydration

Won't drink

Dry, cracked, itchy skin. Increase fluid intake. Use gentle, moisturizing soaps

Xerosis

Can't make it to the bathroom physically

Functional

Waxy, raised lesion. No prevention

Seborrheic keratossi

Screening for sleep apnea

circumference of neck

Treatment for sleep apnea

CPAP

Yeast infection (usually in skin folds), keep skin clean and dry. Keep DM in check

Candidiasis

What is considered a high fever

100.9/ 38.3

water heater should be on no higher than

120

Hypothermia temperature

<35 or 95

Falls are considered what type of syndrome?

Geriatric syndrome

Main side effect of urinary incontinence meds

anticholinergic

Phase: life-threatening

Crisis

Phase: signs and symptoms and diagnosis present

Definitive

ACEIs

-prils

ARBs

-sartan

Calcium channel blockers

-pine

A client developed acute herpes zoster and was treated with antiviral medication within 72 hours of the appearance of the rash. The client reports persistent pain 1 week later. Which statement indicates the cause of the post therapeutic neuralgia? 1. Damage to the nerves 2. Untreated major depression 3. Scarring in the area of the rash 4. Continued presence of the skin rash

1

A client developed acute herpes zoster and was treated with antiviral medication within 72 hours of the appearance of the rash. The client reports persistent pain 1 week later. Which statement indicates the cause of the post therapeutic neuralgia? 1. Place them slightly lower than the head and chest. 2. Use pillows to support the heels above the mattress. 3. Raise the knees using the knee gatch on the bed. 4. Elevate feet by raising the foot of the bed on blocks.

1

A client is admitted for dehydration and an intravenous (IV) infusion of normal saline at 125 mL/h has been started. One hour after the IV initiation the client begins screaming, "I can't breathe!" Which action is the nurse's priority? 1. Elevate the head of the bed and obtain vital signs. 2. Discontinue the IV and contact the primary health care provider. 3. Change the IV to an intermittent infusion device. 4. Contact the primary health care provider to obtain a prescription for a sedative.

1

A client suspected to have a prostate disorder is encouraged to have a rectal examination. Which position of the client will facilitate a rectal examination by the registered nurse (RN)? 1. Sims position 2. Prone position 3. Dorsal recumbent position 4. Lateral recumbent position

1

A client with rheumatoid arthritis is in the convalescent stage of an exacerbation. The client states, "The only time I am without pain is when I lie perfectly still." Considering the client's statement, which intervention would the nurse encourage the client to do? 1. Participate in active joint flexion and extension exercises. 2. Perform flexion exercises three times a day. 3. Do range-of-motion (ROM) exercises once a day. 4. Refrain from exercising until remission occurs.

1

After a prostatectomy, the client reported the urinary catheter tubing pulled too tightly on the leg. The nurse observed the excessively taut indwelling catheter tubing and properly taped tubing to the thigh. Which action would the nurse implement? 1. Explain the tubing traction assists to control bleeding. 2. Adjust the catheter tubing tension to relieve the taut pressure. 3. Untape the urinary catheter and retape the catheter closer to the urinary meatus. 4. Assess the degree of tension on the catheter and contact the primary health care provider.

1

During a routine clinic visit, an older adult complains about being unable to sleep well at night and then feeling sleepy throughout the next day. Which sleep promotion technique would the nurse advise? 1. Include age-appropriate exercise daily 2. Read in bed before sleeping 3. Avoid naps during the daytime 4. Have a hot cup of tea at bedtime

1

Selegiline is prescribed for a client with Parkinson disease who is having an inadequate response to levodopa therapy. Which information would the nurse include when teaching the client about selegiline? 1. "The primary health care provider should be contacted immediately if a severe headache occurs." 2. "The therapeutic blood level of the medication should be monitored each month." 3. "The dosage of the medication can be adjusted daily depending on your response that day." 4. "Side effects of levodopa will decrease when the selegiline and levodopa are taken concurrently."

1

The nurse assesses four clients with foot disorders. Which client would the nurse instruct to use bunion pads to relieve pressure on the bursal sac? 1. Hallux valgus 2. Hallux rigidus 3. Corn 4. Pes planus

1

The primary health care provider prescribed medications to four clients with osteoporosis. Which client would the nurse instruct to remain upright for 30 minutes after receiving the medication? 1. Alendronate 2. Zoledronic acid 3. Calcium supplements 4. Raloxifene

1

When a client is using a hypothermia blanket to reduce fever, which finding indicates a need for a change in the treatment? 1. Shivering 2. Vomiting 3. Dehydration 4. Hypotension

1

When assisting a client with Parkinson disease to ambulate, which instruction would the nurse provide the client? 1. Avoid leaning forward. 2. Hesitate between steps. 3. Rest when tremors are experienced. 4. Keep arms close to the center of gravity.

1

When caring for a client who was admitted with heart failure, which action by the nurse will be most effective in determining whether the client's fluid overload is improving? 1. Weighing the client 2. Monitoring the intake and output 3. Assessing the extent of pitting edema 4. Asking the client about subjective symptoms

1

Which action would the nurse take to assess a client for a fungal infection of the toenails? 1. Determining the rate of toenail growth 2. Cutting the toenails straight across 3. Observing the oral mucosa for cyanosis 4. Checking capillary refill using fingernails

1

Which key feature is associated with a stage 2 pressure ulcer? 1. Presence of non-intact skin 2. Development of sinus tracts 3. Damage to the subcutaneous tissues 4. Appearance of a reddened area over a bony prominence

1

Which precaution would the nurse teach a client prescribed selegiline for the treatment of Parkinson disease? 1. Change to a standing position slowly. 2. Take the medication between meals. 3. Perform self-blood glucose monitoring. 4. Withhold the next dose if nausea occurs.

1

Which finding in a client with hypothyroidism and hypertension who reports taking an extra dose of levothyroxine indicates the need to obtain a thyroid function panel? Select all that apply. One, some, or all responses may be correct. 1. Tremors 2. Diaphoresis 3. Nervousnes 4. Temperature 101°F 5. Heart rate 116 beats/min

1, 2, 3, 4, 5

Which skin conditions would the nurse expect when performing a physical assessment on a client with a new diagnosis of hyperthyroidism? Select all that apply. One, some, or all responses may be correct. 1. Warm 2. Moist 3. Pale 4. SmoothCoarse 5. Dry

1, 2, 4

An older adult male client asks about the risks of having osteoporosis. Which response would the nurse make? 1 "This is only a problem for women." 2 "Start exercising to prevent this problem." 3 "You are not at risk because of your small frame." 4 "You might consider having a bone density test."

4

A client with hyperthyroidism is being treated with propylthiouracil (PTU). Which instruction will the nurse include in the teaching plan regarding this medication? Select all that apply. One, some, or all responses may be correct. 1. "Avoid abrupt discontinuation of the medication." 2. "Monitor your weight, pulse, and mood routinely. 3. "You can expect an immediate response to this medication." 4. "Also take an iodine replacement to aid metabolism of the medication." 5. "Report side effects, such as sore throat, fever, joint pain, or oral lesions."

1, 2, 5

The nurse assesses for which client symptoms that indicate hyperthermia? Select all that apply. One, some, or all responses may be correct. 1. Vasodilation 2. Dry and flushed skin 3. Pale and cyanotic skin 4. Decreased capillary refill 5. Decreased urinary output

1, 2, 5

Which precautions would the nurse implement for herpes zoster? Select all that apply. One, some, or all responses may be correct. 1. Airborne 2. Contact 3. Droplet 4. Hazardous wastes 5. Standard

1, 2, 5

A client has been taking levothyroxine for hypothyroidism for 3 months. The nurse suspects that a decrease in dosage is needed when the client exhibits which clinical manifestations? Select all that apply. One, some, or all responses may be correct. 1. Tremor 2. Bradycardia 3. Somnolence 4. Heat intolerance 5. Decreased blood pressure

1, 4

Which statements made by the nursing student demonstrate adequate knowledge about the etiology of hypothermia and administration of different treatments? Select all that apply. One, some, or all responses may be correct. 1. "Blood infusion causes hypothermia." 2. "Amphetamines cause hypothermia." 3. "β-Adrenergic blockers cause hypothermia." 4. "Tricyclic antidepressants causes hypothermia." 5. "Neuromuscular blocking agents causes hypothermia."

1, 5

Ideal BP of >60 (CDK)

140/90

Acceptable BP of >60

150/90

A client with arthritis states that the prescribed aspirin causes stomach irritation. How would the nurse instruct the client to take the aspirin? 1. An hour before a meal 2. With food and a full glass of water 3. With sodium bicarbonate 4. At the same time as the other medications

2

A client with arthritis takes large doses of aspirin. Which symptom would the nurse include when teaching the client about the clinical manifestations of aspirin toxicity? 1. Feelings of drowsiness 2. Disturbances in hearing 3. Intermittent constipation 4. Metallic taste in the mouth

2

A client with chronic venous insufficiency has ankle edema. Which action would the nurse take? 1. Restrict fluids. 2. Elevate the legs. 3. Apply a Unna boot. 4. Discuss sclerotherapy

2

After a surgical thyroidectomy a client exhibits carpopedal spasm and tremors. The client reports tingling in the fingers and around the mouth. The nurse suspects a deficiency in which mineral? 1. Potassium 2. Calcium 3. Magnesium 4. Sodium

2

The nurse is teaching campfire safety to a group of community members and includes information about what to do if a person catches on fire. The nurse teaches the most effective method for putting out the flames. Which information from the group members indicates successful learning? 1. Wrap hand with towel and slap at the flames. 2. Instruct the victim to roll on the ground. 3. Pour cold liquid over the flames. 4. Remove the victim's burning clothes.

2

Which action would the nurse plan for a client during the early postoperative period after a prostatectomy? 1. Have the client stand to void. 2. Discourage straining for a bowel movement. 3. Use a bulb syringe to aspirate urine from the retention catheter. 4. Notify the primary health care provider if the client does not void by bedtime.

2

Which age-related skin change occurs in older adult clients and increases their potential for developing pressure ulcers? 1. Atrophy of the sweat glands 2. Decreased subcutaneous fat 3. Stiffening of the collagen fibers 4. Degeneration of the elastic fibers

2

Which clinical findings would support the primary health care provider's conclusion of actinic keratosis? 1. Erythematous, barely elevated plaques 2. Elevated, dry, hyperkeratotic scaly papule 3. Variegated colors of tan, brown, and black within a single mole 4. Thin, scaly, erythematosus plaque without invasion into the dermis

2

Which genitourinary factor contributes to urinary incontinence in older adult clients and needs to be considered by the nurse when planning the care for these clients? 1. Sensory deprivation 2. Urinary tract infection 3. Frequent use of diuretics 4. Inaccessibility of a bathroom

2

Which is the reason that the bacterium Escherichia coli would be the probable causative agent in a client with cystitis? 1. It thrives in the kidneys 2. It is a virulent bacterium 3. It inhabits the intestinal tract 4. It competes with fungi for host sites

2

Which term would the nurse use to document observing the characteristic gait associated with Parkinson disease? 1. Ataxic 2. Shuffling 3. Scissoring 4. Asymmetric

2

Which nursing interventions would the nurse implement to promote sleep for a client in a health care setting? Select all that apply. One, some, or all responses may be correct. 1. Restrict visitors. 2. Reduce lighting. 3. Provide activities during the day. 4. Decrease the sounds of the infusion alarms. 5. Increase the dosage of pain prescriptions at night.

2, 3

Which foods would the nurse encourage the client to eat to prevent constipation after a suprapubic prostatectomy? Select all that apply. One, some, or all responses may be correct. 1. Milk 2. Apple 3. Oatmeal 4. Green peas 5. Scrambled eggs

2, 3, 4

Which nursing interventions would the nurse provide to an older client with hypertension? Select all that apply. One, some, or all responses may be correct. 1. Provide skin care. 2. Advise the client to limit salt intake. 3. Teach stress management. 4. Instruct the client to quit smoking. 5. Advise the client to eat finger foods.

2, 3, 4

An older adult is having urinary incontinence. Which nursing interventions would help the client? Select all that apply. One, some, or all responses may be correct. 1. Provide nutritional support. 2. Provide voiding opportunities. 3. Avoid indwelling catheterization. 4. Provide beverages and snacks frequently. 5. Promote measures to prevent skin breakdown.

2, 3, 5

The community nurse is assessing an older adult client who lives alone at home. The nurse finds that the client refrains from physical activity for fear of falling when walking. Which intervention(s) by the nurse are beneficial to promote a healthy lifestyle? Select all that apply. One, some, or all responses may be correct. 1. Instruct the client to apply bedside rails 2. Encourage the client to wear nonskid shoes. 3. Suggest that the client use an assistive device 4. Ask the client to install handrails in the bathroom. 5. Help the client rearrange furniture in the house.

2, 3, 5

When taking the history for a client who is being treated for obstructive sleep apnea, which findings would the nurse expect? Select all that apply. One, some, or all responses may be correct. 1. Daytime hypoxemia 2. Chronic fatigue 3. Enlarged tonsils 4. Subcutaneous emphysema 5. Poor concentration

2, 3, 5

A client is diagnosed with Parkinson disease and receives a prescription for levodopa therapy. Which mechanism of action would the nurse identify for this medication? 1. Blocks the effects of acetylcholine 2. Increases the production of dopamine 3. Restores the dopamine levels in the brain 4. Promotes the production of acetylcholine

3

A client who had a subtotal thyroidectomy asks how hypothyroidism may develop when the problem was hyperthyroidism. Which would the nurse consider when formulating a response? 1. Hypothyroidism is a gradual slowing of the body's function. 2. A decrease in pituitary thyroid-stimulating hormone (TSH) will occur. 3. Less thyroid tissue is available to supply thyroid hormone after surgery. 4. Atrophy of tissue remaining after surgery reduces secretion of thyroid hormones.

3

A married older adult couple lives independently and has three adult children. The husband, who is alert but forgetful, has an enlarged prostate with infrequent urinary incontinence. The wife has diabetes mellitus, rheumatoid arthritis, and walks with difficulty. The nurse identified the couple's need for assistance with bathing, dressing, and meal preparation. Which option would the nurse suggest, which best meets the needs of this couple? 1. Admit them together to an extended care facility (nursing home). 2. Place them in an apartment together, within an assisted-living facility. 3. Keep the couple in their home and schedule assistance with a home health aide. 4. Encourage the couple to move in with one of their children for safety reasons.

3

An older adult client states, "I walk 2 miles [3.2 km] a day for exercise, but now that the weather is hot, I am worried about becoming dehydrated." Which statement would the nurse use to respond to this client? 1. "Drink fruit juices if you start to feel dehydrated." 2. "Thirst is a good guide to use to determine fluid intake." 3. "Fluids should be increased if the urine becomes darker." 4. "Water should be consumed when the skin becomes dry."

3

The client reports crumbly, discolored, and thickened toenails. Which reason could be a possible cause for this condition? 1. Allergy 2. Insect bite 3. Fungal infection 4. Bacterial infection

3

The nurse places a client in restraints due to violent combative behavior. Which intervention would the nurse perform next? 1. Offer food and drink. 2. Document the behavior. 3. Obtain a written or verbal prescription. 4. Provide a 1:1 attendant in the room.

3

Which dietary choice reflects the recommendations of the Dietary Approaches to Stop Hypertension (DASH) diet? Select all that apply. One, some, or all responses may be correct. 1. Salami 2. Pickles 3. Salmon 4. French fries 5. Canned soup

3

Which dietary suggestion would the nurse provide while teaching a group of geriatric female clients who have reduced amounts of circulating estrogen? 1. Include fish in your diet." 2. "Include fruits in your diet." 3. "Include yogurt in your diet." 4. "Include legumes in your diet."

3

Which ethnic group has a greater incidence of osteoporosis due to musculoskeletal differences? 1. Irish Americans 2. African Americans 3. Chinese Americans 4. Egyptian Americans

3

Which finding would lead the nurse to contact the state bureau of motor vehicles to obtain a driving evaluation for an older adult? 1. Cancer 2. Arthritis 3. Dementia 4. Depression

3

Which function would the nurse consider in the plan of care when a client has dysphagia? 1. Writing 2. Focusing 3. Swallowing 4. Understanding

3

Which intervention would the nurse provide to an older adult client with a low body mass index (BMI) with osteoporosis? 1. Encourage continuous, steady weight gain. 2. Monitor for decreased urine calcium 3. Provide instructions relative to diet and exercise. 4. Teach about safety factors in the use of opioids and nonsteroidal anti-inflammatory drugs.

3

Which term would the nurse use to document a client experiencing urinary incontinence via involuntary loss of small amounts (25-35 mL) of urine from an overdistended bladder? 1. Urge incontinence 2. Stress incontinence 3. Overflow incontinence 4. Functional incontinence

3

While hospitalized, a client with diabetes is observed picking at calluses on the feet. Which intervention would the nurse implement immediately? 1. Warn the client of the danger of infection. 2. Suggest that the client wear white cotton socks.3 3. Teach the client the importance of effective foot care. 4. Check the client's shoes for their fit in the area of the calluses.

3

The nurse is assessing a client who is suspected of having candidiasis. Which questions asked by the nurse would help confirm the diagnosis? Select all that apply. One, some, or all responses may be correct. 1. "Do you have interdigital scaling and maceration?" 2. "Do you experience scaliness under the distal nail plate?" 3. "Do you have cheesy plaques in the mouth resembling milk curds?" 4. "Do you have red rashes with satellite lesions around the affected area?" 5. "Do you have white patches in the groin area with increased vaginal discharge?"

3, 4, 5

A client is scheduled to have a thyroidectomy. Which medication is indicated for decreasing the size and vascularity of the thyroid gland before surgery? 1. Vasopressin 2. Levothyroxine 3. Propylthiouracil 4. Potassium iodide

4

A health care provider prescribes bisacodyl for a client with constipation. The nurse explains to the client that this medication acts by which mechanism? 1. Producing bulk 2. Softening feces 3. Lubricating feces 4. Stimulating peristalsis

4

When a client with venous insufficiency has questions about the brownish discoloration of the skin on the legs, which response will the nurse make to explain the discoloration? 1. "The arterial blood supply is inadequate." 2. "There is delayed healing in the area after an injury." 3. "The production of melanin in the area has increased." 4. "There is leakage of red blood cells [RBCs] through the vein wall."

4

When teaching a client how to prevent constipation, the nurse evaluates that the dietary teaching is understood when the client chooses which breakfast cereal? 1. Froot Loops 2. Corn flakes 3. Cap'n Crunch 4. Shredded wheat

4

Which activity places a client at risk for hyperthermia? 1. Snowmobiling 2. Skiing in the winter 3. Hiking Alaskan mountains 4. Performing strenuous activity in high humidity

4

Which finding in a urinalysis indicates a urinary tract infection? 1. Crystals 2. Bilirubin 3. Ketones 4. Leukoesterase

4

Which information will the nurse include when teaching a client with venous insufficiency about prevention of venous thrombosis? 1. Wear snug-fitting pants 2. Sit with the knees flexed. 3. Apply warm soaks to the legs daily 4. Put on compression stockings before arising.

4

Which legal implication would the nurse understand about applying restraints to a client? 1. The law prohibits restraining clients until a written prescription is obtained. 2. A felony charge may be leveled against nurses who use any kinds of restraints. 3. Nurses are not obligated to report institutions that use restraints unlawfully. 4. The nurse can be charged with assault and battery for using restrains improperly.

4

Hold beta blocker when heart rate is

<60

What temperature is considered heat stroke

>104

Precancerous skin lesion. Use sunscreen

Actinic keratosis

2 sleep meds okay for older adults

Ambien (zolpidem) and melatonin

Emollient laxative

Docusate sodium

Phase: progressive decline

Downward

Causes of 10-15% of insomnia (2)

Drugs and alcohol

Phase: immediate weeks/days/hours before death

Dying

Intervention to improve nutritional status (especially in those with alzheimers)

Finger foods

Painful, vesicular rash, over a dermatome. Teach pt to get vaccine starting at age 60.

Herpes Zoster (shingles)

First sign of hypothermia

Mental status change

First line laxative

Metamucil

Osmotic Laxative

Milk of magnesium

Nitrates

Nitroglycerin

Another name for sleep apnea

OSA

Obesity may be protective in those >70

Obesity paradox

Causes most of aging cosmetic problems. Most important intervention is to use sunscreen.

Photo damage

Sleep Assessment Tool

Pittsburg Sleep Quality Index

Itchy skin. (use fragrance free products, lotion)

Pruritus

Bulk forming laxative

Psyllium (Metamucil)

Thin, fragile skin. Teach person to wear long sleeves & protect skin from trauma, especially their arms

Purpura

What stage of sleep do older adults not get?

REM

What is considered the barometer for health?

Sleep

Periods of not breathing while sleeping

Sleep apnea

Red, non-blanchable skin

Stage 1

Top layer of skin is gone, blisters, partial thickness loss

Stage 2

Full-thickness skin loss, down to deeper tissue/fat/muscle

Stage 3