Gero Unit Exam 2

The nurse is educating an older adult client about the pathophysiology of atherosclerosis. What statement will the nurse include in the teaching?

"Atherosclerosis involves the formation of plaque lesions in the blood vessels, which can rupture, remain stable, or continue to grow."

An older adult client asks about over-the-counter sleeping aids. Which response is the most appropriate for the nurse to make to this client?

"Avoid sleeping aids that contain diphenhydramine."

The older adult client is prescribed a new atypical antipsychotic medication. What instructions should the nurse provde the caregiver to manage adverse effects of the medication? Select all that apply.

"Be sure to remove any trip or fall hazards from the house." "Assist the client from a sitting to standing position slowly." "Notify the health care provider if the client appears to be sleeping during the day more than usual."

An older client who smokes half a pack of cigarettes daily and is diagnosed with chronic obstructive pulmonary disease (COPD) expresses regret about starting smoking over 50 years ago at a time when it was considered both fashionable and harmless. Which response by the nurse would be most appropriate?

"Even though you have smoked for a long time, there are still benefits to quitting smoking."

The nurse provides education for a client with renal disease regarding the effects of medication therapy. Which statement made by the client demonstrates the teaching was effective?

"I limit the acetaminophen I take in 24 hours for my arthritis."

A nurse is interviewing a client about the client's gastrointestinal health. Which statement by the client would lead the nurse to suspect that the client is experiencing a potential pathological process rather than a normal age-related change?

"I tend to regurgitate a lot of my food after a meal these days."

A nurse is teaching older adults at a senior center how to reduce the incidence of falls. Which of the following statements indicates that the nurse's teaching has been effective?

"I understand that over-the-counter medications as well as prescription medications can cause falls."

An older adult client with a long-standing history of chronic obstructive pulmonary disease (COPD) was recently placed on warfarin after experiencing atrial fibrillation. Upon discharge from the hospital, which statement by the client indicates a need for further teaching?

"I will continue to use smokeless tobacco since it is a lot better than smoking."

An older adult with pain is to be discharged home with a prescription and daily schedule for oral morphine for persistent pain. The client historically took an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) for pain. Which statement by the client shows the nurse that the client understands the plan?

"I will take a laxative and a stool softener to reduce my constipation."

An older adult started an antidepressant 1 week ago. The client states, "I don't want to take that pill; it's not doing anything." Which response by the nurse is most appropriate?

"It is too soon to see effects; positive effects may begin at around 3 weeks."

A 76-year-old client has been diagnosed with an axial hiatal hernia following several months of belching and heartburn. Which information would the nurse most likely include when teaching this client?

"Losing weight and trying a bland diet might help alleviate some of the symptoms you're experiencing."

An older adult with heart disease asks the nurse, "What foods can I eat to help reduce any further problems with my heart disease?" Which response(s) by the nurse would be appropriate? Select all that apply.

"Reduce your intake of fried foods." "Try increasing your intake of fiber." "Be sure to use cold-pressed olive oil."

A gerontological nurse is conducting a program for staff nurses at a long-term care facility about older adults and sensory function. When discussing this topic, which information would the nurse most likely include? Select all that apply.

"Sensory deficits make it difficult to interpret the older adult's physical environment." "Sensory deficits are a threat not only to quality of life but to safety as well." "Sensory deficits have a negative effect on older adults' social relationships." "Sensory losses commonly lead to impaired communication."

A 75-year-old man has been diagnosed with prostatic cancer. The client is prescribed hormonal therapy with estrogen as part of the treatment plan. The client tells his spouse and the nurse, "These pills are going to make me a woman." Which response by the nurse about the reason for this treatment would be most appropriate?

"The estrogen therapy is designed to prevent the tumor from spreading."

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?

"We need to teach the client that rheumatoid arthritis is not part of the aging process and that the client should increase functional activities."

The nurse is providing care to a group of older adult clients. The nurse would anticipate administering an anti-inflammatory medication to which client?

A 71-year-old client with rheumatoid arthritis

Several older adult clients are being cared for on a subacute medical unit. After assessing each client, which client would the nurse identify as being at highest risk for a cerebrovascular accident (CVA)?

A 79-year-old who has poorly controlled hypertension and smokes half a pack of cigarettes daily

The nurse caring for residents in a long-term care facility administers numerous antidepressant medications each day. For which resident should the nurse investigate a possible change in treatment?

A 91-year-old resident who has been taking a tricyclic antidepressant since the onset of his physical decline several years prior

A nurse identifies clients who are at risk for modifiable risk factors for cardiovascular disease. Which client should the nurse identify as having modifiable cardiovascular functional consequences?

An older adult client who is obese who has type 2 diabetes

The nurse is completing a physical assessment of a female, older client focused on the reproductive health system. Which of the following should the nurse include in the assessment? Select all that apply.

Assess for genital discharge Assess for genital bleeding Palpate the breasts Inspect the genitalia for lesions

An older adult 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 and glassy-eyed and whose breath smells of alcohol. Which action should be a priority with the nurse?

Assess whether the client is safe in the home environment

An 80-year-old client is brought to the emergency department after falling. The client's right arm and hip are injured. The nurse is assessing the client who reports that the fall was painful. Further assessment reveals intact skin without edema or redness. The nurse discusses the client's assessment with the emergency department's medical staff. Which decision would the nurse most likely anticipate?

Assessing the client further for potential fractures despite the absence of obvious signs or symptoms

A gerontological nurse is educating caregivers of older adults about the importance of physical activity. Which suggestion would be most likely to help families increase the physical activity of their older relatives?

Being creative in suggesting pastimes that can stimulate movement

An older male client with benign prostatic hypertrophy says "well at least I won't get prostate cancer." What should the nurse respond to this client?

Benign prostatic hypertrophy is closely related to prostate cancer."

The nurse is caring for an older client with a history of chronic obstructive pulmonary disease (COPD). The nurse would be alert for an increased risk of adverse reactions if the client is prescribed which medication? Select all that apply.

Beta-blockers Long-acting benzodiazepines

A 78-year-old female client who is obese has undergone a bone density scan that reveals bone loss. Which treatment should the nurse expect to be prescribed for this client?

Calcium carbonate po daily

A newly admitted older client has severe edema in the lower extremities and no hair on the legs. The nurse interprets these findings, suspecting which condition is present?

Circulatory problems related to age and a chronic illness

A gerontological nurse is caring for older clients in an acute care facility. The clients are receiving various medications as part of their treatment plan. When administering the medications to these clients, the nurse integrates information about changes in pharmacokinetics in this client population, identifying which factor as most important?

Decreased renal and liver function contributes to an increased half-life for many drugs.

A 70-year-old client tells the nurse, "I've been taking a laxative every day for years." When assessing the client, which complaint would the nurse suspect as being related to this laxative abuse?

Dehydration

An older adult client experiences impairment in physical mobility. Which intervention(s) will the nurse include in the client's plan of care? Select all that apply.

Design an exercise program appropriate for the client's status Remind to maintain good body alignment Promote a healthy nutritional intake Coach to change positions every hour

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?

Have clients sit on the edge of their beds for a minute or two before ambulating.

While ambulating, a client with chronic obstructive pulmonary disease (COPD) becomes confused. What should the nurse do first?

Have the client sit down

The nurse is assessing an older adult client's overall urinary wellness. Which assessment or clinical findings are risk factors for decreased urinary wellness for this client? Select all that apply.

History of Parkinson disease. Reported BMI is 36.0. Reported last bowel movement was three days ago.

The home care nurse is conducting a home environment assessment for an older client with peripheral vascular disease and foot wounds. Which finding would the nurse identify as a safety issue for the client? Select all that apply.

Hot water temperature 124°F Medication labels absent from prescription containers

The nurse is developing a plan of care for an older adult client who is prone to developing constipation. Which intervention would be appropriate for the nurse to include in the plan?

Increase fluids as tolerated

The nurse assesses a 90-year-old client who has chronic obstructive pulmonary disease (COPD). The nurse should include which interventions in the client care plan?

Infection prevention measures

A nurse is preparing a program at a local health fair, promoting activities to reduce clients' risk of cerebrovascular accident (CVA). Which activity would the nurse emphasize as the most helpful measure for risk reduction? Select all that apply.

Managing hypertension Maintaining adequate hydration Controlling diabetes

An older client is prescribed a diuretic for the treatment of hypertension. The nurse would assess the client closely for the development of which health problem?

Manifestations of fluid and electrolyte imbalances

During a health promotion visit, a 73-year-old male client requests an explanation about expected reproductive health changes. The nurse sould include what education? Select all that apply.

More time is required for an erection to be achieved He will experience a reduction in sperm count Enlargement of the prostate gland is likely

Before administering warfarin to an older adult, the nurse should obtain which data?

PT/INR

An older adult client with a history of gastroesophageal reflux disease is prescribed aspirin 81 mg by mouth every day. What should the nurse suggest when teaching the client about this medication?

Purchase buffered aspirin

A 71-year-old male client has presented to the nurse practitioner's clinic complaining of abdominal and flank pain and blood in his urine for the past 48 hours. Assessment reveals the client's temperature is 102 °F orally. Based on these findings, which condition would the nurse suspect first?

Renal calculi

A nurse is preparing to administer an antidepressant medication to an older adult client with depression. Which information would the nurse need to keep in mind?

Side effects that can occur in older adults are likely to be significant.

After reviewing a list of medications, the nurse is concerned that a client is at risk for developing osteoporosis. Which medication(s) caused the nurse to have this concern? Select all that apply.

Steroid Furosemide Thyroid supplement Aluminum-based antacid

The home health nurse is performing an environmental safety assessment at the home of an older adult client. Which finding will the nurse recognize as an environmental risk factor?

The client reports a decreased sense of smell

A healthy older adult has begun using diphenhydramine for allergic rhinitis. Within 1 week, the client begins to exhibit signs of confusion and disorientation. The client's spouse calls the primary care provider's office and speaks with the nurse. Which event should the nurse suspect first?

The older adult is experiencing an adverse drug effect.

The nurse is reviewing the medical record of a 72-year-old client admitted for treatment of a myocardial infarction. The client has a history of hypertension and heart failure. During the past night, the client voided four times. Upon reviewing the client medication regimen, which medication would the nurse identify as being implicated in the client's nocturia?

Thiazide diuretic

The nurse conducts a physical assessment of an older client with a cardiovascular health problem. Which finding should the nurse expect to assess in this client?

Thick dry nails

Which approach should the nurse use when considering pain management of an older adult client recovering from injuries from a recent fall?

Trying nonopioids and adjuvant drugs first, before administering opioid analgesia

A 77-year-old client has been brought to the emergency department by the daughter due to recent visual disturbances and unilateral weakness. The diagnostic workup has led the diagnosis of transient ischemic attacks (TIAs). When reviewing the client's history, which factor would the nurse identify as most likely contributing to the client's current condition?

Use of antihypertensive medications

An older client with Alzheimer's disease is experiencing increasing episodes of agitation and wandering. The client has been prescribed risperidone (Risperdal), an atypical antipsychotic. The nurse notifies the practitioner about the order based on which reasoning?

Using antipsychotics to manage the behavior of clients with dementia is inappropriate

When addressing the leading cause of injury-related deaths for older adults, what is the most important teaching point for the nurse to include concerning safety?

Wear non-skid footwear

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 measure is most likely to prevent heart disease among older adults?

establishing an exercise program

The nurse discusses home safety with an older client before being discharged back to home. Which competency is this nurse implementing?

identify and reduce risks

A nurse assesses an older client who has high blood pressure and chronic obstructive pulmonary disease. The client has been prescribed nicardipine and an ipratropium inhaler. This medication combines a calcium-channel blocker and an anticholinergic. For which urinary effect should the nurse teach the client to monitor?

nocturia

Which is the most important remediable risk factor for cardiovascular disease in older adults?

smoking

Which statement(s) demonstrate that the client has received effective education concerning the promotion of healthy cardiovascular function? Select all that apply.

"I have not smoke a cigarette in 6 months." "Walking is a part of my daily routine." "I rarely eat fried foods." "I have not smoke a cigarette in 6 months." "I have lost 10 lb (4.5 kg) and have 5 lb (2.25 kg) more to go."

Which statement made by an older adult client indicates to the nurse that the client is no longer experiencing a anticholinergic adverse affect to the antacids being taken regularly?

"My bowel movements are much more regular now."

Which variable is considered most important in determining nursing care for a client with effects of aging on genitourinary function?

Changes in renal threshold for glucose

An older client reports taking oral aloe every day. Which prescribed medication is being adversely affected by this herbal supplement?

Digitalis

Which side effect is caused by the administration of antidepressant medication to the older client? Select all that apply.

Dry mouth Diaphoresis Blurred vision Weight gain

A gerontological nurse is providing care to an older adult client with a history of heart failure, type 2 diabetes, and hypertension. Which self-care activity would be most appropriate for the nurse to teach the client how to do?

Monitor pulse rate and lung sounds

On older female client reports occasional urinary retention. What should the nurse suspect this client is experiencing?

Fecal impaction

The nurse is caring for a 79 year-old man. Which reproductive system problem is most likely to be associated with the nursing diagnosis acute pain?

Prostatic enlargement

An older client is prescribed nicotinic acid to control cholesterol. What additional medication should the nurse expect to be prescribed for this client?

aspirin

An older client is prescribed an anticonvulsant medication. What should the nurse include when teaching the client about this medication?

avoid grapefruit juice

An older adult client experiences heartburn, belching, and regurgitation. Which diagnostic test should the nurse anticipate being prescribed for this client?

barium swallow

The nurse prepares an educational session for older female residents of an assisted living facility. Which topic should be included to support reproductive system health?

breast self-examination

The nurse suspects that an older client is developing Parkinson's disease. What did the nurse most likely assess in this client?

hand tremor

An older client is going home after attending rehabilitation after a cerebrovascular accident. Which action should the nurse suggest to maximize this client's independence in the home environment?

install grab bars in the bathroom

An older female client reports a new onset of painless vaginal bleeding. For which health problem should the nurse expect this client to receive diagnostic testing?

cervical cancer

An older client experiences an exacerbation of chronic obstructive pulmonary disease (COPD). What should the nurse expect when assessing this client?

cough

During a home visit the nurse is concerned that an older client recovering from a cerebrovascular accident is at risk for a fall. What did the nurse assess to make this clinical determination?

loose carpeting

An older client is diagnosed with hypertension. For which lifestyle alteration should the nurse prepare teaching material for this client?

low-sodium diet

An older male client reports the inability to empty the bladder. Which health problem should the nurse suspect as the cause of this client's symptom?

enlarged prostate

The nurse is concerned that a client is at risk for developing osteoporosis. What finding caused the nurse to have this concern?

smokes cigarettes

An older adult client with cardiovascular disease experiences vagal episodes. What should the nurse suggest to reduce these episodes from occurring in the future?

stool softener

A client is diagnosed with peptic ulcer disease. What information in the client's health history should the nurse use to help determine the reason for this disorder?

takes aspirin twice a day

A client with open-angle glaucoma is prescribed pilocarpine eye drops. What should the nurse teach the client about this medication?

vision may be blurred for 1 to 2 hours after use

The nurse in the emergency department assesses a 76-year-old female client. The client's bladder is visibly distended and the client has not voided since the previous evening. Which assessment question would be most important to determine the source of the client's condition?

when was your last bowel movement