Intro to Nursing CH. 23

An older adult is admitted to the health care facility with a diagnosis of depression. The nurse would be especially alert for:

suicidal thoughts.

Based on an understanding of the cognitive changes that normally occur with aging, what might the nurse expect a newly hospitalized older adult to do?

take longer to respond and react

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

Depression

Which statement shows that the nurse does not practice ageism?

"Neither intelligence nor personality normally decline because of aging."

A nurse is teaching an older adult client's family about the causes of mental impairment. The nurse sees that the teaching has been effective when the family says which of the following?

"Sundowning is a common problem of dementia."

An adult child accompanies an older adult client to the clinic and states, "I am not sure what is going on with my parent but I think it is depression." What questions should the nurse ask the client to determine if he or she is depressed? Select all that apply.

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

A nurse is reviewing the medical records of clients at a long-term care facility who are experiencing weight loss. The clients' medical conditions have been ruled out as a cause. The nurse understands that which situation would most likely be a factor? Select all that apply.

- evidence of depression - use of appetite-suppressing drugs - need for staff to assist with meals

The nurse is caring for an older adult client who is confused and agitated. When the client's family comes to visit the nurse asks how long the client has been confused. The family states that the client has been confused for a long time and the confusion is getting worse. The client is subsequently diagnosed with dementia. What is the most common cause of dementia in an older adult client?

Alzheimer's disease

One of the greatest causes of death in the United States and Canada is colon cancer. The nurse instructs the community on which of the following factors?

Annual screening after the age of 50

The nurse is evaluating a 42-year-old client who says that he is feeling stressed. Which of the following does the nurse know that could be a cause of stress for this age group?

Being caught in the sandwich generation

A gerontologic nurse practitioner has a large client population with heart disease problems. This nurse practitioner is aware that heart disease is the leading cause of death in the aging adult. What is the cause of this trend?

Blood vessels lose their elasticity with age.

A nurse is making a home visit to an older adult with multiple chronic health problems. The client is alert and oriented and cognition is intact. While talking with the client, the client reveals a belief that the adult child is stealing the client's social security checks to buy beer and eat out all the time. What action should the nurse first do regarding the possible elder abuse to keep the client safe?

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

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

Delirium

A nurse is preparing to medicate an older adult client with an opioid analgesic. Which information will the nurse obtain first to decide about administering the medication?

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

Gould viewed the middle years as a time when adults increase their feelings of self-satisfaction, value their spouse as a companion, and become more concerned with health. Which nursing action best facilitates this process?

Encouraging a client to have regular checkups

A home care nurse is reviewing guidelines for health-related screenings with a 35-year-old client. What are common screening recommendations for physical examinations?

Every 3 years to age 40 and annually from age 40

An older adult client is becoming progressively confused due to Alzheimer's disease. The family can no longer manage the client at home due to wandering. Which of the following living arrangements could the nurse recommend?

Extended-care facility

A group of nursing students is reviewing information about the older adult and mobility. The students demonstrate a need for additional study when they identify which statement as accurate?

Falls are the leading cause of death due to injury in individuals who are over the age of 75 years.

Which of the following health promotion measures should occur most frequently in older adult women?

Fecal occult blood test

A nurse is caring for an older adult client who has been confined to bed for several weeks following a fall. The client has been exhibiting symptoms of sundowner's syndrome. Which of the following are characteristics of sundowner's syndrome?

Feeling agitated and wakeful at night

The middle adult is sometimes called the "sandwich generation". According to Erikson, the developmental task of the middle adult is what?

Generativity versus stagnation

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

Home modification

A nurse encourages residents of a long-term care facility to continue a similar pattern of behavior and activity that existed in their middle adulthood years to ensure healthy aging. This intervention is based on which aging theory?

Identity-continuity theory

The nurse is monitoring T cell activity following a hematopoietic stem cell transplant in an older adult. Which information will the nurse share with the client and family regarding T cell significance?

Immunity is suppressed following chemotherapy, and T cell counts provide information on susceptibility to infection.

The nurse is reminiscing with a 72-year-old client with early onset dementia while providing care in a long-term care facility. How does the nurse implement this form of therapy to maximize the therapeutic value?

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

The nurse practitioner is examining a 55-year-old female client. Which of the following findings would be uncommon for this age group?

Lower extremity pulses are weak

A healthy 52-year-old client asks the nurse what she can do to maintain her health. Which of the following does the nurse recommend?

Perform self-examination of the skin every month

A nurse caring for older adults in a long-term care facility is teaching a novice nurse characteristic behaviors of older adults. Which statement is not considered ageism?

Personality is not changed by chronologic aging.

The home care nurse is visiting an older adult client in the home to assess a leg wound and change the dressings. The nurse is aware that the client receives money monthly but there is no food in the house, no adequate heat, and the client states, "My sister takes my check and cashes it every month." What is the correct action by the nurse?

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

In a report, the night nurse tells the incoming nurse that one client with dementia has sundowning syndrome. Which of the following nursing diagnoses would be most appropriate for this client?

Sleep deprivation

A nurse has attended an inservice workshop that addressed the phenomenon of ageism in the health care system. Which of the following practices is indicative of ageism?

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

Which of the following assessment findings of a male client age 77 years should signal the nurse to a potentially pathologic finding, rather than a normal age-related change?

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

A nurse is preparing a presentation for a group of older adults about health promotion. Which statistic would the nurse need to keep in mind about this group?

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

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

abandonment.