care of the older adult

How should a healthcare professional greet Estelle Bartlett, a petite, widowed elder, on the first home visit? -Hi sweetie, I'm a healthcare professional, Clara Jones."" -Good morning, Estelle, I'm a healthcare professional Clara Jones." -Hi dear, I'm a healthcare professional Clara Jones." -"Mrs. Bartlett, I'm a healthcare professional Clara Jones."

"Mrs. Bartlett, I'm a healthcare professional Clara Jones."

Which statement of the client helps the nurse to reach the conclusion that a client is experiencing a midlife crisis? -"I want be alone in a cottage away from my family members for one week." -"I feel I have not achieved anything great in my life. What can I do to make my life meaningful?" -"I struggled hard to help my children reach their goals." -"I have savings that I can use during emergency situations."

-"I feel I have not achieved anything great in my life. What can I do to make my life meaningful?"

Which question included in the assessment questionnaire will help the nurse to teach appropriate coping skills to the client with prostate cancer? -"What do you do to reduce stress?" -"Do you have a living will or advance directive?" -"Are there any questions about your illness that you'd like me to answer?" -"Do you know how to reach your provider if you have questions about your care?"

-"What do you do to reduce stress?"

What might be an important aspect of an individualized care plan for an older adult with a low income and who is depressed, lives in a community, is treated with an antidepressant, and has favorite pastimes of reading, cooking, and spending time with grandchildren? -A library card -Improved sleep -Improved nutrition -A daily walk

-A library card

Which nonpharmacologic interventions should nurses counsel patients on when they complain of occasional heartburn, constipation, and low energy? -Two tablespoons of liquid antacid 30 minutes after each meal -Adequate consumption of whole grains, fruits, and vegetables -A hot cup of coffee or tea at each meal -Distribution of fatty meals throughout the day

-Adequate consumption of whole grains, fruits, and vegetables

Agnes is a 77-year-old woman who lost her spouse last year and has congestive heart failure. She has moved in with her son. Her son brought her to the ER saying she is short of breath. He does not know how long she has been in the state, nor does he know the medication she should be on.What is the nursing priority in this scenario? -Admit and stabilize the patient -Ask the son if he is overwhelmed -Contact Social Services -Call Agnes's daughter

-Admit and stabilize the patient

What is an effective way to communicate with an older adult living with dementia? -Approach in a nonthreatening manner -Shout to get the older adult's attention -Move the older adult's belongings out of the way -Hold the older adult's hand if the older adult is agitated

-Approach in a nonthreatening manner

Which option best depicts prolonged disease care? -Blending of effective treatments and comfort procedures -Interrupting end-of-life care treatments -Focusing on therapy rather than comfort and quality of life -Supplying care only by friends or other private caregivers

-Blending of effective treatments and comfort procedures

A goal of the national health initiative Healthy People 2010 is to increase the quality and extend the years of healthy life.What are ways that this initiative can achieve its goal?Select all that apply -by pressuring older adults who are lonely to move to nursing homes at younger ages -By helping people overcome views of denial and foreboding as old age approaches -By encouraging people to have more children so that children can help their parents as they grow older

-By trying to spread the view that aging is natural and need not include illness and disease -By helping people overcome views of denial and foreboding as old age approaches

What should be the nurse's primary consideration while allowing for patient autonomy and reducing risk when dealing with end of life care? -Cognitive impairment -Weight -Age -Stage of illness

-Cognitive impairment

Which factor best describes the cornerstone of an individualized plan of care for an older adult? -Normal laboratory results on the complete metabolic panel -Comprehensive assessment -Ability to speak for oneself -Evidence of normal range-of-motion per all extremities

-Comprehensive assessment

What principle is least related to promoting health and preventing certain disabilities in older adults? -Continue activities of daily living (ADLs) -Monitor illnesses through annual health screenings (AHS) -Maintain as active a lifestyle as possible and desired -Keep up on assistive and information technology and other tools

-Continue activities of daily living (ADLs)

Which of the following is a person-centered method to using alternate health modalities to meet patient needs? -Suggesting the patient to take up Pilates or Aikido. -Leading the patient through a guided imagery workout. -Recommending pet or sound therapy and meditation. -Conversing about an array of alternate options with the patient to determine selections.

-Conversing about an array of alternate options with the patient to determine selections.

When calculating BMI, the nurse notes an older adult's score is 30.What does this score indicate? -Falls risk -Healthy lifestyle -Normal hemoglobin -Cognitive impairment

-Falls risk

An 85-year-old widow, living alone, tripped over her beloved dog and broke her leg.Which action should the home-care professional recommend regarding the dog? -Find the dog a good, loving home -Give the d -Call the Humane Society -Find out the elder's ideas

-Find out the elder's ideas

Which communication techniques promote safe transition of care in patients with aphasia?Select all that apply -Give the patient time to speak -Use nonverbal gestures to communicate -Speak more softly so as to never have a harsh tone -Respond in the affirmative when a question is asked

-Give the patient time to speak -Use nonverbal gestures to communicate

Older women experience bone loss, which makes them more susceptible to hip fracture.How should an environment change for an older woman after a hip-fracture repair? -Prohibit the older woman from using stairs -Have the older woman sleep on one side -Have the older woman's toilet seat raised -Advise the older woman to use a shower rather than a bath

-Have the older woman's toilet seat raised

In addition to a living will, advanced directives may also include a durable power of attorney that encompasses healthcare-related decision making.Which two of the following are accurate statements regarding the legal instrument known as the durable power of attorney?Choose 2 answers -It allows for an alternative decision maker in the event that the dying person is incapacitated and no longer able to make healthcare decisions. -The alternative decision maker must be a close relative of a dying person in order to understand his or her wishes. -The living will remains a useful tool in providing direction to the alternate decision maker. -A durable power of attorney for healthcare decisions also enables the alternative decision maker to also handle finances and other legal matters.

-It allows for an alternative decision maker in the event that the dying person is incapacitated and no longer able to make healthcare decisions. -The living will remains a useful tool in providing direction to the alternate decision maker.

When do dying individuals normally encounter mourning? -Lack of bodily function and freedom that occurs as sickness grows more widespread -Loss of fundamental beliefs, ideals and devotion -The sensation that no one cares that the person is fading -Absence of capability to provide and accept love

-Lack of bodily function and freedom that occurs as sickness grows more widespread

Which activity would be helpful for older adults to engage in to prevent or interrupt the course of frailty? -Taking a medication for each chronic disease or disorder -Sleeping more than 10 hours daily -Maintaining social relationships -Avoiding travel

-Maintaining social relationships

Which statement from a nurse would indicate good judgment when considering common myths regarding physical restraint use? -Failure to restrain puts individuals at risk for legal liability. -Alternatives to physical restraints are unavailable. -Inadequate staffing causes the need for physical restraint use. -Risk of falls exists when restraints are used

-Risk of falls exists when restraints are used

What is the most important discussion of the interdisciplinary team at regularly scheduled meetings? -Standardized testing results -Risk reduction assessments -Compliance issues -Care access issues

-Risk reduction assessments

What is the primary reason for having an older adult bring all medications to every office visit, including prescription and nonprescription medicines, vitamins, and herbal supplements? -So the health provider can ensure the older adult takes prescribed medications -So the health provider can determine if the older adult knows the names of medications -So the health provider can reduce potential polypharmacy in the older adult -So the health provider can assess the older adult's lifestyle

-So the health provider can reduce potential polypharmacy in the older adult

A 66-year-old patient lives alone, has a BMI of 32, and has diabetes. As the nurse begins to encourage the patient to increase current levels of physical activity, the nurse should recognize common barriers identified by older patients.Which barrier to physical activity is least common for older patients? -Swelling of ankles -Experiencing fatigue -Having pain from arthritis -Finding safe areas to walk

-Swelling of ankles

Which nursing function, in care transition, shields the patient? -Planner -Listener -Symptom manager -Hospital partner

-Symptom manager

Which roles of the nurse protect the patient from harm in a care transition? -Medication manager, screener, educator, listener -Decision maker, symptom manager, care coordinator -Symptom manager, educator, collaborator, care coordinator -Liaison with hospital, decision maker, collaborator, coordinator

-Symptom manager, educator, collaborator, care coordinator

A talented, accomplished, and very active elder wanted to take up painting after retirement. A recent stroke compromised the elder's short-term memory severely.Which community-based program should the healthcare professional suggest to the elder and family first? -Swimming in the neighborhood pool -Taking memory-enhancer classes at the senior center -Walking to a neighborhood church -Taking painting classes at the senior center

-Taking painting classes at the senior center

Which assessment tool can be used to determine activities of daily living (ADL) independence in older adults? -Mini-mental state examination (MMSE) -The Katz index -Confusion assessment method for the ICU (CAM ICU) -Mini-Cog assessment

-The Katz index

When evaluating an older patient, a nurse finds the patient to be highly depressed and suffering from low self-esteem.What psychosocial problem can the nurse deduce from these symptoms? -The patient is experiencing complicated grieving. -The patient has powerlessness. -The patient has disturbed thought processes. -The patient is at risk for suicide.

-The patient is at risk for suicide.

A spiritual African American older patient has terminal HIV.Why might this patient require careful assessment and monitoring for pain, based on knowledge of spiritual beliefs common in African American communities? -The patient may overstate pain levels so that God will be more likely to hear the patient's suffering. -The patient may understate pain levels because of a belief that the illness is God's plan. -The patient may understate pain levels because of faith in the doctor's ability to treat the patient. -The patient may overstate pain levels so that more drugs can be obtained for religious rituals.

-The patient may understate pain levels because of a belief that the illness is God's plan.

An 81-year-old patient is a new resident at a nursing home. Upon admission, the patient had a Braden score of 17.Which statement would indicate that the RN on duty lacks understanding that the patient is at risk for pressure ulcers? -The primary risk factor is immobility. -The primary risk factor is malnutrition. -The primary risk factor is polypharmacy. -The primary risk factor is a BMI < 24.

-The primary risk factor is polypharmacy.

The Independence at Home Demonstration was created by the Affordable Care Act.Which statement is true regarding primary care teams participating in this initiative? -The teams must be led by a physician. -The teams can be lead by a nurse practitioner. -The teams are led by a licensed administrator. -The teams must serve at least 500 Medicare beneficiaries.

-The teams can be lead by a nurse practitioner.

What is a benefit of using interdisciplinary teams? -They bring better quality services for clients. -They expedite nursing care services. -They meet the Centers for Medicare and Medicaid Services guidelines. -They enhance primary care visitation.

-They bring better quality services for clients.

beer's list of medications

-list of medications that should NOT be used or used with caution in the elderly

Mini-Mental State Examination (MMSE)

A test that is used to measure cognitive ability, especially in late adulthood.

Match each government program with its description.Answer options may be used more than once or not at all.Select your answer from the pull-down list. Provides health insurance for low-income families

Medicaid

katz index

The Katz index of ADLs uses nominal scale index to ID self-care problems and the level of assistance required within six areas: bathing, dressing, toileting, transfers, continence and feeding.

TDAP

every 10 years

pneumonia shot

every 5 years

influenza

every year

mini-cog

is another screening tool that can be administered in 5 minutes or less and requires minimal training. 3 item recall, clock drawing test (CDT)

What is a standard caseload for most transitional care nurses? -6 to 9 cases -10 to 14 cases -15 to 20 cases -24 to 28 cases

-15 to 20 cases

A nurse caring for people at the end of their lives knows that dyspnea is relatively common and interferes with patients' comfort and rest.What is the evidence-based intervention for shortness of breath? -Liquid morphine at a starting dose of 10 mg every 4 hours and titrating the dose upward until dyspnea is relieved -5 mg of liquid morphine every 4 hours, along with lorazepam 0.5-2.0 mg every 4-6 hours PRN for anxiety and restlessness -Elevate the head of the bed no more than 20 degrees -Administer O2 at least 5 liters per minute

-5 mg of liquid morphine every 4 hours, along with lorazepam 0.5-2.0 mg every 4-6 hours PRN for anxiety and restlessness

Several options are available as care approaches to chronic illness care.Which method best describes palliative care? -A combination of active treatment and comfort measures -End-of-life care that suspends active treatment -A continued focus on cure rather than comfort and quality of life -Care that is only delivered by family or other personal caregivers

-A combination of active treatment and comfort measures

An older adult is being cared for by her daughter. The daughter works a full-time job and is only able to care for her mother before she goes to work, on her lunch break, and after she gets off work. The older adult expresses to a nurse that she gets lonely during the day and sometimes cannot perform tasks by herself.Which community resource should the nurse recommend looking into? -A medication assistance program -Adult day services -A local health clinic -Meals on Wheels

-Adult day services

A critical competency in geriatric nursing is the ability to assess family knowledge of the skills necessary in the care of older adults.What broad caregiver competencies are included in this assessment?Select all that apply -Knowing how to safely start an IV -Knowing the science behind the field of geriatrics -Allowing active participation of the patient in all aspects of care -Balancing the patient's autonomy with safety

-Allowing active participation of the patient in all aspects of care -Balancing the patient's autonomy with safety

An older patient has suffered a stroke and is currently in the process of transitioning out of the hospital and into an assisted living facility. The patient's primary difficulty after the stroke is dealing with dysarthria, which has limited the patient's ability to speak.Which communication technology would appropriately promote an optimal transition of care for this patient? -An over-the-ear (OTE) hearing aid -An assistive listening device (ALD) -An augmentative and alternative communication (AAC) device -An analog technology to amplify sound

-An augmentative and alternative communication (AAC) device

An older patient missed an arthritis clinic appointment because the patient could not afford the pain medication.After first meeting the patient's immediate medication needs, which steps should the healthcare professional take in order to prevent a recurrence?Select all that apply -Ask the drug company for help -Enroll the patient in Medicare's hospice care -Recommend alternative therapies -Investigate eligibility for the Medicaid program

-Ask the drug company for help -Investigate eligibility for the Medicaid program

What should the older adult consider when starting an exercise program?Select all that apply -Begin with 10 to 15 minutes of exercise -.Begin with moderate strength training. -Begin with 15 to 30 minutes of exercise. -Begin with intense strength training.

-Begin with 10 to 15 minutes of exercise -.Begin with moderate strength training.

Rick, a 91-year-old male, has a history of chronic otitis media and is experiencing mild hearing loss in his right ear.Which type of assistive technology should Rick use to improve communicative function? -Behind-the-ear (BTE) hearing aid -Completely-in-the-canal (CIC) hearing aid -Augmentative and alternative communication (AAC) -Icon communication board

-Behind-the-ear (BTE) hearing aid

Which medications should the nurse cautiously review from the Beer's List of medications when documenting the patient's drug profile? -Diuretics -Inotropic drugs -Cyclosporines -Benzodiazepines

-Benzodiazepines

Which statements are true regarding health-related quality of life?Select all that apply -Can be measured by an instrument developed by the Centers for Disease Control (CDC) -Is measured by individuals' perceived healthy days per months -is measured by an objective observer based on the number of times an individual emits both verbal and nonverbal signs of happiness and well-being -Cannot be measured in persons with chronic illness

-Can be measured by an instrument developed by the Centers for Disease Control (CDC) -Is measured by individuals' perceived healthy days per months

Harriett is a 92-year-old who lives in assisted living; she recently fell and broke her hip. Harriet and her family would like to keep Harriet safe and at the highest level of independence on her return to her accommodations from the hospital.Which action should the nurse take to help Harriet and her family? -Counsel about home safety assessments -Discuss the rate of unintentional injuries for older adults -Have Harriet and her family request a daily room check by staff -Tell Harriet to become active in the local Tai Chi program

-Counsel about home safety assessments

Which is considered to be a permanent, progressive reduction in mental capacity? -Delirium -Dementia -Stroke -Presbyopia

-Dementia

The End-of-Life Nursing Education Consortium (ELNEC) is a resource targeted to nurses providing end-of-life care that supports evidence-based care of dying patients and their families, as well as self-care that lessens stress and anxiety and sustains nurses in providing excellent end-of-life care.Which of the following are self-care principles?Select all that apply -Maintaining professional boundaries and relationships with patients and families by tightly controlling feelings and empathy -Developing expertise in symptom management, which not only helps patients and their families, but also increases satisfaction and lessens anxiety among professional caregivers -Making good use of the expertise and support of the interprofessional care team -Diminishing attention on maintaining an active personal life since end-of-life care is a calling of sorts

-Developing expertise in symptom management, which not only helps patients and their families, but also increases satisfaction and lessens anxiety among professional caregivers -Making good use of the expertise and support of the interprofessional care team

Which element is part of psychosocial well-being for an older adult? -Avoidance of chronic disease -Avoidance of disability -Looking like a younger person -Engagement with others

-Engagement with others

Functional incontinence refers to problems from factors external to the lower urinary tract.Which is the least likely item to contribute to incontinence? -Polypharmacy -Environmental barriers -Intravenous fluids -Diuretics

-Environmental barriers

How often is tetanus vaccination recommended for older adults? -Yearly -Every 5 years -Every 10 years -Every 15 years

-Every 10 years

A vigorous recent widower visited his primary care team and stated that he was lonely.Which recommendation should the team make for this patient? -taking an antidepressant -Finding a new relationship -Moving in with his children -Taking a sleeping pill

-Finding a new relationship

Which lighting feature in most nursing homes compromises elder adults' ability to function? -Glare -Indirect lighting -Sunlight -Even lighting

-Glare

It has been concluded that an 83-year-old male is no longer suitable to operate a motor vehicle.Which decision should this elderly man take to preserve his quality of life and independence? -He should continue driving and wait until the state formally takes away his license -He should depend on family members to drive him to the places he needs to go. -He should look into and sign up for a local senior transportation program. -He should ask his younger friends for rides.

-He should look into and sign up for a local senior transportation program.

A home care nurse visits an older patient living with dementia whose spouse is providing care. The nurse notices a restraint sitting in the chair.What should the nurse do first in this situation? -Lecture the spouse about the risks of restraints -Find out why the spouse needs to use the restraints -Report the spouse's abuse to adult protective services -Help the spouse plan care without using restraints

-Help the spouse plan care without using restraints

What is a common preventable error that can occur during the transition of care for older adults? -Inaccurate medication reconciliation -Unhelpful hospital staff -Lost nursing equipment -Disorganized dosing schedule

-Inaccurate medication reconciliation

When focusing on the psychosocial needs of older adults, author Virginia Satir recommends that healthcare providers get back to the basics of communication.What are the basic principles Satir describes?Select all that apply -Invite -Follow through -Maximize attention levels -Maximize communication -Respect personal space -Arrange environment -Maximize understanding -Trust

-Invite -Follow through -Maximize communication -Arrange environment -Maximize understanding

Research indicates more than 90% of the deaths occur in older adults 65 and older due to lack of appropriate immunizations.On which annual vaccination should the nurse counsel the patient? -TDAP -Influenza -Pneumonia -varicella

-Influenza

What do dying persons typically experience grief over? -Loss of bodily function and independence that occurs as illness becomes more prevalent -Loss of basic beliefs, values and faith -The feeling that nobody cares that the person is dying -Loss of ability to give and receive love

-Loss of bodily function and independence that occurs as illness becomes more prevalent

A 75-year-old resident in an assisted living facility is at risk for fluid volume deficit.Which nursing actions would ensure the most accurate monitoring of the resident's fluid status in a co-created plan of care?Select all that apply -Take the vital signs every four hours. -heck for crackles in the lungs every shift.

-Measure and record fluid intake and output. -Ask the resident to weigh each day at the same time.

Which important facts about Medicare should nurses know?Select all that apply -Medicare covers certain disabled Americans who have not reached age eligibility. -Medicare requires income assessment in order to qualify for coverage. -Medicare covers assisted-living services for Americans in extreme poverty. -Medicare recipients range from those simply needing wellness services to those who are profoundly frail.

-Medicare covers certain disabled Americans who have not reached age eligibility. -Medicare recipients range from those simply needing wellness services to those who are profoundly frail.

What are common risk factors that contribute to functional decline in the older adult population?Select all that apply -Having small families -Physical inactivity -Low sodium dietary intake -Tobacco use

-Physical inactivity -Tobacco use

The assessment of which factor in the home environment is required for a client with mobility problems? -Availability of adequate care -Presence of stairs or other obstacles -Physical limitation of the caregivers -Access to Medicare

-Presence of stairs or other obstacles

What should a nurse first instruct an older adult to do when the older adult is beginning an exercise program? -Proceed with low intensity and moderate impact -Exercise until you sweat -Purchase new gym clothes -invest in a gym membership

-Proceed with low intensity and moderate impact

Which of the following is often the largest obstacle to overcome in important conversations related to death and perishing? -Uncertainty of healthcare personnel -Price of care -Public mindsets about passing away -Shortage of drive

-Public mindsets about passing away

When considering a nurse practicing in a transitional care role, which areas need to be a focal point?Select all that apply -Investigations find opposing principles in the transition of care. -There is a demand for transitional care. -Elderly recipients of Medicare with several prolonged ailments are recognized for over 75% of Medicare expenditures. -There is no relationship between transitional care and reduction of unwarranted hospitalizations.

-There is a demand for transitional care. -Elderly recipients of Medicare with several prolonged ailments are recognized for over 75% of Medicare expenditures.

What are important areas of knowledge to apply as a nurse practicing in a transitional care role?Select all that apply -There are conflicting research findings regarding the value of transitional care. -There is a growing demand for transitional care because nearly 50% of Americans are dealing with at least one chronic illness. -Medicare beneficiaries with five or more chronic illnesses account for 75% of Medicare spending. -There is no evidence of a relationship between transitional care and reduction of unnecessary hospitalizations.

-There is a growing demand for transitional care because nearly 50% of Americans are dealing with at least one chronic illness. -Medicare beneficiaries with five or more chronic illnesses account for 75% of Medicare spending.

What must the nurse inform the patient and family or caregivers about regarding assistive devices?Select all that apply -They may result in complete recovery from chronic illness. -They may enable independent performance and reduce risk of injury. -They may limit complications of an illness or disability. -They may lessen the importance of ongoing communication with healthcare providers.

-They may enable independent performance and reduce risk of injury. -They may limit complications of an illness or disability.

How is communication further facilitated?Select all that apply -Through active engagement of patients and family caregivers, with a focus on meeting the patient's goals -Through communication to, between, and among the patient, family caregivers, and healthcare providers -Through reliance on text messages that are less disruptive to the patient and family -Through healthcare providers conversing with the patient and allowing the patient to speak with the family

-Through active engagement of patients and family caregivers, with a focus on meeting the patient's goals -Through communication to, between, and among the patient, family caregivers, and healthcare providers

confusion assessment for the ICU

CAM-ICU is a valid and reliable delirium assessment tool recommended by the Society of Critical Care Medicine (SCCM) in its 2013 Pain, Agitation, and Delirium (PAD) guidelines.