Ch. 23 - Aging Adult
A nurse is providing an in-service program for a group of nurses who work with the older adult population. After describing the older adult population's risk for abuse and neglect, the nurse determines that the education was successful when the group identifies a vulnerable adult as having which characteristic? Select all that apply. A. adult 60 years or older lacking self-care ability B. adult with disability C. adult without a legal guardian D. adult in a long-term care facility E. adult receiving provider services while living in his own home
A,B,D,E
The older population, persons 65 and older, numbered over 43 million in 2012. There are limited resources to care for this aging population. Factors that influence society's attitude to this age group include which of the following myths? A. Old age begins at 65. B. Most older adults live in nursing homes. C. Intelligence and personality continue as before. D. The majority of senior citizens are not in good health. E. Loneliness and isolation are problems associated with this age group.
A,B,D,E
A nurse is providing care to an older adult who is experiencing delirium. Which risk factors would the nurse identify as being most common? Select all that apply. A. pre-existing cognitive impairment B. advanced age C. formation of plaques on brain structures D. previous myocardial infarction (MI) E. sleep deprivation
A,B,E
A nurse is reading a journal article about mood disorders in the older adult population. Which information about these conditions would the nurse expect to find? Select all that apply. A. Depression is often misdiagnosed. B. Symptoms often mimic those of other chronic comorbidities of the older adult. C. Depression is considered a normal part of aging. D. The stigma associated with depression is less for older adults. E. Suicide is the most serious consequence of depression.
A,B,E
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. A. "Can you tell me what your sleep patterns are?" B. "Have you had any changes in weight recently such as a gain or loss?" C. "Have you been seeing things that no one else seems to see?" D. "What foods do you like to eat?" E. "Have you lost interest in things you previously found pleasurable?"
A,B,E
An older adult client's daughter asks if the doctor can prescribe an antipsychotic medication for her father because he is so confused and agitated much of the time. The nurse is aware that the client should only be prescribed this medication when which strategy has failed? Select all that apply. A. Behavioral B. Environmental C. Physical D. Chemical E. Social
A,B,E
Nurses who care for diverse populations must be aware of patterns of disease that are more likely to affect certain ethnic or racial groups. Which examples accurately reflect these profiles? Select all that apply. A. Black men in America are 30% more likely to die from heart disease than non-Hispanic White men. B. Hispanics have higher rates of obesity than non-Hispanic Whites. C. American Indian/Alaska Natives have an infant mortality rate 75% higher than that of Whites. D. Black adults are diagnosed with diabetes and die from diabetes almost three times as often as White adults. E. Black adults in America have the highest mortality rate of any minority for most major cancers. F. Tuberculosis is 11 times more common in Asians in America than Whites.
A,B,E,F
A nurse is preparing for a discussion with a group of older adults about the need for adequate nutrition. Which factor would the nurse address as placing an older adult at risk for decreased food intake? Select all that apply. A. reduced thirst sensation B. limited changes in smell C. early satiety D. reduced level of physical activity E. decreased number of taste buds
A,C,D,E
The nurse is caring for a client diagnosed with dementia. Which behaviors would the nurse most likely assess? Select all that apply. A. asking questions repeatedly B. stable mood C. socially inappropriate behavior D. wandering E. irritability
A,C,D,E
A nurse working in a community clinic assists middle-age clients to follow guidelines for health-related screenings and immunizations. What preventive measures would the nurse recommend for this population? Select all that apply. A. A physical exam every year from age 40 on B. Clinical skin examination every 3 years C. Breast self-examination every month for women D. Pelvic examination and Pap test at least every 3 years for women E. Prostate-specific antigen (PSA) test every year for men F. Zoster vaccine live for adults 50 years and older
A,C,D,E,F
A nursing student is studying the normal physiologic changes of older adults. The faculty member knows that the student comprehends the information when the student makes which statements? Select all that apply. A. "Height may decrease 1 to 3 in (2.5 to 8 cm)." B. "Rate of reflex responses increase." C. "There is an increased sensitivity to glare." D. "The senses of taste and smell are decreased, sour taste diminishes first." E. "Fluids and electrolytes remain within normal ranges."
A,C,E
A nurse is performing a home assessment for a 90-year-old widower who lives in a third story apartment. The assessment reveals there are smoke alarm and carbon monoxide alarm systems; slip-proof surfaces in the bathtub and shower; no throw-rugs are present; handrails on the steps; unlocked cabinets with potential poisons; adequate lighting; large flat screen TV on wall; and the water is set at a safe temperature. As the nurse considers the client's home environment, what modifications can be made to enhance safety for the client? A. Locks on cabinets where potential poisons are located. B. Handrails in bathroom C. Removal of large flat screen TV on wall D. Ensuring there is an automated external defibrillator (AED) in the home
B
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? A. Life expectancy has increased for men but not for women. B. The group experiencing the largest growth is those 85 years of age and older. C. The number of older adults has begun to plateau since the year 2000. D. The older adult population appears to be younger than in the past.
B
A nurse is providing care at an ambulatory care center to a wide range of older adults from diverse racial and ethnic groups. Based on recent statistics, which group would the nurse most likely identify as projected to be the largest? A. Blacks B. Non-Hispanic Whites C. Hispanics D. Asians
B
A nurse is teaching an elderly 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? A. "Dementia is an acute process and develops suddenly." B. "Sundowning is a common problem of dementia." C. "Delirium progressively affects cognitive function and is a chronic process." D. "Alzheimer's disease (AD) is a reversible neurologic illness."
B
An occupational health nurse overhears an employee talking to his manager about a coworker 65 years of age. What would the nurse be concerned about when she hears the employee state "he should retire and make way for some new blood"? A. Intolerance B. Ageism C. Dependence D. Nonspecific prejudice
B
An older adult client comes to the health center reporting difficulty sleeping. Which statement by the client would the nurse need to address? A. "I try not to be too active once I've eaten dinner." B. "I find myself napping on and off throughout the day." C. "I go to bed around 10:30 pm every night." D. "I don't drink coffee or alcohol."
B
An older adult female client tells the nurse, "Whenever I sneeze or cough, I urinate a little bit. It's very embarrassing." The nurse interprets the client's statement as indicating which type of incontinence? A. Urge B. Stress C. Overflow D. Functional
B
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? A. Call the police and tell them to swear a warrant for the arrest of the sister. B. Report the incident to social service informing them the client has no food or heat. C. Tell the client to talk with the sister and have her replace the money she has stolen. D. Take the client to the local hospital Emergency Department.
B
The nurse is caring for an older adult client on the medical unit admitted for diagnostic testing. The client is alert and oriented and lives independently. The client was wearing glasses upon admission. Which nursing intervention will be most effective in the prevention of falls for this client? A. using a gait belt each time the client ambulates B. ensuring the client's glasses are close by the bed C. placing a bed alarm on the bed D. moving the client to a room close to the nurse's station
B
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? A. T cells are monitored to determine the aggressiveness of cancer and are used as a guide to select appropriate chemotherapy. B. Immunity is suppressed following chemotherapy, and T cell counts provide information on susceptibility to infection. C. T cell counts are used to identify the presence of infection for clients following hemopoietic stem cell transplant. D. T cells or "thrombocytes" are monitored to determine likelihood of thrombus formation.
B
The nurse is working in a long-term care facility and overhears a group of unlicensed assistive personnel (UAP) discussing some of the residents of the facility. What statement made by a UAP indicates that education regarding older adult clients is needed? A. "Older adult clients still enjoy sexual relations." B. "All old people start to deteriorate mentally." C. "Some of the residents still like to look their best." D. "Not all people that are elderly live in long-term care facilities"
B
The nurse understands that when caring for the older adult it is important to assist in maintaining independence and self-esteem. Assisting the client to adjust to a walker or wheelchair is an example of supporting which of Erikson's developmental tasks of the older adult? A. Adaptation to age and preservation of self B. Ego integrity and coping with reality of limitations C. Functional adaptation and self-awareness D. Prevention of injury and safety in navigation
B
When completing an assessment of the middle-aged adult, the nurse makes note of the client's cognitive development. Then nurse would expect to find what? A. Decreasing ability to focus and solve problems. B. Increased motivation to learn. C. Memory processing is quickly reviewed. D. Client wants to appear competent.
B
When the older adult faces illness, the greatest threat to health is: A. inability to respond to any stress and quickly deteriorating. B. loss of physiologic reserve of the organ systems. C. increased complications with decreased ability to participate in recovery activities. D. developing depression to a life-threatening situation with no desire to fight.
B
Which activity performed by an older adult client would make the client's family suspicious of the onset of dementia? A. The client's air conditioning is broken and he has not reported it. B. The client is an accountant and has had three episodes of bookkeeping errors. C. The client has not attended church services for one month. D. The client has become confused with medications since two new medications were added.
B
A nurse is preparing a presentation for a group of older adults about promoting safety while maintaining their mobility. Based on the nurse's understanding of factors placing the older adult at risk for falls, which area would the nurse most likely address? Select all that apply. A. hearing loss B. medication use C. diminished strength D. environmental hazards E. changes in bowel function
B,C,D
Most older adults gradually modify activities or lifestyle to accommodate for declines in strength and health. The nurse recognizes the need for older adults to maintain activity and exercise in order to preserve all physiologic functions. When encouraging activity, it is important to consider which of the following? Select all that apply. A. Pain is a normal consequence of aging. B. Chronic illness often accompanies aging. C. There is an increased risk of sleep disorders. D. Assistive devices help to maintain mobility and safety.
B,C,D
When describing the older adult's risk for infection, which aspect would the nurse most likely address? Select all that apply. A. enhanced immune function B. decline in humoral immunity C. lowered antibody responses D. inadequate nutrition E. maintenance of T-cell function
B,C,D
The nurse is planning an educational event for a group of senior citizens on the topic of the normal signs of aging. The nurse plans to discuss ways to prevent the problems associated with aging. Which healthy activity(ies) can a person begin before visiting the health care provider? Select all that apply. A. Taking a variety of daily vitamins and supplements B. Initiating good lifestyle habits including diet and exercise C. Following a routine disease prevention and treatment program D. Engaging in aerobic activities only to prevent injury E. Maintaining friendships and social activities
B,C,E
A nurse is providing care to an older adult with moderate cognitive impairment. When interacting with the client, which actions would be most appropriate? Select all that apply. A. Avoid identifying yourself each time. B. Call the client by name. C. Speak in a loud tone of voice. D. Use short, simple words when conversing with the client. E. Ask the client "Do you remember me?" when interacting
B,D
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? A. Have a colonoscopy every 10 years B. Obtain the zoster vaccine C. Perform self-examination of the skin every month D. Have a physical examination every 3 years
C
A home care nurse is making a home visit to a 78-year-old client being cared for by an adult child and in-law. The client has missed several follow up visits to the health care provider over the past several months. The client states, "My child is so busy. I do not want to bother him or her." When the nurse asks the adult child about the missed visits, the child replies, "My parent just saw the doctor a couple months ago. My parent does not need to see the doctor again. Besides, it costs too much money." What is the nurse's next course of action? A. Make an appointment to discuss concerns with the in-law. B. Encourage the client to stand up for oneself and insist on going to the appointments as scheduled. C. Report the neglect to the authorities. D. Give the adult child a 30-day warning to remedy the concern, or a report would be filed.
C
A new graduate nurse has accepted a staff position on a geriatric unit. The preceptor determines that the new nurse understands gerontologic nursing when which statement is made? A. "The focus of care for the elderly with chronic disorders should be on helping them through the acute disease process." B. "All older adult clients are treated the same. There are really no differences in care" C. "Normal changes that occur with aging result from complex interactions." D. "Gerontologic nursing is not a specialty area of nurse."
C
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? A. Implementing falls prevention measures in a setting where older adults receive care B. Providing slightly smaller servings of food for clients who are elderly C. Speaking to older adults with the presumption that they have mild cognitive deficits D. Assessing the skin turgor of an older adult differently than that of a younger adult
C
A nurse is assessing middle-age adults living in a retirement community. What behavior would the nurse typically see in the middle-age adult? A. Believes in establishment of self but fears being pulled back into the family B. Usually substitutes new roles for old roles and perhaps continues formal roles in a new context C. Looks inward, accepts life span as having definite boundaries, and has special interest in spouse, friends, and community D. Looks forward but also looks back and begins to reflect on his or her life
C
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? A. Immediately report the abuse to the state authorities. B. Educate the adult child on how to recognize and prevent elder abuse. C. Complete an elder abuse assessment by using an elder abuse screening tool. D. Educate the client on how to recognize and prevent elder abuse.
C
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? A. Observing client behavior to determine if coincides with report of pain B. Taking the clients vital signs to determine if indicative of pain C. Determining if the client is able to communicate pain verbally or nonverbally D. Obtaining family feedback about client's pain level
C
A nurse is providing discharge instructions to an elderly client and his daughter. The daughter asks for suggestions to help keep her father healthy. Which of the following could the nurse suggest? A. The daughter can talk to the client's physician about taking a vitamin B supplement. B. The client should have a physical examination every 3 years. C. The client should have his eyes examined every year for glaucoma. D. The client should limit carbohydrates in his diet.
C
A nurse is working with an older adult population at a local community senior center. Based on information from the Association of Aging, the nurse would anticipate needing to address which condition as most common? A. Cancer B. Diabetes C. Hypertension D. Arthritis
C
An elderly 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? A. Respite care B. Naturally occurring retirement communities (NORCs) C. Extended-care facility D. Accessory apartment
C
Erikson identified ego integrity vs. despair and disgust as the last stage of human development, which begins at about 60 years of age. Which intervention would best foster older clients' ego integrity? A. Distracting the client B. Praising the client C. Encouraging life review D. Promoting independent living
C
In 2014, what percentage of older adults resided in long-term care facilities? A. 2.5% B. 3.5% C. 3% D. 5.5%
C
The charge nurse in an extended-care facility knows that the new nurse understands ageism when she says which of the following? A. "Most older adults are lonely." B. "Older adults have incontinence." C. "Neither intelligence nor personality normally decline because of aging." D. "Older adults don't mind how they look."
C
The hospice nurse is visiting the spouse of a client who died 4 weeks prior. Which behavior by the spouse concerns the nurse? A. Cries when discussing the client's death B. Leaves the client's clothes untouched in the closet C. Voices the inability to leave the home without the client D. Keeps pictures of the client around at all times
C
The middle adult is sometimes called the "sandwich generation". According to Erikson, the developmental task of the middle adult is what? A. Initiative versus guilt B. Ego-integrity versus despair C. Generativity versus stagnation D. Goal attainment versus crisis
C
The nurse is assessing an older adult client who is having difficulty with mobility. Assessment reveals that the client has stiff and awkward muscle movements. The nurse identifies this as: A. hemiparesis. B. ataxia. C. spasticity. D. disequilibrium.
C
When providing nursing care to the elderly, it is most important to provide comfort due to which of the following changes? A. Dementia B. Isolation C. Thermoregulation D. Sexuality
C
A nurse is screening for Alzheimer disease (AD) in clients in a long-term care facility. Which facts regarding AD are accurate? Select all that apply. A. AD accounts for about one-third of the cases of dementia in the United States. B. AD primarily affects young to middle adults. C. Scientists estimate that more than 5 million people have AD. D. Nearly half of 85-year-old adults have AD E. AD affects brain cells and is characterized by patchy areas of the brain that degenerate. F. AD is a progressively serious but not a life-threatening disease.
C,D,E
A nurse is assessing a 55-year-old female client. What is a normal physical change in the middle adult? Select all that apply. A. Skin moisture increases. B. Hormone production increases. C. Hearing acuity diminishes. D. Cognitive ability diminishes. E. Cardiac output begins to decrease. F. There is a loss of calcium from bones.
C,E,F
A 79-year-old female is admitted to a long-term care facility. She is incontinent of urine and feces and has impaired cognition. What is the best nursing intervention to prevent skin breakdown for this resident? A. Turn her every hour when in bed B. Ask her to call the nurse when she feels the need for elimination C. Insert an indwelling catheter to prevent urine from causing skin breakdown D. Assist her to the toilet every 2 hours and after meals
D
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? A. Awakening more frequently B. Requiring longer time to fall asleep C. Napping during the daytime D. Feeling agitated and wakeful at night
D
A nursing student is studying depression in the elderly adult. Faculty members knows the student has mastered the information when she states which of the following? A. "Sadness is most often associated with suicidal intent." B. "Depression can resolve without treatment." C. "Depression is usually not accompanied by changes in behavior." D. "Treatment of depression includes counseling."
D
After graduation, if you especially want to care for the aged population, you would consider the nursing specialty that focuses on the health and illnesses of the aging. This specialty is: A. hospice nursing. B. geriatrics. C. long-term care. D. gerontologic nursing.
D
An older adult client comes to the clinic for his yearly influenza vaccination. During the visit he asks the nurse, "I've heard about this other vaccine for pneumococcal pneumonia. How often do I need to get this vaccine?" The nurse would encourage the client to receive this vaccination at which frequency? A. Every year B. Every other year C. Every 3 years D. Every 5 years
D
An older adult is admitted to the health care facility with a diagnosis of depression. The nurse would be especially alert for: A. poor cognitive performance. B. sleep problems. C. lack of initiative. D. suicidal thoughts.
D
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? A. Counseling a client who complains of being depressed B. Providing entertainment for a client on bedrest C. Arranging for social services to assist with meals for a homebound client D. Encouraging a client to have regular checkups
D
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? A. Delirium B. Depression C. Excessive drug use D. Alzheimer's disease
D
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? A. Home modification B. Assisted living C. A nursing home D. Homesharing
A
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? A. Annual screening after the age of 50 B. Endoscopic exam every year after 30 C. <20 g of fiber intake per day D. Administration of a stool softener daily
A
The geriatric nurse is evaluating a new nurse's understanding of the theories of aging. Which statement shows the new nurse understands the theories? A. "In the wear and tear theory, cells become exhausted from continual energy depletion." B. "In the cross-linkage theory, molecules with separated high-energy electrons can have adverse effects on adjacent molecules, especially lipids." C. "Free radical theory is a chemical reaction that produces damage to the DNA and cell death." D. "Immunosenescence is thought to be responsible for heart disease as adults age."
A
The nurse is assessing a middle-aged adult age 48 years in the clinic. The nurse recalls the changes that occur in middle age as they complete the physical and cognitive examination. Changes that occur include what? A. Cardiac output decreases. B. Loss of fatty tissue C. Low-pitched sounds are more difficult. D. Visual acuity changes with myopia.
A
The nurse is caring for an older adult client who reports an inability to sleep. Which medication on the client's medication administration record may be contributing to the client's sleep disturbance? A. Diphenhydramine hydrochloride B. Acetylsalicylic acid C. Omeprazole D. Sertraline hydrochloride
A
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? A. Being caught in the sandwich generation B. Retirement C. Losing driving privileges D. Social isolation
A
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? A. Listen to the client's stories and ask questions to facilitate ego integrity and provide companionship. B. Ask questions about the client's childhood and any unresolved relationship issues that may be preventing the client's peace and acceptance of the aging process. C. Ask family members to participate in activities that help the client remember important aspects of life and health so he/she can move through the final stages of aging. D. Encourage the client to talk about special life experiences so discussions regarding death and dying can be easier and can prepare the client for declining health.
A
The nurse practitioner is examining a 55-year-old female client. Which of the following findings would be uncommon for this age group? A. Lower extremity pulses are weak B. Presbyopia occurs C. Menopause occurs D. Agility gradually decreases
A
The student nurse is conducting an informal study on pain management in the older adult population in a local long-term care facility. Which older adult client population will the student most likely find to receive the least effective pain management? A. residents 85 years or older B. residents with a history of frequent hospital admissions C. white females D. residents with diabetes
A
There is an 86-year-old female on the medical inpatient unit. She explains that the hospital is quite noisy and that she is having difficulty sleeping. Which is not true regarding sleep in the older adult? A. Sleep medications are usually the first choice in treating sleep disturbance. B. Stage 1 sleep increases in the older adult. C. Deep sleep declines in the older adult. D. Chronic cardiovascular or respiratory illness can interfere with sleep.
A
Traumatic life events have had a damaging effect on a 55-year-old woman's psychosocial development in recent years. According to Erikson, a failure to achieve the tasks associated with middle adulthood may result in which of the following? A. An unhealthy fixation on her own needs and health B. Emotional detachment from her friends and family C. A loss of trust in her ability to manage relationships with older and younger generations D. A desire to establish new romantic relationships and validate her sexuality
A
What term is used to describe various disorders that progressively affect cognitive function? A. Dementia B. Ageism C. Reminiscence D. Delirium
A
When assessing a client during the middle adult years, the nurse recognizes which of the following as a normal physical change? A. Increased loss of calcium from the bones B. Increased levels of energy C. Increased oil levels in the skin D. Increased cardiac output
A
When creating a nursing care plan, what information should the nurse elicit from a client having difficulty sleeping? A. amount of caffeine consumed per day B. where the client has sexual intercourse C. when the client performs personal hygiene D. the client's family medical history
A
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? A. The client is oriented to person and place but is unsure of the month. B. The client states that his urine stream is less strong than in the past. C. The client claims to hear high-pitched sounds less clearly than earlier in life. D. The client's gait is slow and his posture appears stooped.
A
Which of the following health promotion measures should occur most frequently in older adult women? A. Fecal occult blood test B. Pelvic and Papanicolaou (Pap) exam C. Colonoscopy D. Tetanus booster
A
While assessing an older adult, the client reports pain resulting from shingles. The nurse identifies this as which type of pain? A. Postherpetic neuralgia B. Neuropathic pain C. Phantom limb pain D. Chronic pain
A
Based on Havighurst's theory of human development, which nursing intervention would best facilitate the accomplishment of a developmental task of older adulthood? A. Helping a client move independently using a walker B. Helping a client accept a move to live with a daughter C. Helping a client cope with living alone after the death of a spouse D. Helping a client become established in the community
A
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? A. Sleep deprivation B. Social isolation C. Grieving D. Noncompliance
A
A nurse is providing care to an older adult female diagnosed with incontinence. Diagnostic testing reveals that the incontinence is the result of an overactive detrusor muscle. The nurse identifies this as which type of incontinence? A. Urge B. Stress C. Overflow D. Functional
A
A public health nurse is participating in a health fair that is being held at a local community center. The nurse should encourage adult participants to completely eliminate which of the following from their diet and lifestyle? A. Smoking B. Alcohol C. Salt D. Cholesterol
A
An 85-year-old client's daughter calls the nurse and states her father is recently having periods of confusion, is unable to dress himself, and is having periods of incontinence. Which of the following should the nurse do first? A. Schedule an appointment for a physical examination B. Make arrangements for the client to move to an extended-care facility C. Teach the daughter how to use reminiscence as a therapy D. Perform a SPICES assessment
A
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? A. Delirium B. Dementia C. Disorientation D. Depression
A
An older adult client is prescribed a sleep medication. When explaining the medication to the client, the nurse would emphasize which aspect of therapy? A. greatest effectiveness with short term use B. minimal risk of adverse effects C. rare occurrences of confusion D. need for follow-up laboratory tests
A
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? A. Depression B. Generalized anxiety disorder C. Realistic caution D. Bipolar disorder
A
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? A. Blood vessels lose their elasticity with age. B. Systolic blood pressure decreases with age. C. Resting heart rate decreases with age. D. The cardiac output is increased with age.
A
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? A. Falls are the leading cause of death due to injury in individuals who are over the age of 75 years. B. An older adult experiences numerous factors that increase the risk for falls. C. Older adults are faced with challenges related to the fear of falling and striving for independence. D. Medications in the older adult play a major contributing role to the risk for falling.
A
A home care nurse is reviewing guidelines for health-related screenings with a 35-year-old patient. What are common screening recommendations for physical examinations? A. Every 3 years to age 40 and annually from age 40 B. Annual physical examinations from age 30 C. Every 2 years to age 50 and annually from age 50 D. Annual physical examinations from birth
A
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: A. abandonment. B. exploitation. C. neglect. D. emotional abuse.
A
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? A. Identity-continuity theory B. Disengagement theory C. Activity theory D. Life review theory
A
A nurse is preparing a presentation for families who are caring for older adults at home. Which information would the nurse most likely include about an older adult's cognition? A. Many older adults retain full cognitive function into advanced age. B. Dementia is considered a normal part of aging. C. Delirium is more common in middle-age adults. D. Aging normally leads to impairments in judgment and insight.
A
A older adult client is admitted to a nurse's unit with a community-acquired pneumonia requiring 14 days of intravenous antibiotic treatment. What does the nurse identify to the client as a contributing factor that affects the older adult client? Select all that apply. A. Humoral immunity declines. B. Older adults are more susceptible to pneumonia following respiratory infections. C. Nutrition contributes to immune system function in older adults. D. Alcoholism diminishes immune system function in older adults. E. Pneumonia is caused by polypharmacy in the older adult
A,B
An older adult client tells the nurse, "I just don't seem to have an appetite and food just doesn't taste as good as it used to." The nurse understands that which factor may be playing a role in this client's lack of appetite? Select all that apply. A. decreased number of taste buds B. decreased saliva production C. ill-fitting dentures D. missing teeth E. swallowing difficulties
A,B
An older adult is prescribed an antipsychotic. The nurse understands that this medication is used to treat which manifestation? Select all that apply. A. Delusions B. Hallucinations C. Feelings of hopelessness D. Suicidal ideation E. Excessive anxiety
A,B
A home care nurse is visiting one of her elderly clients. Which of the following does the nurse do to screen for chronic illnesses common to the elderly? Select all that apply. A. Monitor blood pressure B. Perform blood glucose monitoring C. Assess joint mobility and presence of pain D. Assess skin turgor E. Assess visual acuity
A,B,C
A nurse is assessing an older adult with impaired thinking, mood and communication. The nurse would expect to find that the client is most likely experiencing problems with which activity initially? Select all that apply. A. Shopping B. Managing finances C. Cooking D. Bathing E. Feeding F. Ambulating
A,B,C
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. A. evidence of depression B. use of appetite-suppressing drugs C. need for staff to assist with meals D. lack of exercise E. monotonous food choices
A,B,C
An older adult client comes to the senior center for a check-up. During the visit, the client tells the nurse that he knows he should be more active than he is. The nurse reinforces the client's statement, explaining that physical activity helps to lower the risk of which condition? Select all that apply. A. Heart disease B. Stroke C. Diabetes D. Anxiety E. Arthritis
A,B,C
An older adult client is placed on an inpatient unit following a minor stroke after moving in with an adult child recently. The client states to the nurse, I have difficulty finding meaning in life." The nurse suspects that the client is suffering from depression. Which factors may contribute to this client's depression? Select all that apply. A. The depression may have gone undetected since it is an under diagnosed disorder. B. The stroke may be a contributing factor. C. A recent change in living environment can cause depression. D. Older men often are at risk for suicide E. All older adults go through a period of depression
A,B,C
The nurse is assigned to care for a client age 87 years admitted to the medical unit for congestive heart failure. It is the fourth hospital day, and the response to treatment has been good. The client is no longer short of breath and the lung sounds are clearing. There is still a diet restriction of decreased sodium and fluids are limited to no more than 1000 mL per day. The nurse is preparing the client and family for discharge. The nurse's discharge education, in order to promote the older client's health, will include which instructions? Select all that apply. A. Gradually increase activities as tolerated. B. Do not use the salt shaker at meals. C. Increased stress may interfere with recovery. D. Take several naps during the day.
A,B,C
A nurse is participating in a health fair for older adults. The nurse would recommend routine screenings for which conditions for this population? Select all that apply. A. Breast cancer B. Colorectal cancer C. Osteoporosis D. Diabetes E. Renal failure
A,B,C,D
A nurse is caring for an older adult client who fell and sustained a hip fracture. Which intervention needs to be included in the nursing care plan? Select all that apply. A. Cough and deep breathe every 2 hours. B. Avoid massaging over bony prominences. C. Turn the client every 4 hours. D. Auscultate breath sounds every 1-2 hours. E. Monitor daily weights.
A,B,D
When providing care to a client with dementia, which interventions would be most appropriate? Select all that apply. A. maintain levels of sensory stimulation that are tolerable B. ensuring the use of assistive sensory devices C. employing reality orientation D. using validation therapy E. continually correcting the client for mistakes
A,B,D
A nurse is conducting an education session about appropriate measures to promote sleep with an older adult who is experiencing frequent awakenings at night and then awakening early in the morning. The nurse determines that the education was successful when the client states: A. "I should do some mild exercises about 2 hours before bedtime." B. "I need to try and go to bed and get up at the same time each night." C. "I should continue to take my sleep medication for as long as I need to." D. "I should avoid coffee, but tea is okay to drink before bed."
B
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? A. Old age begins at age 65. B. Personality is not changed by chronologic aging. C. Most older adults are ill and institutionalized. D. Intelligence declines with age.
B
A nurse is caring for a 46-year-old male client who is being treated for depression following the death of his spouse. Which action best facilitates the accomplishment of a developmental task of this middle adult? A. encouraging him to start dating again to find a life partner B. helping him to see the value of guiding his children to become responsible adults C. helping him to establish a social network within the community D. encouraging the formation of a personal philosophical and ethical structure
B
