chp 8 med surg

The client asks the nurse why she seems to have bone changes since she has gotten older. What is the best response by the nurse? "Bone changes from aging result from a loss of vitamin absorption." "Bone changes from aging result from most medication therapies." "Bone changes from aging result from a loss of magnesium." "Bone changes from aging result from a loss of calcium."

"Bone changes from aging result from a loss of calcium."

The nurse notes that an older adult adds salt to all foods before eating a meal. Which question would the nurse ask this client? "Don't you know that adding salt to your food is bad for you?" "Does the extra salt help with the dry mouth that older adults experience?" "Have you tried adding herbs, garlic, or lemon to foods for added flavor?" "Are you unable to taste the flavor of salt anymore?"

"Have you tried adding herbs, garlic, or lemon to foods for added flavor?"

After teaching an older adult about measures to relieve constipation, which statement by the client indicates a need for additional teaching? "I'll make sure that I drink plenty of fluids each day." "I should use a laxative every other day." "I need to avoid foods that are high in fat." "I'm going to start walking every day for exercise."

"I should use a laxative every other day."

The nurse caring for residents of a long-term care facility is explaining the occurrence of elder abuse in such facilities. Which statement from the nurse indicates the need for more education? "Older adults in long-term care facilities are at low risk for elder abuse." "Most states requires nurses to report elder abuse." "Limitations to activities of daily living contribute to risk of elder abuse." "Older adults with disabilities are at increased risk for elder abuse."

"Older adults in long-term care facilities are at low risk for elder abuse."

An older adult develops sudden onset of confusion and is hospitalized. The family expresses concern that their loved one is developing Alzheimer disease. What response by the nurse is most appropriate? "What concerns you most about Alzheimer disease?" "Several possible underlying factors could be causing the confusion. Alzheimer's usually does not present with sudden confusion." "Once the underlying cause of the confusion is found and treated, your loved one will be better than ever." "Alzheimer disease can be a great burden on the family. What community resources do you know about?"

"Several possible underlying factors could be causing the confusion. Alzheimer's usually does not present with sudden confusion."

A client with Alzheimer's disease is prescribed donepezil hydrochloride. When teaching the client and family about this drug, which of the following would the nurse include? "The client need to take this drug for the rest of his or her life." "The drug helps to control the symptoms of the disease." "Once it becomes effective, you can stop the drug." "This drug will help to stop the disease from getting worse."

"The drug helps to control the symptoms of the disease."

A nurse is caring for a client with dementia. A family member of the client asks what the most common cause of dementia is. Which response by the nurse is most appropriate? "Dementia is a terrible disease of the elderly." "Depression may manifest as dementia in elderly clients." "The most common cause of dementia in the elderly is Alzheimer's disease." "Drug interactions are the most common cause of dementia in the elderly."

"The most common cause of dementia in the elderly is Alzheimer's disease."

An older female client is concerned because of experiencing vaginal bleeding after having intercourse. Which response will the nurse make to this client? "Bleeding after intercourse results from a thickening of the vaginal walls." "The vaginal tissues are dryer with aging." "Testing for a sexually transmitted infection is needed." "Intercourse should be avoided at your age."

"The vaginal tissues are dryer with aging."

An older adult female has been widowed for several years. Which statements indicate to the nurse that the client may need to consider a change in living arrangements? Select all that apply. "I attend religious services twice a week at my church." "I don't like to cook for myself anymore." "My granddaughter helps me with my laundry." "I have coffee with my neighbor every morning." "There is no one to talk to most days of the week."

"There is no one to talk to most days of the week." "I don't like to cook for myself anymore."

Which is a true statement regarding pharmacologic aspects of aging? Elderly have a decreased percentage of body fat. Absorption may be affected by changes in gastric pH. Potential for drug-drug reactions decreases with the number of drugs prescribed. Aged population tends to be compliant with their medication regimen.

Absorption may be affected by changes in gastric pH.

A client reports to the nurse that over the past few months the elderly mother has become increasingly angry, responds inappropriately to conversations, and does not respond to calls if her back is turned away. What is the nurse's best response? Tell the client it appears the mother has a hearing loss. Inform the client to ignore the behavior and the mother will stop. Teach the client techniques for coping with the mother's anger. Ask if the mother could come in for a hearing evaluation.

Ask if the mother could come in for a hearing evaluation.

An older adult seeks medical attention for a new onset of epigastric distress and bilateral arm pain. Which action will the nurse complete? Encourage the client to ambulate. Recommend taking an over-the-counter antacid. Assess cardiovascular function. Review the contents of the client's most recent meal.

Assess cardiovascular function.

The nurse is preparing an elderly hospitalized client for discharge to home within the hour. What should be the priority for the nurse? Administer intravenous morphine for report of postoperative pain. Encourage physical activity of 30 minutes following breakfast daily. Assess the need for pneumococcal and influenza vaccinations. Instruct the client to receive at least 1 hour of sun exposure each day.

Assess the need for pneumococcal and influenza vaccinations.

The nurse is preparing a teaching tool on promoting gastrointestinal health for a senior center. Which information will the nurse include? Select all that apply. Drink adequate fluids. Lie flat after eating. Avoid the use of laxatives and antacids. Eat small, frequent high-fiber low-fat meals. Brush the teeth and floss regularly. Follow meals with activity.

Brush the teeth and floss regularly. Avoid the use of laxatives and antacids. Eat small, frequent high-fiber low-fat meals. Drink adequate fluids.

An elderly client reports fatigue without shortness of breath with walking 30 minutes five times each week. The nurse assesses the resting heart rate as 72 beats per minute; 10 minutes after walking, the client's heart rate is 92 beats per minute. What should the nurse instruct the client to do next? Increase walking at a faster pace. Decrease walking frequency to three times each week. Continue to walk at his current level. Refrain from any form of exercise.

Continue to walk at his current level.

A nurse is assessing an elderly client with senile dementia. Which neurotransmitter condition is most likely to contribute to this client's cognitive changes? Increased acetylcholine level Increased norepinephrine level Decreased acetylcholine level Decreased norepinephrine level

Decreased acetylcholine level

The nurse is assessing a 78-year-old woman and suspects that the patient may have age-related macular degeneration. Which assessment finding would most likely support this suspicion? Loss of gross detail discrimination Decreased peripheral vision Decreased ability to see all objects Diminished color perception

Diminished color perception Age-related macular degeneration affects central vision, not peripheral vision. It also affects color perception and fine detail discrimination, affecting common visual skills such as reading, driving, and seeing faces.

Which action by the nurse demonstrates ageism? Providing the same high quality of care to all clients Directing all health decisions to the older adult's child Allowing adequate time for the older adult to complete tasks Encouraging the older adult to develop routines not associated with work

Directing all health decisions to the older adult's child

A nurse is teaching nursing assistants in an extended-care facility measures to protect the skin of elderly clients. Which of the following measures is the nurse likely to recommend? Taking the clients outside for sun exposure daily Instructing clients to use perfumed skin creams Encouraging clients to avoid cigarette smoking Assisting clients to soak in the bathtub several times each week

Encouraging clients to avoid cigarette smoking

An older adult with mild confusion lives with a family member who needs to attend work every day. Which suggestion will the nurse make to the family member to ensure the client's safety? Ask a neighbor to watch the client during the day. Contact a home health care agency. Enroll in an adult day care facility. Hire a home health aide.

Enroll in an adult day care facility.

A client has recently brought her elderly mother home to live with her family. The client states that her mother has moderate Alzheimer's disease and asks about appropriate activities for her mother. The nurse tells the client to Turn off lights at night so that the mother differentiates night and day. Allow the mother to smoke cigarettes outside on the porch without supervision. Ensure that the mother does not have access to car keys or drive an automobile. Encourage the mother to take responsibility for cooking and cleaning the house.

Ensure that the mother does not have access to car keys or drive an automobile.

When assessing an older adult's gastrointestinal system, the nurse would identify an increase in which of the following as normal? Gastric motility Stomach emptying Feeling of fullness Calcium absorption

Feeling of fullness

The family of an older adult seeks medical attention for the client because of an increase in inappropriate responses and avoidance of social interactions. On which body area will the nurse focus when assessing the client? Hearing Genitourinary system Respiratory system Digestion

Hearing

An older adult voids a small amount of urine in the toilet but experiences a large volume of incontinence while walking back to the bed. Which nursing intervention would be appropriate for this client? Show disapproval to help prevent reoccurence. Remind the client to verbalize toileting needs. Provide education about medications to treat this problem. Implement a prompted, timed voiding schedule.

Implement a prompted, timed voiding schedule.

The nurse identifies which of the following as an age-related change in the respiratory system? Increased residual lung volume Increased diffusion capacity Increased cough efficiency Increased vital capacity

Increased residual lung volume

An elderly client exhibits blood pressure of 110/76 while prone, 100/72 sitting, and 92/64 standing. The nurse instructs the client to Ingest five or six small meals each day. Take daily hot showers. Minimize the use of stool softeners. Use whirlpool baths for relaxation.

Ingest five or six small meals each day. A client who experiences orthostatic hypotension should eat five or six small meals to minimize hypotension that can occur after large meals. The client should avoid straining when having a bowel movement. A stool softener would be useful. Hot showers and whirlpools should be avoided.

The nurse is describing hospice services to the family of a patient with end-stage heart failure. Which of the following would the nurse be least likely to include as a major focus of care? Invasive therapy Emotional support Symptom management Pain control

Invasive therapy

An elderly female client has been taking prednisone for breathing problems for many years. The nurse notes that the client's current height is 64 inches. Two years ago, her height was 66 inches. The nurse assesses this loss in height is most likely the result of Decreased muscle mass and joint cartilage Loss of bone density Degeneration in the efficiency of bone joints The client's failure to exercise

Loss of bone density

A department of nursing within a health care organization is adopting the Functional Consequences Theory when caring for older adults. Which action would the nurse take to faciliate using this theory when caring for a client? Identify reasons for changes in musculoskeletal function. Recognize that immune system changes cannot be altered. Establish improvement of cognitive function as the overall goal of care. Plan interventions to address consequences of age-related changes.

Plan interventions to address consequences of age-related changes.

An older adult seeks medical attention for a new onset of rectal bleeding. For which reason will the nurse perform a complete physical assessment with the client? Older adult clients may be poor historians of symptoms More than one body system may be affected The bleeding may be coming from another body orifice The symptom of rectal bleeding is vague

More than one body system may be affected

An older adult was diagnosed with Alzheimer disease 2 years ago and the disease has progressed at an increasing pace in recent months. The client has lost 7.5 kg (16 pounds) over the past 3 months, leading to a nursing diagnosis of Imbalanced Nutrition: Less than Body Requirements. What intervention should the nurse include in this client's plan of care? Offer the client only one food item at a time to promote focused eating. Arrange for insertion of a gastrostomy tube and initiate enteral feeding. Offer the client bland, low-salt foods to limit offensiveness. Offer the client rewards for finishing all the food on her tray.

Offer the client only one food item at a time to promote focused eating.

The reason that governments carefully regulate treatment given in licensed health care facilities, particularly long-term care facilities, is expressed by which statement? Clients are unable to make any health care decision. Older adult clients are vulnerable. Clients lack different perspectives. Clients lack capacity because of cognitive impairment.

Older adult clients are vulnerable.

A client with moderate Alzheimer's disease has been eating poorly, losing weight, and playing with food at meals. The nurse best intervenes by Converting liquid foods to a gelatin texture Cutting the client's food into small pieces Serving hot foods at a warm temperature Placing one food at a time in front of the client during meals

Placing one food at a time in front of the client during meals

An elderly client recovering from a hip repair becomes disoriented and tries to get out of bed frequently. The client states, "I forget I am in the hospital." The best nursing intervention is to Place the client in a Posey chest restraint with ties attached to the bed frame. Administer an oral dose of prescribed alprazolam (Xanax). Post a sign stating "You are in the hospital" at the client's eye level. Raise the upper and lower side rails of the bed.

Post a sign stating "You are in the hospital" at the client's eye level.

Which refers to the decrease in lens flexibility that occurs with age, resulting in the near point of focus getting farther away? Cataract Presbyopia Presbycusis Glaucoma

Presbyopia

Which refers to the decrease in lens flexibility that occurs with age, resulting in the near point of focus getting farther away? Cataract Presbyopia Glaucoma Presbycusis

Presbyopia Presbyopia usually begins in the fifth decade of life, when reading glasses are required to magnify objects. Presbycusis refers to age-related hearing loss. Cataract is the development of opacity of the eye lens. Glaucoma is a disease characterized by increased intraocular pressure.

A female elderly client tells the nurse she experiences vague pain during sexual intercourse with her spouse. It is best for the nurse to Assess sexual positions the couple uses during intercourse. Instruct the client to use a water-soluble lubricant before sex. Refer the client to a gynecologist for evaluation. Inform the client about vaginal estrogen-replacement therapy.

Refer the client to a gynecologist for evaluation.

Which is a factor that contributes to urinary incontinence in older female adults? Relaxed perineal muscle Increased bladder capacity Decreased urinary residual Detrusor stability

Relaxed perineal muscle

The nurse is attempting to take vital signs of an older adult hospitalized following knee surgery. The client continuously yells, "It's 1999 and you are going to hurt me!" What action should the nurse do first? Assess for infection. Take the vital signs. Notify the physician. Reorient the patient.

Reorient the patient.

When assessing an older adult, the nurse anticipates an increase in which component of respiratory status? Residual lung volume Gas exchange and diffusing capacity Cough efficiency Vital capacity

Residual lung volume

A client with Alzheimer's disease is admitted for hip surgery after falling and fracturing the right hip. The client's spouse tells the nurse about feeling guilty for letting the accident happen and reports not sleeping well lately because the spouse has been getting up at night and doing odd things. Which nursing diagnosis is most appropriate for the client's spouse? Risk for caregiver role strain related to increased client care needs Defensive coping related to diagnosis of Alzheimer's disease Relocation stress syndrome related to hospitalization Decisional conflict related to lack of relevant treatment information

Risk for caregiver role strain related to increased client care needs

A nurse is caring for a client with dementia. A family member of the client asks what the most common cause of dementia is. Which response by the nurse is most appropriate? "Dementia is a terrible disease of the elderly." "Depression may manifest as dementia in elderly clients." "The most common cause of dementia in the elderly is Alzheimer's disease." "Drug interactions are the most common cause of dementia in the elderly."

Take calcium and vitamin D supplements daily. Obtain the prescribed bone density screening. Increase intake of foods that are high in calcium.

An older adult who is becoming increasingly debilitated refuses to move to an assisted living facility as suggested by an adult child who lives out of state. Which recommendation will the nurse consider to address this situation? The older client can move in with the adult child The adult child can hire caregivers for the older parent The adult child can move in with the parent The older client's grandchildren can move in with the client

The adult child can hire caregivers for the older parent

Which is an accurate rationale for why older adults are more susceptible to serious infections? They do not have easy access to antibiotics. They have less efficient defense mechanisms. They have increased social contact. They are less aware of how to control infections.

They have less efficient defense mechanisms.

The nurse brings the older adult patient a dinner tray and observes the patient placing excess amounts of salt on the food. What suggestions for flavoring can the nurse provide to decrease the amount of salt the patient is placing on her food? (Select all that apply.) Use pepper instead of salt. Use an alcohol-based mouthwash prior to eating. Use lemon instead of salt to flavor food. Use low-sodium herbs and spices. Drink water before the meal.

Use pepper instead of salt. Use lemon instead of salt to flavor food. Use low-sodium herbs and spices.

A nurse is providing a fall prevention clinic for a group of older adults. What information should the nurse include? Select all that apply. Frequently change the furniture layout in the home Have routine vision and hearing screenings Review medications routinely for side effects Place grab bars in the shower and tub Wear nonslip shoes or socks when walking Use scatter rugs on hard wood surfaces.

Wear nonslip shoes or socks when walking Review medications routinely for side effects Place grab bars in the shower and tub Have routine vision and hearing screenings

A client reports to the nurse that her mother had macular degeneration and is concerned that she, too, may be at risk. What should the nurse tell the client? Wear sunglasses with ultraviolet (UV) protection when outside. Reduce the amount of cigarettes smoked daily from 20 to 10. This condition is now curable. Vision loss is not hereditary. It is related to diet.

Wear sunglasses with ultraviolet (UV) protection when outside.

An age-related change associated with the cardiovascular system is thinner heart valves. decreased blood pressure. decreased cardiac output. increased compliance of heart muscle.

decreased cardiac output.

A nurse is preparing a presentation for a local senior center about the health status of older adults. What trends in health promotion and disease prevention activities would the nurse explain as contributing to declining death rates in the older adult population? Select all that apply. decreased community-based services decreased exercise screening for hypertension improved nutrition early detection of elevated cholesterol levels decreased smoking

decreased smoking improved nutrition screening for hypertension early detection of elevated cholesterol levels

A client in a nursing home is diagnosed with Alzheimer's disease and is exhibiting the following symptoms: difficulty with recent and remote memory, apraxia, irritability, depression, restlessness, difficulty swallowing, and occasional incontinence. What stage of Alzheimer's disease should the nurse describe the client? end- stage early middle late

middle

The nurse is preparing a teaching tool that focuses on elder abuse. Which type of abuse will the nurse highlight as being the most common? physical emotional neglect financial

neglect

To encourage adequate nutritional intake for a client with Alzheimer's disease, a nurse should: help the client fill out his menu. stay with the client and encourage him to eat. give the client privacy during meals. fill out the menu for the client.

stay with the client and encourage him to eat.