Geri exam chapters 12-18
The nurse can place an older adult into one of four patient rooms. Which is the most suitable room for an older adult? a. Brightly lit, blue room with cozy throw rugs b. Room with orange carpeting and soft lighting c. Brightly lit, blue room with waxed vinyl floors d. Room for television and children's playtime
b. Room with orange carpeting and soft lighting
A large residual urine volume characterizes what type of incontinence? a. Urge b. Stress c. Overflow d. Functional
c. Overflow
Each of the following is a pharmacologic intervention for pain except which one? a. Acupuncture treatments b. Adjuvant therapy c. Lidocaine patch d. Capsaicin
a. Acupuncture treatments
An older person is admitted to the hospital with an exacerbation of congestive heart failure. The nurse notes that the patient complains of severe itching at night and has a red rash on her torso. The patient is diagnosed with scabies. The patient asks the nurse, "How did I get something like this?" The best response by the nurse is: a. "Scabies is highly contagious and spreads easily through physical contact." b. "Scabies is commonly seen in older adults due to normal age-related changes in the skin." c. "Scabies is only seen in older adults who have multiple chronic illnesses." d. "Certain medications can make you more susceptible to contracting scabies."
a. "Scabies is highly contagious and spreads easily through physical contact."
An older patient asks a nurse, "I really have trouble sleeping, and my doctor does not want to prescribe a sleeping pill for me. He says they are not good for older people. I really don't understand his response. Can you help me?" The best response by the nurse is: a. "Sleeping medications have many adverse effects in older people and only have minimal effects in improving sleep." b. "Prescription sleeping medications have many adverse effects in older people. Why don't you try using an over-the-counter medication?" c. "Sleeping medications do not provide any improvement in sleep for older people." d. "Sleep problems are common in older people. There really is nothing that you can do to help with that."
a. "Sleeping medications have many adverse effects in older people and only have minimal effects in improving sleep."
A 75-year-old woman asks a nurse, "I know I should be moving, but how much is the right amount of exercise for me?" The best response of the nurse is: a. "You need to engage in 30 minutes of moderate intensity exercise on at least 5 days a week." b. "You need to engage in at least 30 minutes of moderate-intensity exercise every day of the week." c. "Because you are 75 years old, the recommendation is for 30 minutes of moderate-intensity exercise three times a week." d. "There are no specific recommendations for someone of your age; just keep moving."
a. "You need to engage in 30 minutes of moderate intensity exercise on at least 5 days a week."
A nurse will be conducting an education session at the local senior citizen's center on the importance of physical activity. Which activities should the nurse include as an example of moderate-intensity aerobic activity? (Select all that apply.) a. Biking b. Range of motion (ROM) c. Weight lifting d. Dancing
a. Biking d. Dancing
The nurse monitors for which clinical indicator when the older adult complains of pruritus? a. Coarse skin b. Brown macule c. Brownish skin d. Regional edema
a. Coarse skin
An older adult who is on bed rest after surgery is prescribed morphine for pain. Which of the following is the nurse's priority for preventive care? a. Constipation b. Diarrhea c. Poor solid food intake d. Poor liquid intake
a. Constipation
Which of the following is a true statement about elimination in older adults? a. Defecation less than once each day is not necessarily constipation. b. Mineral oil is recommended as a laxative for older adults. c. Excessive sleep can be a symptom of constipation. d. Leaking liquid feces should be treated as diarrhea.
a. Defecation less than once each day is not necessarily constipation.
The nurse identifies which of the following interventions in the treatment of fungal infections? (Select all that apply.) a. Eliminate the conditions that created the problem. b. Lubricate the affected area daily with moisturizing lotion. c. Thoroughly clean and dry the skin daily. d. Use an antibacterial cleanser daily. e. Apply miconazole (Micatin) as directed.
a. Eliminate the conditions that created the problem. c. Thoroughly clean and dry the skin daily. e. Apply miconazole (Micatin) as directed.
Which option is part of a program that addresses bowel incontinence in an older adult patient? a. Ensuring that a toilet or commode is readily accessible to the patient b. Encouraging the intake of 1 L of water every day c. Expecting a rapid and full recovery d. Toileting the patient 10 to 15 minutes after meals
a. Ensuring that a toilet or commode is readily accessible to the patient
Which of the following are assessed in a fall prevention assessment of an older adult? (Select all that apply.) a. Environment b. Physical status c. Financial status d. Functional status e. Medical history f. Occupational history
a. Environment b. Physical status d. Functional status e. Medical history
Long-term use of external catheters can lead to which complications? (Select all that apply.) a. Fungal skin infections b. Penile skin maceration c. Atrophy d. Edema e. Phimosis
a. Fungal skin infections b. Penile skin maceration d. Edema e. Phimosis
The nurse plans care to prevent a dangerous thermal environment for an older man who lives in a northern climate of the United States. Which patient assessment data does the nurse recognize that can contribute to his risk of hypothermia? (Select all that apply.) a. Has a history of a cerebrovascular accident (CVA) b. Has a history of diabetes mellitus c. Builds miniature cars for a hobby d. Bathes three to four times a week e. Gets heat from a boiler in the cellar f. Becomes diaphoretic on warm days
a. Has a history of a cerebrovascular accident (CVA) b. Has a history of diabetes mellitus c. Builds miniature cars for a hobby e. Gets heat from a boiler in the cellar
An older woman has diabetes mellitus. Which patient assessment validates the nurse's conclusion that she is in the foreground perspective of the shifting perspectives model of chronic illness? a. Has an amputation of two toes b. Lives at home with her husband c. Frequently self-checks her blood sugar d. Changes the battery in her glucometer
a. Has an amputation of two toes
A group of older women in an assisted living facility are talking about one of the residents who fell and fractured her hip. The women ask a nurse the following: "It seems like so many of us fall and break our hips, and then it is downhill from there. Is this really true?" In formulating a response, the nurse considers which of the following? (Select all that apply.) a. Hip fractures are a leading cause of hospitalization for older people. b. The major cause of hip fractures is falls. c. Women have significantly higher mortality rates from hip fractures than do men. d. Nearly all older patients who sustain a hip fracture will regain prefracture mobility status within 1 year. e. Hip fractures are associated with very high morbidity and mortality rates.
a. Hip fractures are a leading cause of hospitalization for older people. b. The major cause of hip fractures is falls e. Hip fractures are associated with very high morbidity and mortality rates.
An older woman had hip replacement surgery 1 day ago, and the nurse thinks that the woman also has dementia. Which patient assessment does the nurse use to determine whether this woman is experiencing pain? a. Holds her abdomen tightly b. Has stable vital signs c. Is not verbalizing d. Moves during sleep
a. Holds her abdomen tightly
More than 50% of the population aged 65 years and older has which one of the following chronic health conditions? a. Hypertension b. Renal failure c. Multiple sclerosis d. Cancer
a. Hypertension
The nurse plans care to protect the skin covering an older adult's greater trochanter. Which of the following interventions is the nurse's priority when the older adult is positioned on the side? a. Implement a turning schedule. b. Place a cushion between the knees. c. Keep the skin clean and dry. d. Use the Sims' position.
a. Implement a turning schedule.
During the night, an older woman complains to the nurse that she has not slept more than 2 hours since admission to the hospital. Which intervention should the nurse implement to increase the duration of this woman's sleep? a. Inquire about her sleep habits used at home. b. Suggest that she avoid napping during the day. c. Tell her that sleep is fragmented in older people. d. Offer a book to her or suggest watching a movie.
a. Inquire about her sleep habits used at home.
An older man has Alzheimer's disease, and his wife says he is up and wandering around the house at night. Which intervention should the nurse implement to increase the man's duration of sleep? a. Instruct the wife to increase his daily physical activity. b. Collaborate with the health care provider to administer a hypnotic medication. c. Teach the wife how to apply a vest restraint during sleep. d. Help the wife plan daily periods for napping and activity.
a. Instruct the wife to increase his daily physical activity.
A nurse is caring for a frail older adult in a long-term care facility and is concerned about preventing hypothermia. Which of the following interventions should the nurse implement? (Select all that apply.) a. Make sure that the temperature in the resident's room is at least 65 °F. b. Cover residents well when in bed and while bathing. c. Provide a head covering for the resident. d. Maintain resident in bed covered with heavy blankets at all times. e. Provide hot, high-protein meals and bedtime snacks.
a. Make sure that the temperature in the resident's room is at least 65 °F. b. Cover residents well when in bed and while bathing. c. Provide a head covering for the resident. e. Provide hot, high-protein meals and bedtime snacks.
For which of the following conditions does the nurse identify the patient as at risk for developing fungal infections? (Select all that apply.) a. Obesity b. Multiple sclerosis c. Impaired mental status d. Incontinent e. Bedridden
a. Obesity d. Incontinent e. Bedridden
A home care nurse in an area of the country that is prone to tornadoes routinely discusses disaster preparedness with older adult clients. What is the primary rationale for this intervention? a. Older adults are less likely to seek formal and informal help when affected by natural disasters. b. The older adult is more likely to live in a communal environment that provides assistance in times of natural disasters. c. Most older adults have insurance to help them recover from material losses because of a natural disaster. d. Federal and private assistance agencies generally provide older adults with priority attention in time of natural disasters.
a. Older adults are less likely to seek formal and informal help when affected by natural disasters.
Which factors in the patient care environment should be routinely assessed to decrease the risk of falls? (Select all that apply.) a. Outdoor grounds b. Appropriate footwear c. All four bed rails raised d. Grab bars in place
a. Outdoor grounds b. Appropriate footwear d. Grab bars in place
Which of the following statements are true about pain in older adults? (Select all that apply.) a. Pain is not a normal aging process. b. Pain sensitivity decreases with age. c. If patients do not complain, they do not have pain. d. Opioid analgesics are often the best treatment for persistent pain.
a. Pain is not a normal aging process. d. Opioid analgesics are often the best treatment for persistent pain.
A nurse will be conducting an educational session on preventing skin cancer at a local senior citizen's center. Which should the nurse include in the session? a. Squamous cell cancer may appear similar to a wart. b. Basal cell carcinoma is more common in women. c. Actinic keratosis begins as a pearly papule. d. Melanoma is characterized by rough, scaly patches.
a. Squamous cell cancer may appear similar to a wart.
Although intact skin effectively protects an individual, it functions within physiological limits. Which qualities of healthy skin work synergistically within these limits to absorb, cushion against, deflect, or neutralize potentially harmful forces, as well as protect against potentially harmful substances that might impair skin integrity? (Select all that apply.) a. Strength b. Pliability c. Location d. Durability e. Moistness f. Pigmentation
a. Strength b. Pliability d. Durability
An older woman presents to the geriatric clinic for a routine annual wellness visit. Upon assessment, the patient reports that she needs to wear a pad because she loses urine when she coughs and sneezes. She also reports that this happens when she picks up her 2-year-old grandson. The nurse suspects which type of urinary incontinence? a. Stress b. Overflow c. Functional d. Urge
a. Stress
Which assessment finding is a contributor to an older client's risk for falls? (Select all that apply.) a. The client is awaiting cataract surgery on right eye. b. The client type 2 diabetes is poorly controlled with diet and exercise alone. c. The client reports a fall in the past year. d. The client has a history of contact dermatitis and psoriasis. e. The client attends Tai Chi classes at the senior center.
a. The client is awaiting cataract surgery on right eye. b. The client type 2 diabetes is poorly controlled with diet and exercise alone. c. The client reports a fall in the past year.
Which of the following is a true statement about sleep in older adults? a. The time spent in bed increases, but the time spent asleep decreases. b. The amount of leg movement during sleep remains steady throughout life. c. Rapid eye movement (REM) sleep becomes more unevenly distributed with age. d. The amount of stage III sleep increases steadily throughout life.
a. The time spent in bed increases, but the time spent asleep decreases.
Which action should be included in all bladder-retraining programs? a. Toileting at bedtime b. Using adult incontinence pads c. Toileting every hour d. Providing 1000 mL of fluids daily
a. Toileting at bedtime
Continuous indwelling catheter use is indicated for which conditions? (Select all that apply.) a. Urethral obstruction b. Urinary retention c. Stress incontinence d. Severely impaired skin integrity e. Gait impairment
a. Urethral obstruction b. Urinary retention d. Severely impaired skin integrity
A nurse is conducting education on urinary incontinence at a senior center. The nurse is discussing lifestyle changes that are associated with an improvement in urinary incontinence. The nurse includes which of the following interventions? (Select all that apply.) a. Weight reduction b. Smoking cessation c. Increase in physical activity d. Fluid restriction e. Blood sugar control
a. Weight reduction b. Smoking cessation c. Increase in physical activity
The nurse will be educating a group of senior citizens on adaptations for safer driving. Which adaptations should the nurse include? (Select all that apply.) a. Wide rear-view mirrors b. Pedal extensions c. Global positioning system (GPS) devices d. Antiroll bars
a. Wide rear-view mirrors b. Pedal extensions c. Global positioning system (GPS) devices
An older adult who has a balance disorder and has sustained repeated falls is recommended to start an exercise program. Which of the following exercises would be most beneficial in improving balance in this individual? (Select all that apply.) a. Yoga b. Tai Chi c. Swimming d. Pilates e. Weight lifting
a. Yoga b. Tai Chi
A homecare nurse visits an older patient who lives in a smart medical home community environment. The nurse understands that smart homes are: a. an emerging technology to enhance safety of older adults by using environmental control systems. b. an assistive technology that keeps data on vital signs, gait, behavior, and sleep without providing an interactive medical-advising system. c. an emerging technology to aid in the prevention and later detection of disease through the use of sensors and monitors. d. elder-friendly communities where residents participate in the design and operation of the home.
a. an emerging technology to enhance safety of older adults by using environmental control systems.
Benefits of telehealth include that it (Select all that apply.) a. promotes self-management of illness in rural and underserved areas. b. facilitates remote physical assessment and monitoring of chronic conditions. c. decreases costs by replacing the role of the nurse with technology. d. decreases costs by reducing hospital readmissions. e. is reimbursed by all health care insurance plans.
a. promotes self-management of illness in rural and underserved areas. b. facilitates remote physical assessment and monitoring of chronic conditions. d. decreases costs by reducing hospital readmissions.
A nurse is admitting and orienting an older adult to the hospital unit. She discusses fall prevention and demonstrates the use of the call bell to the patient. The patient's daughter asks: "Why don't you just put up all the side rails to prevent my mother from getting out of bed by herself and falling? That should work, right?" The best response by the nurse is: a. "Side rails have only proven to be effective in decreasing falls in patients who have already fallen." b. 'There is no evidence that side rail use decreases falls, and in fact there is a greater risk of injury." c. "Side rails are only effective when used with patients who have dementia" d. "Side rails do not decrease falls, but they do decrease fall-related injuries."
b. 'There is no evidence that side rail use decreases falls, and in fact there is a greater risk of injury."
An older adult admitted for back surgery asks for opioid pain medication. The nurse knows the patient asks for pain medication 15 minutes before it is due. Which recommendation should the nurse implement? a. Validate the pain with other assessment data. b. Administer the pain medication as requested by the patient. c. Tell the patient that it is too soon for pain medication. d. Teach the patient alternative comfort measures.
b. Administer the pain medication as requested by the patient.
The nurse at an assisted-living facility uses the Exercise and Screening for You (EASY) tool to plan an exercise program for a female resident who is in good health except that her height has decreased inch. Which exercise safety tip from EASY calls for the nurse to assess the resident before planning care? a. Do not exercise a red, warm, or swollen joint. b. Avoid stretches that cause you to bend at the waist. c. Evaluate your surroundings for outdoor exercising. d. Begin by warming up with low- to moderate-intensity exercises.
b. Avoid stretches that cause you to bend at the waist.
An older man who is right handed works as a carpenter, but he has been left with a flaccid right arm after a thrombus occluded a cerebral artery. Which is the most important goal for the plan of care to help this man achieve his optimal state of health and wellness? a. Maintain skin integrity of right arm. b. Collaborate with occupational therapy (OT). c. Promote plaque-reversing strategies. d. Support effective coping mechanisms.
b. Collaborate with occupational therapy (OT).
The nurse determines the risk for a pressure ulcer in an older adult who is 6 feet tall and weighs 155 lb. Which patient information should the nurse use in planning care to reduce this individual's risk for a pressure ulcer? (Select all that apply.) a. Osteoarthritis of the neck b. Dry mucous membranes c. Prealbumin level of 7 mg/dL d. Fasting glucose of 140 mg/dL e. Serum sodium of 135 mEq/dL f. Uses food stamps to get food
b. Dry mucous membranes c. Prealbumin level of 7 mg/dL d. Fasting glucose of 140 mg/dL f. Uses food stamps to get food
The nurse recommends that a client diagnosed with moderate stage Alzheimer's disease attend a support group when he becomes defensive about not driving his automobile and the effects it will have on "being stuck at home." Which is the priority outcome expected for this client when attending the group sessions? a. Facilitates socialization, thus minimizing the effects of social isolation b. Helps with minimizing the loss as a factor in causing depression c. Provides caregivers with respite while assuring the client is well attended to d. Allows for the opportunity for a mental health professional to assess the client
b. Helps with minimizing the loss as a factor in causing depression
The daughter of an older patient states the following to a nurse: "I am so concerned that my dad is still driving. He is dangerous! He has had a couple of accidents, and I am worried that he is going to kill himself, or worse, somebody else. What can I do?" The nurse recommends which of the following involved type action strategies for driving cessation? (Select all that apply.) a. Report the person to the division of motor vehicles for license suspension. b. Hold a family meeting with the person to discuss the situation and come to a mutual agreement of the problem. c. Arrange for alternate transportation for the person. d. Confiscate the keys to the car. e. Ask the patient's physician to write a prescription for the person to stop driving.
b. Hold a family meeting with the person to discuss the situation and come to a mutual agreement of the problem. c. Arrange for alternate transportation for the person.
A dermatologist should promptly evaluate which one of the following skin lesions? a. Circumscribed, raised area resembling a blob of brown wax b. Multicolored raised lesion with a fuzzy border c. Bright red, glazed area with satellite lesions around it d. Brown spot on the skin with no raised area
b. Multicolored raised lesion with a fuzzy border
Exercises are prescribed for older adults as therapy to improve which one of the following qualities? a. Relative intensity b. Muscle strength c. Muscle retraining d. Body sculpting
b. Muscle strength
The nurse uses comfort measures to enhance an older adult's pharmacologic pain management. Which of the following would be most helpful for the nurse to use to identify the relationships between the comfort measures, activity, and pharmacotherapy, and the older adult's pain level? a. Older adult's self-report b. Older adult's pain diary c. Faces Pain Scale-revised (FPS-R) d. Pain medication frequency
b. Older adult's pain diary
Which of the following statements is true about a safe, effective care environment for older adults? a. Cold beer with steak and potatoes is a good meal for an older adult on a hot day. b. Older drivers are more likely to be in a fatal motor vehicle accident than younger drivers. c. Barrier-free buses and low fares make public transit a safe transportation option. d. A nurse's perception of temperature is a useful guide for patient thermal needs.
b. Older drivers are more likely to be in a fatal motor vehicle accident than younger drivers.
The health care provider has not ordered the use of a restraint for an alert patient at high risk for falling. The nurse should implement which side rail use? a. Two full-length rails b. One 1/2-length rail c. No side rails d. Four 1/2-length rails
b. One 1/2-length rail
The nurse completes an admission assessment on an older adult patient. The nurse identifies which factor that may contribute to sleep problems? a. Exposure to sunlight b. Polypharmacy c. Use of a sleep aid d. Decreased fluid intake
b. Polypharmacy
The nurse wants to use exercise according to the recommendations of the American Geriatrics Society (AGS) for an older woman who lost her balance and fell. Which nursing intervention is suitable for this older adult according to the AGS? a. Tell her to use an assistive device until her balance improves. b. Provide information on group exercises for balance training. c. Help her to learn how to exercise the core group of muscles. d. Instruct her to enroll in an exercise program for 8 weeks.
b. Provide information on group exercises for balance training.
The nurse assesses a male resident in a nursing home for urinary incontinence and determines that he is unaware of the problem. Which recommendation should the nurse implement? a. Limit oral fluid intake. b. Provide regular toileting. c. Apply absorbent undergarment. d. Encourage frequent rest periods.
b. Provide regular toileting.
The nurse wants to begin helping a resident who is overweight and has urinary incontinence with healthy bladder behavior skills. Which intervention should the nurse implement? a. Begin a low-calorie diet for weight management. b. Schedule voiding at 2- to 4-hour intervals. c. Instruct the resident to practice abdominal exercises. d. Reduce the time between an urge to void and voiding.
b. Schedule voiding at 2- to 4-hour intervals.
Which of the following is a true statement about sleeping in older adults? a. Older adults tend to fall asleep quickly but are awakened throughout the night. b. Sleep disturbances in older adults can be caused by chronic illness. c. Benzodiazepine agents are the medications of choice for sleep disorders. d. The times of day that medications are given has no effect on sleep disturbances.
b. Sleep disturbances in older adults can be caused by chronic illness
Which of the following statements is true about analgesic medications for older adults? a. Opioids are less effective in older patients than in younger patients. b. Stool softeners and laxatives should be used with opioids. c. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) are generally harmless. d. The dose limit for acetaminophen is difficult to reach for older adults.
b. Stool softeners and laxatives should be used with opioids.
An older man was oriented and responded appropriately in the hospital, but he is now disoriented and confused in his home after discharge. Which of the following issues is the first that the home nurse should examine to determine whether an environmental issue is contributing to the patient's condition at home? a. Complaints of shivering b. Temperature of household c. Types of food preparation d. Presence of radon
b. Temperature of household
A homecare nurse visits a client in the home to conduct a fall risk assessment. The nurse assesses the client and the home for extrinsic risk factors for falls. Which of the following are extrinsic risk factors? (Select all that apply.) a. The client has an unsteady gait. b. The client uses a cane but the cane is not the appropriate size for the client. c. The client's home is cluttered. d. The client is on two different medications that cause orthostatic hypotension. e. There are no grab bars in the client's bathroom.
b. The client uses a cane but the cane is not the appropriate size for the client. c. The client's home is cluttered. e. There are no grab bars in the client's bathroom.
An older patient complains of dry skin and asks for advice. Which advice should the nurse offer for improving dry skin? a. Add oil to the bath water to keep skin soft. b. Use tepid bath water. c. Move to a climate with lower humidity. d. Vigorously dry skin with a rough towel after bathing.
b. Use tepid bath water.
A nurse is providing an educational session on vaccines to a group of older adults. The nurse is discussing the zoster vaccine (Zostavax). Which of the following information should the nurse include in the education? a. Zostavax should only be given to individuals who have never had an episode of herpes zoster (HZ). b. Zostavax is recommended for all individuals older than 60 years of age that have no contraindications to the vaccine. c. Zostavax should not be given to anyone with a chronic cardiac or respiratory condition. d. Zostavax will always prevent an individual from developing herpes zoster.
b. Zostavax is recommended for all individuals older than 60 years of age that have no contraindications to the vaccine.
The nurse is caring for a patient who has recently had an indwelling catheter placed. The nurse should assess the patient for a. an increase in oral fluid intake. b. a change in mental status. c. upper back pain. d. a decrease in activity.
b. a change in mental status.
A 79-year-old client resides independently in the community. The visiting home health nurse finds even though it is 90 °F outside, the windows are closed, and the client is wearing a sweater. The nurse initially recognizes that this behavior may be related to a. cognitive changes that diminish the individual's awareness of temperature changes. b. age-related neurosensory changes that diminish awareness of temperature changes. c. delirium related to an acute illness that is affecting body heat production. d. age-related motor deficiencies that result in self-neglect.
b. age-related neurosensory changes that diminish awareness of temperature changes.
An older adult is vitamin deficient. Which of the following does the nurse offer to the older adult to provide the important missing vitamin for maintaining healthy skin and enhancing tissue repair? a. Carrot sticks b. Nonfat milk c. Orange slices d. Unsalted nuts
c. Orange slices
A nurse in a long-term care facility notes that there has been an increase in falls on one unit and that many of the falls are occurring immediately after mealtime. The nurse recommends that the nursing home conduct a trial of six smaller meals instead of the three traditional meals. The nurse makes this recommendation on the understanding that a. postural changes in blood pressure are common in older adults and frequently occur around mealtimes. b. postprandial hypotension occurs after ingestion of a carbohydrate meal and may be related to the release of a vasodilatory peptide. c. residents of long-term care facilities are often on many different medications that are given at mealtimes. d. it is common practice in to take long-term care residents to the bathroom immediately after meals.
b. postprandial hypotension occurs after ingestion of a carbohydrate meal and may be related to the release of a vasodilatory peptide.
When an older adult patient is diagnosed with restless leg syndrome (RLS), the nurse is confident that patient education on the condition's contributing factors has been effective when the patient states: a. "A warm bath at night instead of in the morning is my new routine." b. "Eating a banana at breakfast assures me the potassium I need." c. "I've cut way back on my caffeinated coffee, teas, and sodas." d. "I elevate my legs on a pillow to improve circulation."
c. "I've cut way back on my caffeinated coffee, teas, and sodas."
The nurse is conducting an admission assessment on an older adult and notes a small lesion with a multicolor appearance. Which assessment approach should the nurse use? a. Braden scale b. Wound staging c. ABCD (asymmetry, border, color, diameter) rule d. Pressure ulcer scale for healing (PUSH) tool
c. ABCD (asymmetry, border, color, diameter) rule
The overall temperature in your gerontological unit is 62 °F during the evening shift. In documenting this concern to the administration, which factor is the most important for the health and well-being of older adults? a. It is not fair for older adults to have to deal with an uncomfortable environment. b. Some of the residents are wearing blankets around their shoulders to keep warm. c. An ambient temperature of 62 °F is unsuitable for older people because they have impaired thermoregulation. d. It feels much warmer in the administration wing than out in the patient care areas.
c. An ambient temperature of 62 °F is unsuitable for older people because they have impaired thermoregulation.
The nurse assesses the quality of which of the following patient characteristics when applying the Get Up and Go test from the Hendrich II Fall Risk Model? a. Stride b. Speed c. Balance d. Flexibility
c. Balance
An older adult with moderate dementia is seen in the geriatric clinic. As the nurse is evaluating the patient, the patient's wife states that her husband has developed an increasing number of episodes of incontinence. She does not know what is precipitating the episodes and states, "Maybe he just doesn't remember that he needs to urinate, or maybe it's me; it takes me a while to walk him to the bathroom." The nurse develops a plan of care for this patient and includes which of the following interventions to manage the incontinence? (Select all that apply.) a. Use of adult incontinence briefs b. Use of an external catheter c. Development of a toileting schedule d. Use of a commode close by to where the patient spends most of his time e. Bladder diary to be completed by the patient's wife
c. Development of a toileting schedule d. Use of a commode close by to where the patient spends most of his time e. Bladder diary to be completed by the patient's wife
A nurse visits an older woman in her home. The woman was recently discharged from a subacute rehabilitation facility where she went after a left hip open reduction and internal fixation. The patient ambulates steadily and slowly with a rolling walker. The patient reports that she has an "embarrassing problem" and states that she doesn't always make it to the bathroom and often wets herself on the way. She attributes this to the fact that she moves slowly. The patient has no complaints of burning or pain on urination. The nurse suspects which type of urinary incontinence? a. Stress b. Overflow c. Functional d. Urge
c. Functional
An older woman maintains an active lifestyle playing various games with friends. She reports to the nurse that she experiences wakefulness during the night and an inability to fall asleep after waking up at night. Which intervention should the nurse implement to improve the quality of this woman's sleep? a. Recommend preparation for sleep. b. Suggest trying a cup of warm milk at bedtime. c. Inquire about her nightly sleep rituals. d. Propose volunteer work at a thrift shop.
c. Inquire about her nightly sleep rituals.
Which attempt by the family to prevent an older frail adult from falling causes the home health nurse concern? a. Keeping several low wattage night lights on in the evening b. Installing wooden railings on the stairway to the bathroom c. Keeping the side rails up on the client's bed at night d. Encouraging the client to use a cane when ambulating
c. Keeping the side rails up on the client's bed at night
A home health nurse is making a home visit to an older patient. A nurse conducts a home safety assessment and screens the environment for potential hazards for falls. The nurse recommends that the patient eliminate which of the following? (Select all that apply.) a. Night lights b. Railings on the stairway c. Loose carpeting on the floors d. The use of a cane e. Excess clutter
c. Loose carpeting on the floors e. Excess clutter
Which of the following is a true statement about impaired skin integrity? a. Stage III pressure ulcer cannot regress to stage II because the subcutaneous tissues regenerate. b. Stasis ulcer is another term for pressure ulcer. c. Muscle and fat cannot regenerate. d. Weight reduction is recommended to help prevent pressure ulcers.
c. Muscle and fat cannot regenerate.
The nurse observes that a male patient is snoring every night. Which should the nurse assess in this patient to diagnose the potential for sleep apnea? (Select all that apply.) a. Change in appetite b. Rituals for sleeping c. Number of daytime naps d. Headaches in the morning e. Irritability during the day f. Awakening during the night
c. Number of daytime naps d. Headaches in the morning e. Irritability during the day f. Awakening during the night
An older client who was recently admitted to the subacute setting after having a knee replacement, is very anxious and refuses to get out of bed, stating that it is too painful. Which intervention will the nurse implement? a. Share with the patient that it's important to get out of bed and that there is pain medication available if it does hurt. b. Use the Hoyer lift to get her out of bed so that the knee will not experience much movement and so there will be little pain. c. Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed. d. Allow the patient to remain in bed but share that getting up will be required at least twice a day starting the next morning.
c. Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed.
An older woman tells the nurse practitioner that she fears her family will place her in a nursing home because she developed stress incontinence. Which recommendation should the nurse implement? a. Tell her to eliminate the use of caffeinated beverages. b. Coordinate a family conference with the older adult. c. Recommend exercises to strengthen the pelvic floor. d. Schedule voiding for every 2 hours around the clock.
c. Recommend exercises to strengthen the pelvic floor.
Which of the following is an important consideration about the skin of older adults? a. Generous amounts of soap should be used for cleansing. b. Sweat gland activity increases. c. Skin becomes more vulnerable to damage. d. Skin becomes darker in unexposed areas.
c. Skin becomes more vulnerable to damage.
Which nursing intervention is most likely to prevent the creation of an environment conducive to fungal growth? a. Provide oral care with soft-bristled brush. b. Apply nystatin powder to reddened tissue. c. Use mild skin cleansing agents and blot dry. d. Apply gauze soaked with antifungal lotion.
c. Use mild skin cleansing agents and blot dry.
The nurse understands that stress incontinence occurs a. with a urinary tract infection (UTI). b. because of emotional strain. c. as a result of increased intra-abdominal pressure. d. with a specific amount of urine in the bladder.
c. as a result of increased intra-abdominal pressure.
The older adult is at a higher risk for acute psychological pain than a younger adult because older adults a. have many illnesses. b. possess fewer assets. c. experience more loss. d. live with impairments.
c. experience more loss.
During a routine physical examination, the patient reports, "I have problems falling asleep at night. I regularly engage in vigorous exercise to tire myself every evening." What response by the nurse is indicated? a. "Exercise is recommended and should be done immediately before bedtime to tire you out." b. "Exercise should only be done in the morning; otherwise, it can ruin your sleep." c. "A regular exercise regimen is helpful; it can deepen sleep, but it should not be done immediately before bedtime." d. "Exercise is helpful, but vigorous exercise can lead to restless leg syndrome, which can contribute to insomnia."
d. "Exercise is helpful, but vigorous exercise can lead to restless leg syndrome, which can contribute to insomnia."
Which of the following is a true statement about skin care for older adults? a. A licensed practical nurse is qualified to care for the feet of a patient with diabetes. b. Onychomycosis is quickly eradicated with antifungal creams or powders. c. A ram's-horn nail should be cut to give a smooth, rounded edge. d. Maintaining oral hydration may reduce the incidence of xerosis.
d. Maintaining oral hydration may reduce the incidence of xerosis.
When educating a client on the use of an adjuvant medication, which statement best demonstrates the nurse's understanding of this therapy? a. "These medications are used instead of opioids to decrease the likelihood of addiction." b. "Adjuvant medications are prescribed because they seldom cause any significant side effects." c. "These types of medications are used to eliminate the side effects of opioid medications." d. "These drugs are used in combination with analgesics to increase the effect of the analgesics."
d. "These drugs are used in combination with analgesics to increase the effect of the analgesics."
Which of the following is a true statement about assistive devices to aid older adults with impaired mobility? a. A walker can be used when climbing stairs. b. Cane tips should be smooth. c. Older adults save money by adapting assistive devices from their friends. d. A cane is most useful for unilateral disabilities but not bilateral problems.
d. A cane is most useful for unilateral disabilities but not bilateral problems.
Which of the following qualities does the nurse need to provide caring? a. Sensitivity to the needs of other nurses b. Longing to help others live a healthy life c. Desire to have a stable career and income d. Ability to create a trusting environment
d. Ability to create a trusting environment
The nurse admits an older man who had abdominal surgery. Admission vital signs are heart rate (pulse) (P), 73 beats/min; respiration rate (R), 20 breaths/min; and blood pressure (BP), 136/84 mm Hg. He is receiving intravenous (IV) fluids but has not requested pain medication since surgery. Seven hours later, his vital signs are P, 98 beats/min; R, 26 breaths/min; and BP, 164/90 mm Hg, and he denies pain. Which intervention should the nurse implement? a. Administer an opioid medication by IV route. b. Check the surgical dressing for bleeding. c. Report the vital signs to the health care provider. d. Ask if he has about discomfort at the surgical site or any other location.
d. Ask if he has about discomfort at the surgical site or any other location.
Compared with acute pain, which of the following statements is true of persistent pain? a. Leads to significantly altered vital signs b. Is usually described as a burning pain c. Is generally gone within 4 months d. Can bring about long-term changes in lifestyle
d. Can bring about long-term changes in lifestyle
Which infection-control practice should the nurse implement when caring for an older adult who has active herpes zoster? a. Wear a face shield and gown for all patient contact. b. Instruct the staff and visitors to wear a type of respirator mask. c. Use a hospital room that has negative airflow circulation. d. Cover ruptured skin lesions with a nonabsorbent dressing.
d. Cover ruptured skin lesions with a nonabsorbent dressing.
An older woman who receives intravenous (IV) fluids is making wide gesticulations with her arms and loudly insulting the nursing staff. Which intervention should the nurse implement to maintain safe, effective nursing care initially? a. Apply bilateral upper extremity restraints. b. Administer haloperidol (Haldol) for agitation. c. Close the door to her room to reduce the noise. d. Determine the patient's needs.
d. Determine the patient's needs.
An older Hispanic man states that he is not having pain, but he had knee replacement surgery 2 days ago. Which is the best pain assessment tool as recommended by the Hartford Institute for Geriatric Nursing (HIGN) from "Try This" for the nurse to apply for this man? a. Numeric Rating Scale b. Verbal Descriptor Scale c. Iowa Pain Thermometer d. Faces Pain Scale-revised (FPS-R)
d. Faces Pain Scale-revised (FPS-R)
The nurse administers an opioid analgesic to an older male postoperative patient in the surgical unit. Which is the most important intervention for the nurse to implement before leaving the patient's room? a. Place all side rails up. b. Position the patient comfortably. c. Offer toileting and a sip of water. d. Instruct him to ask for help before getting up.
d. Instruct him to ask for help before getting up.
The nurse cares for an older man who has a malignant melanoma. Which intervention should the nurse implement for this man to prevent a recurrence or advancement of this condition in the future? a. Place posters about sunscreen in the halls of his apartment building. b. Promote the application of a sunscreen at his neighborhood health fair. c. Tell him to schedule all outdoor activities after 4 PM daily. d. Instruct him to wear sun-protective clothing and a hat at all times.
d. Instruct him to wear sun-protective clothing and a hat at all times.
After assessing an older man in his bed, the nurse determines that he is at high risk for falls. The nurse leaves the room to get a fall risk sign and returns to find him on the floor pleading for help. Which of the following was the most important intervention the nurse should have implemented to prevent this event? a. Call for someone to bring the sign. b. Show the older man how to use the call bell. c. Provide a urinal and drinking water. d. Instruct the patient to call for help.
d. Instruct the patient to call for help.
Which one of the following is a true statement about mobility and safety for older adults? a. Use of restraints on older patients helps prevent injuries from falls. b. Falls that do not cause physical injury are not significant. c. The Get Up and Go test provides a measure of a patient's energy and initiative. d. Lowering the bed and fluorescent tapes are interventions to increase safety.
d. Lowering the bed and fluorescent tapes are interventions to increase safety.
What is the most important aspect of care for the nurse to maintain when assisting an older patient with urinary incontinence? a. Availability of protective rubber garments b. Using indwelling urinary catheters c. Using smooth muscle relaxants d. Maintaining an attitude that is respectful and positive about resolving the problem
d. Maintaining an attitude that is respectful and positive about resolving the problem
The nurse is discharging an older woman who uses a walker from rehabilitative care. Which observation does the nurse use to determine whether the patient is prepared for discharge? a. She holds the front of the walker. b. She has a walker with four wheels. c. She takes four steps into the walker. d. She takes the walker to the elevator.
d. She takes the walker to the elevator.
What is the difference between rest and sleep? a. Sleep occurs with rest. b. Rest is an extension of sleep. c. Rest occurs only in brief periods. d. Sleep is restorative and recuperative.
d. Sleep is restorative and recuperative.
A patient who reported "a problem sleeping" shows an understanding of good sleep hygiene when a. doing 10 pushups before bed to encourage a "pleasant tiredness." b. seldom eating a bedtime snack. c. engaging in computer games as a prebed activity. d. limiting the afternoon nap to just 30 minutes.
d. limiting the afternoon nap to just 30 minutes.
