Geriatric Study Guide #1

A nurse is teaching a client who reports insomnia about promoting rest and sleep. Which of the following statements should the nurse identify as an indication that the client understands the instructions?

"I will no longer have a glass of wine before bedtime."

The nurse is performing an assessment on an older adult client. What assessment data would indicate a potential complication associated with the skin of this client? 1. Crusting 2. Wrinkling 3. Deepening of the expression lines 4. Thinning or loss of elasticity of skin

1. Crusting

A nurse is admitting a client to a long term care facility during the admission the patient verballizes a concern about getting dementia now that he is in a nursing home. In which activity should the nurse encourage the patient to participate to maintain brain health? Select all that apply. 1. Exercise 2. Mental activity 3. Socialization 4. Increase dietary intake 5. Crossword puzzles

1. Exercise 2. Mental activity 3. Socialization 5. Crossword puzzles

A nurse assess an older persons instrument activities of daily living using the Lawton instrument. Which of the following are instrumental activities of daily living? 1. Meal prep 2. Medication self administration 3. Bathing 4. Eating 5. Money management

1. Meal prep 2. Medication self administration 5. Money management

Which of the following are common causes of polypharmacy in older adults patient include which of the following? Select all that apply. 1. Use of multiple providers 2. Presence of multiple chronic conditions 3. Using multiple pharmacies 4. High cost of meds 5. Using name brand instead of generics

1. Use of multiple providers 2. Presence of multiple chronic conditions 3. Using multiple pharmacies

A nurse performs an assessment of an older adult's oral cavity. Which of the following findings are normal age related changes? (Select all that apply.) 1. Worn or damaged teeth 2. Inflamed gums 3. A white film on the tongue 4. Decreased saliva production 5. Increase of dentin and enamel

1. Worn or damaged teeth 4. Decreased saliva production

An older adult is admitted to the hospital with a diagnosis of malnutrition. Other than cognitive status, what other factors can increase the risk of malnutrition and dehydration? Select all that apply. 1. Past profession 2. Physical fatigue 3. Limited mobility 4. Sensory decreases 5. Inadequate dental care 6. Family history of malnutrition

2. Physical fatigue 3. Limited mobility 4. Sensory decreases 5. Inadequate dental care

A patient is having difficulty with bowel incontinence. It is determined that the patient needs to be placed on a bowel incontinences program. Which action by the nurse best demonstrates an appropriate intervention to address the issue of bowel incontinence in a older adult patient? 1. Pushing fluid intake rona recommended 4 liters each day 2. Rearranging the furniture to have better access to the toilet 3. Modifying the diet to reduce intestinal motility 4 Assisting the patient to the toilet 10-15 minutes before eating

2. Rearranging the furniture to have better access to the toilet

A nursing instructor delivers a lecture to nursing students regarding the issue of the client's rights and asks a nursing student to identify a situation that represents an example of invasion of client privacy. Which situation, if identified by the student, indicates an understanding of a violation of this client right? 1. Performing a procedure without consent 2. Threatening to give a client medication 3. Telling the client that he or she cannot leave the hospital 4.Observing care provided to the client without the client's permission

4. Observing care provided to the client without the client's permission

A patient has been ordered Lurasidone for schizoaffective disorder. The patient is to receive 70 mgs in the morning, 30 mgs at noon and 50 mgs at night. Available are 20mg tabs. How many tabs of Lurasidone is the patient scheduled to take a day?

7.5 mgs daily

A nurse is providing teaching to a group of older adults about sources of complete and incomplete protein. Which of the following foods should the nurse include as a complete protein? A. Yogurt B. Fresh veggies C. Nuts D. Dried beans

A. Yogurt

A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.) A. Furosemide B. Telmisartan C. Duloxetine D. Clopidogrel E. Atorvastatin

ABC

A nurse is teaching a class of older adults about the expected physiologic changes of aging. Which of the following changes should the nurse include in the discussion? (Select all that apply.) 1. More difficulty seeing due to a greater sensitivity to glare 2. Decreased cough reflex 3. Decreased bladder capacity 4. Decreased systolic blood pressure 5. Dehydration of intervertebral discs

ABCE

A nurse is teaching a class of older adults about the expected physiologic changes of aging. Which of the following changes should the nurse include in the discussion? (Select all that apply.) A. More difficulty seeing due to a greater sensitivity to glare B. Decreased cough reflex C. Decreased bladder capacity D. Decreased systolic blood pressure E. Dehydration of intervertebral discs

ABCE

According to Healthy People 2020, older adults have been identified as a priority, with a goal to improve their health, function, and quality of life. Identify the targeted chronic focus areas for improvement. Select all that apply. a. Diabetes b. Cancer c. Congestive heart failure d. Dementia e. Arthritis

ACDE

Which of the following is a true statement about sleep in older adults? Select all that apply. 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. Older adults tend to fall asleep quickly and remain asleep throughout the night. e. Sleep disturbances in the older adult can be caused by cardiovascular disease, arthritis, or diabetes

AE

During a routine physical examination, a nurse observes a 1-cm (0.4-in) lesion on a client's chest. The lesion is raised and flesh-colored with pearly white borders. The nurse should recognize that this finding is suggestive of which of the following types of skin cancer? A. Squamous cell carcinoma B. Basal cell carcinoma C. Malignant melanoma D. Actinic keratosis

B. Basal cell carcinoma

A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed? A. NPO until dysphagia subsides B. Supplements via nasogastric tube C. Initiation of total parenteral nutrition D. Soft residue die

B. Supplements via nasogastric tube

A nurse is teaching a class about safe medication administration. The nurse should include in the teaching that which of the following references are acceptable for safe medication administration? (Select all that apply.) A. A website that ends in .com B. Published journals C. Pharmacists D. Physicians' Desk Reference E. Pharmaceutical sales representative

BCE

The long-term care nurse is performing assessments on several of the residents. Which are normal age-related physiological changes the nurse should expect to note? Select all that apply. a. Increased heart rate b. Decline in visual acuity c. Decline in long-term memory d. Increased susceptibility to urinary tract infections e. Increased incidence of awakening after sleep onset

BDE

The charge nurse is educating a new nurse on culturally competent communication techniques. Which response(s) made by the new nurse indicates a need for follow-up? Select all that apply. A. "I should identify the clients' needs to create the plan of care." B. "I should use a language interpreter for all culturally diverse groups." C."I should use the client's perspective on health to help lead the conversation." D. "I should use a communication style that promotes optimal health outcomes." E. " I should recognize my own biases and address known stereotypes with the client."

BE

A nurse is providing teaching to a client who has stomatitis. Which of the following statements by the client indicates a need for further teaching? A. "I will drink liquids through a straw." B. "I will season foods with dried spices before cooking" C. "I will rinse my mouth with baking soda and water frequently." D. "I will eat frozen bananas as a snack."

D. "I will eat frozen bananas as a snack."

A nurse working for a home health agency is assessing an older adult male client. Which of the following findings is the priority for the nurse to address? A. Swollen gums B. Pruritus C. Urinary hesitancy D. Dysphagia

D. Dysphagia

A nurse is caring for several clients who are at various developmental stages. The nurse should explain that, according to Erikson, acceptance of death is a primary task of which of the following stages of psychosocial development? A. Autonomy vs. shame and doubt B. Generativity vs. stagnation C. Identity vs. role diffusion D. Integrity vs. despair

D. Integrity vs. despair

Based on current demographic data, which of the following statements identifies a predictive trend regarding the health care needs of society? a. More nursing services will be required to serve the needs of the population older than 85 years of age. b. Most nurses will not need to care for older persons. c. Fewer nurses will be needed to care for older adults. d. Older adults expect their quality of life to be less than that of earlier generations at their ages.

a. More nursing services will be required to serve the needs of the population older than 85 years of age.

A nurse is caring for a group of patients who are all having scheduled invasive procedures. Which of the following patients can legally refuse consent for treatment? a. 25 year old intubated patient who is scheduled for surgery in one hour. b. 78 year old patient with a history of hypoglycemic blood glucose levels and is anxious about the surgical procedure. c. 69 year old patient living in a skilled living facility on the memory care unit, who has been admitted for local removal of a melanoma. d. A 62 year old patient with a leg fracture and suspected alcohol intoxication who is scheduled for surgical repair of the femur.

b. 78 year old patient with a history of hypoglycemic blood glucose levels and is anxious about the surgical procedure.

An older person who is cognitively intact and has decision-making capacity makes a decision to stop chemotherapy for breast cancer after being told of further spread of the cancer. The patient's daughter is upset at her mother's decision and approaches the nurse, stating: "I don't agree with my mother's decision to stop treatments. I am her health care proxy. I want to override her decision." The best response by the nurse is: a. "I understand why you are so upset. I don't think she is doing the right thing either. Let us think together how we can change her mind." b. Your mother is able to make her own decisions. I suggest you talk with her." c. "As the health care proxy, you are the one who makes the decisions. Let's talk with your mom." d. "You will need to go to court and be declared her legal guardian."

b. Your mother is able to make her own decisions. I suggest you talk with her."

The nurse instructs the unlicensed assistive personnel to feed an older adult. If the nurse is unable to observe feeding directly, then which action should the nurse use to assess the older adult's risk for aspiration immediately after feeding? a. Note food volume eaten b. Observe skin color c. Inspect for pocketing d. Monitor for bradypnea

c. Inspect for pocketing

A nurse is caring for an elderly patient with recent episodes of vomiting. The patient states "What can I do to get this nasty taste out of my mouth?" Which of the following recommendations by the nurse is contraindicated? a. "Perform your regular oral care with toothpaste and warm water" b. "You should avoid the use of non-alcohol based mouthwash" c. "You can swish and spit with warm water" d. "You can use lemon glycerin swabs to abate the bad taste"

d. "You can use lemon glycerin swabs to abate the bad taste"

The home health nurse is scheduled to asses several patients for risk of accidental misuse of prescription medication. Which patient would most likely have the highest risk? a. A 98-year-old married patient recovering from recent glaucoma surgery b. A 75-year-old patient on a limited income who's prescription is expensive An 80-year-old patient who is wheelchair bound d. A 77-year-old patient with moderate stage dementia

d. A 77-year-old patient with moderate stage dementia