gero final
Normal aging changes that would influence an older client's experience of pain include which of the following?
-All of the above are normal aging changes that would influence an older client's experience of pain.
You have read that your older adult male client has a history of thyroid disease. After assessing him, you realize he has signs of hyperthyroidism and note which of the following symptoms? (Select all that apply.)
-Atrial fibrillation -Muscle weakness -Anorexia
An older adult client is having some vision problems. Which one of the following disorders is caused by oxidative damage to the lens?
-Cataracts
What are those individuals who are 100 to 109 years of age called?
-Centenarians
You suspect an older adult client is having trouble hearing what you say. It is important to first check for which one of the following interferences in hearing?
-Cerumen impaction
Your clients are interested in a facility that will allow them full care and services for the rest of their lives. Which one of the following would you suggest?
-Continuing care retirement community (CCRC)
Medicare is a big issue for the older adult who depends on this medical insurance to pay for his or her hospital bills, medications, and rehabilitation. When talking to your older client about what Medicare will pay for and what it will not, what do you tell your client that Medicare will not cover the cost of?
-Custodial care
Your male client has been complaining of headaches, poor vision in dim lighting, sensitivity to glare, and impaired peripheral vision, and he has a fixed and dilated pupil. He most likely has which one of the following disorders?
-Glaucoma
Your older adult client lost his wife of 65 years and is approaching their 66th wedding anniversary. You anticipate that he will go through "shadow grief," which can be defined as which one of the following?
-Grief that is often exacerbated on special dates
When an older female adult client complains of itching and pain and several days later shows you a rash, what do you realize she has?
-Herpes zoster
Which statements are true about the Patient Self-Determination Act (PSDA)? (Select all that apply.)
-Hospitals are responsible for providing written information about a client's self-determination rights. -Health maintenance organizations (HMOs) are required to provide written information about self- determination rights. -Hospices are obliged to inform clients of their self-determination rights.
As a nurse caring for a cognitively impaired older adult client, you need to observe for which of the following? (Select all that apply.)
-Increased confusion -Agitation -Aggression -Pointing to a grimacing face or crying
What are some examples of recommended interventions to promote wellness? (Select all that apply.)
-Influenza and pneumonia vaccinations -Breast cancer screenings -Colorectal screenings
Diminished tear production that occurs with age is the definition for which of the following terms?
-Keratoconjunctivitis sicca
What is the recommended daily intake of fiber for older adults?
25g
An older adult is diagnosed with Alzheimer's disease (AD). The nurse knows that this diagnosis is made on the presence of which of the following? (Select all that apply.)
A decline from a previous level of functioning An insidious onset A gradual decline in cognitive abilities
The nurse is caring for a patient diagnosed with hyperthyroidism. Which signs and symptoms indicate hyperthyroidism? (Select all that apply.)
A fib heart failure heat intolerance
Which nursing intervention is a holistic approach to an older adult?
Assigns female nurses to older women who are Islamic.
Which of the following is a true statement about fluid intake for older adults?
Daily total volume should be 1500 to 2000 mL.
The nurse recognizes which of the following signs and symptoms as an indication of hypothyroidism? (Select all that apply.)
Decline in cognitive function. Decrease in functional status. Decrease in thyroid-stimulating hormone (TSH) and thyroxine (T4)
Which of the following is a true statement about elimination in older adults?
Defecation less than once each day is not necessarily constipation.
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.)
Diabetes Arthritis Congestive heart failure Dementia
Which of the following statements is true about diabetes mellitus?
Diabetes is diagnosed after two fasting plasma glucose readings over 125 mg/dL.
After an older adult dies, the brother who has a history of alcohol abuse upsets the family by going on a drinking binge instead of attending the funeral. Which of the following is the best description of the brother's behavior?
Disenfranchised grief
Which one of the following older adults has the highest economic risk in retirement at the beginning of retirement?
Divorced woman who has lived in this country for 3 years
You are taking care of a female older adult client with a loss of height and kyphosis. She is also postmenopausal. Which one of the following diagnostic tools would you order?
Dual-energy x-ray absorptiometry (DEXA) scan
Which of the following are common side effects of Parkinson 's disease (PD) and the medications used to treat it? (Select all that apply.)
Dyskinesias Dystonia
Which of the following statements are true about caregivers or caregiving? (Select all that apply.)
Family caregivers are children, spouses, and other family and friends. Caregiving can have serious negative effects on mental and physical health Caregiving can present financial burdens. Women who are family caregivers are 2.5 times more likely than Non caregivers to live in poverty.
The older adult who has type 2 diabetes mellitus has a sensory impairment and unstable blood sugar levels. Which of the following alterations in sensory function does the nurse address in the plan of care for stabilizing the blood sugar?
Has difficulty hearing in crowded rooms
In differentiating between health and wellness in health care, which of the following statements is true?
Health is a broad term encompassing attitudes and behaviors.
Which of the following issues in the care of older adults are identified in Healthy People 2020?
Identifying minimum levels of training for people who care for older adults.
Which of the following is a true statement about differing health belief systems?
In most cultures, older adults are likely to treat themselves using traditional methods. before turning to bio- medical professionals.
What makes nursing support of caregivers so important for health care in the United States?
Informal caregiving saves the health care system enormous sums of money.
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?
Inquire about her nightly sleep rituals.
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?
Inspect for pocketing.
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?
Instruct him to ask for help before getting up.
The nursing student learns about the Patient Self-Determination Act. What is a key provision of this act?
It requires facilities to educate patients on their rights
A nurse is performing an admission assessment on an older patient who presented with a high fever and cough, reduced oral intake for 3 days, and lower extremity weakness. The patient has sunken eyes, and the patient's skin turgor over the sternum is poor. The nurse suspects that the patient is dehydrated. Which of the following are indica- tors of dehydration in this patient? (Select all that apply.)
Lower extremity weakness Sunken eyes
An older patient learns that she has metastatic cancer. The patient states: ―I must have angered God. This is an example of which type of belief?
Magicoreligious
What is the most important aspect of care for the nurse to maintain when assisting an older patient with urinary incontinence?
Maintaining an attitude that is respectful and positive about resolving the problem
A nurse measures an older adult's blood pressure on the right arm and notes a reading of 150/100 mm Hg. The nurse waits 5 minutes and measures the blood pressure again in the right arm and obtains a reading of 152/100 mm Hg. What is the next action by the nurse?
Measure the blood pressure in the left arm.
A nurse is caring for an older adult who is diagnosed with type 2 diabetes. The patient is prescribed oral medication for diabetes. The nurse can expect that which of the following medications is prescribed as a first line therapy?
Metformin
A dermatologist should promptly evaluate which one of the following skin lesions?
Multicolored raised lesion with a fuzzy border
Exercises are prescribed for older adults as therapy to improve which one of the following qualities?
Muscle strength
A nurse is considering employment in an assisted living facility (ALF). The nurse understands that which of the following are true about nursing in an ALF?
Not all states require an RN in ALFs; however, many do employ RNs.
Which of the following statements is true about Parkinson's disease (PD)?
Older adults taking levodopa-carbidopa (Sinemet) must take it on an empty stomach.
An older patient's daughter asks a nurse the following: ―I have heard about PACE [Program for All-Inclusive Care for the Elderly] programs and think that one might be a good option for my father. Can you tell me more about what the qualifications to be part of a PACE program are?ǁ the nurse includes which of the following in her response to the family member? (Select all that apply.)
PACE programs provide services to individuals who meet the criteria for nursing home admission. PACE programs only provide service to individuals who are age 55 years and over.
Which of the following statements are true about pain in older adults? (Select all that apply.)
Pain is not a normal aging process. Opioid analgesics are often the best treatment for persistent pain.
Which of the following characteristics are associated with acute grief? (Select all that apply.)
Preoccupation with the loss of a loved one Waves of grief or distressing emotion Inability to perform simple self-care tasks
Which is the best goal when planning nursing care for an older patient with diabetes mellitus?
Prevent disease progression.
An older woman tells the nurse practitioner that she fears her family will place her in a nursing home because she developed
Recommend exercises to strengthen the pelvic floor.
Which of the following statements is true about loss in older adulthood?
Referring to the deceased in the past tense can acknowledge the death 's reality.
Which of the following statements describing oral care for the older population is correct?
Regular dental examinations can prevent tooth loss and improve the ability to chew healthful foods.
Which of the following statements is not true about respite care?
Respite care services are used frequently in the course of caregiving.
An older man who resides in a nursing home has a total cholesterol level of 245 mg/dL. Which nursing intervention is most likely to assist this man in achieving his highest level of wellness?
Review a menu with him to choose suitable foods.
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?ǁ The best response by the nurse is:
Scabies is highly contagious and spreads easily through physical contact
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?
Schedule voiding at 2- to 4-hour intervals.
Which of the following is a true statement about sleeping in older adults?
Sleep disturbances in older adults can be caused by chronic illness.
As a nurse, you know that sleep and rest are physiological and mental necessities for survival. Which of the following statements is correct about rest and sleep? (Select all that apply.) -
Sleep is a basic need. -Rest occurs with sleep. -Deprivation of sleep may adversely affect older adults.
For an older adult client who is having trouble sleeping at night, which of the following should be implemented? (Select all that apply.) -
Sleep restriction therapy -Relaxation therapy -Soft music
Which of the following statements is true about analgesic medications for older adults?
Stool softeners and laxatives should be used with opi- oids.
Which of the following interventions is recommended for an older adult in the final stages of dying?
Support the preservation of energy.
An older patient in an adult day care program tells the nurse that, ―I'm very stressed because another neighbor passed away. The most therapeutic response by the nurse is:
Tell me what you did when your other neighbor passed away
Which of the following statements is true about cognitive impairments in older adults?
The Mini-Mental State Exam-2 (MMSE-2) should be administered on admission to detect delirium.
Which statement is true about living arrangements for older adults?
The Program for All-Inclusive Care for the Elderly (PACE) is a community alternative to nursing home care for frail older adults.
Researchers hypothesize that most super-centenarians survive and are in good health due to which of the following factors? (Select all that apply.)
The exact cause of this phenomenon is not known. Contributing factors to their good health include quality medical care and improved social conditions.
Which of the following is a true statement about loss, dying, and death for older adults?
The grieving process is not rigidly structured.
Which of the following statements is true about the mental health of older adults?
The nurse avoids antianxiety medications without an assessment for factors associated with anxiety.
Which of the following is a true statement about sleep in older adults?
The time spent in bed increases, but the time spent asleep decreases.
An older adult with type 2 diabetes who is being treated with insulin wants to increase his activity level and begin a walking program. What recommendations should the nurse provide to this patient?
The walking regimen needs to be done on a regularly scheduled basis.
Hyperglycemia is harder to detect in older adults because of which of the following?
There is a higher tolerance for elevated levels of circulating glucose in older adults.
A nurse in an assisted living facility (ALF) evaluates the application for admission of an elderly woman. The woman is 87 years old, needs assistance with bathing and dressing, and is unable to prepare her own meals or do her own housekeeping. The nurse compares this applicant with the typical residents of an ALF and concludes which of the following?
This woman matches the profile of a typical resident in an ALF.
Which of the following statements is true about the role of grandparents?
Today many grandparents are the primary caregivers of their grandchildren
Which action should be included in all bladder-retraining programs?
Toileting at bedtime
A nurse is assessing an older adult's nutritional status. The nurse understands that which of the follow- ing is the most important indicator for a potential nutritional deficit
Unintentional weight loss
The nurse is assessing an elder client for hydration. What is the best determination of hydration in this client?
Urine color
The nurse is assessing an older adult from a culture different than the nurse's by asking questions from the explanatory model for culturally sensitive assessment. Which question(s) should the nurse ask to follow this model? (Select all that apply.)
What treatment can improve your condition? How long have you experienced the problem? Who, other than me, can make you feel better?
Which of the following is a true statement about heart disease in older men and women?
Women generally receive less aggressive treatment than men do.
Diabetes, dementia, Parkinson's disease, stroke, and vitamin B deficiencies may cause neurological damage leading to what condition?
- Gait disturbances
Older adults should consume how much fluid per day?
-1500 mL/day
An older man is being abused by his daughter, a single working mother of four children, with whom he lives. The nurse investigates and learns that the abuse is due to situational stress. Which of the following interventions should the nurse implement to address the short-term crisis?
Arrange respite care or day care for the patient.
Which pharmacokinetic parameter is affected most by decreased intestinal motility related to the aging process?
Absorption
After completing an admission assessment on a patient who recently had a stroke, the nurse should choose which of the following nursing diagnoses as a priority?
Altered cerebral perfusion
Which older adult is most likely to have normal mental health?
An older adult who grieves over the loss of a spouse for 2 years but is traveling again
Which health belief system uses treatments to repair a body part?
Biomedical
Which of the following is a true statement about heart disease in older adults?
Both excessive urination at night and decreased urination can be signs of heart failure (HF).
Which nursing assessment findings are specific signs of sexual abuse of an older adult? (Select all that apply.)
Bruises or scratches in the genital area Torn undergarments or presence of blood Bruises or scratches in the breast area
Which are potential results of end-organ damage from chronic hypertension? (Select all that apply.)
Carotid stenosis Renal insufficiency coronary artery disease
which herbal supplements when taken with an anticoagulant increase the effectiveness of the medication and should be avoided during anticoagulant therapy? (Select all that apply.)
Chamomile, Garlic, Ginkgo, Ginseng, Green tea
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?
Constipation
A nurse is caring for an older adult in a nursing home. During medication reconciliation, the nurse notes that the patient is prescribed two medications that are listed on the Beers criteria. What is the best action by the nurse?
Contact the prescriber and to inform the prescriber that the medications are on the list.
Which of the following is the most important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults who have HF?
Control fluid balance.
Identify the Healthy People 2020 emerging issues in the health of older adults. (Select all that apply)
Coordinating care for the older adult population Assisting older adults in the management of their own care Identifying levels of training for those caring for older
Which classic sign of an acute myocardial infarction (AMI) can be absent in an older man with an AMI?
Crushing chest pain
Which factor(s) is/are associated with the provision of culturally competent care? (Select all that apply.)
Cultural awareness Cultural knowledge
When teaching a patient about foods that do not increase blood glucose, which should the nurse in- clude?
broccoli
An older patient who is receiving haloperidol (Haldol) is noted to have a change in mental status (increasing confusion). Upon assessment, the nurse notes that the patient has a fever, with temperature,102°F; blood pressure, 92/60 mm Hg; heart rate, 118 beats/min; and respirations, 24 breaths/min. The patient is noted to have rigidity of the upper and lower extremities. The first action of the nurse is to
contact the medical provider immediately.
A nurse completes a cultural assessment of an older adult who is being admitted to an assisted living facility. Reasons for completing a cultural assessment include (Select all that apply.)
culture guides decision making about health, illness and preventive care. culture provides direction for individuals on how to interact during health care encounters. culture impacts attitudes toward aging.
Common iatrogenic complications for hospitalized older adults include (Select all that apply.)
delirium. new-onset incontinence. falls.
The term health disparity is defined as?
differences in health outcomes among groups.
According to researchers, which characteristic do most centenarians share?
female
The home health care nurse suspects that a patient spouse is experiencing caregiver burden. The nurse assesses for this condition by
gathering assessment data from the caregiver and the patient.
A nurse is reviewing an older resident's medication list in a long-term care facility. The nurse notices that two of the medications are on the Beers criteria. The nurse understands that the Beers criteria (Select all that apply.)
include medications that should be used in caution in older adults. include specific drug-drug interactions that are known to cause harm in older adults. include medications that need to be dose adjusted in older adults with impaired kidney function.
An older couple who lives in their own home is considering relocating to a continuing care re- tirement community (CCRC). The wife is independent in activities of daily living and volunteers at a homeless shel- ter twice a week. The husband recently had a stroke and is undergoing rehabilitation in a long-term care facility. One benefit of a CCRC for this couple is
or married couples in which one spouse needs more care than the other, a CCRC allows them to live nearby in different parts of the same community.
A nurse is preparing to administer medications to an older patient. The nurse consults the drug reference book, which provides the half-life of the drug. The nurse understands that half-life is defined as
the amount of time that the drug remains active in the body.
In questioning an older adult, which question is likely to elicit the most accurate information about the individual's adherence to the medication plan?
―How many doses of digoxin (Lanoxin) do you think you missed?
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:
―I've cut way back on my caffeinated coffee, teas, and sodas