Gero Unit 1 Exam

The nurse is reviewing lifestyle changes with an older adult client in order to support urinary continence. Which statement by the client requires further follow up by the nurse?

"I will stay at home to ensure that I can remain close to the toilet."

What statement should a nurse provide to a client who questions the effect of aging on the heart's ability to pump blood effectively?

"Aging does not cause a serious decline in otherwise healthy older adults."

A 60-year-old client asks why it is so easy to gain weight but difficult to lose. How should the nurse respond to this client?

"Basal metabolic rate declines by 2% for each decade of life after age 25."

An older adult asks the nurse for suggestions on how to treat indigestion and heartburn. What is the nurse's best response?

"Eat several small meals rather than 3 large meals."

The unlicensed assistive personnel (UAP) notices that an older adult client's oral intake has been poor since being admitted to the care area. The UAP reports this finding to the nurse, but says, "I am not concerned since older people do not need to eat much anyway." Which response by the nurse would be most appropriate?

"Even though older adults do not need quite as many calories, they need as many nutrients as you or I."

A nurse discusses driving with an older adult who continues to drive but is probably unsafe on the road. Which statement made by the nurse is most appropriate?

"I am concerned about your safety as well as the safety of others."

After an older adult client receives new dentures, the nurse provides instruction about their use and care. Which client statement indicates that teaching has been effective?

"I suppose that I'll have to get these resized and adjusted from time to time."

A nurse manager at a long-term care facility is engaged in efforts to change many staff members' inaccurate and negative views of older adults. When talking with the staff, which statement indicates the need for the nurse manager to intervene?

"It is normal to expect a gradual loss of memory and intelligence with age."

An older adult says to the nurse, "I sure would like to live to get that 100-year birthday card from the president." Which response by the nurse is best?

"Keeping fit and dealing with stress in a positive way helps your chances of living to be 100."

An older adult is sore from "doing too much in the yard yesterday." Which statement by the nurse best promotes healthy aging?

"Let's look at how we can improve your health so you can do more."

A nurse is employed in an assisted living facility. An older adult resident of the facility has expressed a fear that decreased mobility will cause increasing dependence on an adult child. Which response by the nurse would be appropriate to address the resident's concerns?

"Many older adults have similar concerns. We can work together to keep you independent for as long as possible."

A gerontological nurse is aware that older adults have different nutritional requirements than younger adults. Which of the following teaching points reflects these changes in nutritional requirements?

"Overall, you don't need to take in as many calories as you used to."

A newly hired nurse is being orientated to the position in a community health center that provides care to the adjacent large Native American reservation/Canadian aboriginal reserve. Which statement by the nurse indicates a sound understanding of the Native American/First Nations population?

"The high prevalence of diabetes and hypertension mean that strokes are likely to be relatively frequent in the area."

A nurse who works on a palliative care unit has developed a strong partnership with the 77-year-old wife of a client who has recently died of lung cancer. The woman has expressed her fears about being a widow to the nurse. Which response by the nurse would be most appropriate?

"Though it might not feel like it now, many women eventually find joy in new friendships and freedom after the death of a spouse."

The nurse is providing education about urinary incontinence to an older adult client. Which statement by the client requires further follow up by the nurse?

"Urinary incontinence is a condition for which there is no treatment."

During a home visit, the nurse is asked by an older couple if vitamin and nutritional supplements can compensate for poor food intake. Which response by the nurse would be most appropriate?

"Vitamin and nutrient supplements can be useful short-term, but only if they don't interact with prescribed medications."

A nurse is working in an assisted living facility that has a culturally diverse older adult population. Which statement by the nurse best demonstrates cultural sensitivity?

"We need to build our knowledge of residents who belong to cultural and ethnic groups that we're not familiar with."

How will the nurse educate an older adult about the role of the immune response and autoimmune activity in the aging process?

"You may have more difficulty fighting off infections because of a weaker immune systems, and it is possible your body will attack itself."

An older client experiencing kidney stones asks why they developed. What should the nurse respond to this client?

"You might be taking too much calcium each day."

An older woman asks what she can do to reduce the risk of developing osteoporosis. Which response by the nurse would be most appropriate?

"You need to make sure you are getting the recommended daily dose of calcium, which may involve taking supplements at each meal."

A nurse participating in a health fair sponsored by a local seniors' center discusses healthy skin and aging. Which teaching point should the nurse emphasize?

"You should limit your sun exposure to a small amount each day and keep your skin protected from direct sunlight for the remainder."

A nurse who works in an inner-city clinic provides care for a large number of the older black clients. Which health promotion activity best reflects the specific health needs of this population?

A blood sugar and blood pressure monitoring program

To be an effective nurse healer while caring for self, the gerontological nurse must possess which attributes? (Select all that apply.)

Accepting Lifelong learner Respectful Non-judgmental

A gerontological nurse is implementing interventions with an older adult client to promote the client's use of inner resources for self-care. Which outcome would the nurse most likely want to achieve?

Active participation in care rather than passivity

What role should the nurse perform when addressing ethical dilemmas in the care of older adults?

Actively participate in developing ethically sound policies.

How can a nurse manager of an extended care unit for older adults address this population's diverse needs? Select all that apply.

Addressing the need for special interest groups Establishing a list of available translators on call Planning meals to include ethnic food varieties

A nurse is assessing a group of older clients for achievement of developmental tasks based on Erikson's theory. Which situation would lead the nurse to suspect that the client would be at risk for disappointment and despair?

An 80-year-old man describes himself as "useless" since he is unable to help his adult children with their yard and garden work.

A nurse is providing end-of-life care to an older female client who practices Judism. Which intervention would the nurse identify as potentially problematic for this client and her family?

An autopsy was ordered due to the client's unique disease etiology.

A nurse caring for a hospitalized client is not familiar with this client's ethnicity and cultural characteristics. What is the best way for this nurse to become familiar with this client's cultural characteristics?

Ask the client to describe his or her life story

An older adult client experiences impairment in physical mobility. Which intervention(s) will the nurse include in the client's plan of care? Select all that apply.

Coach to change positions every hour Remind to maintain good body alignment Design an exercise program appropriate for the client's status Promote a healthy nutritional intake

An older adult client comes to the clinic for a routine follow-up visit. During the visit, the client asks the nurse, "What foods would be best to eat so that I can stay as healthy and active as possible and prevent any muscle or bone problems?" The nurse would encourage a balanced diet, emphasizing the intake of which foods?

Dairy products and lean meats

An 88-year-old client asks the nurse how to treat chronic constipation. The nurse should address what age-related changes when describing the etiology of the problem?

Decreased peristalsis

An 80-year-old client who has just spent 2 days at the beach with the family is demonstrating confusion; dry skin; a dry, brown tongue; sunken cheeks; and concentrated urine. The nurse suspects which condition?

Dehydration

A nurse is providing care to an older adult client who has a history of falls and fractures secondary to the falls. The nurse institutes measures to reduce the risk of falls based on the understanding that which factor is most likely contributing to the client's fractures?

Diminished calcium absorption

A nurse providing care in a long-term care setting is aware that the cognitive function of older adults does not necessarily decline on an inevitable trajectory. Which action has the greatest potential to enhance the cognitive function of residents and prevent cognitive declines?

Encourage older adults to participate in mentally stimulating activities.

The nurse notes that an older client has "Risk for Aspiration" identified as a problem on the care plan. What should the nurse include when assessing this client?

Gag reflex

During an assessment the nurse notes that the gum tissue around an older client's teeth are red, swollen, and inflamed. How should the nurse document this finding?

Gingivitis

An older male consumed a high-carbohydrate lunch and is now exhibiting signs of acute confusion. What is the priority lab the nurse should assess?

Glucose

The nurse is concerned that an older client is unable to provide self-injections of insulin to treat diabetes. What did the nurse assess to make this clinical determination?

Has arthritis in the fingers and hands

Promoting good immunologic health in the older client would include which of the following?

Managing stress

An older adult client with a history of renal failure is admitted with dehydration and hyponatremia. The nurse identifies which assessment finding(s) as being consistent with the client's diagnosis of dehydration? Select all that apply.

Increased blood urea nitrogen (BUN) Confusion Decreased skin elasticity

An older adult who appears thin and emaciated with little subcutaneous fat is admitted to the geriatric unit. What is the priority safety concern for this client?

Increased chance of hypothermia

An older adult client asks about natural means to promote bowel elimination. What should the nurse encourage the client to incorporate into a daily routine? Select all that apply.

Increased fruit intake Regular physical activity Increased fluid intake A variety of vegetables

An older adult client is demonstrating signs of dehydration. Which action should the nurse initiate first?

Initiate fluid intake and output monitoring

An older gerontological nurse is contemplating retirement. Which self-care method is most effective to allow this nurse to reflect on her career?

Journaling

An 80-year-old widower experiences loneliness because his children and grandchildren live three states away. What suggestions could the nurse make to pass the time? Select all that apply.

Journaling Scrapbooking Arts and crafts activities Local religious activities

When caring for gay, lesbian, bisexual, and transgender (LGBT) older adults, the nurse realizes which fact?

Many older adults who identify themselves as LGBT have been victimized.

Dietary history of an older adult client reveals intake of a significant amount of cheese, milk, and calcium-fortified orange juice along with use of a 750-mg calcium supplement at breakfast. Based on this information, which instruction would the nurse include when talking to the client about calcium intake?

Limit the intake of calcium to a total of 2,000 mg or less from all sources

The nurse prepares material to teach an older client about prescribed medications. What should the nurse keep in mind when providing these instructions?

Motivation to learn may be reduced

A gerontological nurse at an acute care facility that serves a large older adult population is working to develop appropriate programs to address this population's needs. When developing these programs, which concept would the nurse most likely identify as contributing to the complexity associated with caring for this group?

Numerous health conditions can overlap in the older adult population

An older adult woman minimizes pain in the joints and back as "normal aging." Which action by the nurse is most appropriate?

Offer warm packs for joints.

The nurse notes that an 80-year-old client plays golf twice a week and visits with family and grandchildren whenever possible. What impact does this client's activities have on the aging process?

Reduce the rate of declining function

An older client who eats only oatmeal has bad breath. A dental exam reveals a few teeth; use of a partial appliance; and swollen, red, and painful gums. Some of the client's teeth are loose at the gumline. Based on these findings, the nurse suspects which problem?

Periodontal disease

An older adult states experiencing heart palpitations ever since adding a vitamin and nutrient supplement to the diet. The nurse checks the label of the client's supplement. For which vitamin or nutrient is the nurse assessing?

Potassium

A gerontological nurse is conducting an in-service program for a group of nurses who work with a wide range of culturally diverse older adults. After teaching the group about the impact of culture on health and illness, the nurse determines that the teaching was successful when the group identifies which reason as underlying the need to understand culture?

Provide individualized and culturally sensitive care

What is the nurse's best action to assist a client suffering from presbyopia?

Provide more light to see adequately.

A client with cardiovascular disease has a poor appetite. Which intervention should the nurse use to improve this client's nutritional status?

Provide several small meals throughout the day

An older client with heart failure is upset because the nursing staff turns and repositions the client every 2 hours. Why is this intervention a part of the client's plan of care?

Reduces skin breakdown

Older adults experience a number of changes in the structure or function of their cardiovascular system. Which change is considered to be a normal, age-related change?

Regulation of blood pressure and heart rate becomes less efficient.

A older adult client presents to the clinic reporting anxiousness caused by recurrent respiratory infections. What should the nurse teach this client?

The effects of aging create a situation in which respiratory problems can develop more easily and be more difficult to manage.

An older male client with a history of chronic heart failure is admitted to the hospital with dehydration. Which nursing measure is most important for the nurse to add to this client's plan of care?

Strict intake and output monitoring

The caretaker of a client who is in chemotherapy is asking why it is necessary to be alert of signs of medication toxicity in the client. What assessment data suggests the client is demonstrating age-related changes that increases the risk for medication toxicity?

The client's glomerular filtration rate is reduced.

A gerontological nurse is conducting an in-service program for a group of nurses working at a large urban health care center that serves a diverse older adult population. When describing the projections for the future related to the diversity of older Americans, which information would the nurse most likely include?

The number of Hispanic older adults is projected to grow dramatically.

A nurse works to protect vulnerable populations and reduce health disparities. Which nursing actions work toward that goal? (Select all that apply.)

The nurse communicates a nonjudgmental attitude toward health belief systems. The nurse asks the client how the care system can incorporate the clients' health beliefs. The nurse incorporates clients' belief systems into the plan of care. The nurse teaches each client about preventive care.

A nurse is working with an older adult female client newly diagnosed with osteoporosis. Which interaction promotes achievement of wellness outcomes?

The nurse teaches the client about bone density in older women and the role of vitamin D and calcium intake.

A 75-year-old client and 40-year-old daughter both have a gastrointestinal virus with complaints of vomiting and diarrhea. The nurse is concerned about the client being at risk for dehydration for which reason?

The vomiting and diarrhea will cause a reduction in intracellular fluids.

An older adult client has a history of a deep vein thrombosis. The client should be taught to avoid excessive intake of which vitamin or nutrient?

Vitamin K

A nurse gives a presentation regarding eye health at a wellness clinic. Which intervention should the nurse include in the teaching?

Wear sunglasses with ultraviolet-absorbing lenses.

An older adult client who has been living in an assisted living facility for several years is now faced with the prospect of relocating to a nursing home. Which characteristics of the client's current situation is most likely to prompt this move?

a decrease in the client's level of function and activities of daily living (ADLs)

A community health nurse is to create initiatives to foster the health of older adults in the community. Which health promotion activity has the greatest potential to promote the respiratory health of older adult participants?

a smoking cessation program

The nurse suggests that an older client bathe every 3 to 4 days. What did the nurse assess prior to making this recommendation to the client?

dry skin

An older client takes 30 minutes to complete morning care in the bathroom. What action should the nurse take to support this client's biopsychosocial health?

allow the client to take as much time as required

A nurse in the emergency department cares for an 82-year-old man. The man was found wandering the streets looking for his dog in a snowstorm. Which condition is the priority for the nurse to monitor?

altered mental status

A client wants to stop all hemodialysis treatments and understands that this decision will hasten death. The nurse discusses the client's wishes with the healthcare provider and all treatments are cancelled. Which ethical principle did the nurse support for this client?

autonomy

While discussing a health problem with an older client the nurse offers a personal situation that was similar to what the client is currently experiencing. What behavior is the nurse demonstrating?

connection

An older client is instructed to increase dietary fiber to 30 g/day. What additional information should be included with this client's teaching?

drink plenty of water

A nurse at the aging center organizes exercise classes including tai chi. Which principle is the nurse incorporating?

health promotion

A nurse performs a reflective cultural self-assessment. Which outcome should the nurse expect?

progression from judgmental views of other cultures to recognition of positive attributes

The geriatric nurse practitioner identifies a new health problem, but the older client refuses treatment. What should the practitioner do?

respect the client's decision

The nurse is concerned that an older adult client is experiencing undiagnosed malnutrition. What information may cause the nurse to make this clinical determination?

serum albumin level 2.8 g/dL (28 g/L)