Gerontology Quiz
A nurse is admitting an older adult client who fell at home 3 days ago. The client has a fractured hip, malnutrition, and dehydration. Which of the following laboratory values, noted on admission, should indicate to the nurse prolonged malnutrition? a. Increased sodium b. Decreased albumin c. Increased BUN d. Decreased blood glucose
Decreased albumin *RATIONALE* Decreased albumin is indicative of inadequate protein intake, which is a common finding in a client who has prolonged malnutrition.
A nurse is assessing an older adult client for signs of dehydration. Which of the following findings should the nurse consider an expected part of the aging process? a. Elevation of urine specific gravity b. Decreased creatinine clearance c. Dry oral mucous membranes d. Poor skin turgor over the sternum
Decreased creatinine clearance *RATIONALE* Creatinine clearance declines with age and, therefore, the kidneys have a decreased ability to concentrate urine. This expected part of the aging process places the client at risk for dehydration. *FYI* Elevation of urine specific gravity, dry oral mucus membranes, and poor skin turgor over the sternum are unexpected findings that could be indicative of dehydration. Fluid loss of 5% of the body weight is considered mild dehydration, 10% is moderate, and 15% or more is severe dehydration.
A nurse is caring for an older adult client. Which of the following physiologic changes associated with agin can affect medication dosage in this client? a. Increased glomerular filtration rate b. Decreased body fat c. Decreased gastric motility d. Decreased gastric pH
Decreased gastric motility *RATIONALE* Decreased gastric motility results in medications remaining in the digestive tract for longer periods of time, leading to slow absorption of the medication. The provider might have to allow for a longer time for medication onset and peak by extending the length of time between doses. *FYI* The aging process results in a decreased glomerular filtration rate and causes the medications to filter at a slower rate, causing them to remain in the body longer ... Body fat increases with aging; medications that are stored in adipose tissue will have an increased tissue concentration, decreased plasma concentration, and a longer duration in the body ... With aging, gastric pH increases, becoming more alkaline; the nurse should avoid giving preparations that neutralize gastric secretions if a low gastric pH is required for medication absorption.
A nurse is caring for an older adult client who has pneumonia. Which of the following physiologic changes associated with aging places the client at risk for pneumonia? a. Decreased anterior-posterior diameter b. Increased diameter of the small airways c. Decreased number of cilia d. Increased alveolar surface area
Decreased number of cilia *RATIONALE* A physiologic change associated with aging is a decreased number of cilia. This, along with a less effective cough, leads to diminished efficiency of the normal defense mechanisms for clearing the airway, putting the client at increased risk for infection, such as pneumonia. *FYI* A physiologic change associated with aging is a calcification of the bronchial and costal (rib) cartilage and diminished chest wall compliance, leading to an increase in the anterior-posterior diameter; the resultant reduced total lung capacity puts the client at increased risk for hypoxemia ... A physiologic change associated with aging is a decreased diameter of the small airways; however, the diameter of the large airways does increase with age, and these two factors combined can lead to an increase in dead space, gas trapping, and ventilation-perfusion imbalance ... A physiologic change associated with aging is an increase in the size of the alveolar ducts and respiratory bronchioles, leading to a decrease in the alveolar surface area; consequently, there is less surface area for gas exchange to occur, putting the client at an increased risk for hypoxemia.
A nurse is caring for an older adult client who has a new onset of type 2 diabetes mellitus. Which of the following physiologic changes can contribute to the development of type 2 diabetes? a. Increased production of insulin by the pancreas b. Decreased sensitivity to the circulating insulin c. Increased rate of glucose metabolism d. Decreased release of glycogen by the liver
Decreased sensitivity to the circulating insulin *RATIONALE* The pancreas in older adult clients demonstrates reduced tissue sensitivity to circulating insulin, leading to an increased risk of developing type 2 diabetes mellitus. *FYI* In older adults with type 2 diabetes mellitus, there is: an insufficient release of insulin by the beta cells within the pancreas, a decrease in the rate of glucose metabolism (especially if there is a sudden, high concentration of glucose consumed), and a decrease in the amount of glycogen converted to glucose and released to the body that results in a decrease in blood glucose.
A nurse is assessing an older adult client who states he is homeless. Which of the following findings should the nurse document as comorbidities for this client? a. Inadequate shelter and clothing for the weather b. Malnutrition and poverty c. Dementia and tuberculosis d. Lack of preventive health care and immunizations
Dementia and tuberculosis *RATIONALE* The term comorbidity refers to medical conditions known to co-exist in a client. The number of comorbid conditions present in a client is used to provide an indication of his health status and risk of death. Dementia and tuberculosis occurring in an individual client is an example of comorbidity and increases the client's risk. *FYI* Inadequate shelter and clothing for the weather, malnutrition and poverty, and lack of preventive health care and immunizations are risk factors for disease, but are not comorbidities.
A nurse is teaching a group of older adult female clients who are postmenopausal about dietary requirements. Which of the following statements about the role of folic acid should the nurse make? a. "Clients who are postmenopausal need to limit their intake of folic acid to reduce their risk of stroke." b. "Dietary folic acid is not of significant importance after the childbearing years." c. "Healthy clients who are postmenopausal require a daily folic acid supplement." d. "Adequate folic acid intake is associated with a reduced risk for heart disease."
"Adequate folic acid intake is associated with a reduced risk for heart disease." *RATIONALE* Clients who are postmenopausal and consume the recommended daily intake of 400 mcg of folic acid have significantly lower levels of homocysteine, a risk factor for heart disease, than those who do not. Older adult female clients need to improve their daily folic acid intake, which can be accomplished by increasing daily dietary intake of foods such as orange juice, beans, legumes, and green leafy vegetables, as well as foods enriched with folic acid, such as breads and pastas.
An older adult client tells a nurse at a health fair "I am always forgetting things. I cannot even remember where I parked my car! Do you think I have Alzheimer's disease?" Which of the following is a therapeutic response by the nurse? a. "Perhaps you should discuss your concerns with your doctor." b. "I am forgetful too. I can't remember where I parked my car either!" c. "You're probably just having 'senior moments.' Everyone has memory lapses." d. "That must be very upsetting. Can you tell me about your forgetfulness?"
"That must be very upsetting. Can you tell me about your forgetfulness?" *RATIONALE* This statement is an example of the therapeutic communication technique of empathy and clarification. The client has stated a problem with forgetfulness, so the nurse empathizes with the client's concern and seeks additional information with which to counsel the client.
A nurse is providing teaching to an older adult client who has osteoarthritis of the right hip and lower lumbar vertebrae. Which of the following statements by the client indicates an understanding of the teaching? a. "I should avoid the use of a heating pad on my back." b. "To relieve the pressure on my hip, I can use a cane while ambulating." c. "I will have steroid injections to my joints as the first medication of choice to treat my pain." d. "I will exercise even when it causes pain."
"To relieve the pressure on my hip, I can use a cane while ambulating." *RATIONALE* Using a cane as an assistive device enables the client to compensate for weakness in the spine by providing some relief of hip pressure. Use of a cane can provide joint support and safety for self-care activities. *FYI* The use of heat and cold are therapeutic treatments in the management of arthritic pain; the preference of the client drives the decision between the two therapies ... Acetaminophen is the first medication of choice to treat the older adult client's pain from osteoarthritis; the nurse should instruct the client to take the medication as prescribed and not to wait until the pain is severe; steroid joint injections are used for persistent and disabling pain in the joints ... The nurse should teach the client to not exercise if exercise causes pain; goals for clients who have osteoarthritis include balancing rest with activity and avoiding activities that cause pain or discomfort; consistent activity is not beneficial for a client who has an arthritic joint disease because it can produce further damage to the joints and tissues.
A nurse is providing discharge instructions about calcium supplements to an older adult female client who has osteoporosis and a recent repair of a fracture in her right hip. Which of the following instructions should the nurse include? a. "You should take your calcium supplement with a large glass of water." b. "You should increase your intake of grain cereals while taking calcium supplements." c. "You should take at least 2600 milligrams of calcium supplements daily." d. "You will not need to take vitamin D with your calcium supplement after menopause.
"You should take your calcium supplement with a large glass of water." *RATIONALE* The nurse should instruct the client to take calcium supplements with a large glass of water, with or after meals, to promote absorption of the supplement. *FYI* The recommended dietary allowance (RDA) of calcium for the older adult female client is 1200 mg. Clients who are taking a calcium supplement should also take vitamin D to increase absorption even after menopause.
A nurse is conducting an admission assessment for an older adult client. Which of the following actions should the nurse take to collect subjective data? a. Leave the client a written questionnaire to fill out in private. b. Allow sufficient time for the client to respond to the questions. c. Talk to family members to obtain the client's health history. d. Obtain the health history from the client's medical record.
Allow sufficient time for the client to respond to the questions. *RATIONALE* The nurse should recognize that it might take an older adult client longer than other clients to process and respond to questions. Consequently, the nurse should allow adequate time for the client to respond without appearing rushed. The client's verbal responses formulate the subjective data of the health history. *FYI* Only the client can provide subjective data relevant to her health condition.
A nurse is caring for a client who has Alzheimer's disease and refuses to take her morning antihypertensive medication. The client is oriented to name and place and is able to perform ADLs with minimal supervision. Which of the following actions should the nurse take? a. Crush the pills and feed them to the client in applesauce. b. Insist the client comply by informing her of the possible implications of missing a dose. c. Notify the provider of the need for further evaluation of the client's level of competence. d. Ask the client to express her reasons for refusing the medication and document the event.
Ask the client to express her reasons for refusing the medication and document the event. *RATIONALE* Before intervening or making a judgment about the client's competence, the nurse should evaluate the client. The nurse should then determine if the client's reason for refusal can be addressed. *FYI* Forcing or tricking a client into taking medication or receiving treatment is unethical and can constitute battery.
A nurse is developing a plan of care for a client who had a recent stroke and has a history of gastroesophageal reflux disease (GERD). For which of the following disorders should the nurse plan to monitor for this client? a. Duodenal ulcer disease b. Aspiration pneumonia c. Viral pneumonia d. Esophageal varices
Aspiration pneumonia *RATIONALE* GERD results in reflux of gastric secretions from the stomach into the lower esophagus. When regurgitation occurs, the client is at high risk for pneumonia. Pneumonia occurs due to aspiration of gastric contents into the airway. This client is at increased risk for dysphagia due to the stroke and history of GERD; therefore, the nurse should monitor closely for aspiration pneumonia. *FYI* With duodenal ulcer disease, there are ulcers in the duodenum, usually associated with stress, COPD, pancreatic disease, and chronic renal failure ... The cause of viral pneumonia is an inhaled virus that settles in the lungs ... Esophageal varices occur in clients who have portal hypertension, usually due to hepatic cirrhosis.
A nurse is teaching a newly hired assistive personnel about her role in helping older adult clients with activities of daily living (ADLs). The nurse should explain that which of the following is the most common factor that affects a client's performance of ADLs? a. Social withdrawal b. Chronic physical disability c. Emotional impairment d. Cognitive dysfunction
Chronic physical disability *RATIONALE* Physical disability is the most common reason older adult clients have difficulty performing ADLs. Self-care deficit, the nursing diagnosis that describes the inability of the client to perform self-care activities necessary for optimum health and function, is associated with several physical etiologic factors: activity intolerance, pain, neuromuscular impairment, sensory-perceptual impairment, musculoskeletal impairment, and cognitive impairment.
A nurse in the clinic is assessing an older adult client for the second time in a week. The client reports a decreased energy level, insomnia, and anorexia. The client's diagnostic tests are within the expected reference ranges. For which of the following conditions should the nurse screen the client? a. Sarcopenia b. Dementia c. Depression d. Diabetes
Depression *RATIONALE* Depression, an altered mood state characterized by decreased energy levels, insomnia, anorexia, and sadness, is a common condition among older adult clients. Depression can be a response to an acute or chronic illness. Depression in older adult clients can also be the result of medications such as analgesics, antihypertensives, steroids, and cardiovascular agents. *FYI* Sarcopenia is an impairment of muscle tone; the loss of muscle tone is caused by physical inactivity, a change in the central and peripheral nervous systems, and reduced skeletal protein synthesis ... Dementia refers to a group of symptoms involving progressive impairment of all aspects of brain function; most of the disorders associated with dementia are irreversible, degenerative conditions ... The presenting manifestations of diabetes mellitus, a condition caused by the inability of the pancreas to secrete enough insulin for carbohydrate metabolism, include polydipsia, polyuria, and polyphagia; polyuria is also a manifestation of diabetes insipidus, which is a condition caused by the inability of the kidneys to conserve water.
A home health nurse is visiting an older adult client who has anemia. Which of the following foods should the nurse recommend to increase the client's iron intake? a. Greek yogurt b. Bran muffin c. Peanut butter sandwich d. Dried fruit
Dried fruit *RATIONALE* The nurse should recommend the client eat more dried fruit to increase iron in the diet. *FYI* The nurse should recommend greek yogurt to increase the client's intake of zinc and calcium ... The nurse should recommend bran muffins to increase the client's intake of fiber ... The nurse should recommend a peanut butter sandwich to increase the client's intake of a complementary protein, which is when two incomplete proteins are together, making the sandwich a complete protein.
A nurse is reviewing the medical record of a client who is postmenopausal and has osteoporosis. The client has a new prescription for alendronate sodium. Which of the following findings in the client's history should the nurse recognize is a contraindication to this medication? a. Glaucoma b. Paget's disease c. Esophageal achalasia d. Long-term corticosteroid use
Esophageal achalasia *RATIONALE* Clients who have a history of esophageal abnormalities, such as stricture or achalasia, have delayed esophageal emptying, which greatly increases the client's risk for esophageal erosion, bleeding, and perforation. Alendronate sodium is a bisphosphonate, which prevents or slows weakening of bone. It is used to prevent and treat postmenopausal osteoporosis. The nurse should instruct the client to wait at least 30 min after taking alendronate sodium before eating, drinking, or taking other medications, and caution her not to lie down for at least 30 min after taking the medication. Standing or sitting upright ensures that the client gets the full dose and decreases heartburn or the risk of injury to the esophagus. *FYI* Glaucoma is a degenerative eye disease where increased intraocular pressure causes damage to the optic nerve; it is not a contraindication to the use of alendronate sodium ... Paget's disease is a metabolic bone disease that involves bone destruction and regrowth that results in deformity; medical treatment with a bisphosphonate, such as alendronate sodium, is considered first-line therapy ... Long-term steroid use is frequently associated with the development of osteoporosis, and treatment with a bisphosphonate is considered first-line therapy.
A nurse is assessing an older adult client during an annual physical. Which of the following client findings should the nurse report to the provider? a. BP 118/76 mm Hg b. Fasting blood glucose level 160 mg/dL c. Report of waking to void two to three times per night d. Report of bowel movement every other day
Fasting blood glucose level 160 mg/dL *RATIONALE* The nurse should recognize that a fasting blood glucose level of 160 mg/dL is elevated. The nurse should report this value to the provider for further evaluation, as the client might be showing early signs of a tendency for diabetes mellitus. *FYI* The nurse should inform the provider if the client's BP is equal to or greater than 140/90 mm Hg ... Bladder capacity decreases with age, causing the client to reach a sensation of fullness and the need to void several times during the night ... Evacuating the bowels every other day can be due to slowing of peristalsis, which is a part of the aging process.
A nurse at an ophthalmology clinic is assessing a client referred by the provider for a potential cataract. Which of the following client reports should the nurse recognize is consistent with cataracts? a. Halos when looking at lights b. Loss of peripheral vision c. Bright flashes of light and floaters d. Eyestrain and headache with close work
Halos when looking at lights *RATIONALE* A cataract is a cloudy or opaque area in the lens of the client's eye. Cataracts in adults usually develop with advancing age and can be hereditary. Cataracts develop slowly and painlessly with a gradual onset of difficulty with vision. Visual problems include difficulty seeing at night, halos around lights or glare sensitivity, and decreased visual acuity, even in daylight. Cataracts are accelerated by environmental factors, such as cigarette smoke or other toxic substances, or in response to metabolic diseases, such as diabetes mellitus. *FYI* Glaucoma is a condition characterized by increased fluid pressure inside the eye, called intraocular pressure; this increased pressure damages the optic nerve, causing partial vision loss, with blindness as a possible outcome ... Retinal detachment refers to the separation of the light-sensitive membrane in the back of the eye from its supporting layers; bright flashes of light, especially in the peripheral visual field, and floaters are associated with retinal detachment ... Both nearsightedness, which is an error of visual focusing that makes distant objects appear blurred, and farsightedness, which is an age-associated progressive loss of the focusing power of the lens that results in difficulty seeing objects close-up, can cause eyestrain and headache.
A nurse in a long-term care facility is promoting reminiscence among older adult clients. Which of the following actions should the nurse take? a. Establish a weekly pet therapy visitation program. b. Place a calendar and clock in each resident's room. c. Institute a daily storytelling hour. d. Encourage all clients to eat their meals in the dining room.
Institute a daily storytelling hour. *RATIONALE* A storytelling hour is an example of reminiscence therapy, which allows clients to share stories of their past and reminisce with others who might have similar or shared memories. According to Erikson's psychosocial theory, reminiscence is an important action for older adult clients. *FYI* Pet therapy visitation programs can be beneficial in promoting socialization and social skills for clients ... Placing a calendar and clock in each client's room will promote the client's level of orientation to date and time ... Having clients eat their meals in a group dining room is beneficial to promoting socialization.
A nurse is participating on a committee that is developing age-appropriate care standards for older adult clients. Which of the following of Erikson's developmental tasks should the nurse recommend as the focus? a. Intimacy b. Identity c. Integrity d. Initiative
Integrity *RATIONALE* Integrity vs. despair is the conflict that older adult clients must resolve when they reflect on their lives and their roles. If the client has achieved a sense of unity and fulfillment about life, they will accept death with a sense of integrity, not fear. *FYI* Initiative vs. guilt is the conflict that clients must resolve during early childhood. In this stage, children must learn to achieve a balance between eagerness for more adventure and taking on more responsibility, learning to control impulses and childish fantasies ... Identity vs. role confusion is the conflict that clients must resolve during adolescence. This is the time when clients ask the question "Who am I?" To answer this question successfully, Erikson suggests that adolescent clients must integrate healthy resolutions from all earlier conflicts ... Intimacy vs. isolation is the conflict that clients must resolve during young adulthood. In this stage, clients develop love relationships and the capacity for intimacy.
A nurse is caring for an older adult client who has gout and refuses to eat. The client's provider has approved the family to bring food from home. Which of the following foods should the nurse recommend that the client not eat? a. Lentil soup b. Cheese sandwich c. Yogurt d. Raisins
Lentil soup *RATIONALE* The nurse should encourage the client to eat a purine-restricted diet to decrease elevated uric acid levels. The diet is used for clients who have gout, renal calculi, or both in conjunction with medication therapy. Whole grain breads and cereals, oatmeal, wheat germ, wheat bran, meat gravies, fresh and saltwater fish, beans, organ meats, mushrooms, green peas, spinach, asparagus, cauliflower, and baker's and brewer's yeast are all high in purine. Lentils, which are legumes, are a rich source of purines. *FYI* Ripe cheese is high in tyramine; MAOIs interfere with the inactivation of tyramine found in various foods, and adverse effects may occur with consumption of foods that contain tyramine ... Yogurt is a good source of calcium; many older adult clients, especially women, do not get enough calcium in their diets and require foods rich in calcium ... Raisins are rich in potassium; a potassium-restricted diet helps prevent high blood levels of potassium in clients who have renal failure.
A nurse at an assisted living center is conducting an orientation session for a group of newly hired assistive personnel (AP). Which of the following instructions should the nurse include regarding clients who are hearing impaired? a. Maintain eye contact with the clients. b. Stand to one side of the clients and speak into their good ears. c. Speak loudly with exaggerated enunciation. d. Ask only questions with yes or no answers.
Maintain eye contact with the clients. *RATIONALE* Many older adult clients who are hearing impaired use lip-reading and gestures to help understand what is said to them. Maintaining eye contact and speaking slowly will promote lip-reading.
A nurse is teaching an older adult client who is on bedrest following development of deep vein thrombosis (DVT) about methods to increase peristalsis. Which of the following high-fiber food choices should the nurse recommend? a. Navy bean soup b. Canned fruit juice c. White rice pudding d. Soy milk
Navy bean soup *RATIONALE* An older adult client who is on bedrest has an increased risk for constipation due to the decreased peristalsis associated with the aging process. Increasing dietary fiber by adding foods like legumes to the diet, as well as ensuring adequate fluid intake, will promote bowel regularity.
A nurse is planning care for an older adult client following abdominal surgery for a bowel obstruction. Which of the following information about pain management should the nurse consider when planning care? a. Older adult clients have a diminished capacity to perceive pain. b. Older adult clients should not take narcotics for pain control. c. Older adult clients have increased pain as a normal part of aging. d. Older adult clients are sensitive to the analgesic effect of opiates.
Older adult clients are sensitive to the analgesic effect of opiates. *RATIONALE* An older adult client is likely to require a decreased dose of opiates to provide the same level of analgesia as a younger client, with a reduced risk of side effects. *FYI* Older adults do not have a diminished capacity to perceive pain. However, older adult clients might have developed excellent coping skills that make it difficult to observe for cues of pain.
A nurse is caring for an older adult client who has dementia. The client becomes agitated and confused at night and wanders into the hallway. Which of the following actions should the nurse take? a. Place the client's mattress on the floor. b. Restrain the client during the nighttime hours. c. Provide continuous orientation to the client. d. Turn out the lights in the client's room at night.
Place the client's mattress on the floor. *RATIONALE* To ensure the client's safety and prevent falls when he is confused at night, the nurse should place his mattress on the floor. *FYI* The nurse should use a sensor device to alert when the client is wandering; restraints can cause the client to become frightened and struggle against them ... The nurse should provide orientation information only if it calms the client; when a client is agitated, the nurse should not try to force orientation and further increase his distress ... The nurse should keep the area well lit, because lighting can reinforce orientation for the client and minimize illusions.
A nurse is planning to administer diphenhydramine hydrochloride to an older adult client. Which of the following actions should the nurse plan to take prior to administration? a. Review the medical record for a client history of glaucoma. b. Plan to administer the medication 30 min prior to a meal. c. Explain to the client he will need to restrict his fluid intake once he takes the medication. d. Remind the client that his appetite might increase when starting the medication.
Review the medical record for a client history of glaucoma. *RATIONALE* The nurse should review the medical record for a history of glaucoma prior to administration of the medication. Diphenhydramine is contraindicated for clients who have narrow-angle glaucoma because diphenhydramine can dilate the pupils. Clients who have glaucoma are administered medication to constrict the pupils, which improves circulation of the aqueous humor for absorption. *FYI* This medication has an atropine-like drying effect and thickens bronchial secretions.
A nurse at a long-term care facility is providing teaching to a group of adolescents who are new volunteers. The nurse should explain that older adult clients are most likely to exhibit a decrease in which of the following? a. Short-term memory b. Creative ability c. Decision-making skills d. Cognitive capacity
Short-term memory *RATIONALE* The ability to process short-term memories decreases as part of the aging process. As a result, older adult clients might require reminders regarding their medications, ADLs, or daily schedules. The nurse should tell the volunteers that residents might have difficulty remembering their names from day-to-day, ask the same question repeatedly, or need assistance remembering recent events.
A nurse is planning care for a client who had a stroke. Which of the following goals should the nurse identify as the priority for this client? a. The client's skin will remain intact during hospitalization. b. The client will verbalize one new word each week. c. The client will begin to help turn himself in bed, indicating improved mobility. d. The client's airway will remain clear, as evidenced by clear breath sounds.
The client's airway will remain clear, as evidenced by clear breath sounds. *RATIONALE* The nurse should apply the ABC priority-setting framework when caring for this client. This framework emphasizes the basic core of human functioning: having an open airway, being able to breathe in adequate amounts of oxygen, and circulating oxygen to the body's organs via the blood. An alteration in any of these can indicate a threat to life and is the nurse's priority concern. When applying the ABC priority-setting framework, airway is always the highest priority because the airway must be clear and open for oxygen exchange to occur. Breathing is the second highest priority in the ABC priority-setting framework because adequate ventilatory effort is essential in order for oxygen exchange to occur. Circulation is the third highest priority in the ABC priority-setting framework because delivery of oxygen to critical organs only occurs if the heart and blood vessels are capable of efficiently carrying oxygen to them. The priority nursing action is to promote pulmonary hygiene as evidenced by clear breath sounds.
A nurse is teaching a group of healthy older adults about health screenings after age 50 years. Which of the following health screenings should the nurse recommend that the clients complete annually? a. Cholesterol b. Colonoscopy c. Diabetes mellitus d. Visual acuity
Visual acuity *RATIONALE* The nurse should recommend an annual visual acuity screening for all clients over 50 years of age. *FYI* The nurse should recommend cholesterol screening every 3 to 5 years until age 75 years ... While an annual rectal exam, including a stool specimen for occult blood, is a current recommendation, the recommendation for a colonoscopy is every 5 to 10 years beginning at the age of 50 years ... The nurse should recommend that older adult clients have a diabetes mellitus screening performed every 3 years, unless the client is high risk, and then the nurse should recommend more frequent screenings.
