Intro Ch 14 Older Adults

An elderly patient reports that he is unable to see bright lights, far objects appear blurred, and he is unable to read the newspaper as before. After examining the eyes, the nurse finds the patient's lens to be opaque. What does the nurse suspect in the patient? 1 Cataract 2 Presbyopia 3 Diabetic retinopathy 4 Macular degeneration

1 Cataract Sensitivity towards bright lights is called glare. Opacity of the lens indicates loss of transparency of the lens. Loss of transparency of the lens, blurred vision, increased sensitivity to glare, and gradual loss of vision are the clinical manifestations of cataract. Presbyopia is a condition, wherein the eye is unable to focus on near objects; though presbyopia is manifested by discoloration of the lens, it is not associated with blurred vision. Diabetic retinopathy has no early signs and symptoms. Macular degeneration is manifested by accumulation of extracellular material on the retina.

The nurse finds that an older adult patient has reduced consciousness and fatigue, and imagines something that does not exist. Which condition does the nurse suspect in the patient? 1 Delirium 2 Dementia 3 Depression 4 Alzheimer's disease

1 Delirium Delirium is an acute confusion state in which the patient has reduced or disturbed consciousness, is lethargic, and has distorted perceptions accompanied by delusions, hallucinations, and misperceptions. Dementia is a generalized impairment of intellectual functioning that interferes with social and occupational functioning. Older adults sometimes experience late-life depression; this is the most common undetected and untreated impairment. Alzheimer's disease is a progressive cerebral deterioration that can occur in middle or older age.

Which body system is involved in presbycusis? 1 Ears 2 Eyes 3 Taste 4 Touch

1 Ears Presbycusis is characterized by the presence of a loss of acuity for high-frequency tones and conversational speeches due to aging. It is a physiological sensory change that may occur in the ears with aging. Sensory changes in the eyes include yellowing of the lens and altered color perception. A sensory change in taste is often characterized by fewer taste buds. A sensory change in the touch might be caused by decreased skin receptors.

An older patient presents to the nurse with impaired vision, nocturia, and agitation. Which risk is most likely to occur in this patient? 1 Falls 2 Stroke 3 Heart disease 4 Chronic lung disease

1 Falls Impaired vision, nocturia, and agitation may increase the risk of falls in the patient. Diabetes mellitus, hypertension, and hyperlipidemia are the risk factors for stroke. Obesity, stress, and stroke are risk factors for heart disease. Smoking tobacco is a risk factor for chronic lung disease.

The nurse is assessing an anxious older adult who has recently started to make mistakes regarding date and time. What is the best approach by the nurse in this situation? 1 Let the patient continue to think in his or her own way. 2 Insist that the patient recognize the correct date and time. 3 Use touch intervention to reduce anxiety in the patient. 4 Inform the patient that this is an outcome of reminiscence

1 Let the patient continue to think in his or her own way. The anxious nature of the patient and mistaking the date and time are possible signs of dementia. Therefore, the patient may benefit from validation therapy, which involves letting the older adult continue to think in his or her own way. Older adults with dementia are more likely to become agitated if the nurse insists on correcting them. Use of touch therapy is usually done to provide emotional comfort; it does not address the patient's confusion. Reminiscence is a therapeutic approach that involves recalling the past to resolve present conflicts. Therefore, mistaking the present date and time is not an outcome of reminiscence.

An older patient is diagnosed with dorsal kyphosis. What is a contributing factor for developing this disorder? 1 Osteoporosis 2 Impacted cerumen 3 Subdural hematomas 4 Calcification of coastal cartilage

1 Osteoporosis Osteoporosis is a condition that results in loss of bone mass by crushing bones and leaving the bones brittle and prone to fractures. This causes curvature of thoracic spine, which is known as dorsal kyphosis. Impacted cerumen causes diminished hearing acuity in older adults. Subdural hematomas cause delirium in older adults. Calcification of coastal cartilage causes decreased mobility of the ribs in older adults.

Which therapy does the nurse suggest to help older adults recall their past to resolve current conflicts? 1 Reminiscence 2 Validation therapy 3 Reality orientation 4 Therapeutic communication

1 Reminiscence Reminiscence as a therapy uses the recollection of the past to understand and resolve current conflicts. It is a way to express personal identity and be optimistic. Validation therapy is an alternative approach to treat older adults who are confused about the present situation. Reality orientation is a communication technique that helps older adults restore a sense of reality and improve the level of awareness. Therapeutic communication skills enable the nurse to perceive and respect the older adult's uniqueness and health care expectations.

Physiological changes occur due to aging. Which changes can be observed in the integumentary system due to aging? Select all that apply. 1 Spots and lesions on the skin 2 Wrinkles on the face and neck 3 Resilient and supple skin 4 Unaffected elastic collagen fibers 5 Small red or brown cherry angiomas on the trunk

1 Spots and lesions on the skin 2 Wrinkles on the face and neck 5 Small red or brown cherry angiomas on the trunk Aging produces physiological changes in the body. Some changes occur in the integumentary system. Spots and lesions appear on the skin. Wrinkles on the face and neck region reflect lifelong patterns of muscle activity and facial expressions, the pull of gravity on tissue, and diminished elasticity. Small red or brown cherry angiomas occur on the trunk. Skin loses resilience and moisture. Due to aging, elastic collagen fibers shrink and become rigid.

Gastrointestinal function changes due to aging. Which effects are related to alterations in the lower gastrointestinal tract? Select all that apply. 1 Diarrhea 2 Vomiting 3 Flatulence 4 Gastric ulcer 5 Constipation

1 Diarrhea 3 Flatulence 5 Constipation \Alterations in the lower gastrointestinal tract lead to diarrhea, flatulence, and constipation. Due to aging, peristalsis movement becomes slow, and alterations in secretions occur. Alterations in the lower gastrointestinal tract do not cause vomiting or gastric ulcers.

Which are considered risk factors for falls in older adults? Select all that apply. 1 Osteoporosis 2 Airway blockages 3 Impaired hearing 4 Alterations in bladder function 5 Cognitive impairment 6 Peripheral neuropathy

1 Osteoporosis 4 Alterations in bladder function 5 Cognitive impairment 6 Peripheral neuropathy Older adults who are inactive have low bone and muscle mass or muscle tone and are at higher risk for osteoporosis, which can cause falls. Older adults with altered bladder function, such as urinary incontinence and nocturia, are at increased risk for falls. Conditions affecting mobility, such as arthritis and peripheral neuropathy, may lead to falls. Conditions like cognitive impairment and confusion may cause falls in older adults. Lung injury due to smoking leads to the development of chronic obstructive pulmonary disease (COPD), causing airflow blockage and breathing difficulty; airway blockages are not a significant risk factor for falls. Impaired hearing is commonly experienced by older adults; it is not a significant risk factors for falls.

When communicating with a patient who has a visual impairment, which techniques should the nurse use? Select all that apply. 1 Sit at eye level in front of the patient. 2 Cover the mouth while talking. 3 Provide diffuse, bright light without glare. 4 Avoid standing in front of the patient. 5 Encourage the use of eyeglasses or magnifying glasses.

1 Sit at eye level in front of the patient. 3 Provide diffuse, bright light without glare. 5 Encourage the use of eyeglasses or magnifying glasses. Sitting at eye level helps the patient to see the nurse and understand the words better. Help the patient have a better view of the nurse by providing diffuse and bright light, with no glare. Encourage the patient to wear eyeglasses or use magnifying glasses to improve vision. Covering the mouth when talking may muffle the spoken words, which may make them difficult to understand. Standing at eye level with the patient facilitates effective communication.

What may be the reason for decreased mobility of the ribs? 1 Curvature of the thoracic spine 2 Calcification of the costal cartilage 3 Decrease in the respiratory muscle strength 4 Increase in the anteroposterior diameter of thorax CV

2 Calcification of the costal cartilage Decreased mobility of the ribs is due to calcification of the costal cartilage. This occurs with aging. The curvature of the thoracic spine is known as dorsal kyphosis and is due to vertebral change. Decrease in the respiratory muscle strength and increase in the anteroposterior diameter of the thorax are age-related problems due to configurational changes in the thorax.

Which physiological change occurs with aging? 1 Decreased stomach pH 2 Decreased bladder capacity 3 Decreased airway resistance 4 Increased peripheral circulation

2 Decreased bladder capacity Aging is the process of becoming older. Aging decreases bladder capacity, because the bladder elasticity decreases. The stomach pH increases with aging, because the body produces less hydrochloric acid with advancing age. Aging decreases upper airway size and results in increased airway resistance. Peripheral circulation decreases with aging because of a narrowing of the arteries.

The nurse is caring for an elderly patient who is having difficulty recalling directions after hospitalization. On assessment, the nurse noticed that hypoxia has intensified the condition. What is the possible psychological condition of the patient? 1 Stress 2 Delirium 3 Dementia 4 Depression

2 Delirium Difficulty recalling directions may be a sign of delirium. This is an adverse event seen in hospitalized elderly patients. The risk of delirium in these patients is increased by conditions such as hypoxia. Stress is a nonmedical cause that increases the risk of delirium. Difficulty recalling directions is not necessarily a sign of dementia, which is associated with more pervasive memory loss. Depression is not associated with memory loss and is not exacerbated by hypoxia.

The nurse has conducted an assessment of a new patient who has come to the medical clinic. The 82-year-old patient has had osteoarthritis for 10 years and diabetes mellitus for 20 years. The patient is alert but becomes easily distracted during the nursing history. The patient recently moved to a new apartment, and the patient's pet beagle died just 2 months ago. Which is this patient most likely experiencing? 1 Dementia 2 Depression 3 Delirium 4 Disengagement

2 Depression Factors that often lead to depression include presence of a chronic disease or a recent change or life event (such as loss). Patients are alert but easily distracted in conversation. The symptoms presented by this patient do not indicate dementia, delirium, or disengagement.

Upon interacting with an older adult patient with preoccupied thoughts and poor hygiene and self-care, the nurse finds the patient feels lost after losing a family member in an accident. Which condition would the nurse suspect in the patient? 1 Delirium 2 Depression 3 Lewy body disease 4 Alzheimer's disease

2 Depression Older adults may experience late-life depression, but it is not a normal part of aging. Depression may occur with major life changes such as losing family in an accident; this is assessed easily by preoccupied thoughts, and poor hygiene and self-care. Delirium may be manifested by variable affective changes and exaggeration of personality type. It is also associated with acute physical illness. Lewy body disease and Alzheimer's disease are the generalized impairment of intellectual functioning that interferes with social and occupational functioning as aging progresses.

Which statement is true regarding delirium? 1 The onset of delirium is insidious. 2 Disturbed sleep/wake cycle is disturbed. 3 The patient with delirium may have normal alertness. 4 Progression of the delirium is slow over months and years

2 Disturbed sleep/wake cycle is disturbed. The sleep/wake cycle is disturbed in delirium. The onset of delirium is sudden or abrupt but not insidious. Alertness in delirium fluctuates and is lethargic or hypervigilant, but not normal. Progression of delirium is abrupt, not gradual over months and years.

Which body system is affected in presbyopia? 1 Ears 2 Eyes 3 Smell 4 Taste

2 Eyes Sensory change in the eyes is characterized by the presence of decreased accommodation to near or far vision and is called presbyopia. Sensory changes in the ears include thickening of the tympanic membrane and sclerosis of the ear. Sensory changes of smell include diminished sense of smell. A sensory change in the taste is often characterized by fewer taste buds.

While assessing the health of four patients, the nurse discovers one of the patient's findings to be age-related. Which patient supports the nurse's conclusion? 1 Patient A has white sclera. 2 Patient B has yellowing of the lens. 3 Patient C has a decreased sensitivity to glare. 4 Patient D has dilation of pupil in the presence of light.

2 Patient B has yellowing of the lens With aging, the crystalline fibers present in the lens stop regenerating and undergo many post-translational changes. These changes make the lens appear opaque and yellowish. Therefore, patient B's finding supports the nurse's conclusion. White sclera is a normal finding, not an age-related change. In older adults, there will be increased sensitivity to glare as an effect of aging. Therefore, the finding of patient C is not a physiological change related to aging. Pupils dilate upon exposure to light. Therefore, patient D's finding is normal.

Taste buds atrophy and lose sensitivity, and appetite may decrease. As a result, which is the older adult less able to discern? 1 Spicy and bland foods 2 Salty, sour, and bitter tastes 3 Hot and cold temperatures 4 Moist and dry food

2 Salty, sour, and bitter tastes As people, age, salivary secretion is reduced, and taste buds atrophy and lose sensitivity. The older adult is less able to differentiate among salty, sweet, sour, and bitter tastes. Often an adult uses heavy spices because of the inability to taste food. Older adults maintain their ability to differentiate between hot and cold temperatures, and moist and dry food.

Which respiratory change occurs in older adults? 1 Increased cilia 2 Increased alveoli 3 Increased cough reflex 4 Increased chest wall rigidity

4 Increased chest wall rigidity Chest wall rigidity is increased in older adults; it becomes stiffer and more rigid as age progresses due to rib and cartilaginous calcification. The number of cilia decreases as age progresses. The number of alveoli is less and cough reflex decreases in older adults.

Which condition can be inferred in a patient who complains of involuntary release of urine while laughing, sneezing, and coughing? 1 Diabetes mellitus 2 Stress incontinence 3 Prostate hypertrophy 4 Urinary tract infection

2 Stress incontinence Involuntary release of urine while laughing, sneezing, coughing, and lifting things is a sign of stress incontinence. In diabetes mellitus, a patient may show symptoms such as increased frequency of urinating. Prostate hypertrophy can lead to difficulty in initiation of voiding and maintenance of the urinary stream. Patients may have pain while urinating when experiencing a urinary tract infection.

The nurse is assessing the housing needs of an older adult with severe arthritis who has recently undergone knee replacement surgery. Which kinds of house are appropriate for this patient? Select all that apply. 1 A house with pets 2 A house with only one floor 3 A house with a shiny floor 4 A house with no exterior steps 5 A house with many throw rugs

2 A house with only one floor 4 A house with no exterior steps A housing unit with only one floor and without exterior steps is appropriate for the older adult with severe arthritis who has undergone knee replacement surgery. There may be restrictions to joint movements after the knee replacement surgery. A house with only one floor may reduce the need to climb stairs. A house with no exterior steps would be safe and prevent risk of falls. Pets may easily move around the patient's feet resulting in a fall. Shiny floors in a house may appear to be wet and cause falls. The presence of throw rugs increases the chances of falls.

Which type of elder mistreatment involves desertion of a vulnerable elder at a hospital? 1 Physical abuse 2 Abandonment 3 Caregiver neglect 4 Psychosocial abuse

2 Abandonment Abandonment may involve desertion by a caregiver of older adults who are unable to protect themselves at a hospital or other public location. Physical abuse refers to the infliction of physical pain such as hitting, beating or slapping. Caregiver neglect refers to failure of providing caregiving activities such as refusal to provide food, water, or clothing. Psychosocial abuse refers to an act that inflicts mental pain or distress such as humiliation and social isolation.

The nurse is teaching a group of older adults. Which principles are helpful in promoting learning in older adults? Select all that apply. 1 Sit to the side rather than directly facing the patient. 2 Ask for feedback from the patient. 3 Present one idea or concept at a time. 4 Speak fast and in a loud voice. 5 Use audio and visual cues while teaching.

2 Ask for feedback from the patient. 3 Present one idea or concept at a time. 5 Use audio and visual cues while teaching.

The nurse is teaching an elderly patient about care management for safe and effective care. Which teaching strategies will likely lead to effective learning in an older adult? Select all that apply. 1 Scheduling the teaching session in the evening 2 Pausing frequently before providing any new information 3 Using the teaching session to provide detailed information 4 Ensuring the presence of a family member during the teaching session 5 Using lay terms while providing medical information to the patient

2 Pausing frequently before providing any new information 4 Ensuring the presence of a family member during the teaching session 5 Using lay terms while providing medical information to the patient It is important to pause frequently after presenting new concepts or information because older adults need time to process the new information. The nurse should encourage the older adult to invite a family member or friend to ensure active participation of the older adult in the teaching session. Medical terminology is hard to understand and should be avoided when teaching older patients. It is important to use lay terms because it helps ensure proper understanding of the information by the older adult. The teaching session for an older patient should be scheduled in midmorning because energy levels are more likely to be high. By evening, older adults are often tired and unable to concentrate on the teaching provided to them. It is important to limit the message to a few essential key points and to avoid extraneous information in order to minimize distractions and help the older adult focus during the interaction.

A family member is considering having the mother placed in a nursing center. The nurse has talked with the family before and knows that this is a difficult decision. Which criteria should the nurse recommend in choosing a nursing center? Select all that apply. 1 The center should be clean, and rooms should look like hospital rooms. 2 There should be adequate staffing on all shifts. 3 Social activities should be available for all residents. 4 Three meals should be served daily with a set menu and serving schedule. 5 Family involvement in care planning and assisting with physical care is necessary

2 There should be adequate staffing on all shifts. 3 Social activities should be available for all residents. 5 Family involvement in care planning and assisting with physical care is necessary Adequate staffing, provision of social activities, and active family involvement are essential. Meals should be high quality with options as to what to eat and when meals are served. A nursing center should be clean, but it should look like a person's home.

The nurse sees a 76-year-old in the outpatient clinic. The patient's chief complaint is vision. The patient has really noticed glare in the lights at home; vision is blurred; and the patient is unable to play cards with friends, read, or do needlework. What is this patient experiencing? 1 Presbyopia 2 Disengagement 3 Cataracts 4 Depression

3 Cataracts Cataracts normally result in blurred vision, sensitivity to glare, and gradual loss of vision. Presbyopia is a common eye condition resulting in a person having difficulty adjusting to near and far vision. The symptoms are not reflective of depression, because the patient's vision affects the ability to interact. The patient has not chosen to avoid friends. Disengagement is a term referring to aging theory.

Aging affects bodily secretions. What is the effect of reduced salivary secretion and taste bud atrophy in the elderly patient? 1 Gum diseases 2 Mouth ulceration 3 Decease in appetite 4 Inability to differentiate various tastes

4 Inability to differentiate various tastes Reduced salivary secretion and taste bud atrophy occur due to aging, leading to the inability to differentiate among salty, sweet, sour, and bitter tastes. Reduced salivary secretion and taste bud atrophy do not cause gum diseases, mouth ulceration, or a decrease in appetite.

When a patient experiences kyphosis, which should the nurse recognize as a future risk? 1 Decreased bone density in the vertebrae and hips 2 Increased risk for pathological stress fractures in the hips 3 Changes in the configuration of the spine that affect the lungs and thorax 4 Calcification of the bony tissues of the long bones such as in the legs and arm

3 Changes in the configuration of the spine that affect the lungs and thorax Kyphosis is a curvature of the thoracic spine, which can affect the patient's ability to breath deeply and cough effectively. Although kyphosis may be cause by osteoporosis, the primary concern is the impact on the lungs. Decreased bone density, increased risk for stress fractures, and calcification of the bony tissues of the long bones may coexist with osteoporosis.

When an older adult suffers a major life event such as the death of a loved one, a move to a nursing home, or a cancer diagnosis, for what should the nurse be alert? 1 Dementia 2 Delirium 3 Depression 4 Stroke

3 Depression The onset of depression could be abrupt or gradual, but the usual cause is a major life-altering event in the life of the person experiencing the depression. Delirium is rapid onset and usually has a physiological cause; dementia's onset is slow; and a stroke presents with neurological changes.

Which clinical manifestation may present in a patient with dementia? 1 Incoherent speech 2 Impaired attention 3 Difficulty with abstraction 4 Difficult to distinguish between reality and misperceptions

3 Difficulty with abstraction A patient with dementia may face difficulty with abstraction. Incoherent speech may be associated with a patient with delirium. Attention may be altered in a patient with delirium; however, patients with dementia generally have normal attention. Misperceptions are usually absent in dementia. However, in delirium, the patient may find it difficult to distinguish between reality and misperceptions.

While reviewing the x-ray reports of an older patient, the nurse observes curvature of the thoracic spine. What does the nurse document in the patient's health record? 1 Presbyopia 2 Presbycusis 3 Dorsal kyphosis 4 Macular degeneration

3 Dorsal kyphosis Dorsal kyophosis is curvature of the thoracic spine in which the top of the back appears more rounded than normal. Presbyopia is a progressive decline in the ability of the eyes in older patients. Presbycusis is age-related hearing loss in older patients. Macular degeneration is a disorder of the eyes that results in loss of vision in older patients.

The nurse is working with an older adult after an acute hospitalization. The nurse's goal is to help this person be more in touch with time, place, and person. Which technique should the nurse try? 1 Reminiscence 2 Validation therapy 3 Reality orientation 4 Body image intervention

3 Reality orientation Reality orientation is a communication technique that can help restore a sense of reality, improve level of awareness, promote socialization, elevate independent functioning, and minimize confusion. Reminiscence recalls the past to bring meaning to the present. Validation is used with confused patients. Body image intervention is not indicated in this case.

Reminiscence strategies are used to evaluate an older adult patient's memory. What do these strategies do? 1 They produce a positive mood. 2 They reduce the patient's anxiety. 3 They stimulate memory chains through associations. 4 They allow evaluation of a patient's judgment and general knowledge.

3 They stimulate memory chains through associations. Reminiscence strategies can be used to stimulate memory chains by attempting to recall patterns of association that will improve the patient's recollection. These strategies may help the patient to recollect a coping strategy but do not produce a positive mood or reduce the patient's anxiety. Reminiscence strategies are not necessarily helpful in evaluating the patient's judgment and general knowledge.

The nurse is caring for an elderly patient diagnosed with Alzheimer's disease. Which intervention would help reduce the patient's confusion? 1 Reminiscence 2 Touch therapy 3 Validation therapy 4 Reality orientation

3 Validation therapy Validation therapy is beneficial for older adults who are in a confused state, as is common with Alzheimer's disease. It involves accepting and not arguing with patient statements, even if they are incorrect. Reminiscence as therapy involves recollection of the past to help the patient understand the present situation and resolve current conflicts. Touch is a therapeutic tool that is beneficial in older adults to provide physical and emotional comfort when performing any type of procedure. Reality orientation is a communication technique that helps in restore the sense of reality in an older adult.

The nurse is explaining the instrumental activities of daily living (IADL) to an older patient who is preparing to be discharged from the medical-surgical unit following minor surgery. Which activities may be included in the list? Select all that apply. 1 Taking a bath 2 Dressing 3 Cooking meals 4 Shopping 5 Writing checks 6 Making phone calls

3 Cooking meals 4 Shopping 5 Writing checks 6 Making phone calls The functional status in older patients refers to the capacity and safe performance of daily activities that are categorized as activities for daily living (ADL) and instrumental activities of daily living (IADLs). IADLs include activities such as cooking meals, shopping, writing checks, and making phone calls. Basic activities such as taking a bath and dressing are considered ADLs.

The nurse is teaching a group of older adults the importance of daily exercise. Which instructions should the nurse include in the teaching? Select all that apply. 1 Always perform exercise outdoors. 2 Do not drink water before exercising. 3 Stop exercising if there is chest pain or tightness. 4 Walking and swimming exercises protect the musculoskeletal system. 5 Wear good support shoes and clothing appropriate to the exercise.

3 Stop exercising if there is chest pain or tightness. 4 Walking and swimming exercises protect the musculoskeletal system. 5 Wear good support shoes and clothing appropriate to the exercise. The nurse should instruct older adults to stop exercising if there is chest pain or tightness, because this indicates exertion. Walking and swimming exercises are good for protecting the musculoskeletal system, because they condition the muscles and strengthen the bones. Good support shoes should be worn to prevent soft-tissue injuries. Clothing should be appropriate for exercise to promote comfort. Older adults should avoid outdoor exercises in extreme cold or warm weather to prevent temperature-related complications. Older adults should drink water before and after exercising to prevent dehydration. Regular exercise for you—not just for patients—even if only a 10-minute brisk walk each day, aids in reducing stress. Although you may have been able to enjoy regular sessions at the health club or at an exercise class several times a week, you may have to cut down on that time without giving up a set schedule for an exercise routine. Using an exercise bicycle that has a book rack on it can help you accomplish two goals at once. You can exercise while beginning a reading assignment or while studying notes for an exam. Listening to lecture recordings while doing floor exercises is another option. At least a couple of times a week, however, the exercise routine should be done without the mental connection to school; time for the mind to unwind is necessary, too.

A nurse is teaching an older patient about proper medication use. Which statement made by the patient indicates the need for further teaching? 1 "I will seek out low-cost generic drugs." 2 "I will consult a pharmacist before taking multiple medications." 3 "I will continue my treatment by consulting a single physician." 4 "I will use over-the-counter medicines along with prescribed drugs."

4 "I will use over-the-counter medicines along with prescribed drugs." Using over-the-counter medicines along with prescription drugs may result in drug-drug interactions, which may cause the patient to experience severe adverse effects. Low-cost generic drugs can be used as these have similar potency and would not cause adverse effects because composition is not altered. Consulting a pharmacist before taking multiple medications will reduce the risk of polypharmacy. Consulting a single physician will reduce the risk of polypharmacy because the physician would check for drug interactions and prescribe the drug accordingly.

A registered nurse is evaluating the statements of the student nurse regarding reproductive changes that occur in both sexes due to aging. Which statement made by the student nurse indicates a need for further teaching? 1 "The desire to have sex decreases with aging." 2 "Vaginal irritation causes pain during sexual activity." 3 "Lack of lubrication of vaginal mucosa causes irritation." t4 "Production of sperm in men decreases during the third decade of life."

4 "Production of sperm in men decreases during the third decade of life."

A nurse who is caring for an older adult patient observes that the patient lacks confidence and is unwilling to take medications. Which statement by the nurse would promote positive perception in the patient? 1 "You need to take your medication on time." 2 "You should accept that aging is a universal truth." 3 "You should try talking with people in your same age group." 4 "You should try to be happy and spend some time talking with your friends."

4 "You should try to be happy and spend some time talking with your friends."

Sexuality is maintained throughout our lives. Which answer below best explains sexuality in an older adult? 1 When the sexual partner passes away, the survivor no longer feels sexual. 2 A decrease in an older adult's libido occurs. 3 Any outward expression of sexuality suggests that the older adult is having a developmental problem. 4 All older adults, whether healthy or frail, need to express sexual feelings.

4 All older adults, whether healthy or frail, need to express sexual feelings. Sexuality is normal throughout the life span, and older adults need to be able to express their sexual feelings.

An older adult patient complains of knee pain when attempting to do usual activities. Which type of health care setting is most appropriate for this patient? 1 Home care 2 Acute care 3 Skilled nursing care 4 Ambulatory care

4 Ambulatory care Complaints of pain and/or decreased ability to do usual activities are common in older adults and can have a variety of etiologies. The most appropriate setting for this patient to be seen in is ambulatory care, such as a primary care provider office or outpatient clinic. Home care is appropriate when a patient needs care but cannot leave the home easily, requires a service that used to be available only in an acute care setting (e.g., IV therapy, wound care, specialized feedings) or for older adult patients who are in the late stage of a chronic disease. Skilled nursing care is provided to older adults who are unable to live at home safely, but who do not have acute care needs. Acute care is appropriate for older adults who have an acute problem that cannot be managed in an outpatient or home setting.

A patient has presbyopia. Which visual manifestation would most likely be present upon examination of the patient? 1 Difficulty to distinguish between blues and greens 2 Difficulty to distinguish between colors such as blue and black 3 Difficulty with vision when moving from bright to dark environments 4 Decline in the ability of the eyes to accommodate from near to far vision

4 Decline in the ability of the eyes to accommodate from near to far vision Visual activity declines with age. The decline in the ability of the eyes to accommodate from near to far vision is called presbyopia. Aging may also result in changes in color vision and discoloration of the lens, making it difficult to distinguish between blues and greens or between dark colors such as blue and black. However, these are not caused by presbyopia. As one ages, the ability to adapt to abrupt changes from dark to light areas is reduced, thus causing difficulty in vision when moving from bright to dark environments.

Which statement is true regarding dementia? 1 Dementia has a sudden onset. 2 Dementia worsens during daytime. 3 Dementia lasts only for few minutes. 4 Dementia has no effect on attention.

4 Dementia has no effect on attention. Delirium, not dementia, is a state of reduced mental ability, severe enough to interfere with daily activities. Patients with dementia experience no effect on their attention. Dementia starts slowly and is often unrecognized. Dementia does not worsen either in the daytime or at night. It lasts for months to years.

Which system is affected in periodontal disease, which occurs as a result of common physiological change with aging? 1 Respiratory system 2 Neurological system 3 Genitourinary system 4 Gastrointestinal system

4 Gastrointestinal system Periodontal disease may occur as a physiological change in the gastrointestinal system with aging. The respiratory system is characterized by increased cough reflex, decreased cilia, and fewer alveoli. Physiological changes in the neurological system include degeneration of nerve cells and degeneration of neurons. Physiological changes in the genitourinary system include decreased nephrons and decreased bladder capacity.

While caring for an elderly patient, the nurse suspects that the patient has developed depression. Which action of the patient supports the nurse's suspicion? 1 Trying hard to dress and tie a shoelace 2 Making numerous errors in the day-to-day work 3 Getting tired easily after performing a small activity 4 Getting up early in the morning with frequent arousals at the night

4 Getting up early in the morning with frequent arousals at the night An elderly patient with depression may have disturbed sleep at nights and may wake up early in the morning due to preoccupied personal thoughts and poor appetite. A patient with delirium finds it difficult to cope with daily activities such as dressing and tying shoelaces. This is due to exaggeration of personality type associated with acute physical illness. The patient with delirium usually feels distracted from tasks and makes mistakes while performing daily basic activities. A patient with dementia gets tired easily after performing a small activity.

Which description is applicable to therapeutic communication? 1 It provides sensory stimulation. 2 It focuses on older adult recalling the past. 3 It accepts time descriptions as stated by the older adult. 4 It provides care by meeting a patient's expressed or unexpressed needs.

4 It provides care by meeting a patient's expressed or unexpressed needs. Meeting a patient's expressed or unexpressed need is a characteristic of therapeutic communication. Sensory stimulation may be provided through touch therapy. A focus on recalling the past of an older adult is characteristic of reminiscence. The acceptance of time descriptions stated by an older adult is part of validation therapy.

An older adult is unable to distinguish between the colors blue and black. Which is the most likely cause for this condition? 1 A hereditary syndrome 2 Malnourishment 3 A mental disorder 4 Lens discoloration

4 Lens discoloration Changes in color vision may occur due to aging. The lens in the eye can become discolored, making it difficult to distinguish between dark colors such as blue and black. It is neither a hereditary syndrome nor a mental problem, and it is not due to the effect of malnourishment. It is due to aging.

After interacting with an older adult patient, the nurse suspects that the patient has presbyopia. Which action of the patient supports the nurse's suspicion? 1 Repeating words 2 Sipping water occasionally 3 Asking others to speak loud 4 Picking a blue shirt assuming it as black

4 Picking a blue shirt assuming it as black Presbyopia is a visual acuity that leads to progressive decline of the eyes to accommodate vision. Therefore, an older adult patient with presbyopia may not able to differentiate dark colors such as black and blue. A patient with mental impairment finds it hard to remember things and keeps repeating essential words. Salivary secretion reduces in older adults. Therefore, the patient sips water occasionally to reduce thirst. Older adults may have age-related hearing impairment, known as presbycusis. These older adults may ask others to speak loudly.

The caregiver of an older adult patient reports, "My father, in spite of turning up the volume on the radio and television, complains that he is unable to hear." Which condition should the nurse suspect in the patient? 1 Kyphosis 2 Keratoses 3 Presbyopia 4 Presbycusis

4 Presbycusis Auditory changes are often subtle in older adults, and are often unidentified and untreated. A 68-year-old patient with presbycusis may have impacted cerumen, which is a common cause of diminished hearing acuity. Kyphosis occurs in the older adults due to osteoporosis, which leads to curvature of the thoracic spine. Keratoses are irregular, round or oval, brown, and watery lesions usually found on an older adult's skin due to aging. Presbyopia is a visual acuity defect in older adults that occurs due to retinal damage, reduced pupil size, development of opacities in the lens, or loss of lens elasticity.

Which condition does the nurse suspect in an older adult patient who has complained of daily hearing decline? 1 Delirium 2 Dementia 3 Presbyopia 4 Presbycusis

4 Presbycusis Presbycusis refers to progressive loss of hearing that occurs with age. Delirium is a cognitive impairment resulting in a confused state in the patient. Dementia is an impairment of intellectual functioning that interferes with social and occupational functioning. Presbyopia is a progressive decline of the vision.

The nurse is caring for an 80-year-old man who recently lost his wife. He states that he has been drinking more than he ever did in the past and feels hopeless without his wife. He reports that he rarely sees his children and feels isolated and alone. Which is the greatest risk for this patient? 1 Dementia 2 Liver failure 3 Dehydration 4 Suicide

4 Suicide The patient is sharing that he is depressed. Key concepts include recent loss of his wife, excessive drinking, hopelessness, and isolation, making him at risk for suicide. Dementia presents with memory problems; liver failure would occur after significant liver damage; dehydration would occur from poor fluid intake.

The nurse is reviewing medical reports of four older patients. Which patient does the nurse suspect to be at risk for depression? 1 Patient 1 has arthritis. 2 Patient 2 has hemorrhage. 3 Patient 3 has cerebral anoxia. 4 Patient 4 has impacted cerumen.

Patient 1 has arthritis. Depression in older patients is associated with increased disability in those who have arthritis. Arthritis is a pain-provoking chronic disease, which may impair the patient's daily activities. This may lead to depression in older patients. Hemorrhage and cerebral anorexia cause delirium in older patients. Impacted cerumen causes decreased hearing acuity in older patients.