NRS 102 GERO PREP U

An adult child accompanies an older adult client to the clinic and states, "I am not sure what is going on with my parent but I think it is depression." What questions should the nurse ask the client to determine if he or she is depressed? Select all that apply.

"Can you tell me what your sleep patterns are?" "Have you had any changes in weight recently such as a gain or loss?" "Have you lost interest in things you previously found pleasurable?"

An adult child accompanies an older adult client to the clinic and states, "I am not sure what is going on with my parent but I think it is depression." What questions should the nurse ask the client to determine if he or she is depressed? Select all that apply.

"Have you lost interest in things you previously found pleasurable?" "Have you had any changes in weight recently such as a gain or loss?" "Can you tell me what your sleep patterns are?"

An older adult client comes to the health center reporting difficulty sleeping. Which statement by the client would the nurse need to address?

"I find myself napping on and off throughout the day."

A nurse is conducting an education session about appropriate measures to promote sleep with an older adult who is experiencing frequent awakenings at night and then awakening early in the morning. The nurse determines that the education was successful when the client states:

"I need to try and go to bed and get up at the same time each night."

A nurse is teaching an older adult client's family about the causes of mental impairment. The nurse sees that the teaching has been effective when the family says which of the following?

"Sundowning is a common problem of dementia." Rationale: A common problem in patients with dementia is sundowning syndrome, in which an older adult habitually becomes confused, restless, and agitated after dark. Dementia is chronic and usually develops gradually. AD is the most common degenerative illness and is irreversible. Delirium, a temporary state of confusion, is an acute illness that can last from hours to weeks and resolves with treatment.

A nursing student is studying depression in older adults. Faculty members knows the student has mastered the information when she states which of the following?

"Treatment of depression includes counseling."

The nurse in a community health clinic is aware of the significant problems with nutrition in the older adult population. What percentage of older adults living on their own consume fewer than 1,000 calories per day?

16%

One of the greatest causes of death in the United States and Canada is colon cancer. The nurse instructs the community on which of the following factors?

Annual screening after the age of 50

The nurse practitioner is examining a 55-year-old female client. Which of the following findings would be uncommon for this age group?

Answer: Lower extremity pulses are weak. Rationale: Normal physiologic changes of the middle-aged adult do not include peripheral pulses becoming weak and not always palpable. The other options can be seen in a middle-aged adult.

A nurse is providing care to an older adult who is experiencing delirium. Which risk factors would the nurse identify as being most common? Select all that apply.

Answer: advanced age; pre-existing cognitive impairment; sleep deprivation Rationale: Pre-existing cognitive impairment places the client at risk for the development of delirium . Advanced age and sleep deprivation are also risk factors for the development of delirium especially in a hospital setting. Formation of amyloid plaques and tangles of tau proteins have an impact on the brain structure and function in older adults with dementia and not delirium. A previous MI is not a risk factor for the development of delirium.

The nurse is evaluating a 42-year-old client who says that he is feeling stressed. Which of the following does the nurse know that could be a cause of stress for this age group?

Being caught in the sandwich generation

When educating the middle-age adult, it is important to discuss which of the following?

Calcium replacement

In regard to lifespan considerations, the most important functional health pattern to assess in the elderly client is

Cognition-perception

An older adult client enjoys good overall health, but has just been diagnosed with pneumonia and has begun receiving an intravenous (IV) antibiotic. Shortly after being administered the first dose, the client pulled out his IV line and is now attempting to scale his bed rails. Which of the following phenomena most likely underlies this change in the client's cognition?

Delirium

What term is used to describe various disorders that progressively affect cognitive function?

Dementia

Gould viewed the middle years as a time when adults increase their feelings of self-satisfaction, value their spouse as a companion, and become more concerned with health. Which nursing action best facilitates this process?

Encouraging a client to have regular checkups

An elderly client is becoming progressively confused due to Alzheimer's disease. The family can no longer manage the client at home due to wandering. Which of the following living arrangements could the nurse recommend?

Extended-care facility

The middle adult is sometimes called the "sandwich generation". According to Erikson, the developmental task of the middle adult is what?

Generativity versus stagnation

The nurse is assigned to care for a client age 87 years admitted to the medical unit for congestive heart failure. It is the fourth hospital day, and the response to treatment has been good. The client is no longer short of breath and the lung sounds are clearing. There is still a diet restriction of decreased sodium and fluids are limited to no more than 1000 mL per day. The nurse is preparing the client and family for discharge. The nurse's discharge education, in order to promote the older client's health, will include which instructions? Select all that apply.

Gradually increase activities as tolerated. Do not use the salt shaker at meals. Increased stress may interfere with recovery.

A 78-year-old woman is on a nurse's rehabilitation unit status post a cerebrovascular accident (CVA). As the nurse assess her gait, the nurse notices that the client's left foot is dragging and she is not bending her left knee nor swinging her left arm. How would the nurse best describe the client's gait?

Hemiparesis Hemiparesis is weakness on one side of the body.

A 77-year-old woman is on the nurse's unit s/p left knee replacement. The client typically stools every morning but has not had a bowel movement in 3 days. The nurse knows that which medication places the client at increased risk for constipation?

Hydromorphone

When describing the older adult's risk for infection, which aspect would the nurse most likely address? Select all that apply.

Inadequate nutrition Lowered antibody responses Decline in humoral immunity

An 80-year-old woman has had abdominal surgery following a bowel obstruction. The nurse is aware that the recuperation period for this patient will most likely be prolonged due to what common condition found in the elderly?

Increased time for healing

The nurse is caring for an older adult postsurgical client who will be immobile for several weeks. Which evidence prompts the nurse to monitor for a risk for infection?

Increased white blood cell count on laboratory results

The nurse is reminiscing with a 72-year-old client with early onset dementia while providing care in a long-term care facility. How does the nurse implement this form of therapy to maximize the therapeutic value?

Listen to the client's stories and ask questions to facilitate ego integrity and provide companionship.

A nurse caring for older adults in a long-term care facility is teaching a novice nurse characteristic behaviors of older adults. Which statement is not considered ageism?

Personality is not changed by chronologic aging.

An client 81 years of age is in a long-term-care facility. His family could no longer cope with his progressing senile dementia, including wandering away and unpredictable behavior. Late one night the nurse finds the client wandering in the hall. He says he is looking for his wife. What should the nursing approach should be?

Remind him of where he is and assess why he is having difficulty sleeping.

The home care nurse is visiting an older adult client in the home to assess a leg wound and change the dressings. The nurse is aware that the client receives money monthly but there is no food in the house, no adequate heat, and the client states, "My sister takes my check and cashes it every month." What is the correct action by the nurse?

Report the incident to social service informing them the client has no food or heat.

A nurse is assessing an older adult with impaired thinking, mood and communication. The nurse would expect to find that the client is most likely experiencing problems with which activity initially? Select all that apply.

Shopping Managing finances Cooking

In a report, the night nurse tells the incoming nurse that one client with dementia. Which nursing concern will the nurse identify to address the client's sundowning syndrome?

Sleep deprivation Rationale: A common problem in clients with dementia is sundowning syndrome in which an older adult habitually becomes confused, restless, and agitated after dark and does not sleep. Implementing the nursing diagnosis of sleep deprivation will help the client obtain adequate sleep at night and awaken refreshed. Social isolation, grieving, and noncompliance are diagnoses that could be related to dementia but not sundowning.

There is an 86-year-old female on the medical inpatient unit. She explains that the hospital is quite noisy and that she is having difficulty sleeping. Which is not true regarding sleep in the older adult?

Sleep medications are usually the first choice in treating sleep disturbance.

A public health nurse is participating in a health fair that is being held at a local community center. The nurse should encourage adult participants to completely eliminate which of the following from their diet and lifestyle?

Smoking

After obtaining the health history from an older adult client, the nurse develops a plan of care and identifies the client has impaired physical mobility. What information would support this impairment? Select all that apply.

The client states the hip and knee joints hurt and are stiff when ambulating. The client states that he or she must use a walker for stability. The client reports weakness on one side of the body following a stroke.

A nurse is preparing a presentation for a group of older adults about health promotion. Which statistic would the nurse need to keep in mind about this group?

The group experiencing the largest growth is those 85 years of age and older.

An older adult client tells his home care nurse that he doesn't seem to sleep as well as he used to. The nurse is aware that the sleep changes that occur in the older adult client which cause a less restful sleep include:

a decrease in the deep sleep stage of the sleep cycle.

A nurse arrives at the home of an older adult client. The agency was called because a neighbor noticed that the client was home alone. The nurse finds the client alone in the living room. When asked about the client's daughter who lives there and has been caring for her, the client says, "She went on vacation for about a month. She'll be back soon." Further assessment reveals that there are no other family members or services currently involved. The nurse would identify this situation as:

abandonment.

A 76-year-old man is recovering from a myocardial infarction. In regards to his recovery, it is important for the nurse to:

address any questions about sexuality.

A nurse encourages residents of a long-term care facility to continue a similar pattern of behavior and activity that existed in their middle adulthood years to ensure healthy aging. This intervention is based on which aging theory?

identity-continuity theory

An older adult client being cared for at home has developed a decubitus injury. The nurse would instruct the family caregiver to institute measures to:

relieve sustained pressure.

The student nurse is conducting an informal study on pain management in the older adult population in a local long-term care facility. Which older adult client population will the student most likely find to receive the least effective pain management?

residents 85 years or older

An older adult is admitted to the health care facility with a diagnosis of depression. The nurse would be especially alert for:

suicidal thoughts.