NURS 3403 Exam 1

After teaching an older adult about oral hygiene, which statement reflects a need for further teaching? A."I will use toothpaste to clean my dentures." B."It would be best to visit the dentist twice a year." C."Dentures should be kept in cleaning solution overnight." D."Petroleum jelly will help keep my lips from cracking."

A."I will use toothpaste to clean my dentures."

A nurse teaches an older patient and her husband about strategies to continue sexual activity within the limitations of the woman's arthritis which causes pain, fatigue and limited motion. Which statement by the patient indicates she understands the nurse's recommendations? A. "We'll plan our sexual activity for a time when I'm most rested and relaxed." B. "We should always use the missionary position when having sex." C. "I'll wait to take pain medications until after we've had intercourse." D. "I'll use petroleum jelly (Vaseline ®) for vaginal lubrication during intercourse."

A. "We'll plan our sexual activity for a time when I'm most rested and relaxed."

Which factors contribute to Vitamin B12 deficiency in the older adult?(Select all that apply) A. After age 50, the stomach makes less gastric acid, so B12 absorption is less efficient B. Use of Proton Pump Inhibitors or Histamines for over a year C. Older adults don't eat enough Vitamin B12 D. Vitamin B12 binds to calcium in the blood E. Use of Metformin, Colchicine, antibiotics and anticonvulsant agents

A. After age 50, the stomach makes less gastric acid, so B12 absorption is less efficient B. Use of Proton Pump Inhibitors or Histamines for over a year E. Use of Metformin, Colchicine, antibiotics and anticonvulsant agents

A nurse will be conducting an education session at the local senior citizen's center on the importance of physical activity. Which activities should the nurse include as examples of moderate-intensity aerobic activity? A nurse will be conducting an education session at the local senior citizen's center on the importance of physical activity. Which activities should the nurse include as examples of moderate-intensity aerobic activity? A. Biking B. Range of Motion exercises C. Weight Lifting D. Dancing E. Swimming

A. Biking D. Dancing E. Swimming

Which statements about the free radical theory of aging are correct? Select all that apply. A. Exposure to environmental pollutants increases the rate of cell damage. B. High doses of supplemental antioxidants have been shown to be helpful. C. Cell damage is predictable and consistent from one cell to another. D. Free radicals are natural by-products of cell activity. E. Diets that include natural antioxidants are healthful.

A. Exposure to environmental pollutants increases the rate of cell damage. D. Free radicals are natural by-products of cell activity. E. Diets that include natural antioxidants are healthful.

Which statement is true about sleep aids and supplements for the older adults? A. Medications for sleep disorders should be started at the lowest possible dose. B. Benzodiazepines are an appropriate treatment for sleep disorders. C. Antihistamines are effective sleep aids because they do not have many side effects. D. Ingredients in over-the-counter sleep products, such as kava kava, are regulated by the U.S. Food and Drug Administration.

A. Medications for sleep disorders should be started at the lowest possible dose.

According to Healthy People 2020, older adults have been identified as a priority, addressing goals to improve dental health. Identify the correct dental health goals for older adults. (Select all that apply.) A. Reduce the proportion of older adults with untreated dental decay. B. Prevent and control oral and craniofacial diseases, conditions, and injuries. C. Reduce the proportion of pharyngeal cancers detected at the earliest stages. D. Improve access to preventive services and dental care. E. Reduce the proportion of older adults with untreated caries. F. Increase the proportion of older adults 65 to 74 years of age who have lost all of their natural teeth.

A. Reduce the proportion of older adults with untreated dental decay. B. Prevent and control oral and craniofacial diseases, conditions, and injuries. D. Improve access to preventive services and dental care. E. Reduce the proportion of older adults with untreated caries.

An older female patient is reading a large-print magazine and states that reading is difficult for her in the evening. Which intervention should the nurse implement? A.Put a high-intensity lamp at the head of her bed. B.Explain to her that the gray-yellow ring around her cornea, arcus senilis, is interfering with visual acuity. C.Put more powerful tubes in the fluorescent room lights. D.Examine her retinas for signs of damage.

A. The pupils become gradually smaller with age; therefore, the eye requires three times as much light. A high-intensity light on the object of interest is more effective than increasing the overall room illumination. The arcus senilisdoes not affect vision. The patient is describing a gradual overall change, not the more localized or sudden effects of macular degeneration or retinal detachment.

Which of the following is a true statement about sleep in older adults? A.The time spent in bed increases, but the time spent asleep decreases. B.The amount of leg movement during sleep remains steady throughout life. C.Rapid eye movement (REM) sleep becomes more unevenly distributed with age. D.The amount of stage III sleep increases steadily throughout life

A.Olderpersons tend to spend less time asleep than younger persons, although they spend more time in bed. This statement is true because sleep takes longer to arrive and is more fragmented. Leg movements during sleep often tend to increase with age. REM sleep becomes more evenly distributed with age. Stage III sleep decreases with age and virtually disappears in older adults.

An older man asks a nurse: "How do you define aging? Do I meet the criteria of a senior citizen?" The nurse understands that one can define aging in many different manners. If the nurse chooses to define aging as "social aging," the nurse would consider which of the following aspects? A.The man retired from his job as a police officer. B.The man takes six different medications multiple times over the course of the day. C.The man walks with a rolling walker. D.The man celebrated his 65th birthday.

A.Socialaging is determined by changes in roles. Taking multiple medications multiple times over the course of the day and walking with a rolling walker are functional determinants of aging. Age refers to chronological aging.

A nurse is caring for an older adult with cognitive impairment who recently had hip surgery. The nurse assesses the client for pain. The nurse would suspect that the client is in pain when the client demonstrates which of the following? (Select all that apply.) A.The client ate all of her meals. B.The client pushes caregivers away when they attempt to change the dressing on her hip. C.The client rocks back and forth repetitively when sitting in a chair. D.The client sleeps soundly throughout the night. E.The client cries out repeatedly when anyone approaches her.

B, C, E Pain cues in people with communication difficulties involve changes in behavior including restlessness, resistance to care, repetitive movements, and vocalizations. Other cues including sleeplessness and a decreased appetite.

A resident's family member is concerned that the resident is not eating adequately and is at risk for malnutrition. The family member says to a nurse, "I heard that there are drugs that can make my mother eat better. Do you think she should be on one?" The best response by the nurse is: A."Yes, there are some very effective drugs out there. Your mother should be on one of them." B."Use of drugs results in minimal improvement in appetite and weight gain and can have some serious side effects." C."There are no drugs that impact appetite or weight gain." D."These drugs are not permitted to be used in a long-term care facility."

B. Drugs to stimulate appetite and weight gain have demonstrated minimal improvement and can have serious side effects.

A nurse is caring for an older client at home who has a diagnosis of advanced dementia. The client's caregiver reports that over time, the patient has progressively decreased her oral intake and at present is not swallowing the food put in her mouth. The patient's husband reports that the primary care provider has contacted her and asked her to consider placement of a feeding tube. The caregiver asks the nurse what considerations they should be thinking about in making the decision. The nurse responds based on the knowledge that A. there are significantly better outcomes in older adults with dementia who have feeding tubes. B. careful hand feeding for patients with advanced dementia is recommended instead of feeding tubes. C. there are fewer infections in older adults with dementia who have feeding tubes D. feeding tubes are relatively low risk in older patients with dementia.

B. careful hand feeding for patients with advanced dementia is recommended instead of feeding tubes.

Which action should the nurse take firstwhen teaching a widowed older patient living with his son about ways to improve nutrition? A.Recommend a liquid caloric supplement B.Determine who shops and prepares meals C.Arrange for weekly transportation to the store D.Collaborate with a social worker for food stamps

B.Determine who shops and prepares meals

A nurse is observing skin integrity of an older adult. Which finding will the nurse document as a normal finding? A. Oily skin B. Faster nail growth C. Decreased elasticity D. Increased facial hair in men

C. Decreased elasticity

According to the article by Hudson-Barr (How to Read a Research Article), what is an easy way to understand a research article? A. Start by reading the methods section. B. Read the article from beginning to end. C. Identify the conclusions of the study first. D. Decide if the researcher chose the right subjects.

C. Identify the conclusions of the study first.

A nurse caring for residents in a long-term care facility plans interventions to help promote sleep in elderly residents. Which action is recommended for these residents? A. Encourage short periods of napping during the day. B. Administer diuretics during afternoon hours C. Increase physical activities during the day. D. Increase fluids during the evening

C. Increase physical activities during the day.

•An older adult is being treated for severe pain resulting from a history of osteoarthritis. When the nurse does discharge teaching, which information is mostimportant to include forthe successful management of the pain? A. Check for incompatibilities before taking any new medication. B. Arrange to take a dose of analgesic prior to physical activity. C. Take the analgesic around-the-clock as prescribed. D. Be alert for the signs of overdose toxicity.

C. Take the analgesic around-the-clock as prescribed.

Which statement best explains the difference in the treatment of pain in older adults compared with younger adults? A. The incidence of persistent pain is significantly higher in younger adults. B. The concern about addiction to narcotics is greater with older adults. C. There is a greater concern for maintaining function and comfort with older adults. D. There is a greater concern about adverse drug reactions among younger adults.

C. There is a greater concern for maintaining function and comfort with older adults.

In performing a physical assessment for an older adult, the nurse anticipates finding which of the following normal physiological changes of aging? (Select all that apply.) A.Irregular heart rate B.Increased salivation C.Reduced muscle mass D.Decreased lower leg hair E.Diminished bowel sounds

C.Reduced muscle mass D.Decreased lower leg hair

An older woman maintains an active lifestyle playing various games with friends. She reports to the nurse that she experiences wakefulness during the night and an inability to fall asleep after waking up at night. Which intervention should the nurse implement to improve the quality of this woman's sleep? A.Recommend preparation for sleep. B.Suggest trying a cup of warm milk at bedtime. C.Inquire about her nightly sleep rituals. D.Propose volunteer work at a thrift shop.

C.Thenurse completes an assessment of the woman's sleeping habits and other pertinent information before planning care and implementing nursing interventions to individualize therapy. Preparing for sleep is a reasonable intervention to propose after completing an assessment. Sipping warm milk is also a reasonable intervention to suggest after completing an assessment. Engaging in meaningful activities can improve the quality of sleep and is a reasonable intervention to propose after the assessment.

Compared with acute pain, which of the following statements is true of persistent pain? A.Leads to significantly altered vital signs B.Is usually described as a burning pain C.Is generally gone within 4 months D.Can bring about long-term changes in lifestyle

D. Persistent pain affects the patient's experience on a continuing basis. Both acute pain and persistent pain can affect the vital signs. Persistent pain may be described in many possible ways. Persistent pain is unrelenting.

What physiologic change is a normal part of aging? A. Dementia B. Diabetes C. Heart Disease D. Decreased Immunity

D. Decreased Immunity

Which is the most important element for older adults to have for enhancing the transition into retirement? A.Good health B.Private pension C.401k retirement plan D.Preretirement planning

D. Goodhealth is always a desirable state; however, if an older adult in poor health plans for retirement, then the transition to the changes of retirement can be smoother if the planning accounts for health challenges. With preretirement planning, private pensions are not obligatory. With preretirement planning, 401k retirement plans are not obligatory; however, these plans are effective saving plans for retirement; they allow employees to save pretax dollars. Preretirement planning is the most important aspect of a smooth transition into retirement because it affords the individual a chance to prepare for losses associated with retirement such as income, interpersonal communication, health insurance, status, influence, and other issues. Health, social, and financial planning help the older adult adapt to expected or sudden retirement.

A patient has been referred for polysomnography to confirm a diagnosis of sleep apnea. What symptoms would the nurse expect the patient to report? A.Inability to fall asleep with medications B.Kicking and hitting his partner while sleeping C. Consistently falling asleep during the evening meal D. Loud periodic snoring with choking on wakening

D. Loud periodic snoring with choking on wakening

The nurse is assessing dehydration in the older adult. Which of the following is atruestatement that should be considered? A.Urine flow gradually decreases in older age. B.Older adults generally need less fluid than younger people because of their lower body water content. C.Urine-specific gravity and skin turgor can be used to diagnose dehydration in older adults and in younger people. D.Multiple physiological changes of aging place older adults at a greater risk of dehydration than middle-aged persons or children.

D.Theloss of water-containing tissues, the loss of concentrating power in the kidneys, and a decreased sense of thirst all increase an older person's risk for dehydration. Urine flow does not diminish in old age. Specifically, it does not diminish in the presence of dehydration as it does in a younger patient. Lower body water content places an older patient at greater risk of dehydration, not a lower risk. These signs are less reliable in older age because of changes to the tissues.

According to the Popejoy article (Health-related Decision-making by older adults and their families), there is a "Circle of Control" for health-care decision-making for older adults. This is represented by the intersection of what three factors?

Older Adult, Family Members, Healthcare Team