Nursing for the Older Adult Quiz 3
90-year-old woman has been admitted to the hospital with a diagnosis of failure to thrive. What laboratory data would be congruent with malnutrition? A) Low albumin and red blood cells B) Elevated white blood cells and low potassium C) Low platelets and low prothrombin time D) Elevated calcium and magnesium
a
A 70-year-old woman has expressed interest in preventing osteoporosis as a result of the high prevalence of the disease in her peer group. What dietary measures should the nurse recommend? A) High intake of calcium and vitamin D B) A high-protein, low-carbohydrate diet C) High intake of organic fruits and vegetables D) Vitamin C supplements and a high-potassium die
a
A 75-year-old woman who often used to go out to dinner with her friends has stopped from going out because she has been experiencing urinary incontinence and is afraid of having an "accident" in public. When her child asks her why she doesn't go out with her friends anymore, she says, "I'm getting too old for such foolishness." How can the nurse best assist this client? A) Assist the client to view this functional limitation as temporary and treatable. B) Encourage the client to accept this consequence of growing old. C) Rephrase the situation to one of control, and allow the client to make the decisions. D) Teach the client that majority of older adults rate their health as good to excellent.
a
A 99-year-old resident has fallen. Which of the following functional consequences of this fall most strongly impacts the plan of care? A) A 99-year-old is at much higher risk of a fracture from a fall than a younger person. B) A 99-year-old is more likely to have limited range of motion, impacting performance of some activities of daily living (ADLs). C) A 99-year-old who has fallen is unlikely to develop fear of falls. D) A 99-year-old will have diminished muscle strength related to muscle mass loss.
a
A client is unresponsive, the skin is usually dry, confined to bed, with limited mobility and contractures, and the nutrition is less than adequate. Using the Braden score, which score will be assigned to this client's risk for pressure ulcers? A) 8, very high risk B) 8, at risk C) 18, high risk D) 18, moderate risk
a
A nurse assesses a 70-year-old man who has high blood pressure and chronic obstructive pulmonary disease (COPD). He has been prescribed nicardipine and ipratropium inhaler. This medication combines a calcium-channel blocker and an anticholinergic. For which of the following urinary effects should the nurse teach the client to monitor? A) Nocturia B) Urinary tract infection (UTI) C) Urge incontinence D) Hematuria
a
A nurse assesses an 85-year-old Hispanic woman. The client states that her husband was punished by God. To which of the following illnesses is the woman most likely referring? A) Alcohol abuse B) Fainting C) Posttraumatic stress disorder (PTSD) D) Voodoo
a
A nurse at a rehabilitation unit assesses an 86-year-old woman with a BMI of 30 and a history of heart failure, whose oral intake is declining. Which of the following risk factors is related to this older adult's decline in appetite? A) Diuretics B) Exercise C) Female gender D) Obesity
a
A nurse is participating in a health fair that is being sponsored by a local seniors' center, discussing healthy skin and aging. Which of the following teaching points should the nurse emphasize? A) "You should limit your sun exposure to a small amount each day and keep your skin protected from direct sunlight for the remainder." B) "Many drugs can have an effect on your skin, so it's important to avoid most over-the-counter medications." C) "The health of your skin is primarily determined by your genes, so all you can do is try to maintain your overall level of health." D) "Even if you find it difficult to do, it's important to bathe once a day."
a
A nurse is participating in a health fair that is being sponsored by a local seniors' center. What teaching point should the nurse emphasize in an effort to address older adults' risk factors related to skin wellness? A) "As much as possible, try to keep your skin protected from direct sunlight." B) "Many drugs can have an effect on your skin, so it's important to avoid most over-the-counter medications?" C) "The health of your skin is primarily determined by your genes, so all you can do is try to maintain your overall level of health." D) "Even if you find it difficult to do, it's important to bathe once a day."
a
A nurse is responsible for leading a Healthy Aging Class at a community health center. What question should the nurse use to generate discussion among participants in this setting? A) "How did you adjust to your move from your house to the assisted living facility Irma?" B) "Are you satisfied with the care that you're getting from your family doctor, Elizabeth?" C) "Donald, could you tell us why your grandson is living with you?" D) "Have you had any tests done on your heart since we last met, Marie?"
a
A nurse monitors older adults at an assisted living facility for pressure ulcers. Which of the following older adult is at highest risk for a pressure ulcer? A) The obese older adult with continuous positive airway pressure (CPAP) mask B) The frail older adult with a hearing aid C) The older adult undergoing therapy for a weak hand D) The older adult preparing to walk a half marathon
a
A nurse notes a 2-mm open shallow ulcer with a red wound bed on the great toe where shoe touched the skin. Which of the following should the nurse document? A) 2-mm stage II pressure ulcer B) Stage III pressure ulcer on great toe C) 2-mm skin tear with red wound bed D) Red ulcer on the great toe 2 mm in size
a
A nurse on a subacute, geriatric medicine unit is aware that patients' levels of psychosocial functioning have a significant impact on multiple aspects of their lives. Which of the following consequences is known to result from impaired psychosocial function? A) Anxiety B) Elevated blood glucose level C) Increased independence D) Cerebrovascular accident (stroke)
a
A nurse on an acute care for elders unit is disturbed by the increasing incidence of pressure ulcers among patients. What measure should the nurses on the unit prioritize in order to prevent the formation of pressure ulcers? A) Frequent repositioning of immobilized patients B) A high-protein diet C) Use of massage and other forms of tactile stimulation D) Use of prophylactic antibiotics
a
A nurse plans care for a client who states that food is no longer appealing. The nurse notes a dry mouth and teeth in poor condition. Which interventions should the nurse include in the plan of care? (Select all that apply.) A) Eight-ounce bottle of water between each meal B) Hard toothbrush C) Ice cold water at bedside D) Meals in the common room E) Oral care before each meal
a
A registered nurse is teaching a nursing assistant about the impact of culture on older adults' well-being. Which of the following statements by the nursing assistant indicates a need for further teaching? A) "A cultural background has little influence on individuals' standards for 'normal' or 'abnormal' behavior." B) "Western cultures often have a very rigid distinction between health and illness." C) "Culture may influence mental health and illness in individuals." D) "Culture may determine an individual's expression of symptoms or clinical manifestations."
a
An 80-year-old man is seen in the emergency department for a fall. He has bruises on his upper arms and appears depressed. He is accompanied by his grandson, who is unkempt, glassy-eyed, and has alcohol on his breath. Which of the following should be a priority with the nurse? A) Assess whether the older adult is safe in his environment. B) Determine whether legal interventions are appropriate. C) Assess the patient's degree of frailty and chronic health problems. D) Determine the mental capacity of the older adult.
a
An 82-year-old client walked 2 miles last week to enjoy the spring weather. The client says since that time, "I haven't been doing very much, I'm afraid it will hurt." Which action by the nurse is most appropriate? A) Discuss moderation in activity, encouraging continued movement. B) Obtain a cane for use to improve balance, and reduce the client's fears. C) Encourage the client to walk the 2 miles every day. D) Have the client take ibuprofen (Motrin IB) every morning.
a
Despite the lack of a history of strokes or transient ischemic attacks, an 81-year-old woman states that she occasionally has difficulty in swallowing. The woman's primary care provider attributes this problem to presbyphagia, or age-related changes in swallowing ability. This fact should prompt the woman's nurse to assess for which of the following problems? A) Aspiration B) Fluid volume deficit C) Dyspepsia D) Cholelithiasis (gallstones)
a
During a home care nurse's visit to an older woman's home for wound care, the woman has intimated to the nurse that her son sometimes "flies off the handle and gets rough with me." The son is currently at work. How should the nurse respond to this client's statement? A) "When you say that he 'gets rough,' what does that look like?" B) "What do you think usually provokes him when this happens?" C) "I'm going to have to phone adult protective services right now." D) "Why do you think that he responds that way when he gets angry or frustrated?"
a
Matilda's neighbor notices Matilda getting water from someone's outside faucet. The neighbor notices Matilda's ankles are very swollen and that she has an untreated wound on her left leg. Matilda says, "I stopped taking my fluid pill because my water has been turned off by the water company. My daughter forgot to pay the water bill, and she does not have time to take me to the doctor for my sore." The neighbor calls adult protective services. Which of the following interventions is needed first? A) The competency of the older adult in making decisions needs to be determined. B) The daughter needs to be picked up by the police on a neglect charge. C) The older adult needs to be involuntarily committed to a long-term facility. D) An involuntary legal intervention needs to be initiated immediately.
a
Mr. Abramson, age 70, has been diagnosed with benign prostatic hyperplasia (BPH) by his primary care provider. What complaint most likely prompted Mr. Abramson to initially seek care? A) Nocturia B) Recurrent urinary tract infections C) Functional incontinence D) Hematuria
a
Which of the following older adults is most at risk to develop osteoporosis? A) A 65-year-old white female with COPD who takes corticosteroids B) A 65-year-old white male with rheumatoid arthritis C) A 70-year-old African American male with a seizure disorder D) A 68-year-old Hispanic female who recently had a partial hysterectomy
a
Which of the following policies would promote a sense of control for an older adult in an assisted living facility? A) Holding resident council meetings twice monthly and inviting all residents to attend B) Posting a meal menu every Sunday and telling the residents that they must notify the kitchen in advance if they want a menu change C) Designing all the emergency pull cords so they blend in with the wallpaper and are inconspicuous D) Teaching the nurses' aides to use the passkey to do spot checks on every resident at least twice during the night to ensure that the residents are safe
a
Which of the following statements about the assessment of an older adult's urinary elimination is accurate? A) The nurse should try initially to identify the terms that are most acceptable and comprehensible to the older adult. B) Because urinary incontinence can be an embarrassing problem, nurses should wait until the person initiates a discussion of the topic. C) Nurses should use only correct medical terminology, such as micturition and incontinence, in their assessment so that they serve as a role model for the older adult. D) The nurse should ask the older adult to discuss his or her voiding patterns and to keep a diary.
a
The nurse cares for a client with advanced Alzheimer disease who is not mobile. The nurse has assessed the client as high risk for falls. Which of the following should be included in the fall-prevention program? (Select all that apply.) A) Bright orange sticker on the resident's door B) Padded mattress on the floor next to the resident's bed C) Use of chest restraints when in the wheelchair D) Frequent assessment of resident for toileting needs E) Keep lights on in room and bathroom F) Place sensor pad alarm on bed
abdf
A nurse assesses older adults at risk for pressure ulcers. Which of the following assessment tools should the nurse use to identify those who might benefit from interventions? (Select all that apply.) A) Braden Scale B) Norton Scale C) PUSH Scale D) Reverse staging E) Waterloo Scale
abe
A 30-year-old granddaughter lives with and provides care for her 75-year-old grandmother. The grandmother has congestive heart failure, hypothyroidism, and chronic pain from an old compression fracture. The granddaughter supervises her grandmother's medications. The home health nurse notices that the grandmother has extra fluid pills and that her pain medication for the month is gone. The pain medication prescription is not eligible to be refilled for 2 more weeks. The older adult tells the nurse the pain pill is not working and that her back is always hurting. The nurse notices the woman's ankles are very swollen. Which of the following things should the nurse do first? A) Call adult protective services and ask for an immediate evaluation. B) Assess the granddaughter's understanding of her grandmother's needs. C) Take the grandmother to the emergency department immediately. D) Tell the older adult that her granddaughter is probably taking her pain medications.
b
A 69-year-old woman is saddened by her recent diagnosis of type 2 diabetes, as stressor that will make numerous demands on her life in the coming years. Which of the following actions demonstrates a problem-focused approach to this stressor? A) Eliciting support and sympathy from her sister and neighbor B) Obtaining diabetic cookbooks and learning to change her cooking habits C) Seeking out a second opinion from another physician D) Determining to make no lifestyle changes despite her new diagnosis
b
A 70-year-old client with urosepsis is admitted to a nursing unit. The labs include elevated sodium, blood urea nitrogen, hematocrit, and albumin. Which of the following nursing diagnoses is priority for this client? A) Constipation B) Fluid volume deficit C) Imbalanced nutrition: less than body requirements D) Impaired tissue perfusion
b
A 75-year-old woman who often used to go out to dinner with her friends has stopped from going out because she has been experiencing urinary incontinence and is afraid of having an "accident" in public. When her daughter asks her why she doesn't go out with her friends anymore, she says, "I'm getting too old for such foolishness." Her daughter asks her to go to the doctor for an evaluation, but she refuses to do so. Which of the following is occurring with this older adult? A) She is experiencing learned helplessness and low self-efficacy. B) She sees incontinence as an inevitable consequence of aging. C) She views her incontinence as a negative functional consequence of growing old. D) She is unable to find a doctor who is sympathetic and willing to find a solution.
b
A nurse admits an 81-year-old to the hospital for congestive heart failure. The client is widowed, and has recently moved to an assisted living facility. Which of the following contributed the most to this admission? A) Moving changed her daily habits. B) Her age-related changes and risk factors increased. C) The stress of widowhood and relocation stressed her body. D) The assisted living facility serves food high in saturated fats.
b
A nurse assesses an older adult 24 hours after a retropubic suspension surgical procedure. The client is confused, exhibits muscle twitching, and states she is nauseated. Which laboratory data should the nurse assess? A) Blood urea nitrogen B) Sodium C) Hemoglobin D) White blood cell count
b
A nurse assesses older adults at a senior center. One older adult, age 78, has a body mass index (BMI) of 15. Which response by the nurse is appropriate? A) "You are too skinny." B) "Have you been losing weight?" C) "Have you tried to lose this extra weight?" D) "Congratulations your BMI is great."
b
A nurse assesses residents of the acute care facility for pressure ulcers. Which older adult should the nurse monitor closely for pressure ulcers? A) The Asian with multiple nevi on extremities B) The Ethiopian former store clerk C) The fair-skinned Caucasian woman D) The wrinkled face Hispanic ranch worker
b
A nurse develops a plan of care for a family with nursing diagnosis of Caregiver Role Strain related to urinary incontinence. Which of the following interventions is the highest priority? A) Administer diphenhydramine at bedtime. B) Assist the client to the bathroom prior to bedtime. C) Limit the fluid intake of the client to 1000 mL each day. D) Monitor bowels for diarrhea and constipation.
b
A nurse in a long-term care facility assists several residents with bathing each day. What measure should the nurse implement in order to promote and protect the health of residents' skin? A) Cleanse skin with isopropyl alcohol to eliminate potential pathogens. B) Apply emollient products to maintain the moisture of the skin. C) Apply perfumed products after bathing to promote hygiene and self-esteem. D) Leave skin surfaces partially wet after bathing to promote moisture in the skin.
b
A nurse on an acute care unit is disturbed by the increasing incidence of pressure ulcers among older adults. Which of the following measures should the nurses on the unit prioritize in order to prevent the formation of pressure ulcers? A) Apply emollient lotions with baths B) Frequent repositioning of immobilized clients C) High-protein, high-calorie diet D) Massage bony prominences each shift
b
A nurse teaches an older adult man to perform pelvic floor muscle exercises (PFME)? Which of the following should be included in a nurse's instructions? A) Interrupt the flow of urine several times each time you urinate. B)Identify the correct muscle by making the base of your penis move up and down. C) Contract your legs and buttocks while contracting the pubococcygeal muscle. D) Perform the exercise while standing over the toilet.
b
A nurse who provides care in an outpatient clinic comes into contact with numerous older adults, many of whom have bruises of various sizes and stages on their body. What pattern of bruising is most suggestive of possible abuse? A) Significant bruising on the shin region of a client's leg B) Symmetrical bruising on a client's ears and neck C) Bruising on the back of a client's hands D) Bruising on both of a client's elbows
b
An 81-year-old is admitted to the hospital for congestive heart failure. The client is widowed, and the medical staff and client are talking about the client moving to an assisted living facility. Which of the following interventions by the nurse best creates a wellness opportunity? A) Ask the client to explain how cares have been accomplished at home. B) Assist the client to discuss the feelings associated with a potential move to assisted living. C) Describe the options for long-term housing with the client. D) Encourage the client to think positively about this move.
b
An 81-year-old woman has presented to her nurse practitioner with complaints of urinary incontinence. Further assessment reveals that the woman experiences incontinence because the window of time between sensing the urge to void and the involuntary leakage of urine is very short. The nurse would recognize that this woman has A) functional incontinence. B) urge incontinence. C) mixed incontinence. D) stress incontinence.
b
Following a prolonged hospital stay due to an exacerbation of congestive heart failure, an older adult woman has returned to the nursing home where she normally resides. The woman became incontinent of urine during her time in the hospital, a problem that nursing staff wish to now resolve. What action should her caregivers take in performing continence training? A) Limit the woman's fluid intake to 750 mL daily, primarily before suppertime. B) Assist the woman with toileting at timed intervals throughout the day. C) Teach the woman about the functional and psychosocial benefits of restoring continence. D) Perform intermittent catheterization before each meal and before bedtime.
b
If a patient with urinary incontinence has the nursing diagnosis of High Risk for Caregiver Role Strain, which of the following interventions is a high priority for the nurse to pursue? A) Limit the fluid intake of the patient with stress incontinence. B) Walk the patient to the bathroom prior to bedtime. C) Give the patient Benadryl with a glass of milk at bedtime. D) Restrict the patient's activity prior to bedtime.
b
Mr. Reynolds experienced an ischemic stroke 3 weeks ago that had significant effects on his motor and sensory function. Which of the following assessment findings should signal the nurse to the possibility that Mr. Reynolds is experiencing dysphagia? A) Mr. Reynolds complains of being excessively hungry in the mid-afternoon and evening. B) When providing oral care, the nurse finds food pocketed in Mr. Reynolds' cheeks. C) Mr. Reynolds drinks large amounts of water before, during, and after his meals. D) Mr. Reynolds prefers to sit in a high Fowler's position after he eats.
b
Mr. Roth is an 81-year-old hospital patient whose health problems include Alzheimer's disease and failure to thrive. The nurses who provide care for Mr. Roth have emphasized the importance of ringing his call light for assistance when he has the urge to void, but to this point he has failed to do so. During the night, the nurse discovered Mr. Roth attempting to scale his bed rails to go to the bathroom. What nursing diagnosis is most appropriate for Mr. Roth? A) Impaired Mobility B) Risk for Falls C) Ineffective Health Maintenance D) Activity Intolerance
b
The 64-year-old client who went rock climbing last week and snowboarding this week is at risk for broken bones. Which functional consequence of aging most strongly increases this risk? A) A strong musculoskeletal system helps to protect bones. B) Reduced osteoblastic production of bone matrix C) The long bones have decreased blood flow with aging. D) Weight-bearing activities increase calcium uptake into bones.
b
The nurse presents at a conference regarding aging and mobility. Which age-related changes should the nurse include? A) Bones decrease resorption due to decreased parathyroid hormone B) Diminished positioning sensations in the lower extremities C) Outgrowth of collagen and elastin cells D) The number of skeletal muscle fibers increases
b
Which of the following are commonly associated with urinary retention, frequency, and incontinence, and with cognitive impairment in the older adult? A) Angiotensin-converting enzyme inhibitors (captopril, enalapril, lisinopril) B) Anticholinergic agents (antihistamines, antipsychotics, antidepressants, antispasmodics) C) Hypnotics and antianxiety agents (benzodiazepines) D) Alcohol (wine, beer, hard liquor)
b
Which of the following is accurate about functional consequences related to mobility and safety? A) A functional consequence related to mobility and safety for older adults is impaired vision. B) Range of motion may be limited in all joints, causing some difficulties in the performance of some activities of daily living (ADLs). C) A functional consequence of age-related changes and risk factors is decreased susceptibility to falls. D) Fallaphobia and postfall syndromes are not recognized as functional consequences for older adults.
b
Which of the following meals would assist an individual in lowering cholesterol levels? A)Baked chicken, carrots, and angel food cake B)Green salad, applesauce, and an oatmeal cookie C)Vegetable beef soup, crackers, and Jell-O D)Baked pork chop, green beans, and sherbet
b
Which of the following nursing interventions should be the priority for a nurse working in a community of older adults? A) Using restraints to keep nursing home residents from getting out of chairs unattended B) Establishing a fall-prevention program for residents at risk C) Using cordless phones or emergency call systems for residents in assisted living D) Using a monitoring device for people who live alone in their own home
b
Which of the following should be included in a nurse's instructions to an older adult for performing pelvic muscle exercises (PME)? A) A safe and efficient way of doing PME is to interrupt the flow of urine several times every time one urinates. B) The pubococcygeal muscle is identified by contracting the muscle that stops the flow of urine. C) Contract legs, buttocks, and abdominal muscles while contracting the pubococcygeal muscle. D) It will take at least 2 weeks to see improvement in urethral resistance.
b
A community health nurse presents a class on "Aging in America: Living the Dream." Which of the following should the nurse stress when discussing retirement? (Select all that apply.) A) Delaying retirement until unable to work can be beneficial. B) Factors such as health, friendship relationships, and resources influence the transition. C) Sometimes the adjustment is more difficult for the partner who has not been employed. D) The adjustment to retirement is best accomplished quickly and with finality. E) A strong work ethic assists in the adjustment to retirement.
bc
A nurse instructs a class of older adult women about Kegel exercises. In which of the following urinary conditions would Kegel exercises be effective? (Select all that apply.) A) Functional incontinence B) Pelvic organ prolapse C) Stress incontinence D) Urge incontinence
bcd
A nurse who works with older adults recognizes that late adulthood is a time of life that is characterized by a number of significant life events. What psychosocial consequences occur because of life events that are common in late adulthood? (Select all that apply) A) A broadening of social networks B) Adjusting to relocation from home C) Adjustment to a lower income D) Adaptation to chronic illnesses E) Coming to terms with one's mortality
bcde
A gerontological nurse is aware that older adults have different nutritional requirements than younger adults. Which of the following teaching points reflects these changes in nutritional requirements? A) "If possible, try to eliminate animal fats from your diet." B) "You should try to eat less meat and proteins than you did when you were younger." C) "Overall, you don't need to take in as many calories as you used to." D) "As an older adult, you don't need to eat as many starches and complex carbohydrates."
c
A man who appears to be in his 80s or 90s has been brought to the emergency department by emergency medical services after being found wandering in the street. The man is filthy, acutely confused, and exhibits numerous bruises to his face and neck as well as signs of malnutrition and dehydration. What problem should the nurses prioritize for assessment and intervention? A) Hygiene B) Malnutrition C) Dehydration D) Potential elder abuse
c
A nurse evaluates the healing of a full-thickness skin tear on a 92-year-old resident of a long-term care facility. Which of the following would support the continuation of the current treatment plan? A) The wound with redness surrounding at 12 days B) The wound draining serosanguinous drainage at 14 days C) The wound showing 50% healing at 16 days D) Pain at the wound site at 19 days
c
A nurse in a long-term care facility teaches aides to assist several older adults with bathing each day. Which of the following interventions should the nurse include in the teaching? A) Apply perfumed products after bathing to promote hygiene and self-esteem. B) Cleanse groin with isopropyl alcohol to eliminate potential pathogens. C) Dry skin thoroughly; particularly between the toes and other areas where skin touches. D) Use water that is warm to hot (100°F to 105°F)
c
A nurse was recently assisting an 84-year-old resident of a nursing home with the resident's biweekly bath. While the nurse was helping the resident transfer out of the bathtub the resident grabbed on to the nurse forcefully, became rigid, and exclaimed, "Help me quick," despite the fact that the nurse was performing a safe and controlled transfer. Why might this resident have exhibited sudden anxiety during the transfer? A) The resident may be developing a cognitive deficit. B) The resident is experiencing age-related changes. C) The resident may have a fear of falling. D) The resident is ensuring safety.
c
A nursing home has been the site of numerous falls by residents in recent months, a trend that management and care providers are eager to reverse. Which of the following factors is the most likely contributor to falls? A) There are long, narrow hallways that lead to the dining room and common areas. B) Each room has a private sink and toilet but there are only two designated rooms for bathing in the facility. C) The bedrails on each resident's bed are kept in a raised position whenever the resident is in bed. D) The majority of care is provided by nursing assistants, with one registered nurse overseeing the care team.
c
An older adult states, "I just feel so full so fast, I can't eat any more." Which of the following responses is most appropriate? A) "All of us feel that way after a meal." B) "Make an appointment with your health care provider." C) "Slower emptying of your stomach may be the cause." D) "This happens when you have gall stones."
c
Integumentary Function, 16 16. A nurse at the dermatology office triages calls. Which of the following clients is the highest priority to follow up? A) A 2-year-old with diaper rash B) A 20-year-old with red sunburn on the chest and arms C) 478-year-old with a lesion that is black, swollen, and draining liquid
c
Mr. Ames, age 81, has been living for the past 2 years in a long-term care facility. However, financial pressures have required that he move in with his son and daughter-in-law. Which of the daughter-in-law's following statements should signal a potential risk for elder abuse? A) "I sure hope that we'll qualify for some home care because this seems pretty overwhelming." B) "This won't be easy for anyone. I think I might even end up having to juggle my work schedule." C) "He's used to being waited on here, but at our place he's going to have to fend for himself." D) "I'm probably going to even have to get some friends or neighbors to help out from time to time."
c
The incidence and prevalence of urinary incontinence increase with age. What age-related change contributes to this phenomenon? A) Hypertrophy of the detrusor muscle B) Increased sodium retention by the renal tubules C) Decreased renal blood flow D) Decreased antidiuretic hormone (ADH) synthesis
c
Which of the following hospitalized older adults is at greatest risk for in-hospital hip fractures from a fall? A) A 79-year-old client B) A client receiving numerous cardiac medications C) A client with a history of hip fractures from a fall D) A client with new-onset dementia
c
Which of the following interventions can assist nursing home residents in promoting their psychosocial health? A) Planning dining room arrangements according to room and hall assignments B) Dressing residents exclusively for ease in going to and from the restroom C) Adapting the environment to compensate for residents' sensory impairments D) Positioning the residents who are in wheelchairs solely for ease in getting out of the dining area
c
Which of the following observations is a normal cultural variation when assessing the skin and its appendages in older adults? A) Early skin changes are more obvious in people with darkly pigmented skin. B) Asians and Native Americans may have Mongolian spots, which may indicate bleeding tendencies. C) Mongolian spots occur most commonly in African Americans, Asians, and Native Americans. D) Skin cancers are rare in light-skinned individuals of northern European ancestry.
c
Which of the following statements is accurate about functional consequences related to urinary elimination? A) Most older women will develop incontinence by the age of 85. B) Most older adults will experience hypertrophy and relaxation of muscles in the urinary tract and pelvic floor. C) Excretion of digoxin, penicillin, and cimetidine can be affected by age-related renal changes. D) Healthy older adults can have normal doses of water-soluble medication.
c
Which of the following would be the most reliable method for assessing skin turgor in an 85-year-old man who takes furosemide and a tricyclic antidepressant? A) Ask him to open his mouth and stick out his tongue so you can examine his oral mucous membranes for dryness. B) Gently pinch the skin over his lower arms to see if it remains pinched or is slow to return to normal. C) Gently pinch the skin over his sternum to see if it remains pinched or is slow to return to normal. D) Examine the skin on his lower legs to see if it is dry, scaly, and rough.
c
nurse is teaching health interventions to an older adult with osteoarthritis. Which of these statements indicates that the individual needs additional teaching? A) "I will avoid high-impact exercises." B) "I will get adequate intake of vitamins C, D, and C) "I will try to limit my use of walkers and assistive devices." D) "I will lose weight if it turns out that I need to."
c
nurse monitors a group of older adults in the long-term care facility's kitchen. Which of the following actions would cause the nurse to intervene? A) Sharing perfumed hand soap B) Using hand lotion after washing dishes C) Using hot water to rinse the dishes D) Using soap to wash the dishes
c
nurse presents at a conference regarding functional consequences related to urinary elimination. Which of the following statements should the nurse include? A) "Most older women will develop urinary incontinence by the age of 85." B) Most older adults will experience hypertrophy and relaxation of muscles in the urinary tract and pelvic floor." C) "Excretion of penicillin and cimetidine are decreased in older adults." D) "Healthy older adults experience an increase in glomerular filtration rate."
c
A nurse teaches older adults about skin care and aging. Which of the following would be appropriate to include in this teaching? (Select all that apply.) A) Avoid sunscreens with a sun protection factor (SPF) higher than 14. B) Gently apply rubbing alcohol to keratosis growths to remove them. C) Include adequate amounts of fluid and vitamins in the daily diet. D) Use firm rubbing motions when drying your skin. E) Use emollient moisturizing lotions after bathing. F) When bathing or showering, use a mild, unscented soap.
cef
A 70-year-old man is admitted to your unit with sepsis. He has elevated sodium, blood urea nitrogen, and creatinine, and albumin. Which of the following nursing diagnoses is appropriate for this patient? A) Imbalanced Nutrition: Less than Body Requirements B) Fluid Volume Excess C) Impaired Tissues Perfusion D) Fluid Volume Deficit
d
A 79-year-old man was admitted to the hospital for knee arthoplasty (replacement) due to osteoarthritis. During recovery, he developed postoperative pneumonia and became incontinent of urine while recovering from this serious infection. While being treated on the acute medicine unit, he remained in bed for several days. This patient's urinary incontinence and other health challenges are most likely to result in what nursing diagnosis? A) Social Isolation B) Disturbed Body Image C) Anxiety D) Impaired Skin Integrity
d
A 79-year-old woman is scheduled to undergo hip replacement surgery after a fracture that was caused by a fall. Which of the following age-related changes may have contributed to the woman's susceptibility to bone fracture? A) Increased protein synthesis B) Infections within the synovial capsules of the knees and ankles C) Loss of neural control of balance D) Increased bone resorption
d
A gerontological nurse is aware of the changes in the structure and function of the skin and accessory glands that occur with aging. Which of the following changes is a normal accompaniment to the aging process? A) Thickening of collagen in the dermal layers of the skin B) Cessation of eccrine and apocrine sweat gland function C) Increases in the number of melanocytes in the epidermis D) Decrease in the vascular bed of the derm
d
A nurse administers medications to an older man. Which of the following statements if made by the client indicates understanding of the use of tamsulosin? A) "I am so happy that this medication is working to decrease my urinary incontinence." B) "I now have had much less bladder pain and cramping." C) "My blood pressure has been higher since taking this medication." D) "My urine flow starts much faster now."
d
A nurse assesses an older adult in the assisted living facility who has presbyphagia. Which of the following systems should the nurse auscultate? A) Abdomen for bruit B) Bowel sounds C) Heart tones D) Lung sounds
d
A nurse in a long-term care facility organizes a "Healthy Aging" class for residents. Which activity should be prioritized during these classes? A) Present tools that residents can use to develop better psychosocial health. B) Role-play responses to life events that may occur in their near future. C) Assess group members' strategies used to deal with life events. D) Discuss coping strategies helpful in adjusting to challenges of aging.
d
A nurse is teaching older adults at a senior center how to reduce the incidence of falls. Which of the following statements indicates that the nurse's teaching has been effective? A) "Benadryl is a safe medication to take for sleep." B) "It is safe to have rugs in my kitchen and bathroom." C) "It is safe to take a low dose of Ativan when I am anxious." D) "I understand that over-the-counter medications as well as prescription medications can cause falls."
d
A nurse knows additional teaching is needed when an older adult says the following: A) "Alcohol intake will interfere with absorption of B-complex vitamins and vitamin C." B) "Certain 'fluid' pills can decrease the potassium level in my blood." C) "Anticholinergic medications can cause my intestines to work slower." D) "My over-the-counter beta-carotene pill is appropriate for long-term use."
d
A nurse who manages the care in a nursing home has organized a Health Aging Class for residents. Which activity should be prioritized during these classes? A) The nurse teaches skills and tools that they can use to develop better psychosocial health. B) Participants role-play their responses to life events that may occur in their near future. C) The nurse assesses group members' strategies around dealing with life events. D) Participants share their experiences around dealing with psychosocial changes.
d
A nurse who works with the older population is aware that elder abuse takes many forms. Which of the following examples most clearly constitutes elder abuse? A) A woman cleans and assists with shopping for her elderly neighbor in exchange for money. B) A man has agreed to assist with childcare in exchange for room and board at his son's house. C) A man has taken control of his mother's finances after the woman granted him power of attorney. D) A woman will not change her mother's incontinence brief if she deems her mother has been uncooperative.
d
A nurse working for human services visits a long-term care facility. Which resident assessment finding indicates poor quality care? A) BMI of 29 B) Indentured mouth C) Serum albumin of 3.5 D) Unintentional weight loss
d
An older adult develops diarrhea. Which of the following is the priority intervention for the nurse? A) Assess for pancreatitis. B) Determine the last bowel movement. C) Review meal preparation techniques with the client. D) Review the client's medication list.
d
The home nurse assesses a frail older adult for fall risk using the Timed Up and Go (TUG) test. Which score places this client at high risk for falls in his home? A) 6 B) 9 C) 12 D) 15
d
The incidence and prevalence of nutritional deficits is worryingly high among the population of a large nursing home. What measure can care providers institute to address the risk factors for malnutrition? A) Provide incentives for residents to eat all the food on their trays B) Encourage residents to eat in their rooms to minimize distractions C) Offer four to five small meals a day rather than three larger meals D) Prioritize thorough oral care for residents
d
Which of the following functional consequences of skin changes will impact the nursing care of older adults? A) Older adults have an increased incidence of moles requiring intervention. B) There is a decreased incidence of skin cancer in older adults because of an increase in melanocytes. C) In older adults, tactile sensitivity increases and there is an intense response to cutaneous stimulation. D) Collagen changes interfere with tensile strength of older adults' skin, causing the skin to be less resilient.
d
Which of the following is essential in the assessment of pressure ulcers? A) The PUSH tool scores pressure ulcers according to moisture, activity, mobility, and friction and rub. B) A stage V pressure ulcer can become a stage II pressure ulcer with appropriate treatment. C) Softness of the tissue and differences in skin temperature can be estimated and then documented. D) Assessment of pressure ulcers involves visual inspection and other factors.
d
Which of the following is true about cognitive impairment and abuse of the older adult? A) Older adults who live alone are always willing to acknowledge their impairments. B) Cognitively impaired older adults are usually able to meet minimum standards of care. C) When the older adult denies cognitive impairment, the risk for abuse declines. D) Older adults become more vulnerable to abuse because of cognitive impairment.
d
Which of the following points should a nurse stress in a health education class for older adults about constipation? A) Older adults who do not have a daily bowel movement should use a laxative. B) Older adults should limit their intake of high-fiber foods because of a risk of lactose intolerance. C) If older adults need a medication to promote bowel regularity, a laxative or enema should be given. D) If older adults need a medication to promote bowel regularity, a bulk-forming agent is needed daily.
d
Which of the following statements is true about the laws of mandatory abuse reporting? A) Government agencies, not individual nurses, are responsible for reporting abuse. B) Mandatory reporting laws require reporters to know whether abuse or neglect has occurred, rather than just suspecting it has occurred. C) The use of an abuse reporting protocol replaces individual responsibility for reporting. D) A registered nurse is mandated to report abuse or neglect if it is suspected in the home environment.
d
Which of the following would be appropriate to include in health teaching to older adults about skin care? A) Use firm rubbing motions when drying your skin. B) Avoid sunscreens with a sun protection factor (SPF) higher than 14. C) Gently apply rubbing alcohol to actinic keratosis growths to remove them. D) include adequate amounts of fluid and vitamins A and C in the daily diet.
d
Which of these nursing interventions would be most successful to encourage optimal nutrition in older adults with congestive heart failure? A) Encourage calorie supplements B) Teach older adults to sit upright for 2 hours after a meal C) Use moderate to large amounts of flavor enhancers D) Provide 55% of calories from complex carbohydrates
d
n older woman returns to her hospital room after abdominal surgery. As the nurse completes her assessment, the patient asks the nurse to pin her "prayer cloth" to her pillow. Which of the following things should the nurse say or do first? A) Say, "I will pin it on your pillow in a couple of hours after you are stable." B) Ask, "What is the purpose of a prayer cloth? Did you make it?" C) Ask, "What religion do you practice? Did your minister give the prayer cloth to you?" D) Pin the prayer cloth to her pillow since it is an essential part of her spiritual health.
d
