Nursing: The aging adult prep-u
The charge nurse in an extended-care facility knows that the new nurse understands ageism when she says which of the following?
"Neither intelligence nor personality normally decline because of aging."
A nurse is teaching an elderly 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."
A nursing student is studying depression in the elderly adult. Faculty members knows the student has mastered the information when she states which of the following?
"Treatment of depression includes counseling."
The daughter of an elderly client asks the nurse it is is safe for her father to continue driving. Which of the following statements by the nurse is most accurate?
"When it is obvious that your father should no longer drive, family members should address their concerns in an honest, forthright manner."
An occupational health nurse overhears an employee talking to his manager about a coworker 65 years of age. What would the nurse be concerned about when she hears the employee state "he should retire and make way for some new blood"?
Ageism
The nurse is caring for an older adult client who is confused and agitated. When the client's family comes to visit the nurse asks how long the client has been confused. The family states that the client has been confused for a long time and the confusion is getting worse. The client is subsequently diagnosed with dementia. What is the most common cause of dementia in an older adult client?
Alzheimer's disease
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
A gerontologic nurse practitioner has a large patient population with heart disease problems. This nurse practitioner is aware that heart disease is the leading cause of death in the aging adult. What is the cause of this trend?
Blood vessels lose their elasticity with age.
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
An 84-year-old patient has returned from the PACU. The patient is orientated to name only. The patients' family is very upset because before having surgery the patient knew the family. The patient is diagnosed with delirium. What should the nurse explain to the patient's family?
Delirium usually lasts only a short time.
A nurse is preparing to medicate an elderly patient with an opioid analgesic. Which of the following does the nurse consider in the use of this medication?
Delirium, sleep disturbances, cognitive changes, and diminished functional abilities may result when pain is not managed adequately.
What term is used to describe various disorders that progressively affect cognitive function?
Dementia
When assessing an older adult client's home for safety, the nurse should recommend what?
Eliminating throw rugs
An older adult informs the nurse that she is having a difficult time sleeping at night. What action may assist the client in getting a better night of sleep?
Encourage a routine for sleeping and waking.
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 patient to have regular checkups
Erikson identified ego integrity versus despair and disgust as the last stage of human development, which begins at about 60 years of age. Which intervention would best foster older patients' ego integrity?
Encouraging life review
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
Which of the following health promotion measures should occur most frequently in older adult women?
Fecal occult blood test
A nurse is caring for an older adult client who has been confined to bed for several weeks following a fall. The client has been exhibiting symptoms of sundowner's syndrome. Which of the following are characteristics of sundowner's syndrome?
Feeling agitated and wakeful at night
The middle adult is sometimes called the "sandwich generation". According to Erikson, the developmental task of the middle adult is what?
Generativity versus stagnation
Based on Havighurst's theory of human development, which nursing intervention would best facilitate the accomplishment of a developmental task of older adulthood?
Helping a patient move independently using a walker
A nurse is caring for a 46-year-old male patient who is being treated for depression following the death of his spouse. Which action best facilitates the accomplishment of a developmental task of this middle adult?
Helping him to see the value of guiding his children to become responsible adults
Mrs. Jimenez, age 79, became a widow earlier this year and now resides alone in the house that she and her husband shared for 30 years. Her children have encouraged her to move, but she expresses a desire to remain in her home, despite some slight mobility challenges. The nurse who provides occasional home healthcare for Mrs. Jimenez should first propose which of the following?
Home modification
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
When assessing a client during the middle adult years, the nurse recognizes which of the following as a normal physical change?
Increased loss of calcium from the bones
When completing an assessment of the middle-aged adult, the nurse makes note of the client's cognitive development. Then nurse would expect to find what?
Increased motivation to learn.
An elderly patient has come in to the clinic for her yearly physical. The patient tells the nurse that she is having difficulty with bowel movements. What intervention could the nurse suggest?
Increasing intake of water
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 80-year-old client tells the nurse that he has been dizzy since starting to take an herbal remedy for arthritis in addition to prescribed medications. The nurse recognizes that the client may be experiencing the effects of which of the following?
Polypharmacy
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.
An 85-year-old client's daughter calls the nurse and states her father is recently having periods of confusion, is unable to dress himself, and is having periods of incontinence. Which of the following should the nurse do first?
Schedule an appointment for a physical examination
In a report, the night nurse tells the incoming nurse that one client with dementia has sundowning syndrome. Which of the following nursing diagnoses would be most appropriate for this client?
Sleep deprivation
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
Based on an understanding of the cognitive changes that normally occur with aging, what might the nurse expect a newly hospitalized older adult to do?
Take longer to respond and react
Which situation would lead the client's family to suspect onset of dementia?
The client has increasingly experienced disorientation to familiar surroundings.
A nurse is providing discharge instructions to an elderly client and his daughter. The daughter asks for suggestions to help keep her father healthy. Which of the following could the nurse suggest?
The client should have his eyes examined every year for glaucoma
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.
When the home care nurse visits a female client age 78 years who is recently widowed, the nurse finds that the home is cluttered with trash. The client appears sad and disheveled. The nurse should assess the client for symptoms of:
depression.
The nurse who works with elderly patients diagnosed with Alzheimer's disease recognizes that there are various symptoms of dementia and confusion including sundowning syndrome. The nurse recognizes sundowning syndrome as:
habitual increases in confusion, restlessness, and agitation after dark.
When the older adult faces illness, the greatest threat to health is:
loss of physiologic reserve of the organ systems.
A patient often actively engages in reminiscence when the nurse is delivering care. The nurse recognizes that:
reminiscence is a normal process in achieving ego integrity.
The nurse is caring for an older adult postoperative critical care client. The nurse finds that the client is acutely confused and trying to get out of bed. What should the nurse do first?
review with the client that he is in the hospital
An older adult is admitted to the health care facility with a diagnosis of depression. The nurse would be especially alert for:
suicidal thoughts.
A client has an unsteady gait related to arthritis. His daughter states he walks better when he is at the grocery store pushing a cart. The nurse should recommend:
the client use a wheeled walker.
A client is in the postoperative phase of an abdominal resection and colostomy. When educating the client on ostomy care by providing educational materials to read, it is important to assess the client's:
vision.
A nursing student is studying the normal physiologic changes of older adults. The faculty member knows that the student comprehends the information when she says which of the following? Select all that apply.
• "Height may decrease 1-3 inches." • "There is an increased sensitivity to glare." • "Fluids and electrolytes remain within normal ranges."
Nurses who care for diverse populations must be aware of patterns of disease that are more likely to affect certain ethnic or racial groups. Which examples accurately reflect these profiles? (Select all that apply.)
• Black American men are 30% more likely to die from heart disease than non-Hispanic white men. • Hispanics have higher rates of obesity than non-Hispanic Caucasians. • Black Americans have the highest mortality rate of any minority for most major cancers. • Tuberculosis is 11 times more common in Asian Americans than the white population.
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 home care nurse is visiting one of her elderly clients. Which of the following does the nurse do to screen for chronic illnesses common to the elderly? Select all that apply.
• Monitor blood pressure • Perform blood glucose monitoring • Assess joint mobility and presence of pain
The older population, persons 65 and older, numbered over 39 million in 2009. There are limited resources to care for this aging population. Factors that influence society's attitude to this age group include which of the following myths?
• Old age begins at 65. • Most older adults live in nursing homes. • The majority of senior citizens are not in good health.
A nurse is screening for Alzheimer's disease (AD) in patients in a long-term care facility. Which facts regarding AD are accurate? (Select all that apply.)
• Scientists estimate that more than 5 million people have AD. • Nearly half of 85-year-old adults have A • AD affects brain cells and is characterized by patchy areas of the brain that degenerate.
When caring for older adults, nurses must be aware of common conditions found in this population. Which statements accurately describe these conditions? (Select all that apply.)
• Sundowning syndrome is a condition in which an older adult habitually becomes confused, restless, and agitated after dark. • Depression is a prolonged or extreme state of sadness occurring in many older adults. • A significant percentage of older adults limit their activities because of fear of falling that might result in serious health consequences.
Most older adults gradually modify activities or lifestyle to accommodate for declines in strength and health. The nurse recognizes the need for older adults to maintain activity and exercise in order to preserve all physiologic functions. When encouraging activity, it is important to consider which of the following:
•Chronic illness often accompanies aging. • There is an increased risk of sleep disorders. • Assistive devices help to maintain mobility and safety.