Unit 7: Gerontological Care Issues

When explaining family member roles in the care of older adults, which of the following is on the list as a family member victim role?

An economically abused family member

When explaining potential risks for older adults during hospitalization, which is the most important to include about constipation?

Effects of medications

Which end-of-life nursing diagnosis is associated with the aging client and dehydration?

Impaired skin integrity

A 79-year-old man experienced a severe stroke several days ago and his condition has worsened. The patient's wife has been told by the care team that he is unlikely to survive more than a few days and that aggressive treatment would likely be futile. The nurse has just entered the patient's room to find his wife softly crying at his bedside and she has made no attempt to acknowledge the nurse's presence. What is the nurse's most therapeutic response to the patient's wife?

"Would you like to be left alone?"

A notable demographic trend that is expected to become more pronounced involves the sandwich generation. Which of the following individuals exemplifies the demands and challenges experienced by the sandwich generation?

A 50-year-old woman who balances the care of her 82-year-old father and her 20-year-old son

An 84-year-old woman has been living in an assisted living facility for several years but is now faced with the prospect of relocating to a nursing home. Which of the following characteristics of the woman's current situation is most likely to prompt this move?

A decrease in the woman's level of function and activities of daily living (ADLs)

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?

Assess the granddaughter's understanding of her grandmother's needs.

The older client with a chronic condition would need to know which of the following important information about care measures?

Care measures focus on living in harmony with the condition.

Which end-of-life nursing diagnosis is associated with the aging client and loss of body part?

Disturbed body image

Which important questions would the nurse ask the older client to assess attitudes, values, and beliefs?

Do you feel that the younger should take care of the old or that children owe their parents nothing?

Mr. Anderson was admitted to hospice shortly after the metastasis of his malignant melanoma. His nurse knows that particular symptoms are common near the end of life. Which of the following health problems should the nurse anticipate in Mr. Anderson?

Dyspnea

Which of the following is the most complete information for a nurse to include during a presentation on elder care?

Greater numbers of families are providing more complex care for older adults for longer periods of time.

Which is the most important chronic care goal for the older client?

Healing

When conducting a public awareness class on healing for home caregivers of older adults, which is the most complete definition the nurse would include in the lesson plan?

Healing implies the mobilization of body, mind, and spirit to control symptoms.

During the early 1900s, long term care was modeled after which of the following?

Hospitals and prisons

Which end-of-life nursing diagnosis is associated with the aging client and immobility?

Impaired skin integrity

Which end-of-life nursing diagnosis is associated with the aging client and infections?

Impaired skin integrity

Which nursing diagnosis is associated with cataracts in the older client?

Ineffective health maintenance

What is the rationale for boosting the body's immune abilities in the older client with a chronic condition?

Infection prevention

The nurse recognizes that many of the older adult patients on the palliative care unit express spiritual needs and priorities. Which of the following statements best captures an aspect of spiritual care and nursing?

It is important to initially and repeatedly assess patients' spiritual needs.

When explaining potential risks for older adults during hospitalization, which is the most important to include about delirium?

New environment

The nurse is employed on a medical unit that includes several beds dedicated to palliative care of older adults. Which of the following nursing interventions best captures the principles of palliative care?

Providing an opioid analgesic to a patient with bone metastases

When explaining nursing home selection to the older client, which of the following is on the list as an important staff issue?

Ratio of RN to LPN staff

Which is the most important nursing action for the older dying client engaged in silent depression?

Silently sitting

The physical, emotional, and social health of older adult caregivers is assessed using which important tool?

TLC

Which is the most important older client factor that influences the need for long-term care?

The level of function

A nurse who works in a palliative setting is aware of the need to facilitate a "good death" for as many patients as possible. Doing so involves:

empowering the patient and family to maintain as much control as possible.

Surgical intervention in the older client can cause which important outcome? Select all the apply.

• Add years to an older client's life • Add quality to an older client's life • Add functional independence to an older client's life

Which are the most important stages in the dying process? Select all the apply.

• Denial • Anger • Bargaining • Acceptance

When assessing the home care of an older client, which is most important to identify during the family interview? Select all that apply.

• Factors related to family dysfunction • Factors related to support groups • Factors related to self-help groups • Factors related to realistic goals

Which of the following positions would be most important to include when teaching a class to nurses about the prone position? Select all that apply.

• Feet extending over bed to be perpendicular to the legs • Head turned laterally • Elbows flexed • Palms up

At the time of admission to a nursing home, which measure is most important to help families of a relative? Select all that apply.

• Have a staff member who has met the family greet them on arrival. • Tell the family where to find the cafeteria. • Tell the family where to find the rest rooms. • Order a snack or lunch tray so the family can share a meal with the new resident.

Which of the following goals are most important for chronic care in the older adult? Select all that apply.

• Improve self-care capacity. • Manage the disease effectively. • Prevent complications. • Delay decline.

Which nursing action maintains self-care capacity in the older client with a chronic condition? Select all that apply.

• Improvement of health status • Education about disease management • Education about the disease • Stabilization of health status

Which special risks cause complications to occur more frequently in older clients? Select all that apply.

• Inelasticity of blood vessels • Malnourishment • Increased susceptibility to infection • Reduced renal reserves

Which comfort and dignity support actions are most important for a dying older client with a chronic condition? Select all that apply.

• Pain relief • Preservation of energy • Provision of comfort • Assistance with basic needs

When conducting a long term care subacute unit admission assessment of an older adult, which admission criteria is most important? Select all that apply.

• The need for ventilator care • The need for hyperalimentation

When conducting a rehabilitative care presentation about activities of daily living (ADL) for the older adult, the nurse would include which of the following important information? Select all that apply.

• Toileting • Ambulating • Bathing • Dressing

Which of the following important types of long term elder care assistance is provided by families? Select all that apply.

• Toileting • Feeding • Bathing • Dressing