week2grg
The nurse's first response when told by a client during an assessment interview that he "can't take furosemide (Lasix)" is to ask:
"Can you describe what happened when you took Lasix?"
Which nursing statement shows a true appreciation for an older client's willingness to tell his personal stories about "the war"?
"I learn so much about clients when they share their life story with me."
When a client asks, "What could be causing my triglycerides to be so low; I'm really careful about my diet?" the nurse responds by asking the client: (Select all that apply.)
"Are you on medication for hyperthyroidism?" ,"Could you tell me how you are careful about your diet?
The nurse is confident that the client who takes glucosamine sulfate daily is conscientious of the safety issues involved when hearing the client state: (Select all that apply.)
"I'm always careful to buy the same brand of glucosamine sulfate.", "My pharmacist is so helpful when I have questions about the herbals I take.",. "The liquid form of glucosamine sulfate is what I consistently take.","I made sure my physician knew that I was allergic to strawberries."
Which statement by the nurse is the strongest example of ageism by professional nurses?
"It is so difficult to find nurses who are truly effective geriatric nurses."
The nurse admitting a client to a same day surgery unit makes the decision to notify the surgical team to cancel the procedure based on the client's statement that:
"It seemed strange not taking my garlic pill this morning."
An older client prescribed a transdermal morphine patch for severe chronic pain is being educated on the appropriate administration of the medication. The nurse shows an understanding of essential information regarding this route of drug administration when stating: (Select all that apply.) "This is an effective route for delivering small doses of medication over long periods of time."
"Since you have problems with digestion, this is a good way to take your medication." "Please show me how you would apply your patch." . "Be sure to avoid placing the patch on injured skin."
When performing the initial assessment on a new client in a geriatric outpatients practice, the most effective method the nurse can implement to elicit an accurate medication assessment is to ask that the client:
. bring in all of the medications that she is currently taking
A 78-year-old female patient was recently diagnosed with atrial fibrillation and started on Coumadin (warfarin) for stroke prophylaxis. A nurse provides extensive education on warfarin including the need for routine blood testing. The woman states the following to a nurse: "I understand all that you have taught me, but I do not know what a good number for the INR test is." The nurse bases her response on the knowledge that the recommended INR is:
2.0-3.0.
Which of the following are examples of elderspeak? (Select all that apply.)
A nursing assistant refers to one of her patients as "grandma", A nurse attempts to medicate a patient and states, "Now come on and be a good girl", A nursing assistant tells a patient, "It is time for our bath now"
An 81-year-old patient is being discharged from the hospital to home. She is on seven different medications, which are to be taken at four different times during the day. What would be most useful in helping this patient manage her medications?
A pillbox with compartments for each day and each of the doses
Which pharmacokinetic/pharmacodynamic parameter does the aging process least affect?
Absorption
An elderly man is brought to the geriatrics clinic by his wife because of his increasing confusion. As part of his medical workup, the nurse practitioner orders which of the following laboratory tests? (Select all that apply.)
Basic metabolic panel ,Vitamin D level ,Thyroid stimulating panel , Vitamin B12
A nurse manager is providing a novice geriatric nurse with guidelines when encouraging an older client to reminisce about his or her life and past experiences. Which suggestions will be included? (Select all that apply.)
Don't correct the client even when you suspect the memory is incorrect, When the focus remains on sad topics, assess the client for possible depression, Expect and respect a degree of repetition
An antihypertensive medication has been prescribed for an older patient with hypertension. The patient tells a clinic nurse that he would like to take an herbal substance to help lower his blood pressure instead of the prescription medication. Which of the following should the nurse do? (Select all that apply.)
Encourage the patient to discuss the use of an herbal substance with his primary care provider ,Explore with the patient which herbal substance he is planning on taking ,Educate the patient on possible interactions of the herbal substance with his other medications
Which intervention is therapeutic when facilitating communication with a cognitively impaired older client? (Select all that apply.)
Explain a task using simple, concise phrasing and one step at a time, Allow for additional time for the client to respond to questions or directions , Use nonverbal as well as verbal cues to help get your message across to the client
What factor is an important contribution to polypharmacy in older adults?
Inadequate communication among medical care providers
An older patient is prescribed warfarin for stroke prevention. A nurse is providing patient education. Which of the following foods should the patient be taught to avoid? (Select all that apply.)
Kale,Spinach
An older woman with breast cancer has completed a course of external radiation and is receiving chemotherapy. After her recent chemotherapy treatment, she complains of severe weakness, dizziness, and lethargy and is admitted to the hospital. Her platelet count is 45,000. Based on this scenario, what nursing intervention is of the highest priority?
Preventing falls
Which technique is most effective when communicating with a client who is positioned in bed?
Sitting in a chair at the bedside facing the client
The nurse is reviewing the postsurgical laboratory values of an older adult client.
The client's erythrocyte sedimentation rate (ESR) is 20 mm/hr.
interested group:
White females who own their own successful businesses
When discussing pharmacological considerations, a 68-year-old client asks, "Why do medications seem to act differently than they did when I was younger?" The nurse bases the response on the concept that:
age-related changes affect the way drugs are metabolized by older adults.
When caring for an ill adult client, the nurse is particularly concerned that the client communicates well since:
assessment, planning of care, and even the therapeutic relationship is based on effective communication
When a client who routinely takes the herb St. John's Wort (SJW) shares that his or her "hay fever is really bad right now," the nurse initially:
compares the client's current blood pressure to his/her baseline blood pressure.
When a nursing interview identifies that a client is daily taking doses of herbal supplements, the nurse's priority is to:
discuss the client's knowledge regarding the herbal supplements' side effects.
The area in which nurses have the greatest effect on the safe, effective medication therapy of an older client is:
educating the client to all aspects of the medication.
During an admission interview, a patient tells the nurse about taking Ginkgo biloba daily. The nurse responds to this information by inquiring whether the client:
experiences gastrointestinal (GI) upset.
The nurse is conducting a presurgical interview when it is noted that the older adult patient's medication list includes Tylenol 650 mg four times a day for arthritic pain, gingko 80 mg twice a day, and glucosamine chondroitin 500 mg three times per day. The nurse proceeds to share with the client that in order to minimize the risk for postsurgical complications, there is the need to refrain from taking:
ginkgo for 2 weeks due to the potential for increased bleeding
Factors that affect the pharmacokinetics of lipophilic medications in older adults include:
greater adipose tissue ratio to body mass.
The Beers Criteria is an effective tool for health care professionals prescribing and/or managing the medication therapy of older adults since it identifies medications that for this population:
have a higher than usual risk for injury.
An older adult is having difficulty sleeping and asks a nurse, "My neighbor told me that I should take melatonin to help me sleep. What do you think about this?" The nurse responds to the individual's question using the knowledge that: (Select all that apply.)
in the natural state melatonin is produced by the pineal gland and regulates the sleep-wake, it must be used with caution in a patient that is taking other medications that have central nervous system depressant effects. , evidence shows that it is effective at decreasing sleep onset latency, improving quality of sleep, and improving morning wakefulness
A 77-year-old Hispanic Catholic nun (retired) who immigrated to the United States 15 years ago lives alone but in an apartment complex where her biological sister lives as well. She is being discharged home after a hospitalization for congestive heart failure with prescriptions for eight different medications. She is considered at risk for noncompliance due to contributing factors that include: (Select all that apply.)
language barrier.,living alone. ,large number of medications.
An older adult client is being seen for the first time at the outpatient geriatric clinic. As a component of the nursing admission history, the nurse inquires about the use of herbs and other supplements. The basis for this inquiry is that such herbal therapy:
may interact with prescription medications
When asked by an older adult client, "What is the difference between my normal laboratory values and the ones for a 55-year-old?" The nurse responds based on the understanding that there are:
no age-adjusted ranges for older adults due to the large variations within the age group and the increasing number of factors that influence the results
When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse best ensures an understanding of oral hypoglycemic medications when providing:
oral explanations and sending the client home with a written copy
supplements is the:
possibility of dangerous interactions between herbals and the client's prescription medications
An older woman asks a nurse in the cardiology practice, "What is the ideal number that my cholesterol levels should be? I am confused by all of the different numbers." The nurse formulates her response on the knowledge that:
recent guidelines from the American Heart Association state that there is no "one size fits all" recommendation and that recommendations must be individualized to each patient.
The nurse initially responds to this data by:
recognizing that the value is normal for older adults.
A 69-year-old patient in the geriatric clinic has an annual physical examination and a complete blood count and serum electrolytes are drawn. While the physical examination was uneventful, the laboratory results show an elevated blood urea nitrogen (BUN). The nurse will then:
review the client's medication list since BUN can be affected by many specific medications.
When conducting an admissions interview with an older client, the nurse observes that the client pauses for a period of time before responding to the questions. The nurse responds to this client based on the assumption that the client is:
sorting through his or her vast life experiences in order to answer appropriately.
An older resident of a long-term care facility diagnosed with dementia has in the last 48 hours become more confused than usual and while usually requiring help with toileting has been incontinent of urine. The client's health care provider orders a complete blood count and serum electrolytes. When the laboratory tests are all within normal limits, the nurse initially:
speaks with the health care provider regarding the changes in the client's function and the possibility of obtaining a urine culture
The nurse is confident that the client who chooses to take red rice yeast daily for dyslipidemia has an understanding of its possible side effects when the client:
states, "If I start noticing muscle pain, I'll stop taking the pills."
The nurse suspects that a client is experiencing tardive dyskinesia when observing that:
the client's facial muscles are twisting involuntarily.
An older client in a long-term care facility is receiving an annual physical examination and is ordered laboratory tests that include a complete blood count, serum electrolytes, and thyroid tests. When the client's son questions why these tests are being ordered by saying, "Dad is 85 why are you bothering him?" the nurse's response is based on an understanding that:
when conducted annually, all of the tests are helpful in promoting maximum health for older adults in the long-term care setting
