Question 1

Your 70-year-old client has been coming to the clinic for 5 years for medical follow-up of her osteoporosis.Lately she has been complaining of dry skin,and she asks for your advice.What would be the best suggestion you could offer her?

A) Use extra soap to moisturize the skin.
B) Keep bath water at a moderate temperature-90 to 105 degrees F.
C) Move to a climate with lower humidity.
D) Dry vigorously with a rough towel after bathing.

Accepted Answer

Bath water should be kept at a moderate temperatures because hot baths tend to dry out the skin.Soap should be used in moderation because it can cause excessive drying of the skin.Low humidity can lead to dry skin.Drying vigorously with a rough towel can remove moisture from the skin.This action can also injure sensitive skin.

Question 2

An 81-year-old woman complains of pain in the right upper posterior thoracic area and has an elevated temperature (101° F).She subsequently develops clusters of fluid-filled vesicles in the same area where she reported the pain.It is likely that she has:

A) seborrheic keratoses.
B) rosacea.
C) herpes zoster.
D) stasis dermatitis.

herpes zoster.

Accepted Answer

Herpes zoster is a viral illness that may be preceded by a prodrome of fever,chills,malaise,and gastrointestinal disturbances.Clusters of papulovesicles develop.Occasionally,the skin where the eruption will occur is painful.Seborrheic keratoses are benign growths that appear on trunk,scalp,face,or hands as single or multiple lesions.Rosacea is an inflammatory skin condition that is characterized by vascular erythema and flushing,with inflamed pustules on the face.Stasis dermatitis is a chronic inflammatory eczematous dermatitis of the legs.

Question 3

An 88-year-old patient has type 2 diabetes mellitus.During a routine visit to the diabetes clinic,the nurse reviews the principles of diabetic foot care.What should be included in the teaching?&#10;A) Rub feet vigorously after washing to ensure that they are thoroughly dried.&#10;B) Apply skin softening emollients to all areas of the feet,including between the toes.&#10;C) Inspect feet daily for cuts,blisters,cracks,and reddened areas.&#10;D) Soak feet daily for 10 to 15 minutes in tepid water.

Accepted Answer

Inspection of the feet for potential problems is an important part of foot care for the diabetic patient.If potential problems are noted,interventions can be taken to prevent worsening.Rubbing the skin can cause injury to sensitive skin.Applying lotion to the areas between the toes can contribute to fungal infections.Washing feet daily is an important part of diabetic foot care.Soaking feet for 10 to 15 minutes can cause excessive dryness.

Question 4

Normal age-related changes in the mouth include:&#10;A) thickening of the enamel on the teeth.&#10;B) recession of the gums.&#10;C) increase in saliva production&#10;D) leukoplakia.

Accepted Answer

With age,gums tend to recede,leaving the newly exposed area of the teeth below the previous gum line vulnerable to tooth decay.Enamel on teeth is worn away and abraded.The production of saliva decreases with age.Leukoplakia,a white patchy coating that occurs on the oral mucosa,is not normal and requires further evaluation and possibly biopsy.

Question 5

An 88-year-old resident in a long-term care facility tells the nurse she is having mouth pain.The first action the gerontological nurse should take is to:&#10;A) notify the physician in charge about the resident's problem.&#10;B) carefully inspect the resident's mouth,teeth,and tongue.&#10;C) medicate the resident with a prescribed analgesic.&#10;D) instruct the resident to begin rinsing the mouth with an antimicrobial mouthwash.

Accepted Answer

The first step the nurse should do in response to a resident complaining of mouth pain is to carefully conduct a thorough assessment of the oral cavity.Assessment is also the first step in the nursing process and actually should be the first step in response to any complaints by the resident.The nurse needs to look for any obvious source of the pain.Options A,C,and D are not the first steps in response to the resident's complaint.They may be actions that the nurse takes,but the first step is assessment.

Question 6

Your elderly patient's 50-year-old daughter asks about aging dentition,periodontal disease,and tooth loss.In answering her questions,you know that:&#10;A) more than half of people older than age 65 are edentulous.&#10;B) dental insurance is readily available at a low cost to senior citizens through government programs like Medicare.&#10;C) periodontal disease is usually the result of chronic periodontitis from young and middle-age adulthood.&#10;D) tooth loss is a natural part of the aging process.

Accepted Answer

Periodontal disease in older adults usually is the result of chronic periodontitis from young and middle adulthood.Less than 40% of adults older than age 65 are edentulous.Dental care is a low priority in most health care insurance programs for older adults.There is often no or inadequate third party reimbursement for the type of dental care that is required by older adults.Tooth loss is not a natural part of aging; it is usually related to poor hygiene.

Question 7

An important consideration about the skin of an elderly person is that:&#10;A) generous amounts of soap should be used as cleanser.&#10;B) sweat glands increase in activity.&#10;C) the patient's thermoregulating capabilities are decreased.&#10;D) the epidermis becomes thicker and harder.

Accepted Answer

With increased age,there is an increased vulnerability to heat and cold.A common problem in older adults is dry skin (xerosis),which is exacerbated by soap,which further dries it.There is a loss of sweating that occurs with aging.The epidermis thins with aging.

Question 8

An older woman tells the nurse her husband seldom brushes his teeth as he did in the past.One reason for this might be:&#10;A) decreased manual dexterity.&#10;B) loss of some of his natural teeth.&#10;C) decrease in taste acuity.&#10;D) lack of dental insurance.

Accepted Answer

One reason why some older adults stop participating in oral hygiene practices,such as brushing their teeth,may be the inability to physically perform the action related to decreased manual dexterity.Loss of some of the man's natural teeth would not decrease the need for oral hygiene.A decrease in the sense of taste does not impact on performance of oral hygiene.A lack of dental insurance may be a factor as to why a client does not see a dentist for checkups but would not be a reason for omitting oral hygiene altogether.

Question 9

What skin preparations should the nurse instruct the older adult to use with caution?&#10;A) Moisturizing soaps&#10;B) Emollients to keep the skin moist&#10;C) Steroid-based ointments and creams&#10;D) Sun block

Accepted Answer

Older adults have a high rate of adverse reactions to corticosteroids.In addition,long-term use may cause systemic absorption.The older adult should only use steroid ointments and creams when prescribed by a health care provider and only for a limited time period.Moisturizing soaps are an appropriate treatment for dry skin.Emollients are an appropriate treatment for dry skin.Sunblock is appropriate to protect from UV exposure to the sun.

Question 10

A basal cell carcinoma is characterized by:&#10;A) a persistent red lesion with a poorly defined base and an adherent yellow-white scale.&#10;B) a slightly raised discolored patch that may be tan,blue,red,black,or white.&#10;C) an open sore that bleeds,oozes,or crusts and remains for 3 weeks or more.&#10;D) rough,scaly,sandpaper-like patches.

Accepted Answer

A sore that bleeds,oozes,and remains for 3 weeks or more is a characteristic of a basal cell carcinoma.Option A is a characteristic of squamous cell carcinoma.Option B is a characteristic of melanoma.Option D is a characteristic of actinic keratosis.

Deck 8: Biological Maintenance Needs