Question 1

A nurse practitioner is preparing a presentation for a local senior group on common conditions affecting this population. Which condition would the nurse practitioner likely include? Select all that apply.

Accepted Answer

According to the National Council on Aging (2017), the most common conditions to affect older adults are hypertension, high cholesterol, arthritis, ischemic heart disease, and diabetes. These health conditions interact based on physiology, environment, and the person's unique health profile.

Question 2

A nurse is reading a journal article about older adults. Which information would the nurse likely find?

Accepted Answer

Older women have a higher poverty rate (10.5%) than did older men (7.5%). Widows outnumber widowers by 3 to 1. More older adults live with a spouse than live alone. Older adult men are more likely to be married than older women.

Question 3

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:

Accepted Answer

The nurse must ensure that the client's vision allows for reading. Social support and gait do not relate to the provision of written education materials.

Question 4

A client with Alzheimer disease becomes agitated and is unable to communicate. The nurse notes that this is a change from the client's regular demeanor. The nurse performs a thorough assessment of the client, determining that the client has an abscessed tooth. This assessment can be termed:

Accepted Answer

Validation therapy is a type of interpersonal interaction in which the health professional attempts to understand and validate the client's current needs.

Question 5

When the home care nurse visits a female client aged 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:

Accepted Answer

Symptoms of depression include poor cognitive performance, sleep problems, and lack of initiative.

Question 6

An older adult client informs the nurse, "I just don't feel like myself. I cry so easily and my mobility is so bad from my degenerative disk disease in my back." What factor is most likely contributing to the client's depression?

Accepted Answer

Many factors place an older adult at risk for depression, including recent bereavement, a change in environment, alcohol or substance use, and chronic pain.

Question 7

A nurse is teaching a group of older adults about aging and risks to health. The nurse determines that the teaching was successful when the group identifies which condition as a major cause of injury in the older adult?

Accepted Answer

For people older than 65 years, falls are the leading cause of both fatal and nonfatal injuries, with hip fractures resulting in significant morbidity and mortality. According to the CDC, fall death rates in the United States have increased 30% from 2007 to 2016, and if the trend continues, there will be 7 fall deaths every hour by 2030 (CDC, 2017b) Multiple factors place the older adult at risk for falls, including the use of medications affecting balance, thinking, memory, and elimination; impaired vision; environmental hazards (i.e., slippery floors, throw rugs, poor lighting); decreased strength; loss of bone mass; and neurologic and musculoskeletal problems; however, falls are not an unavoidable part of aging (National Council on Aging, n.d.).

Question 8

A nurse is conducting an in-service presentation on depression for a group of nurses working in a long-term care facility. Which information would the nurse likely include?

Accepted Answer

Mood disorders (especially depression) are often unrecognized or misdiagnosed in older adults partly due to the false belief that depression is a natural reaction to illness, advanced age, or life changes that occur with age and is therefore not viewed as something that needs to be treated. Furthermore, symptoms of depression may include poor cognitive performance, sleep problems, and lack of initiative-symptoms commonly seen in people with multiple chronic comorbidities such as diabetes or heart failure and in clients with dementia or delirium, causing it to be unrecognized. According to the CDC, most older adults are not depressed. Delusional and anxiety disorders are less common in the older adult.

Question 9

Which activity performed by an older adult client would make the client's family suspicious of the onset of dementia?

Accepted Answer

Conditions that mimic dementia or depression present distinct challenges because they impair thinking, mood, and communication. Such conditions also affect the older adult's ability to manage self-care.

Question 10

A client has an unsteady gait related to arthritis. The client's daughter states that the client walks better when at the grocery store pushing a cart. The nurse should recommend:

Accepted Answer

Instituting appropriate interventions relies on a thorough assessment of the person's mobility impairments. Interventions may include muscle strengthening, range-of-motion exercises, gait and balance training, and assistive devices such as canes or walkers.

Question 11

Changes in T-cell function in older adults will result in:

Accepted Answer

Humoral immunity declines because of changes in T-cell function, and older adults have lower antibody response to microorganisms that cause pneumonia and infection.

Question 12

Which factor contributes to sleep disturbances in older adults?

Accepted Answer

Older persons experience impairment of sleep. Beta-blockers contribute to sleep disturbances.

Question 13

A 76-year-old man is recovering from a myocardial infarction. In regard to the client's sexuality and recovery, it is important for the nurse to:

Accepted Answer

With regard to sexuality, the nurse should spend time with the older adult; use clear, easy-to-understand language; help the client feel more comfortable talking about sex; be open minded and talk openly; listen and encourage discussion; give advice or suggestions as needed; and understand that sex is not just for the young.

Question 14

The hospice nurse is visiting the older adult wife of a client 4 weeks after the client died. Which comment by the wife would concern the hospice nurse the most?

Accepted Answer

The psychosocial aspects of eating alone after the death of a spouse can lead to problems in maintaining adequate nutrition. Leaving the closet untouched, missing her husband, and crying 4 weeks after the loss are normal grieving responses.

Question 15

An older adult client's daughter asks if the practitioner can prescribe an antipsychotic medication for her father because he is so confused and agitated much of the time. The nurse is aware that the client should only be prescribed this medication when which strategy has failed? Select all that apply.

Accepted Answer

Due to the side effects and adverse reactions that may occur with antipsychotic medications, behavioral, environmental, and social strategies should be attempted to help improve cognition.

Question 16

A nursing student is looking at the demographics related to the older adult and finds that what percentage of the older adult population that is institutionalized falls into the age range of 85+ years?

Accepted Answer

Of the older adult population that is institutionalized, the percentage increases with age. 1% of persons 65 to 74 years, 3% of persons 75 to 84 years, and 9% of persons 85+ years are institutionalized.

Question 17

The unit manager at a long-term care facility is concerned with the recent weight loss of several residents. The nurse plans a staff in-service to discuss weight loss in older adults, including identifying what possible causes? Select all that apply.

Accepted Answer

Various physiologic processes are identified as causes for decreased nutrition intake in older adults. These processes include decreased thirst and smell, alterations in taste, early satiation (feeling full), and anorexia. Decreased dietary intake is also associated with a decline in physical activity that further limits the intake of essential micronutrients.

Question 18

An older adult client tells a home care nurse, "I don't seem to sleep as well as I used to." The nurse is aware that the sleep changes that occur in the older adult client which cause a less restful sleep include:

Accepted Answer

The changes to the sleep cycle that usually occur in the older adult are an increase in stage I and a decrease in deep sleep. These changes lead to a less restful sleep and more frequent awakenings during the night.

Question 19

A nurse is conducting an informal study on common issues in the older adult that cause them to seek healthcare. Which problem would the nurse likely find as the most common cause?

Accepted Answer

Although any condition can cause an older adult to seek healthcare, chronic pain, or ongoing pain after expected time of healing, is the most common issue presented to healthcare professionals in people aged 65 years and older.

Question 20

The nurse is preparing a presentation on chronic pain management to a group of older adult members of a community senior citizens center. Which chronic disease should the nurse focus on in his or her presentation?

Accepted Answer

The nurse should focus on pain control for individuals with osteoarthritis since this disorder is the most frequent cause of chronic pain in the older adult population.

Quiz 16: Caring for the Older Adult