Deck 62: Older Adults

Question 1

An older patient has fallen and broken his hip.As a consequence,the patient's family is concerned about his ability to care for himself,especially during his convalescence.What should the nurse do?

A) Stress that older patients usually ask for help when needed.
B) Inform the family that placement in a nursing center is a permanent solution.
C) Tell the family to enroll the patient in a ceramics class to maintain his quality of life.
D) Provide information and answer questions as family members make choices among care options.

Answer 1

D
Nurses assist older adults and their families by providing information and answering questions as they make choices among care options.Some older adults deny functional declines and refuse to ask for assistance with tasks that place their safety at great risk.The decision to enter a nursing center is never final,and a nursing center resident sometimes is discharged to home or to another less-acute residence.What defines quality of life varies from person to person.Nurses must listen to what the older adult considers to be most important rather than making assumptions about the individual's priorities.

Question 2

An outcome for an older adult patient living alone is to be free from falls.Which of these statements by a patient indicates that teaching on safety concerns has been effective?

A) "I'll leave my throw rugs in place so that my feet won't touch the cold tile."
B) "I'll take my time getting up from the bed or chair."
C) "I should wear my favorite smooth bottom socks to protect my feet when walking around."
D) "I will have my son dim the lighting outside to decrease the glare in my eyes."

Answer 2

B
Older adults taking medications with adverse effects such as postural hypotension,dizziness,or sedation need to be aware of these potential effects and to take precautions such as changing position slowly or ambulating with assistance if unsteady.Household items that are easy to trip over,such as throw rugs,are a risk factor for falls.Other risk factors include wearing shoes in poor repair or slippery soles.Impaired vision and poor lighting are other risk factors.

Question 3

A patient with gradual,progressive cognitive impairment (dementia)is admitted to the nursing unit after hip replacement surgery.Which of the following is a nursing care principle for care of cognitively impaired older adults?

A) Maintain physical health.
B) Evaluate the patient's manifestations of standard symptoms.
C) Assist patient with all ADLs.
D) Isolate patients to protect others.

Answer 3

A
The nurse works to monitor and maintain physical health.The nurse should also assess the person's unique manifestations of the disease as it progresses while facilitating independent performance of activities of daily living (ADLs).Social interaction based on the patient's abilities is to be promoted.

Question 4

Which of these findings,if identified in a patient on a gerontological unit,would be most surprising to a culturally sensitive nurse?

A) The older person not being functionally independent
B) Preferences in food, music, and religion
C) Use of conventions of the handshake, silence, and eye contact
D) Personal health practices and spiritual resources

Question 5

Which teaching strategy is best to utilize with older adult patients?

A) Provide several topics of discussion at once to promote independence and making choices.
B) Avoid uncomfortable silences after questions by helping patients complete their statements.
C) Ask patients to recall past experiences that correspond with their interests.
D) Speak in a high pitch to help patients hear better.

Question 6

Which of the following statements by a new graduate nurse should be corrected by an experienced nurse?

A) "Most older patients are ill and disabled. That's why we care for so many of them in the hospital."
B) "Older adults are many times still interested in sexual relations."
C) "Patients over age 65 are still lifelong learners."
D) "Many older adult patients remain independent enough to live alone."

Question 7

The nurse correctly describes psychosocial theories on aging as theories that

A) Describe role changes in behaviors in older adults.
B) Emphasize that all adults age in similar ways.
C) Stress the need for the aging to discontinue activities as they age.
D) Describe behavior patterns for all aging adults as unpredictable.

Question 8

A 70-year-old patient who suffers from worsening dementia is no longer able to live alone.When discussing health care services and possible long-term living arrangements with the patient's only son,what should the nurse suggest?

A) An apartment setting with neighbors close by
B) Having the patient utilize weekly home health visits
C) A nursing center because home care is no longer safe
D) That placement is irrelevant because the patient is retreating to a place of inactivity

Question 9

During assessment of an older adult's skin integrity,expected findings include which of the following?

A) Decreased elasticity
B) Oily skin
C) Increased facial hair in men
D) Faster nail growth

Question 10

When comparing developmental tasks of middle-aged persons versus older adults,what should the nurse infer?

A) Learning to cope with loss is most common during the middle adult years.
B) After age 65, most older adults age both biologically and psychologically the same way.
C) All older adults will need nursing assistance to deal with loss.
D) Older adults fear and resent retirement as a disruption of their lifestyle.

Question 11

Several theories on aging have been put forth,and the nurse should use these theories to

A) Guide nursing care.
B) Explain the stochastic view of genetically programmed physiological changes.
C) Select one theory to guide nursing care for all geriatric patients.
D) Understand the nonstochastic views of aging as the result of cellular damage.

Question 12

As the aging population in the United States increases,the nurse knows that the

A) Baby boomer generation accounts for a very small percentage of this group.
B) Extension of the average life span has also increased.
C) Population segment over age 85 is decreasing.
D) Diversity of this age group will certainly decrease.

Question 13

An 80-year-old male is brought to the emergency department with an exacerbation of chronic obstructive pulmonary disease (COPD).He states that he quit smoking 30 years ago,so it can't be COPD.He argues,"It's just these colds I've been getting.They're just getting worse and worse." The nurse understands that

A) These symptoms are more associated with normal aging than with disease.
B) Older adults do not have to alter physical activity because of physical changes.
C) The patient's age will require adjustment of lifestyle to one of inactivity.
D) Older adults usually are aware and accepting of the aging process.

Question 14

Which symptom is an expected cognitive change in the older adult patient?

A) Disorientation
B) Slower reaction time
C) Poor judgment
D) Loss of language skills

Question 15

A patient asks the nurse what the term polypharmacy means.The nurse defines this term as

A) Multiple side effects experienced when taking a medication.
B) The concurrent use of many medications.
C) The many adverse drug effects reported to the pharmacy.
D) The risks of medication effects due to aging.

Question 16

A male older adult patient expresses his concern and anxiety about decreased penile firmness during erection.What is the nurse's best response?

A) Explain that over time, his libido will decrease, as will the frequency of sexual activity.
B) Tell the patient to double his antidepressant medication to increase his libido.
C) Tell the patient that this change is expected in aging adults.
D) Tell the patient that touching should be avoided unless intercourse is planned.

Question 17

To promote physical well-being and socialization in an older adult,what should the nurse realize?

A) Social isolationism is always a chosen behavior.
B) Body image plays no role in decision making by the older adult.
C) No community resources are focused on the older adult.
D) Older adults may have a functional purpose in social arenas.

Question 18

As a patient ages,the nursing plan of care

A) Should be standardized because all geriatric patients have the same needs.
B) Needs to be individualized to the patient's unique needs.
C) Should be based on chronological age alone.
D) Focuses on the disabilities that all aging persons face.

Question 19

An older adult patient in no acute distress reports being less able to taste and smell.What is the nurse's best response to this information?

A) Notify the physician immediately to rule out cranial nerve damage.
B) Perform testing on the vestibulocochlear nerve and a hearing test.
C) Schedule the patient for an appointment at a smell and taste disorders clinic.
D) Explain to the patient that diminished senses are normal findings.

Question 20

What is the best suggestion a nurse could make to a family requesting help in selecting a local nursing center?

A) Suggest choosing a nursing center that is as sanitary as possible. The closer the center is to hospital standards, the better.
B) Have family members evaluate nursing home staff according to their ability to get tasks done efficiently.
C) Make sure that nursing home staff members get patients out of bed every day for the entire day.
D) Explain that it is probably best for the family to visit the center and inspect it personally.

Question 21

Which of these patient statements is the most reliable indicator that an older adult has the correct understanding of health promotion activities?

A) "I need to increase my fat intake and limit protein."
B) "I should discontinue my fitness club membership for safety reasons."
C) "I'm up to date on my immunizations, but at my age, I don't need the tetanus vaccine."
D) "I still keep my dentist appointments even though I have partials now."

Question 22

One of the greatest challenges for the nurse caring for older adults is ensuring safe medication use.One way to reduce the risks associated with medication usage is to

A) Periodically review the patient's list of medications.
B) Inform the patient that polypharmacy is to be avoided at all cost.
C) Be aware that medication is absorbed the same way regardless of patient age.
D) Focus only on prescribed medications.

Question 23

A 72-year-old woman was recently widowed.She worked as a teller at a bank for 40 years and has been retired for the past 5 years.She never learned how to drive.She lives in a rural area that does not have public transportation.Which of the following psychosocial changes does the nurse focus on as a priority?

A) Sexuality
B) Housing and environment
C) Retirement
D) Social isolation

Question 24

Which of these assessments of an older adult,who has a urinary tract infection,requires an immediate nursing intervention?

A) Presbycusis
B) Confusion
C) Death of a spouse 3 months ago
D) Temperature of 97.6° F

Question 25

An older adult patient has developed acute confusion.The patient has been on tranquilizers for the past week.The patient's vital signs are normal.What should the nurse do?

A) Take into account age-related changes in body systems that affect pharmacokinetic activity.
B) Increase the dose of tranquilizer if the cause of the confusion is an infection.
C) Note when the confusion occurs and medicate before that time.
D) Restrict telephone usage to prevent further confusion.

Question 26

A recently widowed 80-year-old male is dehydrated and is admitted to the hospital for intravenous fluid replacement.During the evening shift,the patient becomes acutely confused.The nurse's best action is to assess the patient for which of the following reversible causes?

A) Electrolyte imbalance
B) Hypoglycemia
C) Drug effects
D) Dementia
E) Cerebral anoxia