Deck 32: Care of Elderly Patients

Question 1

A student is providing care for a resident in a long-term care facility who must be moved via geriatric chair and requires assistance with feeding. The student has just finished giving the resident a bed bath, and it is currently nearing time for the midday meal. The student's best action is to

A) Leave the resident in the bed and feed the resident in the room.
B) Obtain assistance to transfer the resident to the geriatric chair and into the dining area to be fed.
C) Obtain assistance to transfer the resident to the geriatric chair and feed the resident in the room.
D) Ask the resident's roommate what the resident usually does at mealtime.

Answer 1

Obtain assistance to transfer the resident to the geriatric chair and into the dining area to be fed.

Question 2

Which of the following statistics is anticipated to be true by 2030?

A) The birth rate will be 10% of the death rate.
B) Three million U.S. citizens will be older than 65 years.
C) There will be more than 1 million centurions.
D) One in every five U.S. citizens will be older than 85 years.

Answer 2

One in every five U.S. citizens will be older than 85 years.

Question 3

A student nurse just finished assisting a resident of a long-term care facility in the shower. It is most important for the student nurse to disinfect the shower to help prevent the spread of

A) Normal flora.
B) The common cold.
C) Thrush.
D) Clostridium difficile.

Answer 3

Clostridium difficile.

Question 4

A nurse is assessing an 82-year-old patient with diabetes. Based on the individual's age, the nurse should pay particular attention to the patient's

A) Skin elasticity.
B) Fingernails.
C) Toenails.
D) Feet.

Question 5

A nurse is approached by a resident in a long-term care facility who walks with a cane, has notable facial droop, and takes a long time to express what he wants to say. The best response by the nurse is to

A) Face the individual and directly ask, "What can I do for you?"
B) Loudly ask, "What do you need?"
C) Use hand motions to determine whether the patient is hungry, thirsty, or in pain.
D) Make eye contact, and say, "I'll have the aide come to the room in a minute."

Question 6

While providing care to an elderly individual with chronic obstructive lung disease, a nurse realizes that further teaching is necessary when the patient states:

A) "I get my flu shot every year."
B) "I wash my hands all the time, especially when I'm in public places."
C) "I only come in close contact with others who have a respiratory illness."
D) "I always take my respiratory medications and antibiotics."

Question 7

A nurse is providing care to a resident with rapidly advancing Alzheimer's disease who receives a visit from a granddaughter who lives in another state. The granddaughter states, "She doesn't even know me, and she doesn't seem like Grandma at all." The best response by the nurse is:

A) "Her thought process has changed quite a bit in the few weeks she's been here, so you shouldn't feel guilty that you can't visit often."
B) "This is normal for someone with Alzheimer's. It is a tragic disease."
C) "I'm sure that you're upset seeing your grandmother this way."
D) "I imagine that this is very hard for you. What is your favorite memory of your grandmother?"

Question 8

The Health Resources and Services Administration projects that by the year 2020, the supply of nurses in the United States

A) Will be adequate to deal with the aging population.
B) Will exceed by more than 500,000 the number required to deal with the aging population.
C) Will fall more than 1 million below the number required to deal with the aging population.
D) Will fall more than 100,000 below the number required to deal with the aging population.

Question 9

A nurse is providing discharge teaching to an elderly woman and her family caretakers. Teaching has been effective if the patient states:

A) "I will keep this list of medications that you gave me and bring it to all of the follow-up appointments."
B) "My doctor's office will get a full report of all the labs you did here in the hospital."
C) "I should empty all of my pills into one container so they don't get lost."
D) "I will write down every pill when I take it."

Question 10

A nurse recognizes that an individual who is most likely experiencing frequent loss of friends, family members, and physical capabilities is

A) A 68-year-old man who is anticipating retirement this year.
B) A 71-year-old woman who volunteers with her church three times a week.
C) A 77-year-old woman who lives alone in her own home.
D) An 89-year-old woman who lives in an assisted living facility.

Question 11

When assessing an elderly individual who was brought into the emergency department, a nurse would be most concerned that

A) The patient is wearing wet adult diapers.
B) The patient has a small skin tear across the left wrist.
C) The patient has multiple bruises in various stages of healing across the shoulders and back.
D) There are no family members who accompanied the client to the emergency department.

Question 12

A nurse is providing instruction to an elderly patient about osteoporosis. Further instruction by the nurse is necessary if the patient states:

A) "I take a calcium supplement every day."
B) "I just had a new handrail installed in my tub."
C) "I walk a mile every day."
D) "I never consume any dairy products."

Question 13

A 72-year-old man is complaining that he just does not have the energy to keep up with his preferred lifestyle anymore and that he is having trouble keeping his blood pressure under control. The nurse assures the patient that these concerns are common in people classified as

A) Young-old.
B) Middle-old.
C) Old-old.
D) Elite old.

Question 14

A nurse is notified that a new admission is expected to the unit. The nurse is told that the patient is 101 years old and is being admitted from a nearby nursing home. An appropriate assumption is that

A) The patient will be blind.
B) The patient's risk for falls will be high.
C) The patient will be confused.
D) The patient will need complete care.

Question 15

A nurse who is working in a long-term care facility recognizes that safety concerns in the elderly population are most often related to normal changes in which of the following systems?

A) Cardiovascular
B) Peripheral-vascular
C) Integumentary
D) Sensory

Question 16

While assisting with the admission of an elderly woman who lives at home with her son and his family, a nurse would be most concerned to find that

A) The patient appears to be overmedicated.
B) The patient's pupils are equal, round, and react to light.
C) The patient's bowel sounds are hypoactive.
D) The patient's lower extremities are shiny and lack hair growth.

Question 17

A nurse finds a resident in a long-term care facility crying in her room. The nurse knows that the resident's husband recently passed away. The best action by the nurse is to

A) Gently close the resident's door to provide privacy.
B) Sit quietly with the resident to offer support.
C) Inform the resident that Bingo starts in 5 minutes.
D) Tell the resident that it is time for her shower.

Question 18

An elderly patient expresses concern to a home health-care nurse about his ability to afford groceries along with all of the new medications he was given in the hospital. Which of the following should be added to his plan of care?

A) An appointment with a chaplain
B) A referral for family counseling
C) A referral to a social worker
D) An appointment with a pharmacist

Question 19

When discussing safety in the home with an elderly neighbor, a nurse would say:

A) "It is important not to give out personal information over the telephone."
B) "You just can't trust people nowadays."
C) "I hope that you don't keep a lot of money in your house."
D) "I worry that you are home alone so much of the day."

Question 20

A nurse's coworker states, "All old people are the same-cranky and needy." The nurse's most appropriate response would be:

A) "They can be hard for me to handle sometimes too."
B) "Don't forget confused and incompetent."
C) "It is important that we treat all patients as individuals."
D) "I think most old people are kind and nurturing."

Question 21

A patient suffers a cerebrovascular accident (CVA) caused by a bleeding blood vessel. The nurse identifies this type of CVA as a(n)

A) Transient ischemic attack.
B) Hemorrhagic stroke.
C) Ischemic stroke.
D) Myocardial infarction.

Question 22

An elderly patient is going through drug and alcohol withdrawal, suffering from hallucinations followed by loud emotional outbursts. A nurse identifies this condition as

A) Dementia.
B) Delirium.
C) Depression.
D) Confusion.

Question 23

Older adults are considered easy prey for scams and crime, as they are less skeptical about solicitations for money than younger individuals. Which of the following should a nurse do to protect older adults from becoming victims?

A) Teach them that when a utility worker has an identification card it is acceptable to let them in the house.
B) Teach them that meter readers need access to the basement to read their meter once every few months.
C) Teach them that they should never give out personal information over the telephone.
D) Teach them that if the bank calls, they should confirm their identity by giving them a social security number.
E) Caution them not to allow anyone they are not expecting in their home.

Question 24

A student is providing assistance with meals for residents in a long-term care facility. Which of the following actions would be included in the care?

A) Determining whether food should be cut up first
B) Ensuring that more than 1000 mL fluid is taken each day
C) Providing supplemental nutrition as ordered
D) Ensuring that dentures are in place before meals
E) Recording the amount of food eaten at each meal

Question 25

A patient has a temporary decrease in the blood supply to the brain that causes dizziness, blurred vision, weakness, numbness in the left arm, and difficulty swallowing that lasts for about 10 minutes. The nurse identifies that this patient has suffered a(n)

A) Transient ischemic attack.
B) Ischemic stroke.
C) Hemorrhagic stroke.
D) Myocardial infarction.

Question 26

A nurse is providing care for an elderly patient who has not had a bowel movement in 3 days. The nurse recognizes that which of the following may be contributing to the patient's constipation?

A) Peristalsis increases with aging.
B) Decreased activity is common in the elderly.
C) The individual takes multiple medications.
D) The body temperature decreases with aging.
E) Feces may remain in the large intestines for a longer period.

Question 27

A nurse teaches a patient about the availability of systems that can activate flashing lights for smoke detectors, ringing telephones, and doorbells. This patient is most likely experiencing a body system deficit known as

A) Decreased sensation.
B) Confusion.
C) Poor vision.
D) Impaired hearing.

Question 28

A nurse is providing discharge instructions for an elderly patient with multiple new medication orders. Which of the following should be included in the discharge teaching?

A) The reason that the medication is being taken
B) The generic name of each medication
C) The time when the medication should be taken
D) Foods and drink that should be avoided
E) Potential side effects caused by the medication

Question 29

An older patient is suffering from an inadequate oxygen supply during physical activity. Which of the following nursing actions would be inappropriate?

A) Assessing the patient for pallor and cyanosis during activity
B) Grouping nursing tasks together in short sessions to avoid constantly interrupting the patient
C) Encouraging the patient to increase activity as tolerated to improve stamina
D) Assessing the patient's oxygen saturation level

Question 30

Which of the following assessments are performed on long-term care patients in addition to the traditional head-to-toe physical assessment?

A) Level of cognition
B) Sleep habits
C) Bowel and bladder elimination status and habits
D) Ability to communicate
E) General appearance

Question 31

A patient suffers from an eye disease characterized by increased intraocular pressure, which affects the optic nerve and can lead to blindness. The nurse identifies this condition as

A) Age-related macular degeneration.
B) Cataracts.
C) Glaucoma.
D) Presbycusis.

Question 32

A student nurse is providing care to a patient in a long-term care facility on a Monday. The patient's assigned bath day is Wednesday. Which of the following should the student assist the client in washing while providing morning care?

A) Face
B) Hands
C) Underarms
D) Back
E) Perineal area

Question 33

The most important thing a nurse can teach patients to help them avoid possible complications from polypharmacy is

A) To carry a complete list of all medications and the dosages being taken.
B) Why he or she is taking each medication.
C) How often to take each medication.
D) Possible side effects of each medication.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 34

A nurse is caring for patients in a long-term care facility. Unless a patient is symptomatic or injured, the nurse should generally perform a head-to-toe assessment

A) At the beginning of each shift.
B) Once a week.
C) Once a month.
D) Once every 6 months.

Question 35

A nurse encounters a patient who is depressed about getting older. The nurse explains that there are many positive aspects of aging, including which of the following?

A) Older people no longer need to take care of themselves.
B) Older people have experienced many things that others have yet to experience.
C) Older people have so much knowledge to share with younger generations.
D) Older people no longer need to drive themselves anywhere.
E) Older people have learned from their own mistakes.

Question 36

A nurse is providing care for a resident of a long-term care facility who is incontinent of bowel and bladder. Which of the following actions taken by the nurse will help minimize skin breakdown?

A) Applying barrier ointment to the perineal area if needed
B) Changing soiled clothing as quickly as possible
C) Changing the patient's position in bed or chair every 1 to 2 hours
D) Assessing for soiling every 1 to 2 hours
E) Limiting fluid intake with meals

Question 37

A nurse is developing a plan of care for an individual in long-term care with urinary incontinence who is confined to a wheelchair or bed. The nurse will include which of the following measures in the plan of care?

A) Assessing for wet linens every hour
B) Changing the patient's briefs immediately upon discovering wetness
C) Completely drying the patient's perineum and buttocks after cleansing
D) Offering the patient opportunities to toilet before meals or activities
E) Placing folded towels on the seat of the wheelchair