Deck 6: Geriatric Implications for Medical-Surgical Nursing

Question 1

Which senescence term does the nurse use to describe the hardening of tissue caused by fibrous tissue overgrowth that occurs with the aging process?
1)Atrophy
2)Stenosis
3)Sclerosis
4)Calcification

Answer 1

3

Question 2

The nurse assesses an older adult patient for age-related changes. Which patient statement requires an intervention by the nurse?
1)"I don't drive at night anymore because of glare."
2)"I walk every day to decrease my risk of osteoporosis."
3)"I have to stop eating before I finish my meals sometimes because I start vomiting."
4)"I can't tell the difference between blue and green socks anymore."

Answer 2

3

Question 3

The nurse monitors for which clinical manifestation when providing care to an older adult patient who is diagnosed with Parkinson disease?
1)Tremors
2)Aphasia
3)Vision impairment
4)Right-sided weakness

Answer 3

1

Question 4

Which nursing action supports The Joint Commission's (TJC's) safety goals for providing home care to an older adult patient?
1)Verifying the patient's first and last name during each visit
2)Administering all prescribed medications to the patient during scheduled visits
3)Recommending the use of throw rugs on hard wood floors to prevent patient falls
4)Asking family members to smoke in another room when oxygen is in use by the patient

Question 5

Which senescence term does the nurse use to describe the wasting away of muscle mass that occurs with the aging process?
1)Atrophy
2)Stenosis
3)Sclerosis
4)Calcification

Question 6

Which statement does the nurse include when educating older adult patients about dementia?
1)"Dementia causes impaired judgment."
2)"Dementia causes fluctuations in alertness."
3)"Symptoms of dementia cause day-night reversal."
4)"Symptoms of dementia do not last more than 1 month."

Question 7

The nurse is providing care to an older adult patient who is diagnosed with a vitamin B deficiency. The patient tells the nurse, "I feel so tired all the time and my daughter says I look pale." The nurse correlates this data to which potential complication of this dietary deficiency?
1)Anemia
2)Osteoporosis
3)Atrophic gastritis
4)Gastroesophageal reflux disease (GERD)

Question 8

The nurse correlates which age category to an adult patient who is 70 years of age?
1)Old
2)Old-old
3)Oldest old
4)Young-old

Question 9

The nurse is providing care to an older adult patient who is experiencing bradycardia and correlates this finding to which age-related cardiovascular change?
1)Stiffened artery walls
2)Increased size of the left atrium
3)Reduced number of pacemaker cells in the sinoatrial (SA) node
4)Decreased cardiac responsiveness to beta-adrenergic stimuli

Question 10

The nurse is screening older adults for the risk of developing heart disease. Which patient is at greatest risk?
1)45-year-old patient with decreased cholesterol levels and normal body weight
2)50-year-old patient with a history of smoking for 5 years; quit 10 years ago
3)65-year-old patient with a history of diabetes mellitus and hypertension
4)70-year-old patient who exercises two times per week and is 5 pounds over ideal body weight

Question 11

The nurse is providing care to an older adult patient who is at risk for congestive heart failure (CHF). The nurse correlates this increased risk to which age-related cardiovascular change?
1)Stiffened artery walls
2)Increased size of the left atrium
3)Reduced number of pacemaker cells in the sinoatrial (SA) node
4)Decreased cardiac responsiveness to beta-adrenergic stimuli

Question 12

The nurse monitors for which electrolyte imbalance in the older adult patient prescribed a diuretic?
1)Serum potassium 3.0 mEq/L
2)Serum sodium 128 mEq/L
3)Serum calcium 7.0 mg/dL
4)Serum osmolarity 250 mOsm/L

Question 13

Which senescence term does the nurse use to describe narrowing of the coronary arteries that is often associated with age-related changes?
1)Atrophy
2)Stenosis
3)Sclerosis
4)Calcification

Question 14

The nurse monitors for which electrolyte imbalance in the older adult patient with impaired renal diluting and concentrating ability?
1)Hypokalemia
2)Hyponatremia
3)Hypocalcemia
4)Hypomagnesemia

Question 15

The nurse is providing care to an older adult patient who is diagnosed with atrial fibrillation. The nurse correlates this increased risk to which age-related cardiovascular change?
1)Stiffened artery walls
2)Increased size of the left atrium
3)Reduced number of pacemaker cells in the sinoatrial (SA) node
4)Decreased cardiac responsiveness to beta-adrenergic stimuli

Question 16

The nurse is providing care to an older adult patient who is diagnosed with osteoporosis. Which age-related cause should the nurse explain in the teaching session?
1)Decreased speed of foot movements
2)Decreased absorption of vitamin D
3)Increased intramuscular fat
4)Increased subcutaneous fat

Question 17

The nurse is providing care to an older adult patient who is diagnosed with a gastric ulcer. Which age-related gastrointestinal change does the nurse recognize as often the cause for this diagnosis?
1)Slowed gastric emptying
2)Atrophied gastric mucosa
3)Increased secretion of gastrin
4)Reduced secretion of intrinsic factor

Question 18

The community health nurse is preparing an educational session for older adults that focuses on decreasing risk for chronic diseases and includes activities such as increasing activity, losing weight, and limiting dietary intake of fats and calories. These activities are most likely to decrease the risk of which disease process?
1)Chronic constipation
2)Urinary tract infections
3)Type 2 diabetes mellitus (DM)
4)Gastroesophageal reflux disorder (GERD)

Question 19

Which senescence term does the nurse use to describe deposits of calcium salt in the blood vessels that often occurs with aging?
1)Atrophy
2)Stenosis
3)Sclerosis
4)Calcification

Question 20

The nurse recognizes which older adult is considered a "baby boomer"?
1)Hispanic female born in 1925
2)Asian female born in 1940
3)African American male born in 1960
4)Caucasian male born in 1980

Question 21

In planning an educational program related to healthcare needs of older adults, which U.S. demographic data is it important for the nurse to incorporate? Select all that apply.
1)23% of adults older than age 65 are racial or ethnic minorities.
2)Hispanics represent the largest minority population.
3)The life expectancy for men is longer than that of women. 4.49% of women older than age 75 live alone.
5)Close to 8.9% of older adults live below the poverty level.

Question 22

The nurse correlates which clinical manifestation to the blunted response to infection often observed in the older adult with a urinary tract infection?
1)Elevated white blood cell count
2)Fever
3)Confusion
4)Clear, amber urine

Question 23

Which changes associated with aging does the nurse correlate to possible inhibitors to medication adherence and safety? Select all that apply.
1)Decreased memory
2)Decreased visual acuity
3)Decreased hearing acuity
4)Decreased sense of smell
5)Decreased physical strength

Question 24

The nurse provides care for several older adult patients on the medical-surgical unit. Which patient is at greatest risk for falls?
1)The patient admitted for intravenous (IV) antibiotics to treat pneumonia
2)The patient admitted for a joint replacement surgery who has a history of anxiety
3)The patient admitted for a lumbar laminectomy who receives diazepam for muscle spasms
4)The patient admitted for exacerbation of congestive heart failure who takes a daily diuretic

Question 25

The nurse is assessing the older adult patient using the Get-Up-and-Go test. Because the patient is unable to stand without assistance, which score does the nurse document?
1)0
2)1
3)3
4)4

Question 26

Which items found by a nurse during a home health visit increase the older adult patient's risk for physical safety issues? Select all that apply.
1)Rugs
2)Electrical cords
3)Nonskid appliance in bathtub
4)Medications stored in a weekly divider
5)Telephone with emergency numbers listed

Question 27

The nurse conducts a Mini-Cog assessment on an older adult patient during a regularly scheduled health maintenance visit. Which questions does the nurse ask to complete this assessment? Select all that apply.
1)Ask the patient to state the date and time.
2)Ask the patient to recite the full date of birth.
3)Ask the patient to write down a list of all medications.
4)Ask the patient to remember the words dog, car, and house.
5)Ask the patient to draw a clock face with the hands to the time 12:25.

Question 28

Which assessment is the priority during hourly rounding of older adult patients to enhance safety and decrease the risk of falls?
1)Need for assistance with repositioning in bed
2)Indwelling catheter bag to monitor urine output
3)Current level of consciousness to compare to baseline
4)Intravenous (IV) site for symptoms indicative of infiltration

Question 29

Which clinical manifestation does the nurse monitor for when providing care to an older adult patient diagnosed with failure to thrive (FTT)?
1)Hearing loss
2)A high cholesterol level
3)A weight loss of 5 pounds
4)Skin that loses elasticity with poor turgor

Question 30

The nurse recognizes that which diagnosis in an older adult patient increases the risk of cachexia? Select all that apply.
1)Lung cancer
2)Osteoporosis
3)Gastroesophageal reflux disorder (GERD)
4)Acquired immune deficiency syndrome (AIDS)
5)Chronic obstructive pulmonary disease (COPD)

Question 31

Which is an advantage of the nurse conducting the mini nutritional assessment when determining a plan of care to address an older adult patient's dietary needs?
1)It allows the nurse to review the patient's intake over the last day.
2)It eliminates the need for the nurse to draw the patient's blood for testing.
3)It determines the patient's body mass index for the nurse to document in the medical record.
4)It provides the nurse with a comprehensive list of all prescribed medications that affect appetite.

Question 32

Which priority safety concerns does the nurse assess when providing care to older adult patients? Select all that apply.
1)Falls
2)Neglect
3)Depression
4)Polypharmacy
5)Poor dietary intake

Question 33

Which nursing action is indicated when conducting hourly rounding on older adult patients?
1)Obtaining patient vital signs
2)Assisting the patient to the bathroom
3)Accounting for all personal items in the patient's room
4)Documenting the intake amount for the last meal eaten by the patient

Question 34

The nurse is caring for an older adult patient presenting with delirium and confusion. As the patient becomes increasingly combative, which action does the nurse implement first?

A)Assigning a staff member to stay with the patient
B)Placing the patient in soft wrist restraints
C)Placing the patient in a vest restraint
D)Administering the ordered sedative