Question 1

The nurse is performing nutritional assessments on four older adult clients. What assessment data should indicate to the nurse a potential complication associated with a compromised nutritional status?

A) The client who routinely eats meals with a spouse.
B) The client who eats several small meals a day.
C) The client who drinks a milkshake-like dietary supplement with every meal.
D) The client who has two snacks daily of cheese and almonds.

The client who has two snacks daily of cheese and almonds.

Accepted Answer

Milkshake-like dietary supplements are routinely prescribed when weight loss occurs, but there is some concern that these drinks cause satiety and diminish intake at mealtime. Older clients who eat alone are more at risk for malnutrition. Eating frequent small meals can minimize the problem of early satiety. Nutrient dense foods will offer more calories per bite.

Question 2

An older client is demonstrating signs of a vitamin B6 deficiency. Which foods should the nurse encourage the client to ingest to help address this deficiency? (Select all that apply.)&#10;A) Fish&#10;B) Pork&#10;C) Kale&#10;D) Chicken&#10;E) Whole grains

Accepted Answer

Fish, pork, chicken, and whole grains are food sources high in Vitamin B6. Kale is a rich source of calcium.
Fish, pork, chicken, and whole grains are food sources high in Vitamin B6. Kale is a rich source of calcium.
Fish, pork, chicken, and whole grains are food sources high in Vitamin B6. Kale is a rich source of calcium.
Fish, pork, chicken, and whole grains are food sources high in Vitamin B6. Kale is a rich source of calcium.

Question 3

The nurse instructs a middle-aged female client on ways to increase the daily calcium intake. Which food selections by the client indicate that the teaching has been successful?&#10;A) Eggs, meat, fish&#10;B) Chicken, fish, eggs&#10;C) Sardines, kale, mustard greens&#10;D) Legumes, dried fruit, enriched grains

Accepted Answer

Sardines, kale, and mustard greens are all food sources high in calcium. Eggs, meat, and fish are good sources of phosphorus. Chicken, fish, and eggs are good sources of Vitamin B6. Legumes, dried fruit, and enriched grains are good sources of iron.

Question 4

The nurse notes an older client has lost lean muscle mass. How should the nurse document this finding?&#10;A) Dysphasia&#10;B) Sarcopenia&#10;C) Pagophagia&#10;D) Xerostomia

Accepted Answer

The loss of lean muscle mass in older adults is called sarcopenia. The biological process of aging also brings bout changed in adipose, bone mineral content, and total body water. Dysphagia is difficulty swallowing which can contribute to an altered intake. Pagophagia is the consumption of ice and freezer frost. Xerostomia is the insufficient saliva production which occurs naturally.

Question 5

An older client experiences difficulty swallowing whole wheat bread and crackers. For which age-related change should the nurse assess this client?&#10;A) Dysomia&#10;B) Dyskinesia&#10;C) Xerostomia&#10;D) Leukoplakia

Accepted Answer

Xerostomia is the development of insufficient saliva production which occurs with the adding process. A dry mouth can lead to altered taste perception and difficulty swallowing. Dysomia is the sensation of unpleasant smell. Dyskinesia is a movement disorder characterized by severe, dystonic, involuntary movement of the facial, oral, and cervical musculature. Leukoplakia is used to describe a thickened, white plaque the will not rub or strip off and is not identifiable clinically or pathologically as any other disease.

Question 6

An older client is experiencing diarrhea and a fever. Which assessment finding indicates that this client is dehydrated? (Select all that apply.)&#10;A) Agitation and restlessness&#10;B) Dark yellow urine&#10;C) Orthostatic hypotension&#10;D) Three-pound weight gain&#10;E) Mucous membranes moist

Accepted Answer

The client with diarrhea and fever has an increased risk of developing dehydration. Many clients complain of a headache and will be lethargic with dehydration. They are less likely to become restless and agitated. A dehydrated client's urine is more concentrated and darker in color. The client's fluid balance is decreased, and the blood pressure may reflect orthostatic hypotension with postural changes. Clients lose weight with dehydration due to fluid losses. Mucous membranes will be dry due to dehydration.
The client with diarrhea and fever has an increased risk of developing dehydration. Many clients complain of a headache and will be lethargic with dehydration. They are less likely to become restless and agitated. A dehydrated client's urine is more concentrated and darker in color. The client's fluid balance is decreased, and the blood pressure may reflect orthostatic hypotension with postural changes. Clients lose weight with dehydration due to fluid losses. Mucous membranes will be dry due to dehydration.

Question 7

The nurse reviews the Dietary Reference Intakes (DRIs) for a young adult client. Which nutrients have significant changed from adolescence for this client?&#10;A) Protein, magnesium, and folate&#10;B) Calcium, vitamin B6, vitamin D&#10;C) Vitamin A, vitamin K, and vitamin C&#10;D) Magnesium, vitamin A, and phosphorous

Accepted Answer

The Dietary Reference Intakes for adults between 19 years and 50 years do not change significantly form adolescence with the exception of the recommendations for calcium, phosphorus, and iron. Daily calcium recommendations decrease to 1000 mg from 1300 mg as an adolescent, and phosphorus recommendations drop to 700 mg from 1250 mg. Iron recommendations increase in the adult female.

Question 8

The nurse is reviewing vitamin supplements with an older client. Which vitamin should the nurse recommend because of an age-related change in secretion of hydrochloric acid and poor absorption?&#10;A) B2&#10;B) B3&#10;C) B6&#10;D) B12

Accepted Answer

The diminished secretion of hydrochloric acid that occurs with aging affects the digestion and absorption of nutrients that require a more acid medium in the stomach including vitamin B12. The other vitamins are not altered because of hydrochloric acid changes in the stomach.

Question 9

An older female client reports having an alcoholic beverage every day. What should the nurse respond to this client?&#10;A) &#34;Alcohol has tonic benefits in the older person.&#34;&#10;B) &#34;There is no limit to the amount of alcohol you can ingest in a day.&#34;&#10;C) &#34;An older person needs to drink more alcohol before feeling the effects.&#34;&#10;D) &#34;There are no benefits to consuming more than one alcoholic drink per day.&#34;

Accepted Answer

There are no demonstrated benefits to consuming more than one standard drink/day in women and two/day in men. Alcohol is referred to as both a tonic and a toxin because of its health benefits and risks. An age-related change in alcohol dehydrogenase, an enzyme involved in alcohol metabolism, increases the bioavailability of alcohol in this population. This enzyme alteration can lead to increased blood alcohol levels when coupled with the decreased total body
water associated with aging.

Question 10

An older client with lethargy and a headache has dry mucous membranes, sunken eyes, skin tenting over the sternum, and is oriented to person and place. Which health problem should the nurse suspect this client is experiencing?

A) Xerostomia
B) Edentulism
C) Dehydration
D) Constipation

Accepted Answer

The client's symptoms indicate dehydration in an older client. Edentulism is missing or loose teeth. Xerostomia is insufficient saliva production. Severe dehydration may a precipitating factor for constipation.

Question 11

An older client who is a recent widow has lost 20 lbs. over the past three months. What should the nurse consider as being the most likely explanation for this client's weight loss?&#10;A) Food insecurity&#10;B) Multiple medications&#10;C) Decrease in opportunities for social interactions&#10;D) Depression and sense of loss over spouse's death

Accepted Answer

The answer of An older client who is a recent...

Question 12

An older client reports consuming at least 3 - 4 alcoholic beverages a day for the past 15 years. For which health problem is this client at the greatest risk for developing?&#10;A) Obesity&#10;B) Chronic disease&#10;C) Increase in negative side effects&#10;D) Decrease interaction between alcohol and medications

Accepted Answer

The answer of An older client reports consuming at least...

Question 13

The nurse instructs the spouse of a client who is experiencing dysphagia. which statement indicates that teaching about strategies to help with dysphagia were effective?&#10;A) &#34;I should encourage liquids as often as possible.&#34;&#10;B) &#34;Foods like gelatin and pasta will be easy to swallow.&#34;&#10;C) &#34;We should have a casual conversation during meals.&#34;&#10;D) &#34;It is necessary to sit in a 90-degree angle to the lap when eating.&#34;

Accepted Answer

The answer of The nurse instructs the spouse of a...

Question 14

The nurse reviews with nursing assistive personnel (NAP) strategies to assist an older client with a cognitive impairment eat lunch. Which statement by the NAP indicates that teaching has been effective?

A) "I will stand at the right of the patient when I am assisting them to eat."
B) "I will feed the patient in the main dining room to promote socialization."
C) "I will encourage the patient to independently feed himself when appropriate.
D) "I will place several food choices in front of the person to ensure adequate intake."

Accepted Answer

The answer of The nurse reviews with nursing assistive personnel...

Question 15

The nurse is planning interventions for a client with impaired vision. Which intervention should the nurse select when assisting this client with meals?&#10;A) Assist as much as possible to avoid frustration&#10;B) Encourage to eat with others to promote social interaction&#10;C) Utilize the analogy of a clock face to help locate specific foods on the plate&#10;D) Utilize plates with decorative patterns to aid in making the meal more pleasurable

Accepted Answer

The answer of The nurse is planning interventions for a...

Deck 16: Adult and Older Adult