Question 1

When describing the changes occurring in the older adult population globally, which would be most accurate?

Accepted Answer

In most of the world, the population of those over 85 years of age is growing faster than any other population age group. A higher life expectancy at birth for females compared with males is almost universal. Many countries have few or no social programs available for older adults. By the year 2050, 16% of the population is expected to be over the age of 65 years.

Question 2

While working with another group of community health nurses, a nurse overhears one of the nurses saying, "That older man should just retire. He's 70 years old. How productive can he be?" The nurse interprets this statement as reflecting:

Accepted Answer

The one nurse's statement reflects stereotyping and a negative image of an older adult. This is called ageism. It may be due to negative personal experiences, myths, or a general lack of information. It is not reflective of prejudice or bias. Insight would reflect an understanding of the older adult, which this statement does not do.

Question 3

Which are characteristics of healthy older adults? Select all that apply.

Accepted Answer

Healthy older adults' ability to function is a key indicator of health and wellness and is an important factor in understanding healthy aging. They are able to adapt, to continue to handle stress, and to be active in life and living. They maintain the maximum degree of physical, mental, and social vigor. The vast majority of older adults, even those with chronic diseases or other disabilities, are living outside institutions and are relatively independent.

Question 4

The nurse educator is aware that the nursing student has a grasp of the primary prevention needs of older adults when the nursing student makes which comment?

Accepted Answer

The oral health of older adults is often neglected and so it is important that they see a dentist regularly. It is necessary for older adults to receive immunizations. Neither of these statements is true: all older adults must restrict their sodium intake and older adults don't need to drink as much fluid as they are often less thirsty.

Question 5

When visiting a local senior center, a community health nurse engages several of the older adults in a discussion about immunizations. Which statement best reflects the importance of older adult immunization?

Accepted Answer

Older adults are at risk of not only contracting influenza or pneumonia but of dying from them, underscoring the importance of obtaining the immunizations. The statement about not getting the flu from the shot addresses one of the common reasons for not getting it, the belief that the flu shot will give them the flu. The statement about the doctor telling them to get it indirectly reflects another reason for not getting it, lack of knowledge about the need. The statement about getting the shot for free suggests that finances may be a barrier to obtaining the shot but not why it is important.

Question 6

A community health nurse is teaching a group of older adults at a senior center about strategies to prevent Alzheimer's disease. Which information would the nurse include?

Accepted Answer

Strategies to prevent Alzheimer's disease include staying active, exercising, health eating habits, adequate sleep, and managing cardiovascular risk factors. One crucial way of staying active through work, recreation, and community is maintaining contacts with family and friends. Moderation in drinking is key. The older adult should eat a healthy diet of fruits, whole grains, vegetables, and lean meat. They also should get as much sleep and rest as needed. Getting up early in the morning may or may not be appropriate.

Question 7

An older adult interested in nutrition asks the community health nurse about the number of calories that he or she should eat every day. Which range of calories would be most appropriate?

Accepted Answer

It is generally believed that older people need to maintain their optimal weight by eating a diet that is low in fats, moderate in carbohydrates, and high in proteins with a daily calorie count of 1,200 to 1,600.

Question 8

An older adult presents to the community health center for a checkup and reports constipation. Which suggestion would be most appropriate?

Accepted Answer

Older adults should add more fiber and bulk to their diet with fresh fruits and vegetables instead of relying on the habitual use of laxatives. Also, inadequate fluid intake can contribute to bowel and bladder problems. Consuming a diet that includes 8- or more than 8-oz glasses of fluid (water, juices, tea) each day assists the gastrointestinal and genitourinary system in their functions. Increased physical activity and exercise, such as a daily walk, help keep an older adult's bowel patterns regular.

Question 9

A community health nurse meets with a group of adults at the local senior center. They range in age from 50 to 75 years. The nurse would recommend colonoscopy screening at which frequency?

Accepted Answer

Currently, colonoscopy screenings should be administered every 10 years.

Question 10

A community health nurse is assessing an older adult's ability to perform activities such as shopping, doing the laundry, using the telephone, and handling finances. Which assessment tool would be most appropriate for the nurse to use?

Accepted Answer

The Instrumental Activities of Daily Living Scale looks at an older adult's ability to perform such activities as using the telephone, shopping, doing laundry, and handling finances. The Barthel Index assesses functional independence and is often used to determine levels of disability or dependence of stroke victims in respect to ADLs. The Modified Rankin Scale (MRS) is another common tool used for this purpose. The Katz Index of Activities of Daily Living is based on an evaluation of the functional independence or dependence of clients with respect to bathing, dressing, toileting, and related tasks.

Question 11

A community health nurse is preparing a teaching program that addresses chronic diseases common among older adults. Which information would be most appropriate for the nurse to incorporate into the program?

Accepted Answer

Older adults need to have sufficient cerebral circulation to avoid dizziness. Dizziness can lead to falling. A normal to high-normal blood pressure for the older adult should be maintained. Based on the most current statistics, 15.1% of men and 13.0% of women report having diabetes. Weight-bearing exercises are a way to prevent osteoporosis. Older African American men have the highest rates of hypertension.

Question 12

After teaching a group of older adult women about preventing osteoporosis, which, if stated by the group, indicates the need for additional teaching?

Accepted Answer

Weight-bearing activities are encouraged to promote strong bones. In addition, individuals should be encouraged to eat diets that are rich in vitamin D and calcium and include calcium supplements as needed. Not smoking, maintaining a healthy weight, and receiving ongoing bone density screenings are positive health behaviors that can contribute to strong bones throughout life.

Question 13

After teaching a group of students about the most common health problems affecting older adults in the community, which, if identified by the students, would alert the instructor to the need for additional teaching?

Accepted Answer

Emphysema is not considered a common health problem of older adults. The most common health problems of older people in the community are arthritis, reduced vision, hearing loss, heart disease, peripheral vascular disease, and hypertension.

Question 14

When describing elder abuse to the families of older adults who are attending a local community presentation, which would the community health nurse identify most commonly as the perpetrator?

Accepted Answer

The most common perpetrators of elder abuse are spouses or partners of elders. The next most frequent abuser is the adult child of the elder. Although it may be possible that the perpetrator is the elder's neighbor or grandchild, this situation would be quite rare.

Question 15

Which statement about elder abuse is most accurate?

Accepted Answer

Elder abuse is a problem that is underrecognized and underreported. It is more common for older women to be abused rather than older men. The most common perpetrators of elder abuse are spouses or partners of elders, often in a relationship with long-term domestic violence. In some states, self-neglect is also considered a form of mistreatment.

Question 16

A nurse is reviewing services offered for those over the age of 65 at the clinic. When developing an evaluation tool, which criteria are included to evaluate the effectiveness of the older adult programs? Select all that apply.

Accepted Answer

The primary criteria for effective programs for older adults include coordination, accessibility, comprehensive, and quality.

Question 17

Which are included in a comprehensive set of services? Select all that apply.

Accepted Answer

A comprehensive set of services for senior citizens should include adequate financial support, adult day care programs, access to high-quality health care services, health education, in-home services, recreation and activity programs that promote socialization (not encouragement to spend much time alone), and specialized transportation services.

Question 18

A community health nurse is making a home visit to a family who is providing care to an older adult member with Alzheimer's disease for the past 6 months. During the visit, which would be most important for the nurse to assess?

Accepted Answer

Although assessment of the various aspects of the client's status is important, that of the caregiver is even more important. Often, the person with AD is cared for at home until very late in the disease course. The intense care given to these clients can be a constant drain on the emotional and physical reserves of their families. The stress of providing care puts the caregiver's health at risk, as well.

Question 19

A group of community health nurses who work in continuing care retirement centers are asked to talk to a group of seniors about what they do. Which would the nurses highlight as unique for this setting?

Accepted Answer

Continuing care retirement centers are comprehensive centers and have become the last place an older adult needs to live, meeting independent to dependent needs, including skilled nursing and Alzheimer's disease services. They can age in place without moving to another location as their needs increase. They accept residents at all stages of need, from totally independent living to assisted living to skilled nursing care. In some settings, residents cannot enter the residence at the skilled nursing level. These beds are filled by residents with increasing needs as they move from independent living, to assisted living, to skilled nursing care. Skilled nursing facilities provide skilled nursing care along with personal care that is considered nonskilled. Board and care or personal care homes offer 24- hour basic custodial care but provide no skilled nursing services. Respite care centers provide time off for caregivers. It can take place in an adult day center, home, or residential setting.

Question 20

Which care option would be most appropriate for an older adult who experiences confusion, requires daily insulin injections and blood glucose monitoring, and needs assistance with bathing, dressing, and feeding?

Accepted Answer

Based on the situation, a skilled nursing facility would be most appropriate. A skilled nursing facility provides skilled nursing care, such as injections and blood glucose monitoring, along with personal care that is considered nonskilled such as bathing, dressing, and feeding. A personal care home offers 24-hour basic custodial care but no skilled services. Respite care provides time off for caregivers and can take place in a variety of settings. An intermediate care facility provides health care, but the amount and type of skilled care is less than that provided in skilled nursing facilities.

Quiz 22: Older Adults