Ignatavcius Gerontology HESI

An older resident is newly admitted to an assisted living community. Which actions should the registered nurse (RN) implement to provide the resident ways to maintain safe medication administration? (Select all that apply)

A) Locked medication storage in the client’s room
B) Medication forms for prescribed medications
C) Payment forms for prescribed medications
D) Delivery of adequate supply of medication
E) List of findings indicating medication effectiveness

A,B,D,E

For safe self-medication in an assisted living community, the resident should be provided a locked storage box, create a medication administration record to monitor medication, establish adequate medication supply, and a reference to evaluate the effectiveness of medication

When assessing an older client, which age-related changes in the cardiovascular system should the registered nurse (RN) document? (Select all that apply.)

A) Dyspnea
B) Chest pain
C) Cardiac murmurs
D) Widening pulse pressure
E) Irregular heart rate

C,D

For older clients the expected age-related changes in the cardiovascular system include murmurs and widening pulse pressure

An older client who recently moved into an assisted living community refuses to eat or join any activities. When evaluating the client further, what should the registered nurse (RN) focus on during the next examination?

A) Anxiety
B) Depression
C) Exhaustion
D) Confusion

B

Depression is a symptom that an older client is likely to experience with a sudden change in living accommodations when a loss of personal identity can create low self-esteem

The registered nurse (RN) is caring for an elderly client with functional incontinence who lives in an assisted living community. The client is alert and mildly confused and can self ambulate. Which nursing intervention should the RN implement?

A) Offer assistance with toileting q2 hours
B) Use protective disposal undergarment instead of underwear
C) Ask if the client has attempted to void q2 hours
D) Obtain a prescription for intermittent catherization

A

Maintaining independence and self-esteem is important for an older client with incontinence. Toilet assistance decreases the client’s chances of accidents and embarrassment by introducing a toilet training program

The healthcare provider prescribes a new medication, atorvastatin (Lipitor, for an older client who arrives at the clinic for an annual physical examination. What common side effect should the registered nurse (RN) advise the client to observe for with this medication?

A) Constipation
B) Headaches
C) Muscle weakness
D) Nausea and vomiting

B

Headaches are the most common side effect with this medication, which the RN should direct the client to report

The registered nurse (RN) is re-enforcing discharge instructions with the family of an older client who was recently admitted for an intestinal obstruction. Which statement indicates that the family understands the instructions?

A) Increase protein and carbohydrates in the daily diet
B) Limit activity to bed rest for the first week and increase mobility incrementally each week
C) Report abdominal distention, constipation or any nausea and vomiting to the healthcare provider
D) Drink liquids 2 hours after meals instead of during meals

C

These are symptoms that occur with intestinal obstruction and should be addressed immediately

An older male client asks the registered nurse (RN) how he can reduce his incidents of hemorrhoidal flare ups. What information should the RN offer the client about how to prevent rectal discomfort? (Select all that apply).

A) Increase fiber and liquids in the diet to help prevent constipation and straining
B) Change exercise program to reflect less cardio-exercise and more weight training
C) Use a therapeutic cushion for frequent repositioning for periods of prolonged sitting
D) Take frequent warm sitz baths and do not use abrasive paper that can traumatize tissues
E) Establish bowel habits by scheduling daily time to defecate when the client is not rushed

A,C,D,E

Fluids, comfort measures, and establishment of a regular bowel pattern help reduce incidents of hemorrhoid inflammation.

During the quarterly evaluations of the clients in the assisted living community, the registered nurse (RN) assesses for findings of failure to thrive in the older population. Which findings should the RN document and report as manifestations related to failure to thrive? (Select all that apply.)

A) Unintentional weight loss
B) Increased weakness
C) Increased amounts of sleep
D) Irritation and agitation
E) Seeking constant attention from caregiver

A,B,C

Symptoms of failure to thrive in the older population include weight loss, weakness, and excessive sleep, which should be documented and evaluated by a healthcare provider immediately

An older male client is seeking counseling about his recent sexual issues with his partner. What issue should the registered nurse (RN) explore in this discussion?

A) Certain medications may impact sexual function
B) Normal aging affects sexual function in male clients
C) Safe sex is not necessary with older sexually active elders
D) Sexual interest usually declines with aging in male clients

A

Certain medications can have a direct influence on sexual function and should be discussed with older clients

The registered nurse (RN) is reinforcing discharge instructions to the family of an older client with failure to thrive. What information should the RN include to promote nutritional intake for the client? (Select all that apply).

A) Minimize stress level by providing the client with a quiet environment during meals
B) Provide food variations that the client can manage without assistance
C) Assist the client with eating meals in bed in a semi-fowlers position
D) Encourage fluid intake before meals to decrease dehydration
E) Offer any type of food to the client as long as calories are consumed

A,B

These continue to promote independence and decreased stress for the client, which will cause decreased self worth and depression

An older woman asks the registered nurse (RN) how she can decrease her chances of getting cystitis. What information should the RN provide?

A) Void and empty the bladder completely every 2 to 3 hours
B) Take warm sitz baths with bubble bath to cleanse the vulva
C) Decrease fluid volume intake to reduce urgency
D) Test urine pH daily using over-the-counter (OTC) dipsticks

A

Frequent bladder emptying minimizes overdistention, which can compromise blood supply to the bladder wall and cause irritation to the bladder

An older male client with Parkinson’s disease (PD) is discharged home with levodopa-carbidopa (Sinemet) and instructions to his wife for his care. Which statement best indicates to the registered nurse (RN) that the wife understands her husband’s needs?

A) “It is important to keep my husband in a chair or in bed as much as possible and prevent him form falling.”
B) “I will notify the healthcare provider if my husband has increasing involuntary movements of his extremities.”
C) “Since it is difficult for my husband to eat, we should stay in the house instead of going out to dine.”
D) “I should expect that my husband will be incontinent of bowel and bladder as his disease advances.”

B

Increasing involuntary movements should be reported during the use of levodopa; it is an indicator that the body is failing to readjust to the changes in the level of the intracerebral neurotransmitter dopamine. The client should be encouraged to engage in exercise and regular daily activities

The home health registered nurse (RN) visits an older woman with heart failure (HF) who is on complete bed rest. Which intervention is most important for the RN to suggest to the client to prevent complications related to immobility?

A) Get as much sleep as possible
B) Perform leg exercises while in bed
C) Increase protein intake to combat fatigue
D) Invite friends to visit to decrease risk for depression

B

The client is at risk for complications related to immobility. Active leg exercises should be performed frequently to decrease the risk for thrombophlebitis.

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