Older Adult Nclex questions

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Exam 05: Older Adult NCLEX Questi...

66 terms safalcon7Preview Older Adult Nclex questions 45 terms Shaun_Simmons Preview Care of Older Adults - NCLEX Quest...120 terms iluvmypupsPreview Cardiov 121 terms ang The nurse is setting up an education session with an 85- year-old patient who will be going home on anticoagulant therapy. Which strategy would reflect consideration of aging changes that may exist with this patient?

• Show a colorful video about anticoagulation therapy.
• Present all the information in one session just before

discharge.

• Give the patient pamphlets about the medications to

read at home.

• Develop large-print handouts that reflect the verbal

information presented.

• Develop large-print handouts that reflect the verbal information presented.

Rationale: Option D addresses altered perception in two ways. First, by using

visual aids to reinforce verbal instructions, one addresses the possibility of decreased ability to hear high-frequency sounds. By developing the handouts in large print, one addresses the possibility of decreased visual acuity. Option A does not allow discussion of the information; furthermore, the text and print may be small and difficult to read and understand.When developing the plan of care for an older adult who is hospitalized for an acute illness, the nurse should

• use a standardized geriatric nursing care plan.
• plan for likely long-term-care transfer to allow

additional time for recovery.

• consider the preadmission functional abilities when

setting patient goals.

• minimize activity level during hospitalization.
• consider the preadmission functional abilities when setting patient goals.

Rationale: The plan of care for older adults should be individualized and based on the patients current functional abilities. A standardized geriatric nursing care plan is unlikely to address individual patient needs and strengths. A patients need for discharge to a long-term-care facility is variable. Activity level should be designed to allow the patient to retain functional abilities while hospitalized and also to allow any additional rest needed for recovery from the acute process.

Which information obtained by the home health nurse when making a visit to an 88-year-old with mild forgetfulness is of the most concern?

• The patient's son uses a marked pillbox to set up the

patient's medications weekly.

• The patient has lost 10 pounds (4.5 kg) during the last

month.

• The patient is cared for by a daughter during the day

and stays with a son at night.

• The patient tells the nurse that a close friend recently

died.

• The patient has lost 10 pounds (4.5 kg) during the last month.

Rationale: A 10-pound weight loss may be an indication of elder neglect or

depression and requires further assessment by the nurse.A 70-year-old client asks the nurse to explain to her about hypertension. An appropriate response by the nurse as to why older clients often have hypertension is

due to:

• Myocardial muscle damage
• Reduction in physical activity
• Ingestion of foods high in sodium
• Accumulation of plaque on arterial walls
• Accumulation of plaque on arterial walls

In reviewing changes in the older adult, the nurse recognizes that which of the following statements related to cognitive functioning in the older client is true?

• Delirium is usually easily distinguished from irreversible

dementia.

• Therapeutic drug intoxication is a common cause of

senile dementia.

• Reversible systemic disorders are often implicated as a

cause of delirium.

• Cognitive deterioration is an inevitable outcome of the

human aging process.

• Reversible systemic disorders are often implicated as a cause of delirium.

Rationale: Delirium is a potentially reversible cognitive impairment that is often due to a physiological cause such as an electrolyte imbalance, cerebral anoxia, hypoglycemia, medications, tumors, cerebrovascular infection, or hemorrhage.Which of the following interventions should be taken to help an older client to prevent osteoporosis?

• Decrease dietary calcium intake.
• Increase sedentary lifestyles
• Increase dietary protein intake.
• Encourage regular exercise.
• Encourage regular exercise.

Rationale: Key word in question is prevent

Weight-bearing exercises helps to fight off degeneration of bone in osteoporosis

Which of the following statements accurately reflects data that the nurse should use in planning care to meet the needs of the older adult?

• 50% of older adults have two chronic health problems.
• Cancer is the most common cause of death among

older adults.

• Nutritional needs for both younger and older adults

are essentially the same.

• Adults older than 65 years of age are the greatest

users of prescription medications.

• Adults older than 65 years of age are the greatest users of prescription

medications.

Rationale: Approximately two thirds of older adults use prescription and

nonprescription drugs with one third of all prescriptions being written for older adults

The nurse is aware that the majority of older adults:

• Live alone
• Live in institutional settings
• Are unable to care for themselves
• Are actively involved in their community
• Are actively involved in their community

The nurse works with elderly clients in a wellness screening clinic on a weekly basis. Which of the following statements made by the nurse is the most therapeutic regarding their mobility?

• "Your shoulder pain is normal for your age."
• "Continue to exercise your joints regularly to your

tolerance level."

• "Why don't you begin walking 3 to 4 miles a day, and

we'll evaluate how you feel next week."

• "Don't worry about taking that combination of

medications since your doctor has prescribed them."

• "Continue to exercise your joints regularly to your tolerance level."

A long-term care facility sponsors a discussion group on the administration of medications. The participants have a number of questions concerning their medications. The

nurse responds most appropriately by saying:

• "Don't worry about the medication's name if you can

identify it by its color and shape."

• "Unless you have severe side affects, don't worry about

the minor changes in the way you feel."

• "Feel free to ask your physician why you are receiving

the medications that are prescribed for you."

• "Remember that the hepatic system is primarily

responsible for the pharmacotherapeutics of your medications."

• "Feel free to ask your physician why you are receiving the medications that are

prescribed for you."

Rationale: The nurse should encourage the older adult to question the physician

and/or pharmacist about all prescribed drugs and over-the-counter drugs. The older adult should be taught the names of all drugs being taken, when and how to take them, and the desirable and undesirable effects of the drugs.

In performing a physical assessment for an older adult, the nurse anticipates finding which of the following normal physiological changes of aging?

• Increased perspiration
• Increased airway resistance
• Increased salivary secretions
• Increased pitch discrimination
• Increased airway resistance

Rational: Normal physiological changes of aging include increased airway

resistance in the older adult. The older adult would be expected to have decreased perspiration and drier skin as they experience glandular atrophy (oil, moisture, sweat glands) in the integumentary system. The older adult would be expected to have a decrease in saliva. A normal physiological change of the older adult related to hearing is a loss of acuity for high-frequency tones (presbycusis).There are factors that influence the musculoskeletal system associated with aging. The nurse recognizes that

with age:

• Men have the greatest incidence of osteoporosis
• Muscle fibers increase in size and become tighter
• Weight-bearing exercise reduces the loss of bone

mass

• Muscle strength does not diminish as much as muscle

mass

• Weight-bearing exercise reduces the loss of bone mass

Which of the following statements, made by the daughter of an older adult client concerning bringing her mother home to live with her family, presents the greatest concern for the nurse?

• "If this doesn't work out, she can always go to live with

my sister."

• "I don't think she will react very well to me making

decisions for her."

• "I'm afraid that mom will be depressed and miss her

home."

• "My children will just have to adjust to having their

grandmother with us."

• "I don't think she will react very well to me making decisions for her."

The nurse, preparing to discharge an 81-year-old client from the hospital, recognizes that the majority of older

adults:

• Require institutional care
• Have no social or family support
• Are unable to afford any medical treatment
• Are capable of taking charge of their own lives
• Are capable of taking charge of their own lives

Which of the following responses by an older-adult client is most reflective of a need for further education by the nurse regarding the physiological changes associated with the older adult?

• "I call a cab if I want to go out after dark."
• "I can't help worrying about becoming forgetful."
• "I have my eyes checked regularly. Can't afford to fall."
• "I really enjoy eating good vanilla ice cream, but I have

cut way down." 0%

• "I can't help worrying about becoming forgetful."