CARE OF OLDER ADULT (LECTURE)

MODULE 9

1. 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?

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

2. The nurse asks a newly admitted client,”what can we do to help you?” what is the
purpose of this therapeutic communication technique?

To explore a subject, idea, experience, or relationship.

3. A student nurse is learning about the appropriate use of touch when communicating
with clients diagnosed with psychiatric disorders. Which statement by the instructor best
provides information about this aspect of therapeutic communication.

Touch carries a different meaning for different individuals.

4. Which nursing statement is a good example of the therapeutic communication

technique of focusing?

You mentioned your relationship with your father. Let's discuss that further.

5. After fasting from 10 pm. The previous evening, a client finds out that the blood test
has been canceled. The client swears at the nurse andstates, “ you are incompetent!
Which is the nurse's best response?

“ I see that you are upset, but I feel uncomfortable when you swear at me”.
6. During a nurse-client interaction, which nursing statement may belittle the clients
feelings and concerns.

“ Don't worry. Everything will be alright”.

7. A client states, “you won't believe what my husband said to me during visiting hours.
He has no right treating me that way. :which nursing response would best assess the
situation that occurred?

Describe what happened during your time with your husband.

8. When interviewing a client, which nonverbal behavior should a nurse employ?

Sitting squarely, facing the client

9. When working with an older adult who is hearing-impaired, the use of which
techniques would improve communication?

Check for needed adaptive equipment

Give the patient time to respond to questions
Keep communication short and to the point.

10. Anuew nurse complains to her preceptor that she has no time for therapeutic
communication with her parents. Which of the following is the best strategy to elp the
nurse find more time for this communication?

Include communication while performing tasks such as changing dressings and

checking vital signs.

MODULE 10
1.Why is it important for the nurse to be cautious using medical jargon with an older
adult patient?
It could become a communication barrier.

2. The nurse is engaging the patient in social conversation. What is the benefit of social
conversation in the health care setting?

It lets the patient know that he or she is considered to be a person, not just a
patient.

3. Mr. Gonzeles, 72 years old, is admitted to the emergency room with a diagnosis of
acute myocardial infarction. The client tells the nurse, “ I'm scared. I think I'm going to
die.” which of the following responses by the nurse would be MOST appropriate?

“ It's normal to feel frightened. Were doing everything we can for you.”

4. When using an interpreter to speak with an 84-year-old Chinese patient, what should
the nurse focus on?

The patient, not the interpreter

5. What are the two parts to communication?

WHen someone says something, and the other person understands.

6. Nurse Clara asked mrs.Ramirez about how the day went. Mrs. Ramirez crossed her
arms and rolled her eyes but did not say anything. Nurse Clara nodded her head up and
left the room. Have they communicated?

Yes, they have used non-verbal communication.

7. An unhelpful approach to communication with an older person may involve:

Always speaking slowly
8. AN example of an environmental barrier to effective communication is :

Noisy clinical settings

9. Person-centered communication strategies with older people might involve:

Avoiding assumptions about their capacity to communicate effectively

10. Which of the following can be a barrier to communication?

ALL OF THE ABOVE ( A nurse talking while the patient is talking, A nurse using
slang, A hot room )

MODULE 11

1. What is the leading cause of catastrophic out-of-pocket cost for families and involves
substantial government spending, primarily through medicaid and medicare?

Long-term care

2. Problems that the potential burden on aging society contribute on the cre-giving
system and public finances are the following except,

More health care workers

3. Which of the following is not a solution to add funding for future care services?

Retaining long-term care workers

4. The following are the different disability projection scenarios except:

Middle disability scenario

5. This provides the “best guess” of the future size of the frail older population, does not
assume any particular trend in disability rates.

Intermediate disability projection

6. What is the most appropriate nursing diagnosis for an older adult who is bedridden
because of progressed parkinson disease?

Risk for imparired skin integrity related to immobility

7. An older patient asks why a wound is taking so long to heal. What explanation should
the nurse provide to this patient?

THe amount of blood to the skin is slower with aging.

8. The nurse noted that an older patient complains of always feeling cold. Which age-
related change to the skin could be causing this patient?

Decreased subcutaneous tissue

9. The primary reason an older adult client is more likely to develop a pressure ulcer on
the elbow as compared to a middle-aged adult is :

The older client has less subcutaneous padding on the elbows

10. While bathing an elderly client who has limited abilities for self-care, the nurse
notices several patches of dry skin on the clients heels, elbows, and coccyx. The nurse
cleans and dries all the areas well and apple a moisturizing lotion. The most appropriate
immediate follow-up by the nurse to ensure appropriate nursing care for this client's skin
is to:
Revise the clients care plan to show the need for the application of moisturizing
lotion.

MODULE 12

1. The nurse is performing an assessment on an older client who is having difficulty in

breathing during morning exercise.

“Give yourself time to rest between exercise routine.”

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

Increased airway resistance

3. The patient assigned to you has pneumonia. You are reviewing the age-related
changes involved with the older adult. Select all age-related changes of the respiratory
system that apply.

Decreased gas exchange

Decreased cough efficiency

4. What is the most significant change in vital organs in the aging client?

Organs show signs of decrease in function during the aging process.

5. Factors that may further decrease lung function besides aging include all but:
Exercise
6. The nurse is evaluating a 64-year-old male for coronary artery disease( CAD).
understanding that CAD is the leading cause of mortality, which risk factor would not be
related to CAD?

Sexual Orientation

7. What is the single most cost-effective discovery made in the past 30 years that has
influenced the prevention and treatment of cardiovascular events?

Recognizing the need to lower blood pressure in older adults

8. The nurse is examining a 76-year-old female with the complaints of fatigue, ankle
swelling, and mild shortness of breath over a three-week period. An appropriate nursing
diagnosis might include:

Decreased cardiac output related to altered contractility and elasticity of cardiac

muscle

9. A client is experiencing tachycardia. The nurse's understanding of the physiological

basis for this symptom is explained by which of the following statements?

The heart has to pump faster to meet the demand for oxygen when there is
lowered arterial oxygen tension.

10. According to the best available evidence, which one of the following lifestyle
interventions for reducing primary hypertension is not likely to be effective?

Magnesium supplementation

MODULE 13
1. 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 can't help worrying about becoming forgetful.”

2. When caring for an older adult patient, the nurse uses the following interventions to
accommodate decreased touch sensation except.

Give patients hot beverages.

3. When caring for an older adult patient, the nurse uses the following interventions to
accommodate visual changes with age:

Adequate lighting and uncluttered walkways.

4. Which statement would be most appropriate to ask when assessing an aging adult for
cognitive function?

Have you noticed anything different about your memory or thinking in the past
few months?

5. Which statement demonstrates normal cognitive function for an aging adult?

Occasional memory lapses

6. Which item would not be a focus of a cognitive-perceptual pattern assessment for the
older client?

Financial-have you had any financial hardships over the past several months?

7. For an individual with age-related hearing loss, which sound is most difficult to hear:

A young child talking in a cafeteria line

8. An 80 year old resident of a retirement center state that something is wrong with the
lighting in the room because colored rings appear around the light bulbs. The resident
most likely has:
Glaucoma

9. The nurse recognizes that involuntary movements may appear in the elderly patient
and be normal. These normal involuntary movements may present as which of the
following?

Resting tremors

10. The nurse recognizes the most common eye-related disease affecting the older
adult is:

Glaucoma , Cataracts

MODULE 14

1. Mr.Domingo, a 72 year old, verbalizes his feelings of pain in his fingers. When a
client complains of pain, your initial response is:

2. Decreasing bone density is one of the effects of aging in the musculoskeletal system.
What independent intervention should the nurse do to address thi?

3. Which of the following interventions should be taken to help an older client to prevent
osteoporosis?

4. There are factors that influence the musculoskeletal system associated with aging.
The nurse recognizes that will age:

5. The most common cause of chronic pain in older adults is:

6. A 76 year old patient with osteoarthritis complains of pain, stiffness, and deformities
of the fingers. The gerontological nurse recommends:

7. Changes in bone and muscle in the aging population have the greatest effect on?

8. The nurse caring for the elderly population understands that movement slows with
aging. This is mostly due to:

9. A 69 year old female presents with knee pain. The nurse hears a dry crackling or
grating sound and the client feels the same sensation on exam. The nurse recognizes
this as:

10. The nurse may recommend which of the following for the older client with mild
arthritis?

MODULE 15

1. The nurse would instruct the client to eat which of the following foods to obtain the
best supply of vitamin B12?

2. A vegetarian client was referred to a dietitian for nutritional counseling for anemia.
Which client outcome indicates that the client does not understand nutritional
counseling? The client:

3. Mr. Santos, 79 year old, was admitted with iron deficiency anemia. Which question is
most appropriate for the nurse to ask in determining the extent of the client's activity
intolerance?
4. The nurse is assessing a client's activity intolerance by having the client walk on a
treadmill for 5 minutes. Which of the following indicates an abnormal response?

5. A client with microcytic anemia is having trouble selecting food items from the
hospital menu. Which food is best for the nurse to suggest for satisfying the client
nutritional needs and personal preferences?

6. Which of the following blood components is decreased in anemia?

7. Laboratory studies are performed for an elderly suspected of having iron deficiency
anemia. The nurse reviews the laboratory results, knowing that which of the following
results would indicate this type of anemia?

8. Changes in the immune system that accompany aging include:

9. With advancing age, the immune system

10. The increased incidence of cancer in the elderly reflects the fact that

MODULE 16

1. A 67 year old male client has been complaining of sleeping more, increased
urination, anorexia, weakness, irritability, depression ,and bone pain that interferes with
her going outdoors. Based on these assessment findings, nurse richard would suspect
which of the following disorders?

Hyperparathyroidism
2. Nurse Kate is providing dietary instructions to a maleclient with hypoglycemia. To
control hypoglycemic episodes, the nurse should recommend:

Consuming a low-carbohydrate, high protein diet and avoiding fasting.

3. What factors can cause premature menopause?

ALL OF THE ABOVE ( smoking , autoimmune disorders, a womens mother had

early menopause )

4. What is the serious adverse effect of menopause? SATA

B and C ( OSTEOPOROSIS, HEART DISEASE )

5. Hormone therapy eases some of the negative effects of menopause. Which of these
hormones is used?

Estrogen and progesterone

6. The nurse recognizes that a client is experiencing insomnia when the client reports
SATA:

A,C,D ( Extended time to fall asleep, Difficulty staying asleep, Feeling tired after a
nights sleep )

7. A nursing measures to promote sleep in older adults is to:

Encourage quiet activities prior to bedtime.

8. A female client verbalizes that she has been having trouble sleeping and feels wide
awake as soon as getting into bed. The nurse recognizes that there are many
interventions that promote sleep. SATA:
A,E,F ( Eat a heavy snack before bedtime, Exercise in the afternoon rather than
the evening, count backwards from 100 to 0 when your mind is racing.

9. Which of the following substances is a natural hormone produced by the pineal gland
that indicates sleep?

Melatonin

10. Which of the following symptoms would a patient exhibit with hyperthyroidism?

None of the above