Deck 40: Common Physical Care Problems of the Older Adult

Question 1

The nursing strategy that may be most helpful in preventing falls in older adult patients on a skilled nursing unit would be to:

A) answer call bells promptly.
B) use vest restraints as needed.
C) keep lights dim for eye protection.
D) always keep bed rails up.

Answer 1

answer call bells promptly.

Question 2

The nurse uses the behavioral technique of habit voiding with a confused older adult patient to reduce the frequency of urinary incontinence. This means the:

A) patient is assisted to the bathroom to use the toilet at regular intervals.
B) patient is being taught to request assistance from nursing staff.
C) staff are trying to lengthen the time between voiding for the patient.
D) fluid intake of the patient is being reduced so that voidings are less frequent.

Answer 2

patient is assisted to the bathroom to use the toilet at regular intervals.

Question 3

The home health nurse assesses a hazard for a patient in the home setting. Which of the following assessments is considered a safety hazard?

A) Scatter rugs present in all rooms.
B) Stairways with handrails.
C) Grab bars in the bathroom.
D) Nonskid tape in the bathtub.

Answer 3

Scatter rugs present in all rooms.

Question 4

The home health nurse assesses all of the following relative to a resident in her own home: glasses with a missing eye piece, soft soled floppy house shoes, walker with wheels, a floor devoid of rugs. The item that is most likely to cause a fall would be the:

A) broken glasses.
B) floppy house shoes.
C) rolling walker.
D) no rug on floor.

Question 5

An older adult patient is too weak to walk independently after surgery. Based on the services available on the rehabilitation unit, the nurse should work collaboratively with:

A) an exercise physiologist.
B) a nutritionist.
C) a physical therapist.
D) an occupational therapist.

Question 6

The nurse, in reviewing with an older adult patient the nutritional changes that would be most beneficial, would suggest:

A) reducing sugar intake.
B) increasing fat intake.
C) increasing intake of oils.
D) decreasing intake of roughage.

Question 7

An older adult patient with arthritis is having difficulty using a weekly pillbox as a reminder to take daily medications. The nurse would suggest as the best alternative:

A) a paper and pencil check off system.
B) a colorful calendar.
C) a homemade egg carton container.
D) symbol and color coded medication bottles.

Question 8

An older adult patient on bed rest has been eating poorly. The patient is exhibiting abdominal distention and cramping and is passing small amounts of liquid stool. The nurse assesses these signs as an indication of:

A) constipation.
B) fecal impaction.
C) diarrhea.
D) GI tract infection.

Question 9

A nurse is assisting an older adult neighbor to rearrange her kitchen to reduce fall risk. The nurse should encourage her to avoid unnecessary reaching by placing all objects that are needed below the level of the:

A) knees.
B) waist.
C) head.
D) chest.

Question 10

The nurse is aware that the newly admitted resident has age-related macular degeneration (AMD). The nurse will modify the care plan to accommodate the patient's:

A) loss of central vision.
B) lack of ability to focus on near objects.
C) inability to adjust from light to dark environments.
D) increasing pressure in the eye with progressive blindness.

Question 11

For a patient with visual impairment who wishes to continue to eat independently, the nurse's most helpful intervention would be to:

A) describe positions of foods on the plate by clock position.
B) tell the patient to eat all foods that are firmest first.
C) raise the over the bed table so that all food is within three (3) inches of the eyes.
D) have the patient use a spoon instead of a fork.

Question 12

A nurse who is assisting a blind patient to ambulate should:

A) hold the patient's arm firmly to gently push him in the proper direction.
B) hold the patient by a strap around the patient's waist to prevent his falling.
C) offer the patient an arm for guidance.
D) acquire a cane for the patient.

Question 13

When performing a digital rectal examination to determine the presence of fecal impaction, the nurse must be alert for:

A) increasing blood pressure.
B) increasing respiratory rate.
C) reflexing incontinence.
D) decreasing heart rate.

Question 14

The nurse stresses taking vitamins and minerals to older adult postmenopausal patients. To reduce the risk of osteoporosis, women should increase their intake of:

A) iron.
B) magnesium.
C) calcium.
D) selenium.

Question 15

While discussing ways to increase exercise with an older adult patient with no musculoskeletal disorders, the nurse should encourage the patient to consider walking at a frequency of:

A) 10 to 20 minutes once or twice a week.
B) 10 to 20 minutes four times a week.
C) 20 to 30 minutes once or twice a week.
D) 20 to 30 minutes three times a week.

Question 16

The nurse takes into consideration that of all the physical changes that the older adult experiences, the most common cause of most problems is that of:

A) visual disturbance.
B) hearing deficit.
C) loss of muscle mass.
D) impaired mobility.

Question 17

The nurse recognizes that of all the interventions to assist a dysphagic patient to eat safely, the most significant to preventing aspiration is to:

A) sit the patient upright and remind the patient to tuck in the chin when swallowing.
B) feed small bites of 1/2 inch square.
C) thicken liquids.
D) offer frequent sips of fluid.

Question 18

An older adult patient in a skilled nursing facility tells the nurse that he has controlled his incontinence with the herbal remedies of:

A) black cohosh.
B) pumpkin seeds.
C) feverfew.
D) St. John's wort.

Question 19

The nurse adds to the nursing care plan for a resident with presbycusis. To better communicate with the patient, the staff should use:

A) written notes.
B) a slower speed of speech.
C) a lower, deeper voice.
D) hand signals.

Question 20

The nurse reminds the staff that the most effective method in preventing skin breakdown from urinary incontinence is:

A) reducing fluid intake.
B) turning frequently.
C) ambulating frequently.
D) using protective pads.

Question 21

An older adult Hispanic patient is brought to a clinic. She brings a bag full of medications with her. When the nurse is talking to the patient, a significant question to ask to get a full picture of the patient would be:

A) "Do you live with your family?"
B) "Tell me about your diet."
C) "How many doctors prescribe drugs for you?"
D) "Are you drinking herbal supplements?"

Question 22

The older adults, especially women, are at high risk for decreased mobility. Which nutrient(s) are critical for women to take to decrease this risk? (Select all that apply.)

A) Protein
B) Fat
C) Carbohydrates
D) Calcium
E) Vitamin D

Question 23

The nurse lists the most common causes of polypharmacy as: (Select all that apply.)

A) use of mail order sources.
B) being prescribed to by several health care providers.
C) sharing drugs with others.
D) many drugs being prescribed under different names.
E) availability of OTC medications.

Question 24

The nurse documents the report of painful intercourse as __________.

Question 25

A nurse reviewing the medication list for an older adult patient notices several drugs that would increase the risk of falls because of orthostatic hypotension, which are: (Select all that apply.)

A) anticoagulants.
B) diuretics.
C) stool softeners.
D) antihypertensives.
E) antihistamines.

Question 26

A nurse is caring for an 86-year-old patient who still takes pride in the fact that he drives. The nurse suggests that his driving be limited to:

A) back roads.
B) large shopping centers.
C) going to church and the grocery store.
D) daytime driving.

Question 27

The nurse takes into consideration that the resident in a nursing home has a hearing deficit related to a continuous ringing in his ears, which is a condition called ______________.