Deck 6: Older Adults

Question 1

When admitting an 88-year-old patient to the hospital, the nurse should plan to

A) interview the patient before the physical assessment.
B) speak slowly and loudly while facing the patient.
C) determine whether the patient uses glasses or hearing aids.
D) obtain a detailed medical history from the patient.

Answer 1

determine whether the patient uses glasses or hearing aids.

Question 2

The nurse is planning discharge for an alert, homeless 70-year-old with a chronic foot infection and poorly controlled diabetes. The most appropriate intervention by the nurse is to

A) teach the patient how to assess and care for the foot infection.
B) refer to social services for placement in a low-income assisted living facility.
C) give the patient written information about shelters and meal sites.
D) schedule the patient to return to outpatient services for foot and diabetes care.

Answer 2

refer to social services for placement in a low-income assisted living facility.

Question 3

A confused and agitated 76-year-old patient with a broken arm is brought to the emergency department by a family member. To determine whether elder abuse is the cause of the patient's injury, the nurse should

A) have the family member stay in the waiting area while the patient is assessed.
B) ask the patient how the injury occurred and observe the family member's reaction.
C) make a referral for a home assessment visit by the home health nurse.
D) notify an elder protective services agency about the possible abuse.

Answer 3

have the family member stay in the waiting area while the patient is assessed.

Question 4

When caring for an older adult who lives in a rural area, the nurse will plan to

A) assess the patient for chronic diseases that are unique to rural areas.
B) ensure that the patient has transportation to appointments with the health care provider.
C) obtain adequate medications for the patient to last for 4 to 6 months.
D) suggest that the patient move to an urban area for better health care.

Question 5

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

A) The patient's son uses a marked pillbox to set up the patient's medications weekly.
B) The patient has lost 10 pounds (4.5 kg) during the last month.
C) The patient is cared for by a daughter during the day and stays with a son at night.
D) The patient tells the nurse that a close friend recently died.

Question 6

When assessing a 68-year-old Latina patient who has diabetes, which question will the nurse ask in determining the impact of ethnicity on the patient's health care choices?

A) "Who helps you with your care at home?"
B) "How do you pay your medical bills?"
C) "What do you think helps people get better?"
D) "Which type of insulin do you use?"

Question 7

To obtain the most complete information when doing an assessment for an 81-year-old patient, the nurse will

A) review the patient's chart for the history of medical problems.
B) interview both the patient and the primary patient caregiver.
C) use a geriatric assessment instrument to evaluate the patient.
D) ask the patient to write down medical problems and medications.

Question 8

The home health nurse is caring for a 71-year-old patient who lives alone and is taking seven different prescribed medications for chronic health problems. The nurse will plan to

A) use a marked pillbox to set up the patient's medications.
B) discuss the option of moving to an assisted-living facility.
C) call the health care provider about stopping some of the medications.
D) visit the patient daily to administer the medications.

Question 9

The home health nurse is developing a care plan for an alert and active 85-year-old patient who takes multiple medications for chronic cardiac and respiratory disease. The patient lives with family members who work during the day. An appropriate nursing diagnosis is

A) social isolation related to weakness and fatigue.
B) caregiver role strain related to need to adjust family employment schedule.
C) risk for injury related to drug-drug interactions.
D) compromised family coping related to the patient's many care needs.

Question 10

While obtaining a health history from a 68-year-old patient, the nurse learns that the patient takes daily supplements of antioxidants beta carotene, selenium, and vitamin E. The nurse recognizes that the use of these substances in slowing the aging process is related to the biologic aging theory of

A) telomere-telomerase decrease.
B) free radicals.
C) somatic mutation.
D) programmed cell death.

Question 11

Which question will provide the most useful information when the nurse is performing a comprehensive geriatric assessment of an older adult who is being assessed for admission to an assisted-living facility?

A) "Do you have a history of heart disease?"
B) "Are you able to prepare your own meals?"
C) "Have you had any recent infections?"
D) "How frequently do you see a doctor?"

Question 12

A 42-year-old who is providing home care for a parent tells the nurse, "I don't feel comfortable giving Mom her medications yet, but I think I will be able to do it with a little more practice." Which nursing diagnosis is most appropriate?

A) Caregiver role strain related to inability to safely give medications
B) Anxiety related to lack of confidence
C) Risk for situational low self-esteem
D) Readiness for enhanced therapeutic regimen management

Question 13

Ageism is an important concept for the nurse to understand because it

A) provides statistical information regarding the older population.
B) promotes consideration of the diversity of the older population.
C) may lead to poorer health care for older individuals.
D) increases social awareness of the needs of older people.

Question 14

Which information about a 77-year-old patient who is being assessed by the nurse is of most concern?

A) The patient takes two or three naps during the day and sleeps about 6 hours at night.
B) The patient uses five different medications for chronic heart and joint problems.
C) The patient says, "I don't go on my daily walks since I had pneumonia 3 months ago."
D) The patient organizes medications in a marked pillbox "so I don't forget them."

Question 15

To help prevent drug-drug interactions in an older adult patient taking many medications, the most appropriate instruction by the nurse is,

A) "Do not take any over-the-counter (OTC) drugs with your prescription drugs."
B) "Be sure to have all of your prescriptions filled at the same pharmacy."
C) "Bring all the medications, supplements, and herbs that you use to every health care appointment."
D) "Use a medication reminder system so that you won't forget to take your medications as scheduled."

Question 16

When developing the plan of care for an older adult who is hospitalized for an acute illness, the nurse should

A) use a standardized geriatric nursing care plan.
B) plan for likely long-term-care transfer to allow additional time for recovery.
C) consider the preadmission functional abilities when setting patient goals.
D) minimize activity level during hospitalization.

Question 17

The family of an 85-year-old with chronic health problems and increasing weakness is considering placing the patient in a long-term care facility. Which action by the nurse will be most helpful in assisting the patient to make the transition?

A) Have the family select a LTC facility that is relatively new.
B) Obtain the patient's input about the choice of LTC facility.
C) Ask that the patient be placed in a private room at the facility.
D) Explain the reasons for the need to live in LTC to the patient.

Question 18

The home health nurse is making an 8:00 AM visit to a confused older patient who lives with a daughter. Which information most indicates a need for further action by the nurse?

A) The patient is unable to remember the nurse's name.
B) The patient has not yet taken the daily medications.
C) The patient is weaker than on the previous visit.
D) The patient's daughter asks about respite services.

Question 19

An alert and well-oriented 78-year-old patient with multiple health problems rarely gets out of bed and complains of having "no energy" and feeling increasingly weak. The patient has had an 11-pound weight loss over the last year. The nurse should initially

A) ask the patient about daily dietary intake.
B) schedule regular range-of-motion exercise.
C) discuss long-term care placement with the patient.
D) describe normal changes with aging to the patient.

Question 20

As the home health nurse is teaching a 72-year-old patient who lives alone about a new medication, the patient replies "I just don't learn new information like I used to." The nurse will plan to

A) schedule the patient for daily visits for medication administration.
B) teach the patient's family members to give the medications.
C) spend more time discussing the medications with the patient.
D) tell the patient it is not safe to take medications independently.

Question 21

Which nursing actions will the nurse take to assess for possible malnutrition in a 69-year-old patient? (Select all that apply.)

A) Review laboratory results.
B) Ask about transportation needs.
C) Determine food likes and dislikes.
D) Observe for depression.
E)Assess teeth and oral mucosa.
F) Question about salt use.

Question 22

Appropriate approaches used by the long-term care nurse to provide teaching to a 73-year-old who has just been diagnosed with diabetes include which of the following? (Select all that apply.)

A) Schedule a visit by another resident who is diabetic.
B) Demonstrate food choices using food photographs.
C) Avoid discussion of the patient's favorite foods.
D) Remind the patient that a lot of damage has already occurred.
E) Encourage the patient's family to participate in teaching sessions.
F) Ask the patient about past experiences with lifestyle changes.

Question 23

When admitting a 79-year-old patient who has urinary urgency and a possible urinary tract infection (UTI), the nurse should first

A) assess the patient's orientation.
B) inspect for abdominal distension.
C) question the patient about hematuria.
D) invite the patient to use the bathroom.