Deck 19: Senior Health

Question 1

All the responses are good approaches. However, the nurse should take a broad view of what assets or barriers are involved in relation to nutrition. A nutrition checklist, described by the mnemonic DETERMINE, reviews warning signs and risk factors of poor nutritional health.
A nurse overheard an adult woman,shaking her head in exasperation as she said,"Dad,you're being unreasonable.It's not safe!" Which of the following is the most likely reason for this argument?

A)The dad wants to keep driving.
B)The dad wants to keep cooking his own meals.
C)The dad wants to keep taking care of himself each day without assistance.
D)The dad wants to marry some young woman who may just want his money.

Answer 1

The dad wants to keep driving.

Question 2

All the responses are good approaches. However, the nurse should take a broad view of what assets or barriers are involved in relation to nutrition. A nutrition checklist, described by the mnemonic DETERMINE, reviews warning signs and risk factors of poor nutritional health.
A nurse explained that the elderly are twice as likely to die in a home fire as younger persons and therefore suggested some safety measures.Which of the following strategies would most likely have been suggested by the nurse?

A)Have smoke detectors installed in the house
B)Invite a family member to sleep in the house at night
C)Practice escaping quickly from the house in case of an emergency
D)Program your phone so the fire department can be reached by pushing only one button

Answer 2

Have smoke detectors installed in the house

Question 3

Which of the following best describes why grandparents would be the primary caregivers for their grandchildren?

A)Because they fell in love with the newborn and wanted that small person to be a part of their lives
B)Because the parents were drug abusers or in the prison system
C)Raising a grandchild is easier because grandparents have already been experienced parents
D)Raising a child gives purpose to life for the grandparents

Answer 3

Because the parents were drug abusers or in the prison system

Question 4

Which of the following is the most useful way to discuss aging?

A)By divisions-young-old, middle-old, old-old, and elite-old
B)Chronological age
C)Functional age
D)Number of chronic comorbidities

Question 5

All the responses are good approaches. However, the nurse should take a broad view of what assets or barriers are involved in relation to nutrition. A nutrition checklist, described by the mnemonic DETERMINE, reviews warning signs and risk factors of poor nutritional health.
A nurse completed the health assessment but needed to use the elderly woman's bathroom.The nurse noticed perineal pads under the sink.Which of the following questions would the nurse most likely ask the woman?

A)"Can you tell me why you need to have perineal pads?"
B)"Do you know how to do Kegel exercises to help control your urine?"
C)"Does another woman live with you or visit often?"
D)"Why do you have perineal pads? Are you bleeding down there?"

Question 6

All the responses are good approaches. However, the nurse should take a broad view of what assets or barriers are involved in relation to nutrition. A nutrition checklist, described by the mnemonic DETERMINE, reviews warning signs and risk factors of poor nutritional health.
Which of the following is the most common reason for visual impairment in older adults?

A)Cataracts
B)Glaucoma
C)Macular degeneration
D)Presbyopia

Question 7

A nurse needed to do a quick assessment of a client's lifestyle behaviors to counsel appropriately.Which of the following strategies would be the easiest way to determine the elderly woman's nutritional status?

A)Ask the woman to keep a food diary for 2 weeks and bring it to the clinic
B)Have the clinic dietitian interview the woman about her eating habits
C)Quiz the woman verbally as to her usual meals during the day
D)Use the DETERMINE mnemonic

Question 8

All the responses are good approaches. However, the nurse should take a broad view of what assets or barriers are involved in relation to nutrition. A nutrition checklist, described by the mnemonic DETERMINE, reviews warning signs and risk factors of poor nutritional health.
A nurse is making the first home visit to a recently discharged elderly client.Which of the following should the nurse most likely expect to find?

A)A client who is unhappy with the disorganization of the house
B)A client who will expect the nurse to do everything now that the nurse is at his or her house
C)A client who may well have hearing or vision problems or both
D)A client who is upset with being discharged while still so ill and having to take on problems at home

Question 9

Which of the following groups would most need adult day care services?

A)Caregivers who work all day
B)Elderly who are bored staying home alone
C)Elderly in whom Alzheimer's has been diagnosed
D)Older men who want an opportunity to meet older women
E)Older women who want to engage in arts and crafts activities

Question 10

In the supermarket checkout,a young woman complained to her friend,"Old people think we taxpayers should pay for them to be in a nursing home.Seems like a waste of money." Which of the following would be the most appropriate response by the nurse?

A)"Did you know more than 90% of all the elderly live in their own homes while fewer than 5% live in care facilities?"
B)"Those old people built our society; we owe it to them to support them now."
C)"Would it be better to put each person to sleep when they reach a certain age such as 80 years?"
D)"You know, you'll get old someday too. Won't you want someone to take care of you when you can't anymore?"

Question 11

Which of the following is an example of a nonstochastic theory of aging?

A)Cross-link theory
B)Error theory
C)Free radical theory
D)Immunologic theory
E)Somatic mutation theory
F)Wear and tear theory

Question 12

A daughter tells the nurse that her mother is frequently confused,but what is really upsetting is that she is incontinent during the night."All I do is watch her and wash sheets," the daughter says.Which of the following suggestions should the nurse provide to the daughter?

A)Explain about respite care or the need to ask other family members to help so the daughter can have some time off
B)It's time to have her mother go into a nursing home where they can give her the care she needs.
C)Refer the daughter to Adult Protective Services so responsibility for her mother's care may be assumed by an agency prepared for such tasks
D)Teach the daughter how to establish a toileting routine for the mother to help control the incontinence

Question 13

An elderly gentleman was shoveling his snow when you arrived for a home visit.You notice that when he comes inside he is very pale,is shivering,and seems a bit confused.His skin is very cold when you touch it.Which of the following actions would be most appropriate for the nurse to take first?

A)Apply warm moist towels to his head, neck, chest, and groin
B)Give him hot coffee with sugar to drink
C)Have him get in a tub of very hot water immediately
D)Call 911

Question 14

A man stated,"I used to work out at the exercise room at work,but now that I'm retired I sit and watch TV.My wife keeps nagging me to do something.What do you think I should be doing at my age?" Which of the following would be the most appropriate response by the nurse?

A)"I think you should try to please your wife. What is it she wants you to do?"
B)"It's okay to slow down at your age; why look for problems?"
C)"You should try to exercise just as you did before. Is there a YMCA or club nearby?"
D)"You've worked all your life; you have a right to rest now."

Question 15

"My health problems are too much to handle," said an elderly woman at her annual clinical checkup."What's most important for me to do?" Which of the following would be the most appropriate response by the nurse?

A)"Focus on eating properly and staying active."
B)"Get the shingles immunization along with your flu shot this year."
C)"Keep active mentally-do you do crossword puzzles or Sudoku puzzles?"
D)"Stay involved with others. Do you ever go to the senior citizens center?"

Question 16

A woman said,"I've never been retired before.I didn't plan it but it's OK.I'm still doing what I used to do otherwise; I go to church,make quilts for charity,and babysit my grandkids.Do you think I should be trying to find another job for a few years?" Which of the following would be the most appropriate response by the nurse?

A)"For lots of people, retirement, even if unplanned, is much like life has always been."
B)"It's okay to slow down at your age; why look for problems?"
C)"You really need to get out of your house more and be more active, even if you don't get paid at the position."
D)"Without a job, you really don't have an identity. Have you been to the unemployment office?"

Question 17

Which of the following is the primary source of income for elderly Americans?

A)Employment income
B)Pensions
C)Savings
D)Social Security

Question 18

A male nurse is enjoying a very hot summer day at the zoo when he notices a family approaching.An elderly member of the family is moving very slowly and being scolded by another adult,saying "You are not sick.Let's keep moving." The nurse touches the elderly adult who has a flushed face and notices clammy and moist skin.What should the nurse say to the adult?

A)"I'm a nurse, and your family member needs to go to the emergency department right now."
B)"I'm a nurse, and your family member has heat stroke. I'm calling 911."
C)"Take your family member to the air-conditioned restaurant, and have him drink a cold soda immediately."
D)"Take your family member to the air-conditioned restaurant, and let your family rest for a while."

Question 19

All the responses are good approaches. However, the nurse should take a broad view of what assets or barriers are involved in relation to nutrition. A nutrition checklist, described by the mnemonic DETERMINE, reviews warning signs and risk factors of poor nutritional health.
An ambulance medic reported a client was on the way with a traumatic brain injury (TBI).Which of the following symptoms would the nurse expect this client to display?

A)Blurred vision and a headache
B)Hypotension and tachycardia
C)Irregular heart rate
D)Fecal incontinence

Question 20

"I don't understand," a woman said."I know I'm eligible for Medicare part A and it's free.Part B isn't free.When will I ever use it?" Which of the following would be the most appropriate response by the nurse?

A)"Part A is only for hospital bills. Most care is given on an outpatient basis. Part B pays a large portion of those costs."
B)"Part A is a benefit because you paid into Social Security for more than 10 years. In comparison, part B is optional if you want that additional insurance."
C)"Part B is easy to pay for; they take the cost out of your Social Security check each month."
D)"Researchers have found that people don't waste health care resources if they have to pay a bit for them."

Question 21

A wife explained to the nurse that her husband was becoming awfully forgetful,and now he's started getting lost on the way home from the golf club.She's scared he may be getting Alzheimer's disease.Which of the following would be most appropriate action for the nurse to take?

A)Ask the husband to explain why he thinks he got lost coming home
B)Explain that all elderly persons get a little forgetful and not to worry
C)Ask the husband to count backwards by 7 from 100
D)Hand the husband pencil and paper and ask him to draw a clock

Question 22

"Do you have any advice?" a young woman asked."I'm eating lunch with my dad but he can't hear and he won't wear his hearing aid." Which of the following suggestions should be made by the nurse?

A)Encourage your dad to wear his hearing aid-if only for you
B)Find a very quiet place with good lighting and very little background noise for lunch
C)Repeat yourself several times using exactly the same words and gestures
D)Talk very loudly while facing him directly

Question 23

Which of the following best explains why all family members should want their aged relatives to have a living will?

A)To confirm that the attorney is serving as guardian and family members do not have to be responsible
B)To fulfill the federal Patient Self-Determination Act requirements
C)To help family members know what their loved one does or does not want if he or she becomes incapacitated
D)To keep physicians from writing a do-not-resuscitate order

Question 24

Which of the following would be a problem for an older adult with a hearing loss? (Select all that apply.)

A)Difficulty in finding a hearing aid that is unobtrusive
B)Embarrassment at having to wear a hearing aid
C)Hearing is not part of a routine health screening
D)Long delays in getting an appointment to see an audiologist or otolaryngologist
E)Medicare does not cover the costs of hearing aids
F)The adult may withdraw, become isolated, and depressed

Question 25

A son explained to the home health nurse that since his mother died,his father did not seem to have any interest in life and had even told his son he was considering suicide.Which of the following would be the most appropriate response by the nurse?

A)"If he really wants to kill himself, he will, and there really isn't anything you can do to stop him."
B)"If you talk to him about it, you're strengthening the idea."
C)"People who talk about suicide rarely do it, so don't worry."
D)"Suicide is a serious concern; let's talk to his doctor about what you've noticed."

Question 26

A family member tells the nurse that she is worried about her grandmother driving.Which of the following would be most appropriate for the nurse to suggest? (Select all that apply.)

A)Avoid rush hour traffic.
B)Buy and drive a very large heavy car.
C)Do not converse with any passengers.
D)Drive more slowly.
E)Drive only during daylight.
F)Leave the radio turned off.

Question 27

An elderly woman shared that she had six different physicians,each focusing on one particular health problem.Which of the following would be of immediate concern for the home health nurse? (Select all that apply.)

A)Whether the client has a family physician who was coordinating her care
B)Whether the physicians communicate with each other
C)If each physician was prescribing medications, what drug interactions might be occurring?
D)Were all these health care providers licensed physicians?
E)Who was helping her with transportation to all these physicians?
F)Would all these physician visits add up to more than what Medicare would reimburse the client?

Question 28

A wife,who had just come home after major abdominal surgery,explained to the home health nurse that she was really worried about her husband.He had not been sleeping well or eating well,seemed to have no energy,and did not seem to enjoy anything including activities he used to love.Which of the following suggestions should the nurse give to the client?

A)Ask what medications the husband is taking, because many medications can affect mood
B)Explain her husband has probably been worried sick about her and the surgery, and she should reassure him frequently that she is OK
C)Point out that many people get sad during the winter months and he should be fine when spring arrives, but in the meantime put full-spectrum light bulbs in all the household lamps
D)Share that her husband seems depressed and that they should see his doctor immediately

Question 29

A woman admitted,"I did fall once,but it was an accident that I'm sure won't happen again." Which of the following responses would be most appropriate for the nurse? (Select all that apply.)

A)"Are you getting lots of calcium and vitamin D? Are you drinking milk or taking calcium pills?"
B)"Do you have a couple glasses of wine each evening to relax you before you go to bed?"
C)"Do you live in a one-story house and are your floors even without rugs to trip you up?"
D)"Let me give you some balance and leg muscle exercises to practice at home each day."
E)"Remember that if you start to fall, fall sideways if you can to minimize injury."
F)"Review what medications you are taking."

Question 30

A son did not know what to get his mother for her birthday.She refused most gifts,saying they were just something more for her to take care of.Assuming the mother did not have these,which of the following would be a very helpful gift? (Select all that apply.)

A)Purchase a new front door with a large peephole so she can see who is ringing the doorbell
B)Arrange for Social Security check to be deposited directly into the bank
C)Add bars on all the house windows for added security
D)Buy a shredder for the mother to use on all personal documents
E)Install caller ID on her telephone
F)Have strong deadbolts installed on all outside doors

Question 31

Which of the following situations best describes when a person would most likely be very unhappy and perhaps ill after retirement? (Select all that apply.)

A)If their family total income is now less than when he or she was employed
B)If the retirement was involuntary
C)If the person's self-image was based on job role and status
D)If the person has no outside interests or leisure activities
E)If his or her spouse did not appreciate input into their schedules or activities
F)If the person believes others are now taking credit for his or her achievements

Question 32

A nurse always reviewed the medications taken by elderly clients on each home visit.Which of the following best explains the rationale for the nurse's action? (Select all that apply.)

A)Age-related changes and polypharmacy make elderly clients vulnerable to drug interactions and dangerous adverse reactions.
B)Elderly clients are known to sue if medications taken do not make them feel better, and lawsuits are to be avoided, if possible.
C)Folk or herbal medicines are often the same as the generic medications prescribed by health care providers, so elderly often have overdoses.
D)Older adults are known to consume many over-the-counter medications, as well as folk or herbal remedies.
E)The elderly are known to be particularly noncompliant with pharmaceutical prescriptions.
F)With the high prevalence of chronic diseases, elderly clients are taking a large number of medications.