Question 1

The nurse planning the discharge of a 70-year-old client who lives alone and is recovering from a fractured ankle shows an understanding of factors affecting the client's ultimate return to preinjury function when:

Accepted Answer

A)  encouraging the client to comply with recommendations made by the physical therapist.
B)  arranging for the client's meals to be delivered daily for several weeks after discharge.
C)  assessing the barriers to self ambulation that exist in the client's home.
D)  educating the client on the importance of a diet that promotes both bone and muscle healing. C

Question 2

An 80-year-old client with visual and hearing deficits is admitted for hip replacement surgery.The client has begun to show mild confusion especially regarding the ability to recognize hospital staff and as a result has become resistant to care and treatment.To best minimize this problem, the nurse initially edits the client's care plan to include:

Accepted Answer

A)  frequent reorientation to people in the client's environment.
B)  putting on the client's glasses and hearing aid as a part of ADLs.
C)  assigning the same staff to provide client care whenever possible.
D)  minimizing the number of off-unit trips for the client. B

Question 3

The nurse is about to educate a 70-year-old client newly diagnosed with type 2 diabetes on how to test his serum glucose levels appropriately.The nurse shows an understanding of the adaptation of teaching techniques for this age group by:

Accepted Answer

A)  providing both written and verbal instructions on the skill.
B)  asking the client if he has any hearing or vision deficits.
C)  restating the important points several times.
D)  asking the client to describe the proper technique in his own words. B

Question 4

Which statement by a resident best substantiates the nurse's evaluation that the resident's psychosocial needs are being met?

Accepted Answer

A)  "I'm really enjoying the opportunity to select my own meal times."
B)  "I miss being at home, but I understand why I must live here."
C)  "I appreciate being placed on the waiting list for a private room since I prefer living alone."
D)  "I'm an independent person who has always made my own decisions, and I will for as long as I can."

Question 5

The nurse on a medical acute care unit is preparing for the admission of an 84-year-old client with several diagnosed chronic illnesses.The nurse begins the plan of care for this client based on the understanding that the older adult is likely to:

Accepted Answer

A)  develop hospital induced delirium.
B)  require special attention related to visual and acuity deficits.
C)  need a social services consult.
D)  present with a need for a high level of nursing care.

Question 6

The nurse caring for a 90-year-old client is concerned when the client begins experiencing mild confusion.The nurse notes that the vital signs are all within normal limits for this client.In order to best assess related symptoms, the nurse initially:

Accepted Answer

A)  asks the client to "Squeeze my hand as hard as you can."
B)  reviews charting regarding how the client has been eating over the last 48 hours.
C)  reviews the client's medication for possible adverse reactions.
D)  asks the client's daughter if her mother has ever been confused before.

Question 7

The nurse best shows an understanding of the effects of acute hospitalization on the functional abilities of the older client by:

Accepted Answer

A)  setting goals that support a short hospitalization.
B)  attempting to adapt nursing care to the individual needs of the client.
C)  administering a systematic functional assessment on the client.
D)  assessing for symptoms that show a decline from original baseline function.

Question 8

A 70-year-old client covered by Medicare is being admitted for stabilization of type 2 diabetes.When asked by the family why their parent's care is being comanaged by a geriatric nurse practitioner and a physician, the best explanation is that:

Accepted Answer

A)  the geriatric nurse practitioner is specially trained to work with older adult clients.
B)  research has shown that this care model often results in shorter hospital stays.
C)  the physician will focus on the medical care while the geriatric nurse practitioner addresses the nursing care needs.
D)  this team concept of client care is encouraged by Medicare.

Question 9

The nursing interventions included in the care plan of a confused and frail 70-year-old to best minimize the client's risk of injury related to the geriatric triad include which of the following? Select all that apply.

Accepted Answer

A)  Respond to the client's call bell by going into the room.
B)  Ensure that an activated bed alarm is on at all times.
C)  Remain in the room with the client during meals and snacks.
D)  Assess the client's elimination needs every 2 hours during the day.
E)  Offer the client fluids each time there is client-nurse interaction.

Question 10

The nurse responsible for the planning of care of a confused 85-year-old client shows the best understanding of the management of the cascading effect of iatrogenic illnesses in this population cohort by:

Accepted Answer

A)  reorienting the client to person, place, and time frequently.
B)  offering the client liquids each time there is client-nurse contact.
C)  repositioning the client every 2 hours.
D)  using restraints to ensure client safety only as a last resort.

Question 11

The nurse best addresses the possible intrinsic factors that contribute to falls experienced by older adult clients in an acute care setting by:

Accepted Answer

A)  encouraging the client to wear his glasses.
B)  keeping a low-level light on in the room after the client retires for the night.
C)  instructing team members to keep the client's bed low to the floor.
D)  regularly assessing the room for clutter on the floor.

Question 12

The nurse is caring for an older adult client admitted with a stage 3 pressure ulcer on the left heel and who also has a history of Parkinson's disease and chronic renal failure.To best minimize the client's risk of developing an iatrogenic illness, the nurse:

Accepted Answer

A)  uses sterile technique when changing the heel's dressings.
B)  reviews all the medications that the client is currently taking for possible adverse reactions.
C)  instructs the client to use the call bell to get assistance when needing to go to the bathroom.
D)  assists the client in choosing the appropriate foods from the daily menu he receives.

Question 13

The nurse in an acute care facility is caring for a 79-year-old client recovering from a cerebral vascular accident that has resulted in mild loss of muscle function in his right arm and leg.The nurse is best addressing the client's need via the functional model of care when:

Accepted Answer

A)  assessing the client's right-sided muscle strength daily.
B)  reaffirming to the client that physical therapy will improve his muscle strength.
C)  instructing the client's family on how to properly assist the client in walking.
D)  placing the telephone where it can be reached with his left hand.

Question 14

When admitted to the acute care environment, in order to best meet the older adult client's major psychosocial concern, the admitting nurse will:

Accepted Answer

A)  assure the client that his or her belongings will be securely stored.
B)  address the client as "Mr.," "Mrs.," or "Ms."
C)  provide the client with instructions on how to use the room's telephone.
D)  present the client with written material regarding orientation to the unit.

Question 15

The nurse at an assisted living facility is caring for a 73-year-old cognitively impaired client who has recently been admitted.The nurse creates a care plan that strives to help maintain the client's independence by including:

Accepted Answer

A)  sufficient time for the client to complete self-care.
B)  encouraging the client to make personal decisions regarding self-care.
C)  regular assessment to determine the client's ability to provide self-care.
D)  regular cueing by staff to direct client self-care.

Exam 9: Health Care Delivery Settings and Older Adults