ATI GERONTOLOGY FINAL QUIZ 2020 with Rationales

ATI GERONTOLOGY FINAL QUIZ 2020 with Rationales 1. A public health nurse is planning an immunization clinic for older adults. Which of the following times should an older adult client receive the influenza vaccine? A- Once during the client’s lifetime B- Every 10 years C- every 5 years D- annually in the fall Answer- d The nurse should recommend that older adult clients receive the influenza vaccine annually. Influenza outbreaks occur annually, and the influenza virus changes constantly. Consequently, an influenza vaccine from a previous year will not protect a client exposed to this year’s influenza strain. Influenza in older adults can result in the development of primary viral influenza pneumonia, which causes several deaths a year. An influenza vaccine given in the fall, prior to the onset of flu season, will be most effective in preventing influenza in this target population. A- The nurse should recognize that the older adult is at increased risk for developing influenza due to changes in the immune system that occur with age. Prior immunization with the influenza vaccine does not guarantee continued life-long immunity from the illness. B- The nurse should recognize that the influenza virus changes constantly, eliminating the possibility of long-term immunity. C- The nurse should recognize that because of constant changes in the influenza virus itself, an immunization received 5 years previous will not protect the client from the illness currently. 2. A nurse is assessing an older adult client who has right-sided heart failure. Which of the following findings is the nurses priority? A- Oxygen saturation is 92% on room air B- the client consumes 20% of males C- weight has increased 0.91 kg or to lbs in 24 hours D- the client has 1 + edema in the lower extremities Answer- c The nurse should apply the urgent versus nonurgent priority-setting framework. Using this framework, the nurse should consider urgent needs to be the priority need because they pose more of a threat to the client. The nurse might also need to use Maslow’s hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. The nurse should evaluate daily weight of client’s experiencing heart failure. A weight gain of 0.45 to 0.91 kg (1 to 2 lb) overnight or 1.36 kg (3 lb) within one week is an indication of worsening heart failure. A- The nurse should monitor the oxygen saturation of the client because a decrease in oxygen saturation below 90% indicates a worsening of condition and, potentially, pulmonary edema. Although the client’s oxygen saturation rate is less than the expected reference range of greater than 93%, another finding is the priority. B- The nurse should evaluate the client’s food intake and appetite. Anorexia and nausea are common manifestations of right-sided heart failure and place the client at risk for nutritional deficiencies; however, another finding is the priority. D- The nurse should report pitting edema because this is an indication of fluid retention; however, another finding is the priority. 3. A nurse is teaching an older adult client about osteoporosis. Which of the following statements should the nurse include in the teaching? A- Cottage cheese is a good source of calcium B- increase your caffeine intake C- brisk walking will help prevent bone loss D- hormone replacement therapy with estrogen will increase your risk of osteoporosis Answer- c The nurse should encourage weight-bearing exercises to help minimize bone loss in the older adult client. A sedentary lifestyle, on the other hand, leads to a loss of minerals in the bones, especially calcium and phosphorus. A- The nurse should include dietary sources of calcium and vitamin D in the teaching. Cottage cheese, however, is not a good source of calcium as it loses the calcium during processing. B- The nurse should encourage the client to limit caffeine intake because it enhances the excretion of calcium. D- The nurse should provide information about medications for prevention and treatment of osteoporosis. Estrogen can reduce the fracture rate in women who have osteoporosis, although there are other complications related to its use, such as cancer. 4. A nurse is managing an adult day care is developing a treatment plans for older adult clients. Which of the following therapeutic strategies should the nurse use to help the clan Chief Erikson's developmental tasks for this age group? A- Music therapy B- reminiscence therapy C- meditation therapy D- pet therapy Answer- b The nurse should incorporate reminiscence therapy as a therapeutic strategy for the purpose of encouraging clients to engage in life review. The process of sharing memories helps clients to achieve a sense of fulfillment and self-worth and allows a positive outcome to Erikson’s developmental task of integrity vs despair. A- The nurse should use music therapy for the purposes of providing sensory and intellectual stimulation, as well as maintaining or increasing the clients' levels of physical, mental, social, or emotional functioning. C- The nurse should encourage meditation therapy to quiet the mind and improve overall health, such as promoting sleep, decreasing pain, and improving cognitive function. D- Pet therapy is beneficial for older adult clients by mitigating loneliness, promoting better physical and mental health, and providing loving companionship. 5. A nurse is admitting an older adult client who has urinary incontinence and smells strongly of urine. The clients partner, who has been caring for her at home, states that he is sorry and embarrassed about the unpleasant smell. Which of the following responses should the nurse make? A- A lot of clients who are cared for at home have the same problem B- don't worry about it. She will get a bath, and that will take care of the odor C- it must be difficult to care for someone who has incontinence D- when was the last time that she had a bath? Answer- c The nurse should use therapeutic responses such as acknowledgement and empathy when addressing the client’s partner. This response is nonjudgmental and acknowledges the effort the client’s partner has made. The use of therapeutic communication also encourages further discussion and provides the nurse with an opportunity to teach and to evaluate the need for assistance in the home. A- This response is judgmental and implies that the caregiver is not able to keep the client odor-free. B- The nurse should avoid using automatic responses that devalue the caregiver’s feelings and attempts to care for the client. D- This response is judgmental and implies to the client’s caregiver that the odor of urine developed because he has not bathed his partner for some time. 6. A nurse is performing an assessment on an older adult client who has chronic pain. Which of the following effects of unrelieved pain should the nurse identify as a priority finding to report? A- Impaired mobility B- decreased Independence C- decreased self-esteem D- impaired socialization Answer- a The nurse should apply the safety and risk reduction priority-setting framework. This framework assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one positing the greatest threat is the highest priority. The nurse should use Maslow’s hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the greatest threat to the client. The nurse should identify that limited mobility will have an effect on the client’s skin integrity, respiratory function, and elimination. Complications of the immobility resulting from unrelieved pain include pressure ulcers, pneumonia, and constipation. B- The nurse should address the limitations to the client’s independence that unrelieved pain causes and the increased need for assistance with ADLs because this can negatively impact the client’s self-esteem and well-being; however, there is another finding that is the priority. C- The nurse should more fully assess the effect that a decrease in self-esteem has on the client as this can negatively affect nutrition, motivation, and well-being; however, there is another finding that is the priority. D- The nurse should evaluate the impact the impaired socialization has on the client and assist the client in finding ways to regain social contacts since impaired socialization can have a negative effect on mood and cognition; however, there is another finding that is the priority. 7. A home health nurse is caring for a client who has cancer and is using a fentanyl transdermal patch for pain control. Which of the following actions should the nurse take when caring for this client? A- Avoid using a heating pad on the area with the patch B- to decrease the dose, cut the patch in half C- dispose of the used patch by placing it in the trash can D- assess the client for urinary retention every 8 hours Answer- a Applying heat over the site of the transdermal patch will increase the rate of absorption of the opioid medication and might cause respiratory depression. B- The nurse should obtain a new patch with the appropriate dosage of medication. Cutting the patch will effect delivery of the medication and will result in inappropriate dosage delivery. C- The nurse should dispose of a used patch by folding it with the adhesive edges together and placing it in a tamper-proof receptacle. D- The nurse should assess the client using a fentanyl patch for urinary retention every 4 to 6 hr. 8. A nurse is assessing an older adult client who reports feeling anxious about financial concerns and having difficulty sleeping for several months. Which of the following factors should the nurse identify as a factor in the client's sleep pattern? A- Older adults require much less sleep than younger adults B- older adults sell them awake at night once they have fallen asleep C- older adults have an increase in stages 3 and 4 of sleep D anxiety can cause Disturbed sleep patterns Answer- d The sleep patterns of older adults are different from those of young adults. However, anxiety and emotional stress can result in sleep disturbances in people of all ages. The nurse should further assess the client’s sleep problems and anxiety. A- The sleep needs of older adults are similar to those of young adults. However, older adult clients experience more awakenings during the night along with shorter time periods spent in deep sleep. B- Older adults tend to awaken several times during the night, limiting their ability to obtain the rest they require. C- Altered sleep patterns in older adult clients result in a decreased amount of time spent in stages III and IV, which is where deep sleep occurs. 9. A nurse is caring for an older adult client who is unresponsive following a stroke. Which of the following actions should the nurse take while providing Oral Care? A- Turn the client on his side before starting Oral Care B- use the thumb and index finger to keep the clients mouth open C- cleanse the clients oral mucosa with a toothbrush D- perform oral care using sterile gloves Answer- a The nurse should place the client in a lateral position to allow excess fluids to run out of his mouth into a basin, which reduces the risk of aspiration of fluids and secretions. B- The nurse should use a padded tongue blade or an oral airway, not a thumb and index finger, to keep the client’s mouth open. The client might suddenly bite down and injure the nurse’s fingers. C- The nurse should use a moistened foam swab to clean the oral mucosa. The nurse should cleanse each area of the mouth with a separate swab to avoid transferring microorganisms from one area to another. D- The nurse should apply clean gloves prior to performing oral care for a client. 10. A nurse is caring for an older client who is on bed rest. Which of the following foods should the nurse plan to include on the client's breakfast tray to prevent constipation? A- A banana B- hash brown potatoes C- egg and cheese omelet D- stewed prunes Answer- d The nurse should include foods that are high in dietary fiber, such as stewed prunes, to help prevent constipation for the client who is on bed rest. A- The nurse should include fruits as a part of a healthy diet; however, bananas are low in fiber and will not prevent constipation. B- The nurse should include a variety of vegetables as part of a healthy diet; however, potatoes are low in fiber and will not prevent constipation. C- The nurse should encourage the client to consume proteins such as eggs and cheese; however, they are not high in fiber and can cause constipation. 11. A nurse is teaching a client who has chronic obstructive pulmonary disease COPD and has been losing weight about ways to improve his nutritional intake. Which of the following statements by the client indicates an understanding of the teaching? A- I will choose hot foods to decrease the sense of fullness when eating B- I should add grated cheese to sauces and vegetables C- I will eat my largest meal of the day in the evening D- I should consume a diet high in carbohydrates Answer- b The nurse should reinforce that adding cheese to side dishes will increase the protein and calcium intake as well as increase calories. This will assist the client in regaining weight and stamina. A- The nurse should emphasize to the client that consuming cold foods will decrease his sense of satiety, allowing him to consume more calories. C- The nurse should recommend that the client consumes his largest meal early in the day, when energy is highest. This will allow him to consume more calories without causing fatigue. D- The nurse should emphasize that the client who has COPD should consume a high- protein diet. The client should limit carbohydrates because these break down into carbon dioxide and increase food-related dyspnea. 12. A nurse is conducting an in-service for a group of assistive Personnel about the basic needs of older adult clients. Which of the following statements should the nurse include in the teaching? A- Caloric needs are increased B- renal function is increased C- deep sleep is decreased D- exercise needs are decreased Answer- c The sleep architecture, or time spent in