Older Adult - Review Questions And Answers 100& verified updated chapter 1-33

Chapter 1 1. Primary prevention strategies for older adults include which of the following? (Select all that apply.) a. An annual influenza immunization clinic b. A smoking cessation program c. A prostate screening programs d. A cardiac rehabilitation programs e. A meal planning education program for type 2 diabetics 2. One reason why many “baby boomers” have multiple chronic conditions such as heart disease, diabetes, and arthritis is that: a. they have less access to medication and other treatment regimens. b. there was a lack of importance placed on healthy living as they were growing up. c. they did not have access to immunizations against communicable disease when they were children. d. they grew up in an era of rampant poverty and malnutrition. 3. A nursing student is preparing a presentation on the Wellness-Based Model for Healthy Aging. Which of the following concepts should the student include in the presentation? (Select all that apply.) a. Healthy aging is defined by the absence of physical illness alone b. Healthy aging is individually defined and can change over time c. There are many strategies to promote healthy aging that are believed to be helpful but do not have empirical evidence to support them d. Healthy aging cannot be achieved by only focusing on later life. It is a lifelong process e. According to this model, an individual with a chronic disease would not be considered healthy 4. When asked by new parents what the life expectancy is for their African American newborn, the nurse replies that, “2010 statistics indicate that your son: a. can realistically expect to live into his late 80s.” b. has a good chance of celebrating his 75th birthday. c. is likely to live into his late 90s.” 5. A nurse is caring for an 85-year-old male client with diabetes in a community setting. The nurse promotes functional wellness by which of the following activities? a. Encouraging the client maintains current levels of physical activities b. Assisting the client to receive all the recommended preventive screenings that are appropriate for his age group c. Teaching the patient how to use a rolling walker so that he can ambulate for longer distances 6. A nurse organizes a health fair for older adults. The nurse’s goal is to focus on the six priority areas identified by the National Prevention Council**. Which of the following activities should the nurse include? (SATA) a. Smoking cessation b. Depression screening c. Recognizing elder abuse d. Cholesterol screening e. Fitness training 7. A nurse is planning an education program on wellness in a local senior citizen center. The nurse plans to provide education on the importance of immunizations, annual physical examinations, screening for diabetes, and vision and hearing screening. It is important for the nurse to understand which of the following? a. Approximately 40% of older adults (ages 65 and older) utilize available preventive services b. Preventive strategies are more widely used in the 40-64 age group than in the 65 and over age group c. The research on health promotion strategies in older adults demonstrates that they have low efficacy d. There is an abundance of research specific to health promotion and aging 8. The “in-between” generation (individuals born between 1915 and 1945) were subject to which of the following health challenges during their childhood? (Select all that apply.) a. Polio b. Lack of fluoride in the water causing teeth to be soft and cavity prone c. “Pigeon Chest,” a malformation of the rib cage due to a lack of vitamin D 9. A nurse is planning care for a group of super-centenarians in an assisted living facility. The nurse considers which of the following? a. Most super-centenarians are functionally independent or require minimal assistance with activities of daily living b. The majority of super-centenarians have cognitive impairment c. The number of super-centenarians is expected to decrease in coming years as a result of heart disease and stroke d. It is theorized that super-centenarians survived as long as they have due to genetic mutations that made them less susceptible to common diseases 10. Based on the census reports of 2010, the typical profile of a centenarian in the United States includes which of the following characteristics? a. A Caucasian woman who lives in an urban area of a Southern state b. An African American woman who lives in a rural area of a Southern state c. A Hispanic man who lives in an urban area of a Midwestern state d. A Caucasian man who lives in a rural area of a Midwestern state Chapter 4 1. A paper on culture and illness would be likely to include the statement that: a. culture is the same as ethnicity. b. ethnic groups always share common geographic origin and religion. c. ethnicity involves recognized traditions, symbols, and literature. d. most members of an ethnic group exhibit identical cultural traits. 2. Ethnocentrism is defined as: a. a belief that one's ethnic group is superior to that of another 3. Regarding health care disparities, it is true that older adults of color have: a. equal risk factors for vulnerability as do all older adults. b. equal risk factors for vulnerability as do the young adults of color. c. increased risk factors for vulnerability if they are female. d. an increase in risk factors for vulnerability if care is provided by public facilities. 4. An older female patient tells a nurse the following: "In my culture, women are the silent partner in the family. Men make all of the decisions. However, when we came to the United States, all that changed. I became an American. I am in charge of my family just like my husband." This is an example of: a. Acculturation 5. A home care nurse is caring for an older patient from a different culture who is bed-bound and high risk for development of a pressure ulcer. The nurse discusses the plan of care with the patient's daughter, emphasizing the importance of turning every 2 hours and posts a turning clock on the wall. When the nurse returns later in the week, the turning clock has been removed, and the patient's daughter reports that she turns her mother occasionally. She states, "I am taking very good care of my mother. You just don't understand; our ways do not involve doing things on schedules." The best response by the nurse is: a. d. "How can we best work together to provide the best care for your mother?" 6. An older patient learns that he has metastatic cancer. The patient states: "I must have angered God." This is an example of which type of belief? a. Biomedical b. Magico-religious c. Naturalistic d. Ayurvedic 7. A female nurse is caring for an older woman from the Hasidic Jewish community. The woman's son is at the patient's bedside. The nurse notes that when she communicates with the patient and her son, the son does not maintain eye contact with her and also notes that he withdraws when she attempts to shake his hand. The best response by the nurse is to: a. continue conversing with both the patient and the son. 8. The nurse in a clinic setting that provides care for an ethnically diverse population of older clients shows an understanding of the LEARN Model** to direct the assessment process when: (Select all that apply.) a. recognizing that the client's hands are clenched as she answers the assessment questions. b. asking the client to describe what he thinks will help him feel better. c. explaining to the client that herbal remedies may not be sufficient treatment for his chest congestion. d. acknowledging that the client has a different view of the appropriate treatment. 9. A nurse completes a cultural assessment of an older adult who is being admitted to an assisted living facility. Reasons for completing a cultural assessment include: (Select all that apply.) a. culture guides decision-making about health, illness, and preventive care. b. culture provides direction for individuals on how to interact during health care encounters. c. culture impacts attitudes toward aging. d. all members of a culture react in the same way in similar situations. e. knowledge of culture eliminates health care disparities 10. A nurse in the ambulatory care setting is preparing to do an interview with a non-English-speaking client. The nurse secures an interpreter. In order to have the most effective interview, the nurse should do which of the following? (Select all that apply.) a. Look and speak to the interpreter b. Use technical terminology to ensure accuracy c. Allow more time for the interview d. Watch the client's nonverbal communication e. Have the interpreter check whether the client understands the communication Chapter 5 1. An older resident in a senior community tells a nurse: “I am really worried. I joined an exercise class, and I just learned everyone’s name yesterday, and I cannot remember them all today. Am I developing Alzheimer’s disease?” The best response by the nurse is: a. “You should be concerned. It is very unusual to forget something that you just learned.” b. “There is no reason to be concerned. Short-term memory decreases with age.” c. “Don’t worry, a decline in both short- and long-term memory is a normal part of getting older.” d. “Although it is normal to have some changes in memory, forgetting names is very unusual.” 2. A nurse is planning a fall prevention education refresher session for the residents of a long- term care facility. The individuals are all cognitively intact and range in age from 80 to 100. The previous education on fall prevention was presented 2 months ago. What special considerations should the nurse take in relation to teaching this group of older adults? (Select all that apply.) a. Make sure that all pamphlets are in large readable font (14-16 points) and include upper and lower case lettering b. Start education on falls from the beginning. It is unlikely that anyone remembers previous material c. Present all the information at once in one long session d. Ensure that there is adequate lighting in the room and that the temperature is comfortable e. Provide ongoing positive feedback during the session 3. A nurse hears a colleague state the following: “Can you believe that Mr. Jones’ daughter just bought him a tablet computer? He is 90 years old. It is ridiculous to think that he can learn to use it.” The nurse formulates a response based on research that shows: (Select all that apply.) a. older adults comprise the fastest growing population using computers and the Internet. b. Internet use is less prevalent in individuals over age 75 than those ages 65-74. c. older American men are the fastest growing group of social networking site users. d. older adults use the Internet only for social networking and recreational uses. e. technology has the potential to improve quality of life for older adults. 4. An older female resident of an assisted living facility says the following to a nurse: “I am very frightened about getting dementia. I have read a lot about brain exercises, but I am not sure what I should be doing.” The nurse formulates a response based on knowledge of which of the following? (Select all that apply.) a. Individuals should engage in some type of brain fitness activity a couple of times a week for at least 25 minutes b. Brain fitness activities are only effective if an individual has not experienced any memory problems at all c. Brain fitness activities may include computer-based games, memory training, board games, reading, and engaging in conversation d. Physical activity is important for wellness but is unrelated to brain fitness e. Individuals should choose brain exercise activities that are unfamiliar, challenging, and fun 5. The daughter of an older hospitalized patient tells a nurse: “I am worried about my father. His memory is sharper when he is at home. He is forgetful but is functional. Since he has been hospitalized his memory problems are much worse.” The best response by the nurse is: a. “It is common for long-term memory to be more impacted by age-related changes than short-term memory.” b. “Memory changes are often worse when an individual is in an unfamiliar or stressful situation.” c. “Perhaps you are just noticing your father’s memory loss now that he is hospitalized.” d. “There is a lot of new information for your father to process here in the hospital; he is overloaded.” 6. Health literacy is defined as: a. the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions. 7. A nurse is developing an educational session for a group of older adults at a senior center. Which of the following would the nurse include in the education? (Select all that apply.) a. Attention span, language, and communication skills typically remain stable with increasing age b. Older brains slow down and take longer to process constantly increasing amounts of information c. In order to preserve brain function, it is important to engage in challenging cognitive activities d. Older adults are not able to develop new cognitive abilities e. Individuals over age 100 have a higher prevalence of dementia than younger individuals Chapter 7 1. A nurse completes a functional status assessment of an older person using the Lawton IADL instrument, a self- reported instrument. The nurse knows that limitations of self-reported measures include that: (SATA) a. individuals tend to overestimate their functional ability. b. self-reports often differ from that of proxy reports. c. older adults are not able to complete self-reported measurements. 2. A limitation of the Katz Index of activities of daily living (ADLs) is that: a. all ADLs are weighted equally. 3. A 78-year-old man is being evaluated in the geriatric clinic. His daughter reports that he has been very forgetful lately, and she is concerned that he might be “senile.” The advanced practice nurse administers the clock- drawing test and the patient draws a distorted circular shape and places the numbers all on one side of the shape. Based on his performance, the nurse concludes that the patient: a. needs further evaluation. b. needs a functional status assessment 4. A nurse utilizes the SPICES tool (Sleep disorders, Problems with eating, Incontinence, Confusion, Evidence of falls, and Skin breakdown) to assess an older female patient in the hospital. The nurse notes that the patient has new onset urinary incontinence. The first action by the nurse is to: a. conduct a more in-depth focused assessment of the urinary incontinence. 5. When comparing the Older American’s Resources and Services (OARS**) with the Katz Index of ADLs, what is true? a. The Katz Index and the OARS both measure only ADL performance b. The OARS is a comprehensive assessment tool that measures ability in five areas; the Katz Index measures only ADL performance 6. A resident of a long-term care facility is assessed by a nurse upon admission to the facility. The assessment includes a comprehensive health, social, and functional profile. The tool that the nurse utilizes is: a. Outcomes and Assessment Information Set (OASIS). **homecare setting** b. Resident Assessment Instrument (RAI). **long-term** c. Older Americans Resources and Services (OARS). **functional status test** d. .Comprehensive Geriatric Assessment (CGS). **approach to assessment** e. Mini Mental Status Examination (MMSE). **mental status tool* 7. Factors that complicate assessment of older adults include: (Select all that apply.) a. presence of multiple comorbid conditions. b. atypical presentation of illness. c. difficulty in differentiating symptoms of disease from normal age-related changes. d. increase in iatrogenic illness. e. lack of assessment instruments specific for the older adult population. 8. The FANCAPES assessment tool focuses on the older adult’s: a. ability to meet personal needs to identify the amount of assistance needed. b. ability to perform instrumental activities of daily living (IADLs). c. cognitive abilities. d. level of dementia present. 9. A nurse is assessing a patient’s activities of daily living. The nurse will assess which of the following? (Select all that apply.) a. Eating b. Continence c. Toileting d. Self-medication administration e. Bathing 10. A nurse identifies a need to assess a patient’s cognitive status. The nurse chooses to use the MMSE. The nurse knows that the patient must have which of the following abilities? (Select all that apply.) a. Number fluency b. Familiarity with analog clocks c. Ability to hear and see d. Ability to sit up for 10 minutes e. Ability to speak English Chapter 8 1. The nurse is reviewing the postsurgical laboratory values of an older adult client. The client's erythrocyte sedimentation rate (ESR) is 20 mm/hr. The nurse initially responds to this data by: a. asking the client if he or she has been diagnosed with any chronic inflammatory diseases. b. recognizing that the value is normal for older adults. **normal value is: 10-20** c. notifying the client's health care provider immediately. d. requesting that the laboratory rerun the test. 2. An older client in a long-term care facility is receiving an annual physical examination and is ordered laboratory tests that include a complete blood count, serum electrolytes, and thyroid tests. When the client's son questions why these tests are being ordered by saying, "Dad is 85 why are you bothering him?" the nurse's response is based on an understanding that: a. when conducted annually, all of the tests are helpful in promoting maximum health for older adults in the long-term care setting. 3. When asked by an older adult client, "What is the difference between my normal laboratory values and the ones for a 55-year-old?" The nurse responds based on the understanding that there are: a. age-adjusted ranges for older adults for all of the common laboratory findings, similar to those for infants and children. b. no age-adjusted ranges for older adults due to the large variations within the age group and the increasing number of factors that influence the results. 4. An older resident of a long-term care facility diagnosed with dementia has in the last 48 hours become more confused than usual and while usually requiring help with toileting has been incontinent of urine. The client's health care provider orders a complete blood count and serum electrolytes. When the laboratory tests are all within normal limits, the nurse initially: a. attributes the changes in the resident's functioning to advancing dementia. b. speaks with the health care provider regarding the changes in the client's function and the possibility of obtaining a urine culture. 5. An older woman with breast cancer has completed a course of external radiation and is receiving chemotherapy. After her recent chemotherapy treatment, she complains of severe weakness, dizziness, and lethargy and is admitted to the hospital. Her platelet count is 45,000. Based on this scenario, what nursing intervention is of the highest priority? a. Preventing falls 6. A 69-year-old patient in the geriatric clinic has an annual physical examination and a complete blood count and serum electrolytes are drawn. While the physical examination was uneventful, the laboratory results show an elevated blood urea nitrogen (BUN). The nurse will then: a. ask that the test be rerun since the client showed no physical signs of renal failure. b. review the client's medication list since BUN can be affected by many specific medications. c. instruct the client on collecting a 24-hour urine specimen for a more detailed analysis. 7. A 78-year-old female patient was recently diagnosed with atrial fibrillation and started on Coumadin (warfarin) for stroke prophylaxis. A nurse provides extensive education on warfarin including the need for routine blood testing. The woman states the following to a nurse: "I understand all that you have taught me, but I do not know what a good number for the INR test is." The nurse bases her response on the knowledge that the recommended INR is: a. 1.0-2.0. b. 2.0-3.0. **normal for ppl on warfarin** c. 3.0-4.0. d. 4.0-5.0. 8. An older woman asks a nurse in the cardiology practice, "What is the ideal number that my cholesterol levels should be? I am confused by all of the different numbers." The nurse formulates her response on the knowledge that: a. recent guidelines from the American Heart Association state that there is no "one size fits all" recommendation and that recommendations must be individualized to each patient. 9. When a client asks, "What could be causing my triglycerides to be so low; I'm really careful about my diet?" the nurse responds by asking the client: (Select all that apply.) a. "Is your type 2 diabetes well managed?" **elevated** b. "Have you ever been diagnosed with renal failure?" ** elevated levels** c. "Do you have a history of pancreatitis?" **elevated** d. "Are you on medication for hyperthyroidism?" e. "Could you tell me how you are careful about your diet?" 10. An elderly man is brought to the geriatrics clinic by his wife because of his increasing confusion. As part of his medical workup, the nurse practitioner orders which of the following laboratory tests? (Select all that apply.) a. Basic metabolic panel b. Vitamin D level c. Thyroid stimulating panel d. Vitamin B12 e. Serum albumin level **not part of dementia workup** Chapter 9 1. The nurse’s first response when told by a client during an assessment interview that he “can’t take furosemide (Lasix)” is to ask: a. “Is your health care provider aware that you are allergic to Lasix?” b. “Can you describe what happened when you took Lasix?” c. “When was the last time you took Lasix?” d. “Have you any questions regarding your reaction to Lasix?” 2. When performing the initial assessment on a new client in a geriatric outpatients practice, the most effective method the nurse can implement to elicit an accurate medication assessment is to ask that the client: a. bring in all of the medications that she is currently taking. 3. An older patient is prescribed warfarin for stroke prevention. A nurse is providing patient education. Which of the following foods should the patient be taught to avoid? (Select all that apply.) a. Milk b. Whole grains c. Kale d. Spinach e. Red meats 4. The area in which nurses have the greatest effect on the safe, effective medication therapy of an older client is: a. educating the client to all aspects of the medication. b. assessing for adverse reactions to the medication. c. monitoring overall health of the client as it is affected by the medication. d. evaluating the outcomes resulting from the medication. 5. An 81-year-old patient is being discharged from the hospital to home. She is on seven different medications, which are to be taken at four different times during the day. What would be most useful in helping this patient manage her medications? a. The package inserts from all of the medications for the client to read b. A pillbox with compartments for each day and each of the doses c. A written list of all the client’s medications and administration routine d. A suggestion that the client’s daughter administers the medications 6. The nurse suspects that a client is experiencing tardive dyskinesia when observing that: a. the client can’t seem to stop moving. b. the client’s facial muscles are twisting involuntarily. c. the client not able to get up out of a chair. d. the client’s hand tremors so much that drinking from a cup is difficult. 7. An older client prescribed a transdermal morphine patch for severe chronic pain is being educated on the appropriate administration of the medication. The nurse shows an understanding of essential information regarding this route of drug administration when stating: (Select all that apply.) a. “This is an effective route for delivering small doses of medication over long periods of time.” b. “Since you have problems with digestion, this is a good way to take your medication.” c. “Please show me how you would apply your patch.” d. “Be careful to put the patch only on your chest but change locations with each application.” e. “Be sure to avoid placing the patch on injured skin.” 8. What factor is an important contribution to polypharmacy in older adults? a. Inadequate communication among medical care providers b. Implementation of Medicare Part D prescription drug benefit c. Use of generic medications d. Increasing popularity of dietary and herbal supplements 9. The Beers Criteria is an effective tool for health care professionals prescribing and/or managing the medication therapy of older adults since it identifies medications that for this population: a. are not typically covered by drug benefit plans. b. have a higher than usual risk for injury. c. are likely to be abused. d. generally, cause allergic reactions 10. When discussing pharmacological considerations, a 68-year-old client asks, “Why do medications seem to act differently than they did when I was younger?” The nurse bases the response on the concept that: a. age-related changes affect the way drugs are metabolized by older adults. 11. When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse best ensures an understanding of oral hypoglycemic medications when providing: a. the package insert and assessing the client’s reading skills. b. the client with the website address for the American Diabetes Association. c. oral explanations and sending the client home with a written copy. d. the information in paragraph form as opposed to numbered line fashion. 12. Which pharmacokinetic/pharmacodynamic parameter does the aging process least affect? a. Absorption b. Distribution c. Metabolism d. Excretion 13. An antihypertensive medication has been prescribed for an older patient with hypertension. The patient tells a clinic nurse that he would like to take an herbal substance to help lower his blood pressure instead of the prescription medication. Which of the following should the nurse do? (Select all that apply.) a. Tell the patient that herbal substances are less effective than prescription medications b. Encourage the patient to discuss the use of an herbal substance with his primary care provider c. Explore with the patient which herbal substance he is planning on taking d. Educate the patient on possible interactions of the herbal substance with his other medications e. Instruct the patient not to take the herbal substance, as it is dangerous 14. Factors that affect the pharmacokinetics of lipophilic medications in older adults include: a. greater adipose tissue ratio to body mass b. decreased total body water. c. increased glomerular filtration rate. d. increased creatinine clearance. Chapter 10 1. The nurse preparing an educational program focused on herbal supplement targets as a likely interested group: a. Inner-city females who live below the poverty level b. White females who own their own successful businesses c. Male Hispanic Americans who are single, divorced, or widowed d. Men and women from small rural communities who are self-employed farmers 2. The nurse is conducting a presurgical interview when it is noted that the older adult patient's medication list includes Tylenol 650 mg four times a day for arthritic pain, gingko 80 mg twice a day, and glucosamine chondroitin 500 mg three times per day. The nurse proceeds to share with the client that in order to minimize the risk for postsurgical complications, there is the need to refrain from taking: a. glucosamine chondroitin for 1-2 weeks due to a potential for excess anesthetic sedation. b. ginkgo for 2 weeks due to the potential for increased bleeding. c. Tylenol for 24-48 hours due to the potential for increased bleeding. d. gingko for 1 week due to the potential for an allergic reaction during surgery. 3. When a nursing interview identifies that a client is daily taking doses of herbal supplements, the nurse's priority: a. evaluate the effectiveness of the herbal supplement self-treatment. b. determine why the client feels the need to take the herbal supplements. c. identify when the herbal supplementation began. d. discuss the client's knowledge regarding the herbal supplements' side effects. 4. The nurse admitting a client to a same day surgery unit makes the decision to notify the surgical team to cancel the procedure based on the client's statement that: a. "Will I start taking my St. John's wort as soon as I can eat again?" b. “I've haven't taken my ginkgo for exactly 10 days." c. "I didn't want to risk catching a cold, so I took my echinacea with just a sip of water." d. "It seemed strange not taking my garlic pill this morning." 5. When a client who routinely takes the herb St. John's Wort (SJW) shares that his or her "hay fever is really bad right now," the nurse initially: a. notifies the primary care provider that the client has been self-medicating for hay fever. b. compares the client's current blood pressure to his/her baseline blood pressure. c. stresses the need to avoid over-the-counter (OTC) medications containing monoamines. d. suggests that the client stop taking the herb until the hay fever has improved. 6. The major focus regarding nursing education for the older adult regarding the use of herbal supplements is the: a. high risk of herbal overdose since the manufacturing process lacks effective controls. b. likelihood that the client will substitute herbals for more expensive prescribed medications. c. expense of the herbal supplements since they are seldom covered by insurance. d. possibility of dangerous interactions between herbals and the client's prescription medications. 7. The nurse is confident that the client who chooses to take red rice yeast daily for dyslipidemia has an understanding of its possible side effects when the client: a. has regular laboratory work to monitor cholesterol levels. b. shows caution by slowly rising from the chair. c. states, "If I start noticing muscle pain, I'll stop taking the pills." d. schedules regular, yearly glaucoma screenings 8. The nurse is confident that the client who takes glucosamine sulfate daily is conscientious of the safety issues involved when hearing the client state: (Select all that apply.) a. "I'm always careful to buy the same brand of glucosamine sulfate." b. "If glucosamine sulfate wasn't safe the drug store wouldn't sell it." c. "My pharmacist is so helpful when I have questions about the herbals I take." d. "The liquid form of glucosamine sulfate is what I consistently take." e. "I made sure my physician knew that I was allergic to strawberries." 9. An older adult is having difficulty sleeping and asks a nurse, "My neighbor told me that I should take melatonin to help me sleep. What do you think about this?" The nurse responds to the individual's question using the knowledge that: (Select all that apply.) a. in the natural state melatonin is produced by the pineal gland and regulates the sleep-wake cycle.. b. it must be used with caution in a patient that is taking other medications that have central nervous system depressant effects. c. evidence shows that it is effective at decreasing sleep onset latency, improving quality of sleep, and improving morning wakefulness Chapter 11 1. You have four rooms to choose from for your older client to be admitted this afternoon. Which room would you choose? a. A brightly lit, blue room with cozy throw rugs b. An orange-carpeted room with soft lighting and yellow walls c. A brightly lit, blue room with an EZ-Glide wax floor d. A fluorescent-lighted room with green walls and a glossy, tiled floor 2. An older adult client shares with the nurse that, “I don’t know what it is, but it seems that I need more light for reading or even watching television as I get older.” The nurse explains that aging may cause this change due to the: a. slower ability of the pupil to adjust to changes in lighting. b. impact arcus senilis has on visual acuity c. flattening and thinning of the cornea. d. retinal changes that begin to occur with aging 3. An older patient reports the following symptoms to a nurse during a routine visit to the geriatric clinic: blurry vision, the need for more light when reading, and blind spots in the middle of his visual field. He also states, “Strangely enough my peripheral vision continues to be pretty good.” The nurse suspects that the patient has which of the following? a. Glaucoma b. Age related macular degeneration c. Diabetic retinopathy d. Cataracts 4. A nurse is performing preoperative teaching for an older adult who is scheduled to have a cataract extraction and lens implant. The nurse includes which of the following in the teaching plan? (Select all that apply.) a. Avoid lifting heavy objects after the surgery b. Avoid bending from the waist after the surgery c. Take stool softeners as needed d. Maintain strict control of your blood sugar and blood pressure e. Maintain a dry sterile dressing over the eye for 10 days 5. A 77-year-old client being treated for glaucoma asks the nurse what causes glaucoma. The nurse’s response is: a. the exact etiology of glaucoma is variable and often unknown. b. spasms of the orbicular muscle. c. changes to the suspensory ligaments, ciliary muscles, and parasympathetic nerves. 6. An older resident in a long-term care facility reports to the nurse that she has been noticing changes in her vision, including the appearance of halos around objects and a yellow tint to most objects. The nurse knows that these complaints are most often associated with: a. cataracts. b. glaucoma. c. diabetic retinopathy. d. age-related macular degeneration 7. An older patient is diagnosed with diabetic retinopathy. The patient asks a nurse: “Is there anything that I can do to prevent progression of this disease and blindness?” The nurse includes which of the following into the response? (Select all that apply.) a. Strict control of blood glucose levels is important in slowing disease progression b. Laser photocoagulation treatments can stop progression of the disease c. Control of blood pressure and cholesterol levels are important steps slowing disease progression d. Wearing sunglasses to protect the eyes from ultraviolet light can stop disease progression e. Eating a diet high in beta-carotene can stop disease progression 8. An older man tells a nurse, “The doctor says I have something wrong with my eyes, something called presbyopia. Can you explain why I have this? I was always fortunate to have good eyesight.” The nurse formulates a response based on the knowledge that: a. the lens of the eye loses elasticity causing a loss of focus for near objects. 9. A nurse is conducting an assessment of an older patient’s eyes. The nurse expects to see which of the following normal age-related changes of the external eye? (Select all that apply.) a. The eyelids are less elastic and droopy b. The eyes are very dry c. The eyelids may not close completely d. There is a loss of eyelashes e. The lower lid may be turned outward 10. A nurse is providing glaucoma education for a group of older adults in a senior center. The nurse knows that the following groups are most likely to develop glaucoma. (Select all that apply.) a. African Americans b. Mexican Americans c. Individuals with a family history of glaucoma d. Individuals with diabetes e. Asian Americans Chapter 12 1. An older patient asks a nurse, “My doctor referred me to a hearing specialist who thinks that surgery for a cochlear implant may be beneficial for me. Can you tell me how one of those things works?” The nurse formulates a response based on the knowledge that: a. a cochlear implant is permanent, surgically-implanted hearing aid. b. a cochlear implant speeds up the conduction of sound to the auditory nerve. c. a cochlear implant functions as an artificial auditory nerve. d. a cochlear implant directly stimulates the auditory nerve. 2. A nurse in an assisted living community notes that one of the residents who has hearing impairment and new bilateral hearing aids frequently does not wear the hearing aids. The nurse knows that which of the following factors contribute to low hearing aid use after purchase? (Select all that apply.) a. Difficulty placing hearing aid properly in the ear b. Stigma associated with wearing a hearing aid c. Difficulty changing the batteries in the hearing aid d. Hearing annoying loud noises 3. An older nursing home resident reports that her hearing loss is getting worse. What is the first action of the nurse? a. Refer the resident for an evaluation for a hearing aid b. Raise her voice when speaking to the resident c. Examine the resident’s ears for cerumen impaction d. Teach the resident to read lips 4. A 74-year-old client who has experienced a progressive loss of hearing acuity in recent years obtains a new hearing aid. Which of the following should be included in the nurse’s teaching plan? a. “Many people find that hearing aids only help with certain types of hearing loss that are caused by previous noise exposure.” b. “With the right hearing aid, you can expect your hearing to be back to normal.” c. “Hearing aids are covered by Medicare Part B.” d. “Even though hearing aids will help you, they also bring challenges like distorted speech and amplified background noise.” 5. An older patient is diagnosed with sensorineural hearing loss. The nurse knows that causes of sensorineural hearing loss include: (Select all that apply.) a. tumors of the middle ear. b. cerumen impaction. c. infections of the external and middle ear. d. age-related hearing impairment. e. excessive and loud noise 6. An older person reports hearing whistling in both ears when no external sounds are present and is diagnosed with tinnitus. Which of the following are causes of tinnitus? (Select all that apply.) a. Exposure to loud noises b. Use of a hearing aid c. Cerumen buildup d. Side effects of medications e. Age-related changes in the middle and inner ear Chapter 13 1. A nurse is providing an educational session on vaccines to a group of older adults. The nurse is discussing the zoster vaccine (Zostavax). Which of the following information should the nurse include in the education? a. Zostavax should only be given to individuals who have never had an episode of herpes zoster (HZ) b. Zostavax is recommended for all individuals 60+ yrs that have no contraindications to the vaccine c. Zostavax should not be given to anyone with a chronic cardiac or respiratory condition d. Zostavax will always prevent an individual from developing Herpes Zoster 2. A nurse is educating a group of nursing assistants in long-term care on the prevention of skin tears. Which of the following interventions should the nurse include in the education? (Select all that apply.) a. Lubricate the resident’s skin with moisturizers twice daily b. Ensure that the resident has adequate nutrition and hydration c. Bathe the resident in hot soapy water d. Avoid the use of lifting shifts when transferring the resident e. Dress the resident in long sleeves and long pants to protect the extremities 3. A nurse assesses a nursing home resident’s pressure ulcer to be a “healing stage III.” The primary reason reverse staging is never used is because: a. even though all tissue layers are replaced as a wound heals, the healed skin is not as strong as it originally was. b. not all tissue layers are replaced as a wound heals & the healed skin is not as strong as it original c. reimbursement in nursing homes does not allow for reverse staging to be utilized. d. the collagen layer is not replaced during wound healing 4. A nurse is assessing an older patient and notes a cluster of fluid-filled vesicles on the right thoracic area. The nurse suspects HZ. The patient asks the nurse, “I really don’t understand how I got shingles. I don’t even know anyone who has this infection.” The nurse includes which of the following in formulating a response to the patient? a. HZ is caused by a reactivation of dormant varicella zoster virus within the sensory neuron of the dorsal root ganglion 5. An older patient tells a nurse. “The nurse practitioner told me that these ugly purple bruises on my arms are called purpura and are due to fragile blood vessels. I still don’t understand why this happens to me.” The nurse responds based on the knowledge that: (Select all that apply.) a. purpura is due to normal age-related changes. b. the incidence of purpura increases with age. c. purpura is a precancerous skin condition. d. individuals who take blood thinners are especially prone to purpura. e. individuals prone to purpura should make sure that affected areas are open to the air. 6. Which of the following are subscales on the Braden Scale for predicting pressure ulcers? (Select all that apply.) a. Nutrition b. Moisture c. Mobility d. Age e. BMI 7. The nurse is most concerned by observing when assisting with an older client’s bath: a. A firm, irregularly-shaped, pink-colored nodule b. A slightly raised multicolor lesion with an asymmetrical, irregular border c. A pearly papule with prominent blood vessels d. Rough, scaly, sandpaper-like patches that are slightly tender 8. A nurse is caring for an older adult with xerosis. Which of the following interventions should the nurse include in the patient’s plan of care? (Select all that apply.) a. Encourage adequate fluid intake b. Encourage daily baths of at least 20 minutes c. Maintain a humid environment d. Apply water-laden emulsions to skin immediately after bathing e. Use only deodorant soaps when bathing 9. An older person is admitted to the hospital with an exacerbation of congestive heart failure. The nurse notes that the patient complains of severe itching at night and has a red rash on her torso. The patient is diagnosed with scabies. The patient asks the nurse “How did I get something like this?” The best response is: a. “Scabies is highly contagious and spreads easily through physical contact.” b. “Scabies is commonly seen in older adults due to normal age-related changes in the skin.” c. “Scabies is only seen in older adults who have multiple chronic illnesses.” d. “Certain medications can make you more susceptible to contracting scabies.” 10. An older patient complains of pruritus. The nurse suggests which of the following interventions to alleviate the patient’s complaint? (Select all that apply.) a. Use only non-perfumed laundry detergent and fabric softeners b. Avoid sudden temperature changes c. Wear loose-fitting clothing Chapter 14 1. An older adult’s nutritional status is screened by a nurse using the Mini Nutritional Assessment (MNA). The older adult scores a score of “10” on the screening portion of the tool. The best action by the nurse is to: a. refer the patient to a dietician. b. complete the assessment portion of the tool. c. conduct a 72-hour calorie count. d. initiate nutritional supplements between meals 2. Many older adults have a vitamin B12 deficiency. Reasons for this include which of the following? (Select all that apply. a. Normal age-related changes in the stomach include a lower production of gastric acid making vitamin B12 absorption less efficient b. The major source of vitamin B12 is sunlight, and older adults are less likely to be outdoors and absorb vitamin B12 in this manner c. Proton pump inhibitors, a frequently prescribed medication in older adults, impairs absorption of vitamin B12 from food d. Most older adults do not consume five servings of fruits and vegetables daily, which is the main dietary source of vitamin B12 e. Certain antibiotics and anticonvulsant medication increase the risk of vitamin B12 deficiency 3. A hospitalized older adult who recently had surgery and a wound infection postoperatively is noted to be losing weight despite consuming his meal trays and snacks. One reason that this might be occurring is: a. an injury may trigger inflammatory mediators that increase metabolic rate and impair nutrient utilization. b. an injury may cause malabsorption of nutrients. c. most hospitalized older patients do not consume adequate amounts of micro- and macronutrients. 4. Symptoms of gastroesophageal reflux disease (GERD) in older adults include: (Select all that apply.) a. heartburn. b. regurgitation. c. abdominal pain within one hour of eating. d. vomiting. e. fever and elevated white blood cell count. 5. A nurse identifies that an older adult needs more education on nutritional needs when the older adult states the following: a. “Since I am an older person, I need more calories because my metabolic rate is slower” b. “Since I am an older person, I need fewer calories since my metabolic rate is slower” c. “Even though I am an older person, I still need the same amount of nutrients in order to be healthy” d. “Even though I am an older person, I still need to pay attention to my diet and activity levels” 6. A nurse is preparing to hand feed an older adult with a history of a right cerebrovascular accident (CVA) with facial weakness and dysphagia. Which techniques should the nurse utilize when feeding this patient? (Select all that apply.) a. Sit the patient upright in a chair at 90 degrees b. Allow the patient to sit upright for 15 minutes after the meal is completed. c. Feed the patient only liquids to make swallowing easier. d. Place the solid food in the left side of the mouth. e. Have the patient swallow twice for every mouthful of food given. 7. A nursing student asks the instructor, “Our textbook discussed the obesity paradox in older adults. I am not sure I understand; isn’t obesity bad for everyone?” The best response by the instructor is: a. “While there is evidence that obesity in younger people lessens life expectancy, it remains unclear whether overweight and obesity are predictors of mortality in older adults.” b. “Obesity is usually not a concern in older adults, as most older people tend to weigh less than they did when they were younger.” 8. An older adult who is within a normal weight range asks a nurse, “I have heard that it is important to limit the amount of fats in my diet, but I don’t know how much I should be taking in daily. Can you help me?” The best response by the nurse is: a. “Someone of your age needs to limit fats.” b. “Since you are at your ideal weight, you should limit your daily fat grams to half your weight.” c. “Fat intake will depend on the presence of any cardiac issues.” 9. A nurse is developing a care plan for an older adult in a long-term care facility that has a nutritional problem. Which of the following interventions are appropriate to ensure adequate nutrition? (Select all that apply.) a. Assign a nursing aide to feed the resident to ensure adequate consumption of meals b. Supervise the resident during meals c. Provide a pleasant eating environment d. Provide nutritional supplements for the resident e. Assess the resident for ability to feed himself/herself Chapter 15 1. A nurse is caring for an older adult who has a gastrostomy tube. The nurse is developing a care plan related to oral care. Which of the following should the nurse consider for this patient? (Select all that apply.) a. Oral care should be provided every four hours. b. Teeth should be brushed with a toothbrush after each tube-feeding. c. Lemon glycerin swabs should be used in between feedings to keep the mouth moist. d. Foam swabs should be used in place of a toothbrush to clean the teeth after each tube-feeding. e. Oral care should be provided only twice daily if the older adult is edentulous. 2. A nurse administers hypodermoclysis (HDC) to an older nursing home resident. The purpose of hypodermoclysis is: a. to rehydrate an individual with severe dehydration. b. to quickly administer 4-5 L of fluid within a 24-hour period. c. to rehydrate an individual with mild to moderate dehydration. d. as a supplement to IV hydration to expedite rehydration. 3. Which of the following nursing interventions should be implemented to prevent dehydration in hospitalized older adults? (Select all that apply.) a. Implementing intake and output recording for any patients with fever, diarrhea, vomiting, or an infection b. Limiting duration of NPO requirements for diagnostic tests and procedures c. Administering IV fluids to all hospitalized older adults d. Limiting the use of diuretic medications in hospitalized older adults e. Making sure that hospitalized patients have easy access to fluids 4. A nurse is performing an admission assessment on an older patient who presented with a high fever and cough, reduced oral intake for 3 days, and lower extremity weakness. The patient has sunken eyes, and the patient’s skin turgor over the sternum is poor. The nurse suspects that the patient is dehydrated. Which of the following are indicators of dehydration in this patient? (Select all that apply.) a. Poor skin turgor over the sternum b. Lower extremity weakness c. High fever d. Sunken eyes e. Cough 5. A nurse is observing a nurse aide perform denture care for a resident in the nursing home. The nurse recommends that the nurse aide receive additional education on denture care when the nurse observes which of the following? a. The nurse aide places a face cloth in the sink and fills the sink half full of water. b. The nurse aide uses toothpaste to clean the dentures. c. The nurse aide utilizes a specially designed denture brush to clean the dentures. d. The nurse aide stores the dentures in a denture cup filled with denture cleansing solution. 6. In a long-term care facility, a nurse is having a discussion with the nurse aides about ways to deal with dementia clients who are uncooperative with mouth care. Appropriate methods to use include: a. speaking to the client sternly and instructing the client to open the mouth and cooperate immediately. b. having another nurse aide assist in holding the client’s mouth open with a tongue depressor. c. involving the client in the process of oral hygiene, such as using the hand over hand technique to brush the client’s teeth. d. quickly performing oral hygiene without explanation since the client is uncooperative. 7. Which of the following statements describing oral care for the older population is correct? a. Regular dental examinations can prevent tooth loss and improve the ability to chew healthful foods. b. Losing one’s teeth is considered a normal part of the aging process. c. Oral malignancies seldom occur in older adults so oral examinations are of low priority. d. Preventative dental care is covered under Medicare. 8. An older woman asks a nurse, “You always seem to be telling me that I need to drink more water. How much water do I really need to drink?” The nurse bases her response on the knowledge that older adults should consume at least: a. 1000 mL of fluid per day. b. 1500 mL of fluid per day. c. 2000 mL of fluid per day. d. 2500 mL of fluid per day. 9. An older adult complains of xerostomia. Which of the following interventions should the nurse implement for this patient? (Select all that apply.) a. Encourage the patient to brush and floss teeth regularly. b. Encourage the patient to have regular dental screenings. c. Provide antiseptic mouthwash (e.g., Listerine) for the patient. d. Encourage adequate intake of water. e. Provide saliva substitutes. Chapter 16 1. The nurse interviewing an older adult for a nursing history recognizes that the client is experiencing symptomology inconsistent with normal aging of the urinary tract when the client reports: (Select all that apply.) a. finding it more difficult in the last few months to start voiding. b. having two bladder infections in the last 4 years. c. getting up once or twice each night to urinate. d. occasionally experiencing pain when urinating. e. needing to urinate at least every 2 hours during the day. 2. An otherwise healthy older adult reports having begun to experience problems “holding my water.” The nurse shows an understanding of interventions that may help minimize the problem of urinary incontinency when: (Select all that apply.) a. asking whether the client smokes tobacco. b. assessing the average amount of caffeine, the client drinks daily. c. asking if the client has been evaluated for diabetes recently. d. suggesting the client keep a record of the amount of fluids ingested daily. e. reviewing the client’s current medication list. 3. A nurse is caring for an older adult in a hospital who has an indwelling catheter. The nurse assesses the patient based on the knowledge that which of the following are correct indications for an indwelling catheter? (Select all that apply.) a. To assist with incontinence management b. To manage acute urinary retention c. To assist in healing of open sacral or perineal wounds in incontinent patients d. To accurately measure urinary output in critically ill patients e. To prevent falls related to toileting in hospitalized older patients 4. A 74-year-old woman who is in the hospital for rehabilitation following hip replacement has been experiencing incontinence since admission. Which of the following interventions are likely to facilitate the restoration of the patient’s bladder function? (Select all that apply) a. Assess the patient’s recent voiding pattern. b. Request an order for an indwelling catheter from the patient’s physician. c. Teach the patient how to meet hydration needs while still limiting fluid intake. d. Assist the patient to use the bathroom. 5. A 78-year-old patient has a history of osteoarthritis and lives alone in a two-story home. The bathroom is on the first level and the bedroom is on the second level. The patient states, “I am so upset. I have been wetting the bed at night.” What type of incontinence does the patient most likely have? a. Mixed incontinence b. Stress incontinence c. Urge incontinence d. Functional incontinence 6. An 89-year-old hospitalized female patient tells a nurse, “I go to the bathroom really often, but I manage this by not drinking too much before I go to bed so I can sleep for the night.” The patient has no pain or discomfort with voiding. The nurse considers this finding to be a: a. manifestation of urge incontinence. b. manifestation of a urinary tract infection. c. normal age-related change in an 89-year-old woman. d. manifestation of diabetes. 7. Which of the following nursing actions would help minimize the psychosocial impact of bladder and/or bowel incontinence for individuals experiencing incontinence prior to going to a group dining room? a. Assess for soiled clothing and change, if necessary. b. Toilet the client and then promptly transport to the dining room. c. Provide peri-care and fresh underclothing. d. Ask the client if toileting is needed and assist as necessary. 8. A nurse implements a nursing care plan for a patient with constipation. Which of the following should the nurse include in the plan? a. Increasing fiber in the diet b. Administering aluminum hydroxide antacids c. Bed rest d. Restricting fluids 9. A patient tells the nurse, “Every time I laugh or cough, I wet myself.” Which type of urinary incontinence is this patient describing? a. Urge b. Functional c. Stress d. Mixed 10. A nurse caring for a cognitively impaired older adult client shows an understanding of the unique clinical symptoms of constipation in this population when: (Select all that apply.) a. checking documentation to determine if the client has had a bowel movement in the last 24-36 hours. b. questioning staff as to whether the client has any unexplained falls in the last few days c. asking the client to name all of his or her children and grandchildren. d. requesting that the client’s temperature be taken now and again in 4 hours. e. reviewing the client’s food intake over the last 24-36 hours Chapter 17 1. An older patient asks a nurse, “It seems like all of my friends and I have difficulty sleeping. Is it common among older people?” The nurse formulates a response based on the knowledge that normal age-related changes in sleep include: (Select all that apply.) a. total sleep time and sleep efficiency are reduced. b. rapid eye movement (REM) sleep is shorter, less intense, and more evenly distributed. c. sleep requirements for older adults are less than that of younger adults. d. daytime napping is common. e. sleep tends to be deeper in older adults than in younger adults. 2. An older adult’s diagnosis of sleep apnea is supported by nursing assessment and history data that include: (Select all that apply.) a. followed a vegetarian diet for last 28 years. b. male gender. c. a smoking history of 1 pack a day for 45 years. d. 30 pounds over ideal weight. e. history of Crohn’s disease. 3. A nurse in a long-term care facility notes that an older resident with Alzheimer’s disease awakens frequently at night and is restless and agitated. Which of the following interventions will be most effective to help manage this resident’s sleep problems? a. Taking the resident outside in the garden for 45 minutes daily b. Limiting fluid intake for the resident 4. A long term care facility has selected sleep promotion as its quality improvement project. Which of the following interventions would be appropriate to implement on this unit? (Select all that apply.) a. Ensuring that all residents receive evening care and are in bed by 8:00 PM b. Taking as many residents as possible outside for 30 minutes daily c. Instituting quiet time (keep noise down, speak in hushed tones, no overhead paging) between 9:00 PM and 6:00 AM d. Avoiding waking residents for routine care during the night e. Limiting caffeine and fluids before bedtime 5. When an older adult client is diagnosed with restless leg syndrome (RLS), the nurse is confident that client education on the condition’s contributing factors has been effective when the client states: a. “A warm bath at night instead of in the morning is my new routine.” b. “Eating a banana at breakfast assures me the potassium I need.” c. “I’ve cut way back on my caffeinated coffee, teas, and sodas.” d. “I elevate my legs on a pillow so as to improve circulation.” 6. An older adult tells a nurse that he is experiencing difficulty falling asleep, he routinely gets into bed at 8:30 PM and watches his favorite television shows until 11:00 PM, and often lies awake for hours after. Which of the following suggestions are appropriate for the nurse to give to this patient? (Select all that apply.) a. Go to bed only when sleepy. b. If unable to sleep within a reasonable time (15-20 minutes), get out of bed and pursue relaxing activities c. Engage in moderate exercise to induce fatigue. d. Do not watch television or work in bed. e. If unable to sleep, engage in enjoyable activities on the computer. 7. An older patient asks a nurse, “I really have trouble sleeping and my doctor does not want to prescribe a sleeping pill for me. He says they are not good for older people. I really don’t understand his response. Can you help me?” The best response by the nurse is: a. “Sleeping medications have many adverse effects in older people and only have minimal effects in improving sleep.” b. “Prescription sleeping medications have many adverse effects in older people. Why don’t you try using an over-the-counter medication?” c. “Sleeping medications do not provide any improvement in sleep for older people.” 8. An older patient is diagnosed with RLS. Which of the following nonpharmacologic interventions should the nurse include in the plan of care? (Select all that apply.) a. Engage in regular mild to moderate physical activity including stretching activities for the lower extremities. b. Avoid caffeine, alcohol, and tobacco. c. Avoid hot baths. d. Relaxation techniques may be helpful. e. A mild sleeping medication such as diphenhydramine (Benadryl) might be helpful. 9. A client who reported “a problem sleeping” shows an understanding of good sleep hygiene by: a. doing 10 pushups before bed to encourage a “pleasant tiredness.” b. seldom eating a bedtime snack. c. engaging in computer games as a pre-bed activity. d. limiting the afternoon nap to just 30 minutes. Chapter 18 1. A 75-year-old female asks a nurse “I know I should be moving, but how much is the right amount of exercise for me?” The best response of the nurse is: a. “You need to engage in 30 minutes of moderate intensity exercise on at least 5 days a week.” b. “You need to engage in at least 30 minutes of moderate intensity exercise every day of the week.” c. “Since you are 75, the recommendations are 30 minutes of moderate exercise three times a week.” d. “There are no specific recommendations for someone of your age; just keep moving.” 2. A nurse is discussing the importance of exercise with a 78-year-old female who states: “I know I should be exercising, but I have arthritis in my knees, and it is painful. Can you recommend a type of exercise that would be beneficial and cause me less pain?” Which of the following exercises should the nurse recommend? a. Tennis b. Swimming c. Dancing d. Use of a treadmill and elliptical machine in the gym 3. A nurse at a senior center promotes activity by leading exercise programs. Which of the following is a benefit of such exercise? a. Improvement of mood 4. A nurse is using the function-focused care approach to care for a hospitalized older adult. The nurse is assisting the patient to transfer from the bed to a chair. Which of the following statements by the nurse is most congruent with this approach to care? a. “Place your hands across your chest and let us move you to the edge of the bed.” b. “Place both of your hands on the overbed trapeze and pull yourself up to a sitting position.” 5. A nurse is working with an older individual who has recently started an exercise program. The individual tells the nurse, “This exercise thing is really hard, and I absolutely hate walking on a treadmill going nowhere. I think I am going to call it quits.” Which of the following responses by the nurse will be most effective in encouraging the individual to remain in the program? a. “If you stop exercising, you will reverse all the good effects that the exercise accomplished.” b. “I will have to report that to your physician.” c. “What types of exercise do you enjoy doing?” d. “Most older people hate exercising, but they do it anyways.” 6. A nurse caring for an older hospitalized woman is concerned about promoting functional status. Which of the following interventions should the nurse include in this patient’s plan of care? (Select all that apply.) a. Conduct a baseline functional status assessment of the patient b. Request a physical therapy referral c. Make sure that the patient has all activities of daily living performed for her d. Progressive mobility interventions e. Encouraging the patient to feed herself 7. A nurse is educating a group of older adults on the benefits of an exercise program. The nurse includes education on when not to exercise. Which of the following should the nurse include in the education? (Select all that apply.) a. Do not exercise if your resting heart rate is over 80 b. Do not exercise if your blood pressure is greater than 200 systolic and 100 diastolic c. It is important to wait 30 minutes after a big meal before engaging in vigorous exercise d. Do not exercise if a joint that you are using to exercise is red, warm, and painful e. Do not exercise if you have a fever and muscle aches 8. An older adult who has a balance disorder and has sustained repeated falls is recommended to start an exercise program. Which of the following exercises would be most beneficial in improving balance in this individual? (Select all that apply.) a. Yoga b. Tai Chi c. Swimming d. Pilates e. Weightlifting Chapter 19 1. A group of older women in an assisted living facility are talking about one of the residents who fell and fractured her hip. The women ask a nurse the following: “It seems like so many of us fall and break our hips, and then it is downhill from there. Is this really true?” In formulating a response, the nurse considers which of the following? (Select all that apply.) a. Hip fractures are a leading cause