NURS 3325 Holistic Care Older Adult
Test #2
1. An older adult client who has worked on an assembly line since the client was 24 years
old began taking aspirin for arthritis 6 months ago. The client presents to the nurse with
hearing problems and ringing in the ears. Which problem should the nurse suspect?
Vertigo
Tinnitus
Impacted cerumen
Ototoxicity
Rationale: the older has symptoms of ototoxicity. Aspirin is a known ototoxic
drug. Tinnitus is the persistent sensation of ringing in the ears, which is on of this
client’s symptoms. Vertigo is a sensation of motion, which is not a reported
symptom of this client. Although common, impacted cerumen would not lead to
ringing in the ears.
2. A nurse is teaching a group of hearing-impaired nursing home resident about hearing
aids. Which point should the nurse emphasize?
The hearing aid is only used in the dining room or social area
It is not necessary to use the hearing aid for one-on-one conversations
While inserting the hearing aid, make sure the volume is of
If whistling occurs, the volume of the hearing aid may need to be increased
Rationale: Insert the hearing aid with the volume off and the canal portion
pointing into the ear. Use a hearing aid for one-on-one conversation. It is not
effective in a dining room where there is background noise. If whistling occurs,
the volume should be decreased.
3. An 85-year-old client who lives alone says to the nurse, “There is nothing I can do about
my hearing. I am 85 years old, and I am not really interested in listening to television
programs anymore.” Which would be the nurse’s best response?
“You are lucky you still live alone at 85, and I understand why you don’t care
about the programs on television.”
“Did you know that there are closed-caption television sets that would allow you
to enjoy some shows?”
“I know a hearing aid dealer who ofers free testing. Have you thought about
trying a hearing aid?”
“Have you talked with your health care provider about a hearing evaluation? This
would determine the problems and possible solutions to it.”
Rationale: The first step would be to determine what the problem is. Free testing
is not comprehensive in its evaluative scope. Remarking that the client is lucky to
be living alone at 85 years of age is nontherapeutic communication, and
suggesting that the client use closed-caption television does not address the
hearing issue.
,4. A new nursing assistant asks the nurse how best to approach a hearing-impaired older
adult. Which approach should the nurse recommend?
Raise the volume of your voice
Leave the ratio on to calm the older adult
Use exaggerated lip movements
Lower the tone of your voice
Rationale: Communication interventions for the hearing impaired should aim at
clarity of word. This occurs by slowing the rate of speech and eliminating
environmental noise and distractions. When communicating, lower the tone
while speaking in a moderately loud voice.
5. After a scheduled trip to the optometrist, an older adult client is informed that the
pressure in the client’s left eye is 24 mmHg. Which assessment finding should the nurse
report?
Loss of central vision
Loss of peripheral vision
Headache
Eye pain
Rationale: Normal eye pressure should range between 10 and 20 mm Hg. Thus,
this client may have glaucoma. The term glaucoma refers to a group of eye
diseases in which the ganglion cells of the optic nerve become damaged by an
abnormal buildup of aqueous humor in the eye. Loss of peripheral vision is a key
sign of glaucoma. Eye pain, loss of central vision, and headache are not
associated with glaucoma.
6. A resident of a nursing home has experienced a progressive loss of vision over the past
several months. How should the nurse accommodate the resident’s loss of visual acuity?
Have the walls in the resident’s room painted a neutral color that matches the
color of the flooring
Provide the resident with brightly colored grooming utensils
Remove books from the resident’s room to avoid the reminder of vision loss
Replace the resident’s tube television with a flat screen
Rationale: Brightly colored utensils and grooming supplies can make it easier for
an older adult to identify and use them. Replacing the television is not an
effective intervention, and it is not appropriate to remove books simply because
they may remind the resident of vison loss. Contrasting, not monochromatic,
color schemes facilitate vision.
7. A nurse assesses risk factors for vision loss in an older adult client. Which question
should the nurse include in this assessment?
“Did your parents wear glasses or have cataracts?”
“Do you have high blood pressure or diabetes?”
“Do you have high cholesterol?”
, “How much red meat do you usually eat?”
Rationale: Diabetes and hypertension are significant risk factors for vision loss.
Family history, diet, and high cholesterol are not closely associated with vision
loss in older adults.
8. A nurse is providing an educational program about age-related macular degeneration
(AMD) to a group of older adults. Which statement by an older adult indicates the need
for further teaching?
“The dry type of macular degeneration occurs rapidly.”
“Smoking is a risk factor for AMD.”
“People with macular degeneration should have any sudden changes evaluated.”
“Macular degeneration causes a loss of central vision.”
Rationale: The dry type of AMD progresses slowly and does not cause total
blindness. The wet type of macular degeneration develops rapidly and causes
visual loss. Smoking is a risk factor for macular degeneration. As AMD
progresses, it affects central vision. People with AMD should have any sudden
changes evaluated.
9. A nurse presents at a conference regarding functional consequences related to urinary
elimination. Which statement should the nurse include?
“Most older women will develop urinary incontinence by the age of 85.”
“Health older adults experience an increase an increase in glomerular filtration
rate.”
“Most older adults will experience hypertrophy and relaxation of muscles in the
urinary tract and pelvic floor.”
“Excretion of penicillin and cimetidine are decreased in older adults.”
Rationale: Age-related changes in kidney function can impact water-soluble
medications that are highly dependent on the glomerular filtration rate. This
would include digoxin, penicillin, aminoglycoside, and cimetidine.
10. A nurse assesses the urinary elimination of older adults. Which action by the nurse is
most appropriate?
Work to identify terms that the older adult comprehends
Give the interview questions to the client in writing
Wait until the person initiates a discussion of this embarrassing topic
Ask the older adult to keep a urination diary
Rationale: Although nurses usually learn to discuss urinary elimination with
relative ease, older adults may feel uncomfortable with the topic, especially if
there are gender or age difference between the older person and the nurse. In
addition, older adults may be reluctant to discuss urinary problems because they
tend to accept urinary leakage as an inevitable consequence of aging and
gradually increase their tolerance threshold. Because of varying social contexts,
successful interviewing about urinary elimination and incontinence depends on
Test #2
1. An older adult client who has worked on an assembly line since the client was 24 years
old began taking aspirin for arthritis 6 months ago. The client presents to the nurse with
hearing problems and ringing in the ears. Which problem should the nurse suspect?
Vertigo
Tinnitus
Impacted cerumen
Ototoxicity
Rationale: the older has symptoms of ototoxicity. Aspirin is a known ototoxic
drug. Tinnitus is the persistent sensation of ringing in the ears, which is on of this
client’s symptoms. Vertigo is a sensation of motion, which is not a reported
symptom of this client. Although common, impacted cerumen would not lead to
ringing in the ears.
2. A nurse is teaching a group of hearing-impaired nursing home resident about hearing
aids. Which point should the nurse emphasize?
The hearing aid is only used in the dining room or social area
It is not necessary to use the hearing aid for one-on-one conversations
While inserting the hearing aid, make sure the volume is of
If whistling occurs, the volume of the hearing aid may need to be increased
Rationale: Insert the hearing aid with the volume off and the canal portion
pointing into the ear. Use a hearing aid for one-on-one conversation. It is not
effective in a dining room where there is background noise. If whistling occurs,
the volume should be decreased.
3. An 85-year-old client who lives alone says to the nurse, “There is nothing I can do about
my hearing. I am 85 years old, and I am not really interested in listening to television
programs anymore.” Which would be the nurse’s best response?
“You are lucky you still live alone at 85, and I understand why you don’t care
about the programs on television.”
“Did you know that there are closed-caption television sets that would allow you
to enjoy some shows?”
“I know a hearing aid dealer who ofers free testing. Have you thought about
trying a hearing aid?”
“Have you talked with your health care provider about a hearing evaluation? This
would determine the problems and possible solutions to it.”
Rationale: The first step would be to determine what the problem is. Free testing
is not comprehensive in its evaluative scope. Remarking that the client is lucky to
be living alone at 85 years of age is nontherapeutic communication, and
suggesting that the client use closed-caption television does not address the
hearing issue.
,4. A new nursing assistant asks the nurse how best to approach a hearing-impaired older
adult. Which approach should the nurse recommend?
Raise the volume of your voice
Leave the ratio on to calm the older adult
Use exaggerated lip movements
Lower the tone of your voice
Rationale: Communication interventions for the hearing impaired should aim at
clarity of word. This occurs by slowing the rate of speech and eliminating
environmental noise and distractions. When communicating, lower the tone
while speaking in a moderately loud voice.
5. After a scheduled trip to the optometrist, an older adult client is informed that the
pressure in the client’s left eye is 24 mmHg. Which assessment finding should the nurse
report?
Loss of central vision
Loss of peripheral vision
Headache
Eye pain
Rationale: Normal eye pressure should range between 10 and 20 mm Hg. Thus,
this client may have glaucoma. The term glaucoma refers to a group of eye
diseases in which the ganglion cells of the optic nerve become damaged by an
abnormal buildup of aqueous humor in the eye. Loss of peripheral vision is a key
sign of glaucoma. Eye pain, loss of central vision, and headache are not
associated with glaucoma.
6. A resident of a nursing home has experienced a progressive loss of vision over the past
several months. How should the nurse accommodate the resident’s loss of visual acuity?
Have the walls in the resident’s room painted a neutral color that matches the
color of the flooring
Provide the resident with brightly colored grooming utensils
Remove books from the resident’s room to avoid the reminder of vision loss
Replace the resident’s tube television with a flat screen
Rationale: Brightly colored utensils and grooming supplies can make it easier for
an older adult to identify and use them. Replacing the television is not an
effective intervention, and it is not appropriate to remove books simply because
they may remind the resident of vison loss. Contrasting, not monochromatic,
color schemes facilitate vision.
7. A nurse assesses risk factors for vision loss in an older adult client. Which question
should the nurse include in this assessment?
“Did your parents wear glasses or have cataracts?”
“Do you have high blood pressure or diabetes?”
“Do you have high cholesterol?”
, “How much red meat do you usually eat?”
Rationale: Diabetes and hypertension are significant risk factors for vision loss.
Family history, diet, and high cholesterol are not closely associated with vision
loss in older adults.
8. A nurse is providing an educational program about age-related macular degeneration
(AMD) to a group of older adults. Which statement by an older adult indicates the need
for further teaching?
“The dry type of macular degeneration occurs rapidly.”
“Smoking is a risk factor for AMD.”
“People with macular degeneration should have any sudden changes evaluated.”
“Macular degeneration causes a loss of central vision.”
Rationale: The dry type of AMD progresses slowly and does not cause total
blindness. The wet type of macular degeneration develops rapidly and causes
visual loss. Smoking is a risk factor for macular degeneration. As AMD
progresses, it affects central vision. People with AMD should have any sudden
changes evaluated.
9. A nurse presents at a conference regarding functional consequences related to urinary
elimination. Which statement should the nurse include?
“Most older women will develop urinary incontinence by the age of 85.”
“Health older adults experience an increase an increase in glomerular filtration
rate.”
“Most older adults will experience hypertrophy and relaxation of muscles in the
urinary tract and pelvic floor.”
“Excretion of penicillin and cimetidine are decreased in older adults.”
Rationale: Age-related changes in kidney function can impact water-soluble
medications that are highly dependent on the glomerular filtration rate. This
would include digoxin, penicillin, aminoglycoside, and cimetidine.
10. A nurse assesses the urinary elimination of older adults. Which action by the nurse is
most appropriate?
Work to identify terms that the older adult comprehends
Give the interview questions to the client in writing
Wait until the person initiates a discussion of this embarrassing topic
Ask the older adult to keep a urination diary
Rationale: Although nurses usually learn to discuss urinary elimination with
relative ease, older adults may feel uncomfortable with the topic, especially if
there are gender or age difference between the older person and the nurse. In
addition, older adults may be reluctant to discuss urinary problems because they
tend to accept urinary leakage as an inevitable consequence of aging and
gradually increase their tolerance threshold. Because of varying social contexts,
successful interviewing about urinary elimination and incontinence depends on
