Gerontological Nursing Study Guide Rated A

Gerontological Nursing Study Guide Rated A+ A 78 yr old female presents to the ED with complaints of nausea and sudden onset shortness of breath. The initial workup includes ____________, a. upper endoscopy b. CT of the head c. liver function studies d. EKG and serial enzymes for determination of an MI The following statement is not true. a. osteoarthritis is progressive erosion of articular cartilage with formation of new bone in this space b. rheumatoid arthritis is symmetrical inflammation of peripheral joints c. osteoarthritis occurs more commonly in the hands, elbows and shoulders whereas rheumatoid arthritis occurs in weight bearing joints more commonly d. osteoarthritis is associated with obesity, trauma, cold climate and overuse of a joint A 75 yr old client is recovering from abdominal surgery. The DR. has ordered morphine 2-6 mg every 4 hrs prn for pain. As the nurse plans to administer this medication, what intervention would the nurse choose to administer this drug to an older person. a. administer the highest dose of 6 mg b. administer the lowest dose of 2 mg c. avoid the narcotic because of the risk of addiction d. administer the dose only when the client asks for the medication 2 times ________ is a factor that contributes to a high incidence of falls in the elderly. a. increased muscle mass and tone b. high likelihood of orthostatic hypotension upon rising quickly c. increasing acuity in eyesight in dim light d. constipation Identify the correct statement describing the abuse of elderly persons in the United States. a. Elder abuse is the most often reported form of domestic violence b. Statistically, neglect is the most common form of elder abuse c. Most cases of elder abuse are reported to the proper authorities d. Healthcare practitioners are only mandated to report verified, not suspected, cases of elder abuse An 81 yr old female presents to the ED with altered level of consciousness. All of the following except____ are possible causes for this condition. a. peripheral arterial disease b. hypoglycemia c. pneumonia d. hypotension from dehydration Pneumonia in the older client can be caused by all of the following except_____ a. aspiration from a poor swallow b. community acquired pneumonia c. sleep apnea d. compromised immune function and decreased pulmonary antibodies Which of the following cases seen by a nurse working in the ED identifies a situation that suggests a case of elder mistreatment? a. an 85 yr old male who has several areas of bruising on the back of the hands and is taking Clopidogrel sisulfate(Plavix) and aspirin daily b. an 86 yr old woman who has 3 dime sized burned areas on her upper inner thigh c. a 77 yr old woman who fell at home after tripping over her dog and broke her arm about 30 minutes earlier d. a 73 yr old male with a history of gastric ulcers who is found to be anemic after vomiting blood 3 hours earlier Mr J., an 80 yr old who has had flu like symptoms with diarrhea and has vomited 4 times in the last 24 hours is seen in the ED. Mr. J seems confused and is lethargic. The nurse notes that Mr. J has dry skin, a brown tongue, sunken cheeks and concentrated urine. This array of symptoms indicates: a. congestive heart failure b. dehydration c. urinary tract infection d. bowel obstruction The microvascular changes that occur as a result of uncontrolled diabetes include all of the following except___: a. Retinopathy b. nephropathy c. neuropathy d. cerebral vascular disease All of the following conditions except___ can cause renal failure, especially in the older adult. a. diabetes mellitus b. prostate hypertrophy causing obstruction of urine thru the urethra c. heart failure d. ingesting more than 4 gms of acetaminophen (Tylenol) per day consistently for 2 years Which of the following clients is at greatest risk for orthostatic hypotension? a. a 75 yr old woman who uses a walker b. an 80 yr old male hypertensive who strains to void when using the bedside commode c. a 69 yr old is a long leg cast on his right leg d. an 80 yr old woman who is taking Premarin for post menopausal osteoporosis Which of the following can occur as a result of decreased hearing in the older person ? a. Decreased stressful interactions due to need to have verbal communication repeated. b. Increased danger due to inability to hear smoke or security alarms c. Decreased danger when driving or walking in traffic due to inability to hear car horns or traffic sounds d. Increased incidence of falls Which of the following interview questions would be most appropriate when a nurse is assessing a client's respiratory function? a. Would you be interested in finding out more about environmental smoke? b. Did wither of your parents experience lung disease? c. Have you ever worked in a job where you were exposed to dust, fumes, smoke or other pollutants? d. What do you do to actively maintain your health? Which nursing intervention would not help a patient with xerostomia? a. Using humidifiers b. Using mouth rinses or artificial saliva products c. Providing sugar free hard candies d. Increasing medications from once a day to twice a day All of the following except___ can occur due to the decreased tactile sensations that occur in the older person. a. Burns on feet and hands due to inability to feel the temperature of bath water b. Social isolation due to not wanting to be touched c. Development of sores on feet due to inability to feel pressure and injury d. Increased tendency to fall due to decreased sensation of feet to floor Which of the following statements best conveys an aspect of diabetes and the older adult? a. a combination of lifestyle factors and age related changes contribute to the high incidence of diabetes in the older population b. nurses should have a knowledge base sufficient to accurately diagnose diabetes among older adults c. nurses should avoid drawing conclusions about diabetes risk based on ethnicity d. development of diabetes is considered a normal age related change Which of the following are examples of appropriate communication techniques for dealing effectively with persons with dementia? a. Ask open ended questions so the person feels that he or she feels they can make choices b. for people in the later stages of dementia, talk to them as you would a child c. maintain good eye contact and a relaxed and smiling approach d. when a person forgets something, remind them not forget it the next time An older women tells the nurse that her husband seldom brushes his teeth as he did in the past. A reason why older clients stop participating in daily oral hygiene, such as brushing the teeth, include: a. decreased manual dexterity and inability to hold a tooth brush b. malocclusion of teeth c. decrease in taste acuity d. lack of dental insurance Which of the following statements describing dental care for the elderly population is incorrect? a. Losing one's teeth is considered a normal part of the aging process. b. Clients who are edentulous continue to need to see dentists for regular checkups. c. Regular dental examinations can prevent tooth loss and correct bite misalignments, thus improving the elderly client's ability to chew healthful foods. d. The incidence of oral malignancies increases as a person ages. Therefore, regular oral exams are important to the health of the older adult. The nurse is responsible for the care of several patients on an acute medical unit. Which of the following patients would the nurse most likely expect to have his or her condition worsen at night? a. a woman diagnosed with osteoarthritis and failure to thrive b. a man diagnosed with COPD exacerbation c. a woman diagnosed with foot cellulitis secondary to diabetic neuropathy d. a man with chronic anemia receiving transfusions of packed red blood cells All of the following except______ pertain to the older clients newly diagnosed with HIV/AIDS_____ a. are likely to have contracted the disease from receiving contaminated blood or blood products. b. often have vague symptoms such as memory loss, fatigue or weight loss that may be attributed to other conditions associated with age. c. are usually more ill with the initial infection than younger clients with HIV/AIDS due to later diagnosis d. have higher death rates from HIV/AIDS than younger clients. An 81 yr old man is admitted to the hospital with aspiration pneumonia. the nurse would be justified in predicting that this patient has a history of____. a. Cigarette smoking b. lung cancer c. dysphagia d. sleep apnea A 72 yr old man's diagnostic testing and physical assessment have resulted in a diagnosis of COPD. What symptoms likely prompted this client to seek medical care? a. hemoptysis and orthostatic hypotension b. chest pain and shortness of breath c. cough and dyspnea d. apneic spells and fatigue A nurse on an acute care unit for older adults is disturbed by the rising incidence of pressure ulcers in her patients. What measure should the nurse prioritize in order to prevent pressure ulcers? a. frequent reposition of immobilized patients b. us of prophylactic antibiotics c. high protein diet d. us of daily massages and other tactile interventions Mr Reynolds experienced a transient ischemic attack (TIA) 3 weeks ago that had significant effects on his motor and sensory function. Which of the following assessment findings should signal to the nurse to the possibility that Mr Reynolds is experiencing dysphagia? a. Mr. Reynolds complains of being excessively hungry in the mid afternoon and evening b. When providing oral care, the nurse finds food pocketed in Mr Reynolds cheek c. Mr Reynolds drinks large amounts of water, before, during and after meals d. Mr Reynolds prefers to sit in a high fowlers position after meals _________ are signs of hypothyroidism? a. tachycardia b. flushed skin c. heat intolerance d. fatigue, waxy, pale skin, bradycardia The most common factor related to xerostomia in elderly clients is: a. Side effect of medications b. Increased oral intake c. Tendency to mouth breathe d. Oxygen therapy The principal goals of therapy for older adults who have NIDDM with poor glycemic control are: a. enhancing quality of life b. decreasing the chance of complications c. improving self care through education d. all of the above A nurse who works on a geriatric subacute medicine unit is aware that many of the clients have a documented history of orthostatic hypotension. What measure should the nurse prioritize in order to ensure safety for these clients? a. Encourage patients to use a bedpan or incontinence brief to prevent falls while ambulating to the bathroom b. Have patients sit on the side of the bed for a few minutes before ambulating c. mobilize clients within 2 hours of eating a meal d. Have clients take several deep breaths before getting up out of bed