Chapter 31 - Older Adults Flashcards
A student nurse visiting a senior center says, “It’s depressing to see these old people. They are weak and frail. I doubt any of them can engage in a discussion.” The student is expressing what bias?
a. reality.
b. ageism.
c. empathy.
d. vulnerability.
b. ageism.
A nurse plans an educational program for staff of a home health agency specializing in care of the elderly. Which topic is the highest priority to include?
a. Pain assessment techniques for older adults
b. Psychosocial stimulation for those who live alone
c. Preparation of psychiatric advance directives in the elderly
d. Ways to manage disinhibition in elderly persons with dementia
a. Pain assessment techniques for older adults
What is the best comment for a nurse to begin an interview with an elderly client?
a. “I am a nurse. Are you familiar with what nurses do?”
b. “Hello. I am going to ask you some questions to get to know you better.”
c. “You look comfortable and ready to participate in an admission interview. Shall we get started?”
d. “Hello. My name is _______ and I am a nurse. How you would like to be addressed by staff?”
d. “Hello. My name is _______ and I am a nurse. How you would like to be addressed by staff?”
Which information is most important to obtain during assessment of an older adult diagnosed with health problems?
a. Functional ability and emotional status
b. Chronological age and sexual function
c. Economic status and sources of income
d. Developmental history, interests, and activities
a. Functional ability and emotional status
A 75-year-old client comes to the clinic reporting frequent headaches. As the nurse begins the interaction, which action is most important?
a. Complete a neurological assessment.
b. Determine whether the client can hear as the nurse speaks.
c. Suggest that the client lie down in a darkened room for a few minutes.
d. Administer medication to relieve the client’s pain before continuing the assessment.
b. Determine whether the client can hear as the nurse speaks.
Which statement about aging provides the best rationale for focused assessment of elderly clients?
a. The elderly are usually socially isolated and lonely.
b. Vision, hearing, touch, taste, and smell decline with age.
c. The majority of elderly clients have some form of early dementia.
d. As people age, thinking becomes more rigid and learning is impaired.
b. Vision, hearing, touch, taste, and smell decline with age.
When assessing an elderly client, the nurse should complete the Geriatric Depression Scale if the client answers which question affirmatively.
a. “Would you say your mood is often sad?”
b. “Are you having any trouble with your memory?”
c. “Have you noticed an increase in your alcohol use?”
d. “Do you often experience moderate to severe pain?”
a. “Would you say your mood is often sad?”
A primary health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2 g sodium diet, restraint as needed, limit fluids to 1800 mL daily, continue antihypertensive medication, milk of magnesia 30 mL PO once if no bowel movement for 3 days. The nurse should implement what action regarding these prescriptions?
a. implement the fluid restriction.
b. question the order for restraint.
c. transcribe the prescriptions as written.
d. assess the resident’s bowel elimination.
b. question the order for restraint.
An elderly client must be physically restrained. Who is responsible for the client’s safety?
a. The nurse assigned to care for the client
b. Unlicensed assistive personnel who apply the restraint
c. Family member who agrees to application of the restraint
d. Health care provider who prescribed application of restraint
a. The nurse assigned to care for the client
A new nurse asks the nurse manage, “My elderly client’s CT scan of the head shows many Lewy bodies are present. What should I do about assessing for pain?” What is the best response from the nurse manager?
a. “Ask the client’s family if they think the client is experiencing pain.”
b. “Use a visual analog scale to help the client determine the presence and severity of pain.”
c. “There are special scales for assessing clients with dementia. Let’s review how to use them.”
d. “The perception of pain is diminished by this type of dementia. Focus your assessment on the client’s mental status.”
c. “There are special scales for assessing clients with dementia. Let’s review how to use them.”
An advance directive gives legally binding direction for health care interventions when a client presents with what scenario?
a. has a new diagnosis of cancer.
b. is diagnosed with Parkinson’s disease.
c. is unable to make decisions for self because of illness.
d. diagnosed with amyotrophic lateral sclerosis is unable to speak.
c. is unable to make decisions for self because of illness.
A client asks, “What is the purpose of having advanced directives?” What is the nurse’s best response?
a. “It give you control gives your treatment decisions during any illness if you are incapacitated.”
b. “It can be given only to a relative, usually the next of kin, who has your best interests at heart.”
c. “It can be used only if you have a terminal illness.”
d. “The instructions take effect immediately.”
a. “It give you control gives your treatment decisions during any illness if you are incapacitated.”
A physically frail elderly client with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this client during the evening and night. Which type of facility should the nurse suggest to meet this client’s needs?
a. Adult day care program
b. Skilled nursing facility
c. Partial hospitalization
d. Group home
a. Adult day care program
A 79-year-old adult tells a nurse, “I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing.” The nurse should analyze this comment as suggestive of what?
a. normal pessimism of the elderly.
b. evidence of risks for suicide.
c. a call for sympathy.
d. normal grieving.
b. evidence of risks for suicide.
In a sad voice, an elderly client tells the nurse of the recent deaths of a spouse and close friend. The client has no other family and only a few acquaintances in the community. The nurse’s priority is to determine whether which nursing diagnosis applies to this client?
a. Risk for suicide related to recent deaths of significant others
b. Anxiety related to sudden and abrupt lifestyle changes
c. Social isolation related to loss of existing family
d. Spiritual distress related to anger with God
a. Risk for suicide related to recent deaths of significant others
