GERIA UNIT 2 Flashcards
A 78-year-old woman presents to the clinic with complaints of dry skin and itching. On examination, her skin appears thin and wrinkled with visible senile lentigenes (liver spots). What is the most appropriate initial intervention?
A) Recommend the use of topical steroids.
B) Advise daily sun exposure for at least 30 minutes.
C) Educate the patient on applying emollients like petroleum jelly to moist skin after bathing.
D) Suggest using anti-aging creams to improve skin appearance
C
A 72-year-old man reports frequent falls over the past month. Upon examination, he has reduced muscle mass, kyphosis, and gait instability. What should the nurse prioritize in his care?
A) Encouraging regular swimming to improve joint flexibility.
B) Recommending a diet rich in calcium and Vitamin D.
C) Referring him to physical therapy for muscle strengthening and balance training.
D) Suggesting the use of a cane or walker without further evaluation.
C
An 80-year-old woman with osteoporosis complains of back pain and has a visible decrease in height. What is the most likely cause of her symptoms?
A) Degeneration of the intervertebral disks.
B) Compression fractures of the vertebrae due to bone demineralization.
C) Muscle atrophy leading to postural instability.
D) Osteoarthritis of the lumbar spine.
B
A 75-year-old patient with a history of smoking presents with a persistent cough, wheezing, and dyspnea on exertion. Which of the following is the most likely age-related change affecting the respiratory system?
A) Increased elasticity of the lung tissue.
B) Enhanced pulmonary circulation.
C) Reduced alveolar function and elasticity.
D) Heightened immune response to lung infections.
C
A 77-year-old man has been diagnosed with age-related macular degeneration. What symptom would the nurse expect him to report?
A) Loss of peripheral vision.
B) Difficulty distinguishing colors, particularly blue.
C) Blurry vision when reading or doing tasks that require fine detail.
D) Frequent flashes of light and floaters in the visual field.
C
A 79-year-old male presents with urinary incontinence, particularly when he sneezes or lifts heavy objects. What type of urinary incontinence is most likely?
A) Urge incontinence.
B) Overflow incontinence.
C) Functional incontinence.
D) Stress incontinence.
D
A 79-year-old woman presents with symptoms of constipation, including infrequent bowel movements and abdominal discomfort. She has a history of reduced mobility and poor fluid intake. What is the most appropriate nursing intervention?
A) Initiate a high-fiber diet and encourage increased fluid intake.
B) Administer a strong laxative immediately.
C) Instruct the patient to avoid physical activity to reduce discomfort.
D) Recommend bed rest to reduce straining.
A
A 75-year-old woman is admitted to the hospital with pneumonia. She has a history of chronic obstructive pulmonary disease (COPD) and is short of breath. Her oxygen saturation is 88% on room air. What is the most appropriate nursing intervention?
A) Administer oxygen at 4 liters per minute via nasal cannula.
B) Encourage deep breathing exercises without supplemental oxygen.
C) Place the patient in a supine position to increase lung expansion.
D) Limit fluid intake to prevent pulmonary congestion.
A
An 82-year-old patient with congestive heart failure complains of waking up at night due to difficulty breathing. What is the most appropriate nursing intervention?
A) Encourage the patient to drink fluids before bedtime.
B) Advise the patient to sleep in a reclined position with extra pillows.
C) Instruct the patient to avoid napping during the day.
D) Reduce salt intake to improve breathing.
B
An 83-year-old woman complains of difficulty falling asleep and frequent waking throughout the night. Which of the following interventions should the nurse recommend?
A) Encourage the use of over-the-counter sleep aids.
B) Promote good sleep hygiene practices, such as maintaining a regular sleep schedule and avoiding caffeine late in the day.
C) Suggest daytime naps to reduce fatigue.
D) Increase evening fluid intake to prevent dehydration.
B
An 81-year-old man with a history of benign prostatic hyperplasia (BPH) complains of frequent nocturnal urination and incomplete bladder emptying. What is the most appropriate next step in managing his condition?
A) Initiate fluid restriction.
B) Refer him for surgery.
C) Educate him on pelvic floor muscle exercises.
D) Start him on a diuretic.
C
A 76-year-old woman with mild cognitive impairment struggles with meal preparation. She lives alone and has a limited social network. What would be the most appropriate community-based service to recommend?
A) Assisted living facility.
B) Hospice care.
C) Adult day care center.
D) In-home nursing care.
C
A 70-year-old woman presents with complaints of joint pain, particularly in her knees and hips, which worsens with movement. Her physical exam reveals crepitus and limited range of motion in her joints. What is the likely diagnosis?
A) Rheumatoid arthritis.
B) Osteoarthritis.
C) Osteoporosis.
D) Gout.
B
A 78-year-old man is diagnosed with Alzheimer’s disease and has increasing difficulty recognizing his family members. Which nursing intervention is most appropriate to help him with orientation?
A) Use large, colorful calendars and clocks in his room.
B) Frequently quiz him on the names of family members.
C) Avoid discussing past events that might confuse him.
D) Place him in a quiet, low-stimulation environment.
A
A 73-year-old woman has been living in a nursing home for several months. She has recently become more withdrawn and is refusing to participate in social activities. What is the most appropriate initial nursing action?
A) Refer her to psychiatric counseling.
B) Encourage participation in group activities without addressing her concerns.
C) Assess for underlying causes such as depression or medical conditions.
D) Initiate antidepressant therapy.
C
An 80-year-old man is admitted to the hospital with dehydration. He has been living alone and reports that he forgets to drink water throughout the day. What is the best nursing intervention to prevent future episodes?
A) Encourage him to drink fluids only during meals.
B) Advise him to keep a water bottle nearby and set reminders to drink.
C) Recommend a fluid restriction to avoid overhydration.
D) Suggest the use of sports drinks to prevent dehydration.
B
A 76-year-old man with a history of diabetes presents with a foot ulcer that has not healed for several weeks. On examination, the area is red and warm to touch. What is the most appropriate nursing intervention?
A) Apply a dry dressing and monitor the ulcer for healing.
B) Educate the patient on proper foot hygiene and foot care.
C) Refer the patient to a wound care specialist and monitor for signs of infection.
D) Encourage the patient to increase walking to improve circulation.
C
A 79-year-old female with a history of osteoporosis fell at home and presents with hip pain and difficulty walking. What is the nurse’s priority action?
A) Apply a heating pad to the affected area.
B) Elevate the leg and apply a compression bandage.
C) Immobilize the hip and prepare for radiographic evaluation.
D) Encourage the patient to walk to maintain mobility.
C
A 72-year-old woman with mild dementia is confused and disoriented at night but remains calm and lucid during the day. What is the most appropriate nursing action?
A) Restrain her at night to prevent wandering.
B) Administer a sedative to ensure she sleeps through the night.
C) Provide a well-lit, calm environment with a consistent nighttime routine.
D) Reduce her daytime activity to ensure she sleeps more at night.
C
An 85-year-old female presents with fatigue and pallor. She reports a lack of appetite and a weight loss of 5 kg over the past 2 months. Lab results show low hemoglobin and low serum vitamin B12 levels. What is the most likely cause of her anemia?
A) Iron deficiency anemia.
B) Anemia of chronic disease.
C) Vitamin B12 deficiency due to impaired absorption.
D) Hemolytic anemia.
C
An 80-year-old woman with Alzheimer’s disease frequently wanders around the care facility and becomes agitated in the late afternoon. What nursing intervention is most appropriate to manage her behavior?
A) Increase her activity level in the morning to reduce wandering in the afternoon.
B) Administer a sedative to calm her down.
C) Keep her in a dimly lit room to prevent overstimulation.
D) Establish a calm and structured routine with consistent cues for daily activities.
D
A 75-year-old man with a history of chronic constipation presents with abdominal bloating and discomfort. What lifestyle modification would be most appropriate to prevent further episodes of constipation?
A) Increase intake of high-fiber foods and fluids.
B) Encourage bed rest to reduce strain.
C) Initiate a laxative regimen on a daily basis.
D) Decrease physical activity to avoid discomfort.
A
An 84-year-old man with a history of hypertension and hyperlipidemia presents with chest pain. He describes the pain as tightness in his chest that radiates to his left arm. What is the most appropriate immediate action?
A) Administer nitroglycerin sublingually.
B) Perform a 12-lead electrocardiogram (ECG).
C) Advise the patient to take deep breaths and relax.
D) Call for immediate medical assistance and administer oxygen.
D
A 74-year-old man presents with complaints of dizziness and unsteadiness when standing up. He is on multiple medications for hypertension. What is the most likely cause of his symptoms?
A) Medication-induced orthostatic hypotension.
B) Cerebral vascular insufficiency.
C) Inner ear infection.
D) Dehydration.
A
A 70-year-old man with a history of benign prostatic hyperplasia (BPH) reports difficulty initiating urination and a feeling of incomplete bladder emptying. What nursing intervention would be most appropriate?
A) Encourage the patient to perform Kegel exercises.
B) Teach the patient to use double voiding techniques.
C) Increase the patient’s fluid intake before bedtime.
D) Advise the patient to avoid drinking fluids during the day.
B
A 74-year-old man has been experiencing frequent headaches, vision problems, and a stiff neck. Upon examination, you notice that his pupils are sluggish in response to light, and his intraocular pressure is elevated. What condition should you suspect?
A) Cataracts.
B) Glaucoma.
C) Macular degeneration.
D) Diabetic retinopathy.
B
An 81-year-old woman presents with urinary frequency, urgency, and dysuria. She has no history of urinary incontinence. What condition should the nurse suspect?
A) Overactive bladder.
B) Urinary tract infection.
C) Stress incontinence.
D) Functional incontinence.
B
A 79-year-old woman with mild cognitive impairment is experiencing episodes of incontinence due to her inability to reach the bathroom in time. Which intervention is most appropriate?
A) Administer anticholinergic medication.
B) Implement a timed voiding schedule.
C) Use adult diapers to manage the incontinence.
D) Restrict fluid intake in the evening.
B
A 77-year-old woman is recovering from hip surgery and is now experiencing constipation. What is the most likely contributing factor to her constipation?
A) High fiber diet.
B) Decreased mobility post-surgery.
C) Overuse of laxatives.
D) Increased fluid intake post-surgery.
B
A 79-year-old female living in an assisted living facility is refusing to eat, stating that food tastes bland. She has recently started taking a new medication for her hypertension. What should the nurse assess next?
A) The patient’s dental health.
B) The side effects of the new antihypertensive medication.
C) The patient’s level of physical activity.
D) The patient’s bowel movement history.
B
A 78-year-old male is having difficulty hearing during conversations, especially when there is background noise. He denies any ear pain or infection. What is the most likely cause of his hearing loss?
A) Presbycusis, age-related hearing loss.
B) Cerumen impaction.
C) Tympanic membrane rupture.
D) Meniere’s disease.
A
A 78-year-old male presents with progressive difficulty swallowing both solids and liquids. He has lost 6 kg in the past two months. What is the most likely cause of his dysphagia?
A) Gastroesophageal reflux disease (GERD).
B) Age-related decline in esophageal motility.
C) Medication side effect.
D) Esophageal cancer.
B
A 76-year-old female patient is hospitalized for pneumonia. She has difficulty eating due to fatigue and reports a lack of appetite. What is the best nursing intervention to improve her nutritional intake?
A) Provide three large meals a day to ensure sufficient calorie intake.
B) Offer smaller, more frequent meals that are high in protein and easy to eat.
C) Increase her fluid intake to prevent dehydration.
D) Restrict her intake of solid foods until her fatigue resolves.
B
An 82-year-old female with advanced dementia has become less mobile and spends most of her time in bed. She has developed a reddened area on her sacrum. What is the best initial intervention to prevent pressure ulcer development?
A) Apply an occlusive dressing to the area.
B) Frequently reposition the patient every 2 hours.
C) Use a heating pad to improve circulation.
D) Encourage the patient to walk as much as possible.
B
A 74-year-old male with a history of smoking presents with chronic cough, weight loss, and clubbing of the fingers. His chest X-ray shows a mass in the lung. What is the most likely diagnosis?
A) Chronic obstructive pulmonary disease (COPD).
B) Pulmonary fibrosis.
C) Tuberculosis.
D) Lung cancer.
D
An 80-year-old man with congestive heart failure is experiencing shortness of breath, particularly when lying down. What is the most appropriate nursing intervention?
A) Encourage ambulation to improve circulation.
B) Elevate the head of the bed to a semi-Fowler’s position.
C) Restrict fluid intake to prevent pulmonary edema.
D) Administer a diuretic to reduce fluid overload.
B
A 76-year-old woman reports frequent nighttime urination, making it difficult for her to sleep through the night. What is the most appropriate intervention?
A) Restrict fluid intake after dinner.
B) Encourage her to take diuretics at bedtime.
C) Teach pelvic floor exercises to improve bladder control.
D) Provide a bedside commode to minimize walking distance.
A
A 73-year-old female has been diagnosed with osteoarthritis in her knees. She reports increasing pain during activity. Which non-pharmacological intervention should the nurse recommend to help manage her pain?
A) Complete bed rest to prevent further joint damage.
B) Apply heat therapy to reduce stiffness and increase joint mobility.
C) Encourage daily jogging to strengthen the joints.
D) Recommend using a heating pad for 30 minutes before activity.
B
An 83-year-old woman with osteoporosis asks the nurse how to reduce her risk of fractures. What is the best advice?
A) Increase dairy product intake to boost calcium levels.
B) Perform weight-bearing exercises regularly to strengthen bones.
C) Avoid sun exposure to prevent vitamin D depletion.
D) Take vitamin E supplements to enhance bone strength
B
A 77-year-old man reports poor appetite and difficulty chewing due to tooth loss. What nursing intervention would be most beneficial in improving his nutritional status?
A) Offer him softer foods and ensure adequate caloric intake.
B) Suggest dental implants or dentures to improve chewing ability.
C) Encourage high-fiber foods to prevent constipation.
D) Advise him to avoid snacks between meals to stimulate hunger.
A
A 78-year-old woman with Alzheimer’s disease has been increasingly agitated in the evenings. This pattern of behavior is known as:
A) Delirium.
B) Sundowning.
C) Depression.
D) Psychosis.
B
An 81-year-old male with a history of hypertension and diabetes reports difficulty walking due to pain in his legs that worsens with exertion and improves with rest. What is the most likely diagnosis?
A) Diabetic neuropathy.
B) Peripheral artery disease (PAD).
C) Deep vein thrombosis (DVT).
D) Sciatica.
B
A 79-year-old woman is admitted for recurrent falls. Upon assessment, you note muscle weakness, postural instability, and kyphosis. She takes a calcium supplement and Vitamin D regularly. What is the next most appropriate step in managing her risk of fractures?
A) Continue calcium and Vitamin D without further intervention.
B) Prescribe bisphosphonates to prevent bone resorption.
C) Increase weight-bearing exercises and monitor calcium levels.
D) Schedule her for dual-energy X-ray absorptiometry (DEXA) to assess bone density.
D
An 82-year-old man is admitted with confusion and lethargy. His vital signs include BP 90/60 mmHg, HR 105 bpm, and temperature 39°C. His medical history includes chronic heart failure and Type 2 diabetes. Lab results show elevated blood urea nitrogen (BUN) and creatinine levels, as well as a white blood cell (WBC) count of 16,000/mm³. What is the most likely cause of his symptoms?
A) Diabetic ketoacidosis.
B) Acute renal failure secondary to dehydration.
C) Sepsis due to a urinary tract infection.
D) Hypovolemic shock from heart failure.
C
A 78-year-old male with a history of congestive heart failure and atrial fibrillation is admitted for new-onset confusion and shortness of breath. His medication list includes digoxin, furosemide, and warfarin. His serum digoxin level is 2.5 ng/mL (normal: 0.5-2.0 ng/mL). What is the most appropriate immediate intervention?
A) Administer digoxin immune fab (Digibind).
B) Increase furosemide to reduce fluid overload.
C) Adjust warfarin dose to prevent further complications.
D) Discontinue digoxin and monitor for resolution of symptoms.
A
An 80-year-old female presents with complaints of fatigue, shortness of breath, and ankle edema. She is on multiple medications for hypertension. Upon examination, her lungs have crackles, and there is jugular venous distension. What is the most likely diagnosis?
A) Chronic obstructive pulmonary disease (COPD).
B) Right-sided heart failure.
C) Left-sided heart failure.
D) Pulmonary embolism.
C
An 85-year-old woman presents with increasing confusion, hallucinations, and agitation. She was recently started on diphenhydramine for her allergies. What is the most likely cause of her symptoms?
A) Progression of dementia.
B) Delirium due to anticholinergic effects of the medication.
C) Exacerbation of underlying depression.
D) Onset of Lewy body dementia.
B
A 76-year-old male with a history of Parkinson’s disease presents with worsening tremors, rigidity, and bradykinesia. He has been taking levodopa/carbidopa for several years. What adjustment should be made to his treatment plan to manage the motor fluctuations?
A) Increase the dose of levodopa/carbidopa.
B) Add a dopamine agonist or MAO-B inhibitor.
C) Discontinue levodopa and switch to anticholinergic therapy.
D) Decrease the frequency of levodopa/carbidopa to reduce side effects.
B
An 83-year-old woman with osteoporosis presents with a new vertebral compression fracture. Despite treatment with bisphosphonates and calcium/vitamin D supplementation, she continues to have fractures. What is the next best step in managing her osteoporosis?
A) Increase calcium intake to 2000 mg/day.
B) Discontinue bisphosphonates and initiate hormone replacement therapy.
C) Consider switching to denosumab or teriparatide.
D) Add physical therapy for spine stabilization exercises.
C
An 80-year-old female with advanced dementia is admitted to the hospital for pneumonia. She has a history of dysphagia, leading to aspiration. What is the most appropriate intervention to prevent future aspiration?
A) Recommend mechanical ventilation.
B) Insert a nasogastric tube for feeding.
C) Place the patient on a soft diet with thickened liquids.
D) Perform a percutaneous endoscopic gastrostomy (PEG) for feeding.
C
A 75-year-old man with a history of hypertension and diabetes is brought to the emergency department with sudden-onset right-sided weakness and difficulty speaking. His blood pressure is 190/110 mmHg. What is the priority in managing this patient?
A) Administer intravenous fluids to maintain perfusion.
B) Initiate thrombolytic therapy within the appropriate window.
C) Lower blood pressure immediately with antihypertensives.
D) Perform an emergency CT scan to assess for ischemic or hemorrhagic stroke.
D
A 77-year-old woman with Type 2 diabetes has developed a foot ulcer that is not healing despite appropriate wound care. Her glycemic control has been suboptimal with an HbA1c of 9.5%. What is the most important next step in managing her condition?
A) Increase the frequency of foot dressing changes.
B) Refer to a podiatrist for amputation evaluation.
C) Optimize blood glucose levels with insulin therapy.
D) Administer antibiotics for possible infection.
C
An 81-year-old male presents with nocturnal confusion, insomnia, and excessive daytime sleepiness. His wife reports that he often acts out his dreams by talking or moving during sleep. What sleep disorder should be suspected?
A) Obstructive sleep apnea.
B) Restless leg syndrome.
C) REM sleep behavior disorder.
D) Circadian rhythm sleep disorder.
C
An 82-year-old male with a history of atrial fibrillation and hypertension presents with sudden-onset left-sided weakness and facial droop. He was last seen normal 3 hours ago. His CT scan shows no hemorrhage. What is the most appropriate next step in his management?
A) Administer aspirin and monitor for changes.
B) Initiate thrombolytic therapy (tPA) immediately.
C) Administer anticoagulation with warfarin.
D) Control blood pressure with intravenous antihypertensives.
B
A 79-year-old female presents with sudden-onset vision loss in her right eye. She describes it as a “curtain falling” across her visual field. What is the most likely diagnosis?
A) Acute angle-closure glaucoma.
B) Retinal detachment.
C) Age-related macular degeneration.
D) Cataract formation.
B
A 79-year-old woman with a history of hypertension and type 2 diabetes complains of dizziness upon standing, which is worse in the morning. Her medications include metformin and lisinopril. Her blood pressure is 135/85 mmHg when sitting and 95/60 mmHg when standing. What is the best intervention?
A) Discontinue lisinopril and start a different antihypertensive.
B) Encourage the patient to drink more fluids and rise slowly from sitting or lying positions.
C) Increase her antihypertensive dosage to stabilize blood pressure.
D) Initiate diuretic therapy to reduce volume overload.
B
An 85-year-old woman is hospitalized for a hip fracture and is at risk for deep vein thrombosis (DVT). What is the most appropriate prophylactic intervention?
A) Start anticoagulation therapy with warfarin.
B) Place the patient on bed rest and monitor for signs of DVT.
C) Apply graduated compression stockings and encourage early ambulation.
D) Use diuretics to reduce fluid retention and prevent DVT.
C
A 76-year-old man presents with worsening lower extremity edema, weight gain, and shortness of breath. His medication list includes a beta-blocker and an ACE inhibitor for heart failure. What should be the next step in his management?
A) Add a diuretic to manage fluid overload.
B) Discontinue the ACE inhibitor due to possible side effects.
C) Increase the beta-blocker dose to improve cardiac function.
D) Recommend fluid restriction to reduce edema.
A
An 81-year-old female presents with constipation, abdominal distention, and pain. She is on multiple medications for chronic pain management, including opioids. What is the most appropriate intervention to manage her constipation?
A) Increase dietary fiber intake and encourage hydration.
B) Start a stimulant laxative and stool softener regimen.
C) Discontinue opioid therapy to resolve constipation.
D) Recommend bed rest to reduce discomfort.
B
An 85-year-old man presents with progressive memory loss, difficulty performing daily tasks, and getting lost in familiar places. He also experiences mood swings. His Mini-Mental State Examination (MMSE) score is 18/30. What is the most likely diagnosis?
A) Vascular dementia.
B) Alzheimer’s disease.
C) Lewy body dementia.
D) Frontotemporal dementia.
B
