CV
An older client, who enjoys good health, is experiencing a decline in stamina despite being physically active over the years. The client's history and physical exam is unremarkable. The nurse suspects that the client is experiencing age-related changes that are affecting stamina. Which change would the nurse suspect?
A. Increased resting heart rate and blood pressure
B. Reduced heart contractility and a prolonged cardiac cycle
C. Stenosis of the aorta and decreased muscle tissue perfusion
D. Hypotension with consequent inadequate peripheral blood supply
After completing an assessment of an older adult client, the nurse interprets which finding as a pathological process rather than age-related respiratory changes?
A. Posture is slightly kyphotic
B. Slight wheeze on exhalation
C. Uses accessory muscles on expiration
D. Mucous membranes drier than younger clients'
A gerontological nurse at a wellness center is conducting an exercise program for older adult clients with diabetes. The nurse instructs the clients to exercise with caution for which reason?
A. The resting heart rate is lowered.
B. Hypoglycemia may occur.
C. The heart rate is temporarily increased.
D. The absorption of insulin is lowered.
An 80-year-old client who has just spent 2 days at the beach with the family is demonstrating confusion and has concentrated urine. What action will the nurse take?
A. Administer fluids.
B. Obtain a urinalysis.
C. Administer a mini-mental exam.
D. Apply a cooling blanket.
A gerontological nurse is caring for an older adult client receiving various medications in an acute care facility. Which will the nurse use to evaluate the appropriateness of a medication prescription?
A. changes in gastrointestinal (GI) motility
B. body-composition factors
C. preexisting chronic conditions
D. renal and liver function
An older client recovering from surgery is experiencing left calf edema. On inspection, the area is red and painful to touch. When developing this client's plan of care, which intervention would the nurse include?
A. Enforcing bed rest and administering nitroglycerin as ordered
B. Massaging the affected leg and providing analgesia as ordered
C. Mobilizing the client and providing an ice pack for the affected leg
D. Applying elastic stockings and administering anticoagulants as ordered
A client, who is prescribed deep breathing and coughing every hour, has a nonproductive cough and is easily fatigued. What can the nurse do to increase the client's secretions?
A. Have the client blow the nose.
B. Encourage the client to rest for 30 minutes.
C. Provide the client with aerosol medication.
D. Give the client a piece of hard candy to eat.
The nurse assesses a group of older adults at a senior center for conditions related to changes of the endocrine system related to aging. Which assessment findings should the nurse prioritize and address first?
A. Blood glucose of 300 mg/dl in an 88-year-old adult
B. Metabolic syndrome in a 67-year-old adult
C. New onset of constipation in a 72-year-old adult
D. Evidence of a Dupuytren contracture in a 78-year-old adult
A nurse at an assisted living facility is promoting the value of fiber to a client. Which statement by the nurse would be appropriate to include in the teaching?
A. "Fiber increases metabolic rate."
B. "Fiber decreases serum cholesterol."
C. "Fiber improves gastric emptying."
D. "Fiber increases nutrient absorption."
When administering a proton pump inhibitor to a client with gastroesophageal reflux disease (GERD), the nurse notes that the client has great difficulty swallowing the enteric-coated pill. Which action would be most appropriate for the nurse to do when administering this medication to the client in the future?
A. Crush the pill and mix with applesauce
B. Split the pill in two parts and give each separately
C. Reposition the client and provide more fluid when giving the pill
D. Request a nonpharmacological alternative from the prescriber
An older client with hypertension has been admitted to a nursing home to recover from orthopedic surgery. Which action would be appropriate for the nurse to include in this client's plan of care to improve tissue perfusion?
A. Educating the client about the importance of diet
B. Encouraging the client to ambulate several times each day
C. Inspecting the client's extremities daily for signs of altered tissue circulation
D. Maintaining an adequate blood pressure level
An older client with asthma is prescribed an inhaler. The nurse is assessing the client for possible factors that might impact the client's ability to comply with this treatment. Which condition would the nurse identify as impacting the client's compliance?
A. Severe arthritis
B. Type 2 diabetes
C. Cataracts
D. Ventricular tachycardia
The nurse admits a client to the skilled care unit with symptoms of fatigue, weakness, and lethargy. Before the primary care provider completes a diagnosis of depression, which laboratory test would the nurse expect to be completed?
A. Estrogen and testosterone
B. Random blood glucose and A1c
C. T4 and TSH
D. Triglyceride and cholesterol
The nurse is discussing nutritional health with an 89-year-old client. Which factor would the nurse interpret as a potential pathological process rather than a normal age-related change?
A. A decrease in the amount of pepsinogen released in the stomach
B. A decrease in peristalsis of the esophagus and stomach
C. A decrease in taste sensations and decreasing food intake
D. A decrease in the number of teeth and chewing ability
During the admission interview, the nurse learns that an older adult frequently experiences constipation. Which response by the nurse would be most appropriate?
A. "I will make sure that a laxative is prescribed for you while you are here in the hospital."
B. "Many older adults find that increasing their activity level and taking a mild laxative daily provides relief."
C. "Constipation is usually a sign of a more serious health problem, so I will pass that information on to your health care provider."
D. "There are measures that I can teach you, such as changing your diet and increasing the amount of fluids you drink."
An older client, who recently retired from working as a waitress for 40 years, describes leg cramps that interfere with sleeping. The client also experiences dizziness when getting out of bed first thing in the morning. The nurse interprets these findings as suggesting which condition?
A. Varicose veins
B. Arteriosclerosis
C. Thrombophlebitis
D. Peripheral aneurysms
A client with dementia has difficulty swallowing and frequently coughs when eating. Recently, the client has developed a nonproductive cough with a temperature of 99 °F. The nurse is concerned that this client is at risk for developing which health problem?
A. Lung cancer
B. Chronic bronchitis
C. Lung abscess
D. Chronic obstructive lung
A nurse is teaching an older client, who had been diagnosed with hypothyroidism, about the treatment plan. Which client statement indicates to the nurse that additional teaching is needed?
A. "I will continue to take the stool softener until my constipation is better."
B. "I will call the office if I have any chest palpitations."
C. "I will not need to refill this prescription once it's completed."
D. "I will start with a low dose but the dose may be gradually increased."
The nurse is caring for an older adult client who is prone to developing constipation. The client asks; "What can I do to prevent this from happening?" Which recommendation(s) will the nurse make? Select all that apply.
A. "Increase the amount of water you drink each day."
B. "Get exercise each day."
C. "Instill a saline enema each night before bed."
D. "Take an over-the-counter laxative each day."
E. "Eat more fruits and vegetables."
An older adult client with reduced kidney function was prescribed a barbiturate. The client experienced a severe adverse reaction, which was nearly fatal. The nurse would identify which event as being the most likely reason for this occurrence?
A. Increased drug dosage
B. Increased kidney filtration
C. Increased biological half-life of the drug
D. Increased reabsorption of the drugs into the blood
A newly admitted older adult client has severe edema in the lower extremities and no hair on the legs. Based on these findings, which assessment will the nurse perform?
A. Calculate fluid intake and output.
B. Compare the temperature of extremities.
C. Observe the gait for safety.
D. Palpate the peripheral pulses of the legs.
A nurse is teaching an older adult with a history of bronchitis how to reduce his signs and symptoms. The nurse determines that the teaching was successful when the client identifies which action? Select all that apply.
A. Maintaining a high fluid intake
B. Maintaining a healthy body weight
C. Consciously expectorating secretions
D. Avoiding respiratory infections
E. Using over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) regularly
A nurse is assessing a 94-year-old client of a nursing home who has diabetes mellitus. Which finding would lead the nurse to check the client's blood glucose level?
A. Restlessness and postural hypotension
B. Somnolence and slurred speech
C. Perspiration and incontinence
D. Numbness and weak pulses
The nurse observes the skin of an older adult client. The nurse decides to follow up the skin assessment with questions about the client's nutritional status based on which finding?
A. Purpura, which may indicate hyperglycemia
B. Fungal infection, which may indicate zinc deficiency
C. Poor skin turgor, which may indicate overhydration
D. Persistent "goosebumps," which may indicate a vitamin deficiency
A nurse is reviewing the medication history of a newly admitted older adult client. The nurse notes that the client has been taking a beta-blocker for many years despite no apparent history of hypertension or cardiac disease. Which action would the nurse take?
A. Hold the drug in the short term until an indication is determined
B. Monitor the client's blood pressure and apical heart rate closely
C. Request that the health care provider reconsider the use of the drug
D. Investigate and provide non-pharmacological measures to replace the drug