Family
An incapacitated older adult with dementia is brought to the emergency department by a rescue squad after falling and breaking an arm. When the client’s children arrive, they are adamantly against the client having any medical care and insist that prayer will heal the broken arm. What action by the nurse is most appropriate?
a. Allow the family to pray with the client then escort them to the waiting room.
b. Call security to keep the family from interfering with medical care.
c. Check facility policies and contact the hospital social worker.
d. Call the police who can force the family to accept medical care.
c. Check facility policies and contact the hospital social worker.
A 76-year-old client was admitted earlier and diagnosed with a stroke on the right hemisphere of the brain. Deficits include left hemiparalysis. In planning the discharge for the client, the nurse meets with the client and family members to discuss placing the client for rehabilitation.
Which criteria is important to use for the health team to decide the most appropriate setting for care?
a. Availability of supports
b. Financial resources
c. Insurance type
d. Functional status
d. Functional status
The nurse is caring for a Chinese client who subscribes to the yin and yang theory of treating illness. The client tells the nurse that she has a hot illness. The nurse explains to the oncoming shift that the client will likely wish to consume which of the following in the diet to treat illness?
a. Foods that are consumed yang or hot
b. Foods that are considered yin or cold
c. Foods more hot than cold
d. Foods more cold than hot
b. Foods that are considered yin or cold
The adult child of a long-term care facility resident receives a phone call from the director of nursing stating that her parent has 30 days to move out of the home. Under what conditions can a facility require a resident to move? Select all that apply:
a. Nonpayment for services received
b. Needs exceeding what the facility can provide
c. Stay is no longer required based on the resident’s medical condition
d. Facility is going out of business
e. Frequent disruptive behavior during the night
A, B, C, D
The nurse is planning care based on the biologic radical theory of aging. Based on the dynamics inherent in this theory, which of the following recommendations would the nurse recommend to the client to prevent destruction of tissue?
a. Avoid excessive intake of zinc or magnesium
b. Supplement his or her diet with vitamins C and E
c. Increase intake of complex carbohydrates
d. Avoid the use of alcohol or tobacco
b. Supplement his or her diet with vitamins C and E
As the client is preparing to be transferred for rehabilitation, the client asks how he is supposed to manage his financial affairs. The client is very close to their children. What legal recourse does the older person have?
a. Guardian
b. Conservator
c. Health care proxy
d. Financial Power of Attorney
d. Financial Power of Attorney
An 80-year-old client is admitted to rule out bacterial pneumonia. The only abnormal assessment values include heart rate 102 bpm, slight cyanosis of the nail beds, and mild confusion. The client’s daughter questions the possibility of pneumonia stating, “He isn’t coughing, or having any difficulty breathing.” What is the nurse’s most appropriate response?
a. “We are very lucky to determine the problem in its early stage.”
b. “Respiratory problems develop only after the infection is well established.”
c. “People your dad’s age often lack the muscular strength to cough.”
d. “Older adults frequently lack the typical signs of a respiratory infection.”
d. “Older adults frequently lack the typical signs of a respiratory infection.”
A client who was raised in the 1930s has been prescribed several medications for a variety of chronic health issues. To help ensure medication compliance based on knowledge of this age cohort, what action by the nurse is best?
a. Provides a detailed explanation about the importance of taking the medications appropriately.
b. Educates the client about the cost-effectiveness of generic brands of the prescribed medications.
c. Includes family members with the client in the medication education plan.
d. Offers suggestions on ways to minimize the risk of “forgetting” to take medication correctly.
b. Educates the client about the cost-effectiveness of generic brands of the prescribed medications.
19. The student asks the gerontologic clinic nurse why so many older people are women. What information does the nurse provide? Select all that apply.
a. Reduced maternal mortality
b. Decreased deaths from infectious diseases
c. More deaths from chronic disease in men
d. The protective role of estrogen
e. Women tend to smoke and drink less than men
The geriatric nurse is admitting a client to the assisted living facility. To plan for a comprehensive care, the nurse utilizes the Barthel Index to obtain information. Information analyzed from this tool will be essential for which of the following?
a. Planning the amount of help that the client will need with ADLs
b. Counseling the client about realistic expectations for achieving independence
c. Consulting appropriate interdisciplinary team members
d. Assigning appropriate staff to the unit to ensure safety needs of all clients are met
a. Planning the amount of help that the client will need with ADLs
While the children of a 72-year-old man voice concern about their father living alone after having a mild stroke that resulted in only minimal disability, the client angrily disagrees, stating that he’s always managed on his own and can do so now. What response is most helpful for the nurse to make to the family?
a. Assuring them that their father’s physical limitations should not cause a safety issue
b. Assisting them to discuss with their father assistance that will allow him to live independently
c. Advocating for a social service consult to arbitrate the conflict
d. Advising the client to accept the services of a home care aide on a short term trial basis
b. Assisting them to discuss with their father assistance that will allow him to live independently
A 76-year-old postsurgical diabetic client has reported feeling dizzy and clammy. The daily serum glucose level shows the client’s levels to be within normal limits. The gerontologic nurse shows an understanding of established health norms for the older adult when stating
a. “This client’s normal may not be within the typical lab norms.”
b. “I’ll ask the lab to rerun the test so we can double-check the results.”
c. “There must be another reason for the symptoms.”
d. “I’ll compare the client’s baseline lab work with today’s results.”
a. “This client’s normal may not be within the typical lab norms.”
Which client is most likely to be seen at a clinic that services older adults who are at or below the poverty level?
a. A Hispanic male living with extended family
b. An African American male living with a spouse
c. A Hispanic female who lives alone
d. An African American female who lives with her sister
c. A Hispanic female who lives alone
A nurse is teaching a class of older adults about the expected physiologic changes of aging. Which of the following changes should the nurse include in the discussion? Select all that apply.
a. More difficulty seeing due to a greater sensitivity to glare
b. Decreased cough reflex
c. Decreased bladder capacity
d. Decreased systolic blood pressure
e. Dehydration of intervertebral discs
A, B, C, E
The nurse is caring for an older adult client in need of hospitalization. The nurse is aware this client is a member of an ethnic group that holds a collectivist perspective on community. What action by the nurse best addresses the client’s medical needs?
a. Calling an interpreter to assure the client is making an informed decision.
b. Assuring the client that his spiritual advisor will meet him at the hospital.
c. Arranging for admission to a hospital that is familiar with this client’s culture.
d. Offering to phone the client’s family and ask them to come in and discuss the hospitalization.
d. Offering to phone the client’s family and ask them to come in and discuss the hospitalization.
An older client with cognitive impairment is being cared for by family members. They have expressed concerns about providing appropriate care as his functional level declines. How can the nurse best respond?
a. “I’m glad that you are interested enough in his care that you’ve expressed this concern.”
b. “His abilities will certainly continue to decline. This is the time to discuss other care options.”
c. “You are right to be concerned. Let’s talk about what issues may come up as he declines further.”
d. “As the condition is going to worsen, you should prepare for when you can’t meet his needs.”
c. “You are right to be concerned. Let’s talk about what issues may come up as he declines further.”
A nurse is teaching about risk factors of developing a stroke with a group of older adult clients. Which of the following nonmodifiable risk factors should the nurse include in the teaching?
a. History of smoking
b. Obesity
c. History of hypertension
d. Race
d. Race
A nurse working with older adults recognizes that the client at greatest risk for homelessness is the
a. Female with a psychiatric diagnosis.
b. Male with a chronic illness.
c. Female with a history of social isolation.
d. Male with an alcohol abuse issue.
a. Female with a psychiatric diagnosis.
What provisions for nursing service are part of the Omnibus Budget Reconciliation Act (OBRA) as it pertains to long-term facilities? Select all that apply
a. Resident assessments
b. Annual screenings
c. Minimum staffing
d. Ensuring resident rights
e. Dietary requirements
A, B, C, D
When discussing stressors with the primary caregiver of an 83-year-old client, the nurse explores the issue of dissolving familiar social boundaries by asking which question?
a. “Has it been a problem taking over the role of head of the family?”
b. “What do you do to help relax and revitalize yourself?”
c. “Do you find it difficult to ask for help when you need it?”
d. “Are there any physical care tasks that you find difficult to complete?”
d. “Are there any physical care tasks that you find difficult to complete?”
What is the purpose of respite care for adult family members caring for the elderly client?
a. Placement in a nursing home for long-term care
b. Provisions for short-term accommodations so care-givers can have a break
c. Placement of unlicensed personnel in the home to help with care
d. Place where an older person can stay for the day and engage in activities
b. Provisions for short-term accommodations so care-givers can have a break
As the nurse talks to the client about the changes in his life due to the stroke, the nurse uses Erickson’s Theory of Psychological Development to assess the development of personal ego structure. Which of the following nursing actions would be an appropriate intervention for a 76-year-old client?
a. Determine his feelings regarding the effects of aging on his physical being
b. Describe his feelings regarding what he expects the future to hold for him
c. Identify aspects that provide him either a sense of self-worth or pleasure
d. Elaborate on his feeling about the prospect of his personal health
c. Identify aspects that provide him either a sense of self-worth or pleasure
The nurse is presenting an educational workshop at a senior center where most of the clients will be 75 years or older. What does the nurse consider about this population when designing the presentation?
a. Most of these clients only have a high school diploma.
b. Many clients may have lower reading skills so handouts should be simple.
c. A great number of clients never attained a high school.
d. A lot of these clients went to college on the GI bill.
a. Most of these clients only have a high school diploma.
The clinic nurse caring for an older diabetic client with a sixth-grade education anticipates that the
client may have trouble with which of the following? Select all that apply.
a. Recognizing the importance of keeping clinic appointments.
b. Following a low-carbohydrate diet.
c. Paying for insulin and syringes.
d. Deciding on a primary health care provider.
e. Naming a health care surrogate.
A, B, C
The nurse uses the LEARN Model when providing care. What event best demonstrates that this model has been successful?
a. The nurse learns about the client’s culture and how it impacts care
b. The client and nurse agree on a mutually acceptable plan of action
c. The nurse listens carefully to the client’s concerns and beliefs
d. The client understands how medical care will be beneficial
b. The client and nurse agree on a mutually acceptable plan of action