Question 1

The nurse is planning care for an older patient who is newly admitted. What nursing interventions are necessary to prevent the geriatric cascade? Select all that apply.

Accepted Answer

Frequent assessment of pressure ulcers, monitoring of confusion, and monitoring the risk of thrombophlebitis are necessary interventions to prevent the geriatric cascade. These actions help in identifying and managing common issues in older patients that can lead to a rapid decline in health. Usage of physical and chemical restraints (C) and indwelling urinary catheters (D) are generally avoided unless absolutely necessary, as they can increase the risk of complications such as infections, delirium, and physical harm.

Question 2

The nurse is admitting an older frail patient with dementia as a resident in a long-term care facility. Which problem is a priority when planning interventions for this patient's care?

Accepted Answer

Polypharmacy is a priority concern because it involves the use of multiple medications, which can increase the risk of drug interactions, adverse effects, and medication nonadherence, especially in older adults with dementia. Addressing polypharmacy can help in reducing these risks and improving the patient's overall health and safety.

Question 3

The nurse is concerned that an older patient with a chronic illness is on a trajectory towards frailty and dependence. From the nursing assessment findings listed, which is the priority?

Accepted Answer

A decline in functional ability is a priority because it directly impacts the patient's independence and quality of life, potentially leading to frailty and dependence.

Question 4

A frail older patient with diabetes is diagnosed with a urinary tract infection. Which statement from the patient would concern the nurse to further assess for complications?

Accepted Answer

The patient's statement "My vaginal area is itching" would concern the nurse to further assess for complications. This symptom may indicate a yeast infection, which is a common complication of urinary tract infections in older patients with diabetes.

Question 5

During a nursing assessment, a frail older patient with cognitive impairment has a higher level of confusion than normal. What symptoms indicative of a urinary tract infection should the nurse further assess?

Accepted Answer

The answer of During a nursing assessment, a frail older...

Question 6

An older patient with chronic renal failure is admitted; the healthcare provider is planning modified care for this patient. Nursing interventions for modified level of care would focus on which of the following? Select all that apply.

Accepted Answer

The answer of An older patient with chronic renal failure...

Question 7

The nurse is caring for an older patient recently diagnosed with cancer. The nurse is concerned about the patient moving towards a trajectory of frailty. What laboratory findings support the nurse's concern?

Accepted Answer

Serum albumin levels less than 2.5 g/100 dL indicate malnutrition or a chronic disease state, both of which are risk factors for frailty in older adults.

Question 8

The nurse manager is concerned about the increased number of medication adverse effects being observed in older patients. What should the manager do to reduce these effects? Select all that apply.

Accepted Answer

The answer of The nurse manager is concerned about the...

Question 9

The nurse is assessing an older patient in a skilled facility for frailty. During the assessment, the nurse determines frailty through the presence of which characteristics? Select all that apply.

Accepted Answer

Frailty in older adults is often characterized by poor endurance, low activity tolerance, and generalized weakness. Unplanned weight loss, not gain, and decreased grip strength are also common indicators of frailty.

Question 10

An older patient is diagnosed with cardiovascular disease. The nurse is planning care for him; which factors can contribute to frailty? Select all that apply.

Accepted Answer

Frailty in older adults can be influenced by decreased sense of thirst leading to dehydration, electrolyte imbalances affecting bodily functions, inability to walk indicating reduced physical capability, and polypharmacy which can cause adverse effects and interactions.

Question 11

An older patient is demonstrating delirium since being admitted from a nursing home for treatment of a wound infection. What should the nurse identify as the most likely cause for the patient's delirium?

Accepted Answer

A windowless hospital room can contribute to delirium in older patients due to lack of natural light and disruption of the sleep-wake cycle, which can exacerbate confusion and disorientation.

Question 12

The nurse is caring for an older patient who is receiving palliative care. Which intervention is the highest priority for this patient?

Accepted Answer

Pain management is the highest priority in palliative care, aiming to alleviate suffering and improve the quality of life for patients with serious illnesses.

Question 13

The nurse is preparing a community education program focusing on cardiovascular disease in the older patient. Which information should the nurse include?

Accepted Answer

A woman of 70 is as likely as a man to develop heart disease. This is because the protective effects of estrogen on the heart diminish after menopause, equalizing the risk between men and women as they age.

Question 14

A multidisciplinary team in a long-term care facility is meeting with the family of a frail older patient to discuss care issues and concerns. What key issues should be addressed in the conference? Select all that apply.

Accepted Answer

The answer of A multidisciplinary team in a long-term care...

Question 15

The nurse is assessing an older patient's risk for developing problems while hospitalized for an acute illness. The Hospital Admission Risk Profile (HARP) tool will be utilized. Which assessment areas would alert the nurse to a risk? Select all that apply.

Accepted Answer

The HARP tool assesses risk based on age, cognitive function, and independence in instrumental activities of daily living (IADLs). An age of 87, a cognitive function score of 7, and an IADL score of 5 indicate potential risks.

Question 16

An older patient admitted for treatment of pneumonia has severe osteoarthritis. The nurse notices that the client is progressing on a trajectory towards frailty. What nursing assessment findings support this?

Accepted Answer

Decreased stamina and deconditioning are signs of frailty.

Question 17

An older client asks the nurse what they can do to live to a healthy old age. Which response by the nurse promotes healthy aging?

Accepted Answer

Preventive and screening services are crucial for early detection and management of diseases, which can significantly contribute to healthy aging. Vaccinations, adequate nutrition, and appropriate physical activity, including weightlifting with proper guidance, are also important for maintaining health in older age.

Question 18

An older patient with diabetes is prescribed high-dose antibiotic therapy for a wound infection. Which effects of antibiotic therapy should the nurse further assess in relation to the patient?

Accepted Answer

Antibiotics can disrupt the normal gut flora, leading to diarrhea. This is a common side effect of antibiotic therapy, especially with high doses or prolonged use.

Question 19

A frail older patient is more at risk for poor treatment outcomes in an acute care setting due to what factors? Select all that apply.

Accepted Answer

Frail older patients are more susceptible to nosocomial infections due to weakened immune systems (A), have a higher risk of adverse outcomes from treatments due to frailty and comorbidities (B), and cognitive impairments can complicate care and recovery (E).

Question 20

The nurse is planning a presentation for nursing assistants on caring for older patients. Which criteria should the nurse include when explaining frailty? Select all that apply.

Accepted Answer

Frailty in older patients is characterized by slowness, low activity, weakness and exhaustion, and unplanned weight loss of at least 10 lbs. in a year. Short-term memory loss is not a criterion for frailty but may indicate cognitive impairment or other health issues.

Quiz 24: Caring for Frail Elders With Comorbidities