Question 1

The nurse teaching a 79-year-old with type 2 diabetes about the importance of regular exercise suggests that the client:
A)swim 10 laps in the community center pool three times a week.
B)enroll in a daily lunch time aerobics class at the senior center.
C)lift 5 pound weights in a routine of 10 repetitions in each arm.
D)walk on the treadmill each morning for 30 minutes.

Accepted Answer

Older adults may derive the greatest benefit from morning exercise because that is the time of greatest insulin resistance.

Question 2

The nurse is preparing to provide an older newly diagnosed diabetic client with information regarding type 2 diabetes.The nurse initially:
A)asks the client whether they would prefer to watch a video or read a pamphlet.
B)invites the client's spouse to be present during the instruction.
C)selects a quiet, well-lighted space for the class.
D)ensures that the client is pain-free and comfortably seated.

Accepted Answer

Cognitive function and learning styles vary, so knowing the client's preferred learning style facilitates education. Some individuals prefer to learn by visual methods, others by listening, and still others by experiencing contact in a hands-on approach.

Question 3

The nurse recognizes that an older adult on both antihypertensive and antidepressant drug therapies has a specific need for:
A)regular blood pressure monitoring.
B)an effective history focusing on sexual function.
C)an increase in daily fluid intake.
D)frequent assessment of emotional stability.

Accepted Answer

Drugs such as oral contraceptives, hormone replacement, antihypertensives, antidepressants, or sedatives can cause a sexual arousal disorder as a side effect.

Question 4

During the daily assessment of an older adult client 2 days after abdominal surgery, the nurse observes signs that the client may have an underactive thyroid.The data supporting this suspicion includes:
A)heat intolerance, low-grade fever, and patchy hair loss.
B)polycythemia, tachycardia, and oral candidiasis.
C)muscle cramps, fatigue, and cold intolerance.
D)increased blood pressure, postural hypotension, and blurred vision.

Accepted Answer

Older clients are seen with complaints of fatigue, cold intolerance, weight gain, muscle cramps, paresthesias, and confusion which are symptoms of hypothyroidism but often attributed to old age. Application (Apply)

Question 5

The nurse suspects that an older client with elevated plasma triglyceride levels as possibly experiencing metabolic syndrome when assessment observations also include which of the following? Select all that apply.
A)Blood pressure of 148/90 mm Hg
B)A fasting blood glucose of 109 mg/dL
C)Reports of frequent urination
D)Weight measurement of 50 inches
E)HDL level of 52 mg/dL

Accepted Answer

Metabolic syndrome's clinical criteria includes increased waist circumference (population-specific) plus any two of the following:
 (1) blood pressure >129/84 mm Hg or taking hypertension medication
(2) plasma triglyceride levels over 149 mg/dL or taking triglyceride medication
(3) high-density lipid levels less than 40 mg/dL in men or less than 50 mg/dL in women or taking HDL-C medication
(4) fasting glucose >99 mg/dL (including patients with diabetes).

Question 6

The nurse caring for an older adult with type 2 diabetes mellitus places importance on assessing the client for:
A)painful nodules on the fingers and toes.
B)reddened rash and brittle nails on the hands.
C)heartburn and flatus after meals.
D)skin temperature and hair growth pattern on the legs.

Accepted Answer

Insulin resistance causes increased production of inflammatory cytokines correlating with the development of type 2 diabetes mellitus and atherosclerotic vascular disease.

Question 7

Aware that older adult clients often present with nonclassic symptoms of type 2 diabetes mellitus, the nurse is particularly suspicious of a client reporting:
A)bouts of diarrhea alternating with periods of constipation.
B)recent problems reading and an infected sore on his toe that won't heal.
C)periods of depression and severe indigestion after eating.
D)dizziness when getting up too quickly and a red rash on the hands.

Accepted Answer

Often a newly diagnosed older individual will describe symptoms of fatigue, blurred vision, weight change (gain or loss), and infections.

Question 8

A 66-year-old is being evaluated for an underactive thyroid gland.The diagnosis of hypothyroidism is supported when the nursing assessment notes:
A)2-cm wound noted on medial aspect of left foot.
B)apical rate: 98/min.
C)client report that "I always wear a sweater."
D)weight loss of 10 pounds over 6 weeks.

Accepted Answer

Older clients are seen with complaints of fatigue, cold intolerance, weight gain, muscle cramps, paresthesias, and confusion.

Question 9

The nurse responsible for teaching a newly diagnosed diabetic client who is obese about his metformin prescription includes which of the following warnings? Select all that apply.
A)Alcohol intake is contraindicated when taking oral hypoglycemic agents.
B)Metformin is sometimes poorly tolerated by overweight clients.
C)Oral hypoglycemic agents can increase the risk of hyperglycemia.
D)Metformin has been the cause of anorexia in older clients.
E)Vitamin D absorption is affected by oral hypoglycemic agents.

Accepted Answer

Recent studies indicate that metformin, classified as a biguanide, may be the drug of choice for overweight clients. Side effects such as anorexia, nausea, and abdominal discomfort may, however, limit its use in older adults. Alcohol is contraindicated when taking oral hypoglycemic agents.

Question 10

The suspicion that an older adult client is experiencing hyperthyroidism is supported when the nursing assessment documents the symptoms most commonly observed in this cohort includes which of the following? Select all that apply.
A)Tremors
B)Heat intolerance
C)Tachycardia
D)Palpable goiter
E)Atrial fibrillation

Accepted Answer

The classic geriatric presentation of Hyperthyroidism includes tachycardia, fatigue, tremors, and nervousness in contrast to tachycardia, heat intolerance, and fatigue in younger patients. An enlarged, palpable goiter is present in 60% of older adults with hyperthyroidism. The most common complication, occurring in 27% of geriatric hyperthyroid patients, is atrial fibrillation that does not convert back to sinus rhythm when a euthyroid state is achieved.

Question 11

The nurse shows an understanding of the effective assessment of an older adult diabetic client's cardiac status when documenting:
A)radial pulse: 88 and regular.
B)carotid pulses equal and strong.
C)BP 126/78 recumbent and 122/78 sitting.
D)nail beds pale in color.

Accepted Answer

To assess circulation, the nurse should take an apical pulse, noting rate and rhythm; check pedal pulses bilaterally; and note the presence of hair on the lower extremities. The nurse should take blood pressure measurements with the client in both recumbent and sitting positions, note any dizziness associated with a change of position, and assess the respiratory rate, depth, and chest sounds.

Question 12

A 73-year-old is being admitted to an assisted living facility.During the admission assessment and history, the nurse suspects the client may be experiencing primary osteoporosis when noting:
A)the client's report an allergy to dairy produces.
B)a lactase enzyme among the client's drug regime.
C)bones in one of the client's lower legs are shorter than in the other.
D)the client is ½ inch shorter than he was at his last physical.

Accepted Answer

Dorsal kyphosis, chronic back pain, and loss of height are common signs of primary osteoporosis in older persons.

Quiz 25: Endocrine Function

The nurse teaching a 79-year-old with type 2 diabetes about the importance of regular exercise suggests that the client:

The nurse is preparing to provide an older newly diagnosed diabetic client with information regarding type 2 diabetes.The nurse initially:

The nurse recognizes that an older adult on both antihypertensive and antidepressant drug therapies has a specific need for:

During the daily assessment of an older adult client 2 days after abdominal surgery, the nurse observes signs that the client may have an underactive thyroid.The data supporting this suspicion includes:

The nurse suspects that an older client with elevated plasma triglyceride levels as possibly experiencing metabolic syndrome when assessment observations also include which of the following? Select all that apply.

The nurse caring for an older adult with type 2 diabetes mellitus places importance on assessing the client for:

Aware that older adult clients often present with nonclassic symptoms of type 2 diabetes mellitus, the nurse is particularly suspicious of a client reporting:

A 66-year-old is being evaluated for an underactive thyroid gland.The diagnosis of hypothyroidism is supported when the nursing assessment notes:

The nurse responsible for teaching a newly diagnosed diabetic client who is obese about his metformin prescription includes which of the following warnings? Select all that apply.

The suspicion that an older adult client is experiencing hyperthyroidism is supported when the nursing assessment documents the symptoms most commonly observed in this cohort includes which of the following? Select all that apply.

The nurse shows an understanding of the effective assessment of an older adult diabetic client's cardiac status when documenting:

A 73-year-old is being admitted to an assisted living facility.During the admission assessment and history, the nurse suspects the client may be experiencing primary osteoporosis when noting: