Question 1

In reviewing changes in the older adult,the nurse recognizes that which of the following statements related to cognitive functioning in the older client is true?

Accepted Answer

Delirium is a potentially reversible cognitive impairment that is often due to a physiological cause such as an electrolyte imbalance,cerebral anoxia,hypoglycemia,medications,tumors,cerebrovascular infection,or hemorrhage.Delirium is not always easily distinguishable from irreversible dementia.Because of the close resemblance between delirium and dementia,the presence of delirium must be ruled out whenever dementia is suspected.The cause of senile dementia (e.g. ,Alzheimer's disease)is not known.Medications and drug effects can cause delirium.Dementia is not an inevitable outcome of aging.

Question 2

In performing a physical assessment for an older adult,the nurse anticipates finding which of the following normal physiological changes of aging?

Accepted Answer

Normal physiological changes of aging include increased airway resistance in the older adult.The older adult would be expected to have decreased perspiration and drier skin as they experience glandular atrophy (oil,moisture,sweat glands)in the integumentary system.The older adult would be expected to have a decrease in saliva.A normal physiological change of the older adult related to hearing is a loss of acuity for high-frequency tones (presbycusis).

Question 3

The nurse is aware that the majority of older adults:

Accepted Answer

The majority of adults are indeed active within their community.The majority of older adults live with a spouse or have other living arrangements such as living with a family member.Most older adults live in noninstitutional settings.Most older adults are able to care for themselves.

Question 4

Which of the following statements made by a family member of a client recently diagnosed with Alzheimer's disease is most reflective of an understanding of this disease process?

Accepted Answer

Medications can slow the process of Alzheimer's disease considerably when prescribed appropriately.There is no cure for Alzheimer's disease.This option suggests that the family member still clings to the hope that there is a cure.Alzheimer's disease usually progresses gradually with a deterioration in function,but medications can be given to slow the progression of symptoms,not halt them.Although Alzheimer's disease usually progresses gradually with a deterioration in function with some clients living years after the diagnosis of Alzheimer's disease,this option does not reflect the best understanding because no mention of management is made.

Question 5

Which of the following statements accurately reflects data that the nurse should use in planning care to meet the needs of the older adult?

Accepted Answer

This is a true statement.Approximately two thirds of older adults use prescription and nonprescription drugs with one third of all prescriptions being written for older adults.Approximately 90% of adults older than 65 have at least one chronic health condition.Approximately 70% of older adults have multiple chronic conditions with arthritis,hypertension,heart disease,vision impairment,and diabetes mellitus being the most common in noninstitutionalized older adults.Heart disease is the leading cause of death in older adults.Nutritional needs of older adults are affected by their levels of activity and by clinical conditions.

Question 6

A client has been recently diagnosed with Alzheimer's disease.When teaching the family about the prognosis,the nurse must explain that:

Accepted Answer

Alzheimer's disease usually progresses gradually with a deterioration in function.Medications,not diet and exercise,can slow the process of Alzheimer's disease considerably.Clients may live years after the diagnosis of Alzheimer's disease.There is no cure for Alzheimer's disease but medications can be given to slow the progression of symptoms.

Question 7

Which of the following responses by an older-adult client is most reflective of a need for further education by the nurse regarding the physiological changes associated with the older adult?

Accepted Answer

Although some "forgetfulness" is accepted,memory loss is not a normal physiological change of aging.This expressed fear requires further education by the nurse so as to help eliminate the client's concerns.A common physiological change in the older-adult client is an increased sensitivity to glare,which makes night driving difficult.A common physiological change in the older-adult client is an alteration in visual acuity,which would require regular vision check-ups.Hyperlipidemia is a concern regarding cardiac health and should be considered by the older adult.

Question 8

A 70-year-old client asks the nurse to explain her hypertension as she is to have her blood pressure checked each shift.An appropriate response by the nurse as to why older clients often experience hypertension is because of:

Accepted Answer

Although hypertension is not a normal physiological change of aging,older adults often experience hypertension because of vascular changes and accumulation of plaque on arterial walls,both of which reduce contractility.Vascular changes include thickening of vessel walls,narrowing of vessel lumen,and loss of vessel elasticity.Myocardial damage is not the reason for older adults commonly experiencing hypertension.Hypertension is not caused by a reduction in physical activity.Older adults with hypertension should be counseled on limiting fat and salt in their diet.However,ingestion of processed foods high in salt is not the reason why older clients often experience hypertension.

Question 9

To assist older adults to meet their needs for sexuality,the nurse should recognize that the greatest impact on the sexuality of older adults is:

Accepted Answer

Many older adults use prescription medications that depress sexual activity,such as antihypertensives,antidepressants,sedatives,or hypnotics.Some drugs increase libido in older adults.For example,phenothiazines increase sexual desire in women,and levodopa has a similar effect in men.It is a common misconception that older adults are not interested in sex.The older adult's libido does not decrease,although frequency of sexual activity may decline.Physiological changes may have an adverse influence on sexual activity.The older man may experience decreased firmness in his erection,a decreased need for ejaculation with orgasm,or a longer recovery period between episodes of intercourse.The older woman may experience vaginal dryness.Information about the prevention of sexually transmitted diseases should be included when appropriate.

Question 10

The nurse works with elderly clients in a wellness screening clinic on a weekly basis.Which of the following statements made by the nurse is the most therapeutic regarding their mobility?

Accepted Answer

Clients in the older adult age group should be advised to exercise their joints regularly to their level of tolerance.Shoulder pain is not a normal finding in the older adult.It may indicate a condition such as arthritis.Exercise programs should begin conservatively and progress slowly.Periodic and thorough review of all medications being used is important to restrict the number of medications used to the fewest necessary.Concurrent use of medications increases the risk for adverse reactions.

Question 11

A nurse is performing a physical examination on an older-adult client in an assisted living facility.On completion of the examination,the nurse compares the results to findings expected for individuals in this age-group.An expected finding for this client is:

Accepted Answer

A common physiological change in the older-adult client is an increased sensitivity to glare.Increased tactile responsiveness would not be an expected finding in the older-adult client.An expected physiological change in the older adult-client is a loss of hearing acuity for high-frequency tones (presbycusis).The older adult has decreased thoracic expansion during ventilation because of musculoskeletal changes.

Question 12

The nurse is presenting an information session on nutritional guidelines at a senior living center.Which of the following foods meets the recommended nutritional guidelines for older adults?

Accepted Answer

Grilled chicken would be a good source of protein that is also low in fat.A hamburger and french fries are high in fat content and calories,making them a less desirable food choice.A hot dog with pickle relish is high in fat and sodium.Good nutrition for the older adult includes a limited intake of fat and salt.A baked potato with cheese and bacon bits is higher in calories and fat.A plain baked potato would be a healthier food choice.

Question 13

Which of the following behaviors shows the greatest risk to an older adult as they attempt to minimize the effects of the aging process?

Accepted Answer

Some older adults may deny functional declines associated with aging and refuse to ask for assistance with tasks that place their safety at great risk.Some older adults find it difficult to accept themselves as aging and attempt to conceal physical evidence of aging with cosmetics.Older adults who find it difficult to accept themselves as aging may understate their age when asked.Spending more time with other older adults is indicative of the older adult's acceptance of personal aging.Those who find it difficult to accept themselves as aging may avoid activities designed to benefit older adults,such as senior citizens' centers and senior health promotion activities.

Question 14

The nurse is presenting an information session on nutritional guidelines at a senior living center.Incorporated into the discussion are the recommendations for nutritional intake for individuals of this age-group,which include a reduction in:

Accepted Answer

Good nutrition for older adults includes a limited intake of refined sugars.Fiber should not be reduced as it has benefits of aiding bowel elimination and lowering cholesterol.Protein should not be reduced.Protein intake may be lower than recommended if older adults have reduced financial resources or limited access to grocery stores.Difficulty chewing meat may also limit protein intake.Vitamin A does not need to be reduced in the older adult.Vitamin intake may be less than recommended if shopping for fresh fruits and vegetables is difficult.

Question 15

The nurse is planning client education for an older adult being prepared for discharge home after hospitalization for a cardiac problem.Which nursing action addresses the most commonly determined need for this age-group?

Accepted Answer

Approximately two thirds of older adults use prescription and nonprescription drugs with one third of all prescriptions being written for older adults.A system that allows the client to sort his medication for daily dosage would help minimize the risk of overdosing as well as missing ordered medications.While this option addresses the risk of injury in the home,it does not address the greatest need experienced by this age-group-the risk of overmedication or undermedication of prescribed drugs.While this option does address the client's nutritional needs,it does not address the greatest need experienced by this age-group-the risk of over- or under-medication of prescribed drugs.Although this option does address the client's need to monitor the medications he is prescribed,it does not address the greatest need experienced by this age-group-the risk of overmedication or undermedication of prescribed drugs on a daily basis.

Question 16

Which of the following nursing questions is best directed towards the assessment of a normal finding regarding physiological changes in an older-adult client?

Accepted Answer

A common physiological change in the older-adult client is an increased sensitivity to glare,which makes night driving difficult.Decreased sexual drive is not a normal physiological change of aging.Memory loss is not a normal physiological change of aging.Hyperlipidemia is not a normal physiological change of aging,nor should it be monitored only by the older adult.

Question 17

There are factors that influence the musculoskeletal system associated with aging.The nurse recognizes that with age:

Accepted Answer

Older adults who exercise regularly do not lose as much bone and muscle mass or muscle tone as those who are inactive.Postmenopausal women have a greater problem with osteoporosis than older men.Muscle fibers are reduced in size with aging.Muscle strength diminishes in proportion to the decline in muscle mass.

Question 18

The nurse,preparing to discharge an 81-year-old client from the hospital,recognizes that the majority of older adults:

Accepted Answer

The majority of older adults are interested in their health and are capable of taking charge of their lives.Most older adults do not require institutional care.The majority of older adults have social or family support.Most older adults live with a spouse or have other living arrangements,such as living with a family member.Most older adults receive Social Security benefits and are able to afford medical treatment.

Question 19

In the assessment of older-adult clients,it is often difficult to discriminate between delirium and dementia.Delirium is characterized by:

Accepted Answer

Delirium is characterized by short,diurnal fluctuations in symptoms and is worse at night,in darkness,and on awakening.Delirium has an abrupt onset.Dementia has a slow progression.Delirium lasts hours to less than 1 month,seldom longer.Dementia may last months to years.Delirium is characterized by fluctuating alertness;the client may be lethargic or hypervigilant.Alertness is generally normal with dementia.

Question 20

A long-term care facility sponsors a discussion group on the administration of medications.The participants have a number of questions concerning their medications.The nurse responds most appropriately by saying:

Accepted Answer

The nurse should encourage the older adult to question the physician and/or pharmacist about all prescribed drugs and over-the-counter drugs.The older adult should be taught the names of all drugs being taken,when and how to take them,and the desirable and undesirable effects of the drugs.The nurse should teach the client how to avoid adverse side effects and to report them to their care provider if they occur.If the client is disturbed by minor side effects,it could be an indication of beginning drug toxicity.Another possibility is that the client may become noncompliant with their medication because they dislike how the side effects make them feel.The hepatic system is not the only system responsible for the pharmacotherapeutics of medication.Older adults are at risk for adverse reactions because of age-related changes in the absorption,distribution,metabolism,and excretion of drugs.Changes in the GI system may affect absorption,distribution may be affected by changes in body composition and by reduced serum albumin levels,and changes in kidney functioning may impair excretion.

Quiz 14: Older Adult