Ch. 7 Older Adults Flashcards
(20 cards)
While obtaining a health history, the nurse finds that the patient takes daily supplements of the antioxidants beta carotene, selenium, and vitamin E. What biological aging theory is related to the use of these substances? a. Free radicals b. Cross-linking c. Somatic mutation d. Telomere-telomerase depletion
ANS: A
The free radical theory was initially proposed in 1956, and since then, research has focused on the use of antioxidants to slow the oxidative process caused by free radicals.
Which of the following is an element of a stochastic theory of aging? a. Programmed b. Transcription c. Neuroendocrine d. Immunological-autoimmunological
ANS: B
Transcription is an element of a stochastic theory; all of the others are elements of nonstochastic theories.
Which of the following is an appropriate approach that the nurse should use to facilitate learning in older adults?
a.
Using peer educators
b.
Avoiding issues of a personal nature
c.
Presenting material quickly to avoid fatigue
d.
Acknowledging the older adult’s dependence
ANS: A
A specific strategy to decrease anxiety and distractions when teaching older adults is to use peer educators to enhance learning.
In planning care for older adult patients with chronic illnesses, what does the nurse recognize that management of chronic illness requires?
a.
Institutionalization in long-term care facilities
b.
Adjusting to changes in the course of the disease
c.
Restricting social interactions outside of the home
d.
Frequent hospitalizations for treatment of acute episodes of the illness
ANS: B
Individualized care is the standard of practice with older adults; therefore, it is important during the planning phase of managing chronic illness to adjust care to changes in the course of the disease.
What should be considered when developing the plan of care for an older adult who is hospitalized for an acute illness?
a.
Use a standardized geriatric nursing care plan.
b.
Consider preadmission functional abilities when setting goals.
c.
Minimize activity level during hospitalization.
d.
Plan for likely long-term care transfer to allow additional time for recovery.
ANS: B
The plan of care for older adults should be individualized and based on the patient’s current functional abilities, so it is important for the nurse to assess preadmission functional abilities when setting goals.
As the nurse is teaching a 72-year-old woman about her new medications, she replies that she “just can’t remember all that information anymore.” What knowledge about aging does the nurse use to understand why the woman may have difficulty learning about the medications?
a.
Intellectual ability declines with age.
b.
All mental abilities slow as individual’s age.
c.
Declining physical health can impair cognitive function.
d.
Impaired vocabulary and verbal function decrease reasoning with age.
ANS: C
The process of learning new information is slower in older adults with declining physical health as it can impair cognitive functioning, but the patient has given no indication that she will be unable to learn about the new medications.
Which of the following is a normal physiological age-related change of the cardiovascular system? a. Elastin and smooth muscle increases. b. Vessel rigidity decreases. c. Heart muscle decreases. d. Mitral valve constriction increases.
ANS: C
A normal physiological age-related change in the cardiovascular system is that the heart muscle decreases.
What data collection method does the nurse recognize as eliciting the most complete information during a geriatric assessment?
a.
Having the patient recount his or her health history
b.
Having the caregiver provide the information on the patient
c.
Using a reliable geriatric assessment instrument to evaluate the patient
d.
Having the patient provide a diary of medical conditions and treatments
ANS: C
The most complete information about the patient will be obtained through the use of an assessment instrument specific to the geriatric population, which will include information about medical diagnoses and treatments as well as about functional health patterns and abilities.
An older adult patient has experienced physiological changes of the cardiovascular system that are related to aging. What is an appropriate nursing diagnosis for the nurse to document for this patient?
a.
Fatigue related to decreased hemoglobin
b.
Activity intolerance related to bed rest deconditioning
c.
Fatigue related to loss of muscle strength and increased work of breathing
d.
Activity intolerance related to imbalance between oxygen supply and demand
ANS: D
Activity intolerance is a common nursing diagnosis for the older adult because of age-related cardiovascular changes.
Which of the following functions declines during old age? a. Fluid intelligence b. Spatial perception c. Mental performance speed d. Short-term recall memory
ANS: D
Short-term memory recall is a manifestation of healthy aging that declines during old age. Fluid intelligence and mental performance speed decline during middle age. Spatial perception remains constant or improves with aging.
In planning care for an older adult, what does the nurse recognize as a major goal of health promotion and prevention of health problems in the elderly?
a.
Adequate planning for post-hospital care
b.
Preventing the physiological degeneration of aging
c.
Teaching the older adult about alternative care options
d.
Increasing personal participation and responsibility in health
ANS: D
By increasing personal participation and responsibility in health, the nurse is assisting with the priority goals for the older adult, which contribute to gaining a sense of control, feeling safe, and reducing stress.
When performing a nutrition assessment of an older adult using the SCALES acronym, what would the nurse be assessing when documenting the findings from the “A” portion of this assessment tool? a. Anxiety b. Albumin level c. Appearance in general d. AC glucose level
ANS: B
The A in the SCALES acronym for a nutritional assessment if an older adult represents albumin levels; specifically, assessing if the albumin level is low.
What is an appropriate teaching topic to help prevent drug–drug interactions in an older adult patient taking many medications?
a.
“Do not take any over-the-counter drugs with your prescription drugs.”
b.
“Be sure a family member knows the name and use of all of your medications.”
c.
“Bring all the medications, supplements, and herbs that you use to every health care appointment.”
d.
“Use a medication reminder system so that you won’t forget to take your medications as scheduled.”
ANS: C
The most information about drug use and possible interactions is obtained when the patient brings all prescribed medications, over-the-counter medications, and supplements to every health care appointment.
The nurse assesses an older adult patient’s living arrangements and care needs with the knowledge that abuse of older adults often occurs in which of the following situations?
a.
Stress in the caregiver is overwhelming.
b.
Programs for the elderly are not being utilized.
c.
Several generations are providing the care.
d.
The older adult is not appreciative of those who provide care.
ANS: A
The intensity and complexity of caregiving place the caregiver at risk for high levels of stress. The caregiver may develop a sense of being overwhelmed and have feelings of inadequacy, powerlessness, and depression, which may lead to abuse of the older adult.
When admitting an older adult patient to the hospital, the nurse asks the patient about advance directives. The patient notes that he has a proxy directive for health care. What does the nurse recognize that the patient has done?
a.
Left instructions that are not legally binding about actions to be taken regarding his care in the event of a terminal or irreversible condition
b.
Designated another person to make legally binding health care decisions for him if he is unable to do so for himself
c.
Documented directions that are legally binding about actions to be taken regarding his care in the event of a terminal or irreversible condition
d.
Designated another person to make health care decisions for him if he is unable to do so for himself, but those decisions are not legally binding.
ANS: B
In a proxy directive, the older adult specifies who is to make health care decisions if the person becomes unable to make his or her wishes known.
Why is ageism an important concept to understand when caring for the elderly?
a.
May damage the self-esteem of older adults
b.
Increases social awareness of the needs of older adults
c.
Provides statistical information regarding the older adult population
d.
Promotes consideration of the diversity of the older adult population
ANS: A
Negative attitudes about aging may lead to disparities in the way older patients are treated, thus damaging their self-esteem.
Among the older population, what classification would represent a 78-year-old woman who has multiple health problems associated with her diabetes, including unplanned weight loss (7 kg over the past year), poor endurance, and low activity? a. Old-old b. Ill older adult c. Young-old d. Frail older adult
ANS: D
Frail older adult is a term used to identify those older adults who, because of declining physical health and resources, are most vulnerable. Risk factors include disability, multiple chronic illnesses, and the presence of geriatric syndromes. Frailty has been defined as the presence of three or more of the following: unplanned weight loss (4.5 kg in the last year), weakness, poor endurance and energy, slowness, and low activity.
The frail older adult is at particularly high risk for which one of the following health interferences? a. Hip fractures b. Malnutrition c. Overhydration d. Obesity
ANS: B
The frail older adult is at particular risk for malnutrition and problems with dehydration.
In establishing a therapeutic environment for an older adult patient, how can the nurse provide special considerations?
a.
Limiting the contact to 15-minute intervals
b.
Allowing greater time to gather a medical history
c.
Speaking slowly and loudly to ensure understanding
d.
Ensuring that the patient is free of pain and is comfortable
ANS: D
When beginning the assessment process, the nurse should attend to primary needs first, for example, ensuring that the patient is free of pain and does not need to urinate.
In planning discharge teaching for an older, homeless adult, what is a common reason that older homeless adults often do not utilize shelter and meal-site services?
a.
They are ashamed about being homeless.
b.
They fear that they will be institutionalized.
c.
They feel that they do not deserve community support.
d.
They feel that use of such services means they cannot make it on their own.
ANS: B
Fear of institutionalization may explain the reason the older homeless adult does not use shelter and meal-site services.
