The nurse in the long term care facility notes the patient never attends social events in the facility despite encouragement from staff. What is the best intervention for this patient?

A) Schedule time to sit with the patient
B) Allow the patient to spend time alone
C) Continue to encourage the patient to attend each event
D) Call the patient's family and request help getting the patient to participate

A

The nurse is contributing to the admission assessment of a patient. Which questions are most appropriate to determine if the patient is at risk for social isolation?
(Select all that apply.)

A) "What is your marital status?"
B) "Are you up-to-date on all of your immunizations?"
C) "What do you do for a living?"
D) "Is there a faith leader you would like me to contact?"
E) "Are you experiencing unresolved pain?"
F) "Are you involved in any clubs or groups?"

A, C, D, and F

The nurse is caring for aging patients who often experience role changes and losses. The nurse knows which factor increases the patient's successful adjustment to life after retirement?

A) Having several other meaningful roles remaining
B) Disliking the job from which he or she has retired
C) Being forced to retire due to health issues that no longer allow the patient to work
D) Being successful and having good memories of the job from which he or she has retired

A

What is the most appropriate intervention to use for an older adult who always stays in his or her room?

A) Tell the older adult, "It's time to go out and see people."
B) Use a wheelchair to transport the older adult to the activity room.
C) Spend one-on-one time discussing the older adult's concerns.
D) Call the family and request that they visit more often.

C

What characteristics place an older adult at increased risk for social isolation? (Select all that apply)

A) Sensory changes
B) Decreased physical mobility
C) Advanced age
D) Limited financial resources
E) Incontinence
F) Physical deformity
G) Belongs to an ethnic minority group

A, B, C, D, E and F

The nurse is setting up an education session with an 85-year-old patient who will be going home on anticoagulant therapy. Which strategy would reflect consideration of aging changes that may exist with this patient?

A.Show a colorful video about anticoagulation therapy.

B.Present all the information in one session just before discharge.

C.Give the patient pamphlets about the medications to read at home.

D.Develop large-print handouts that reflect the verbal information presented.

D

When developing the plan of care for an older adult who is hospitalized for an acute illness, the nurse should?

A.Use a standardized geriatric nursing care plan.

B.Plan for likely long-term-care transfer to allow additional time for recovery.

C. Consider the preadmission functional abilities when setting patient goals.

D.Minimize activity level during hospitalization.

C

When performing a comprehensive geriatric assessment of an older adult, focus of the nursing assessment is on the patient's:

A.Physical signs of aging.

B.Immunological function.

C.Functional abilities.

D.Chronic illness.

C

A 62-year-old patient has not been taking her medications. When questioning the patient, she discovers that her grandson recently moved in with her, and is managing her accounts. He has been refusing to buy her medications and all her accounts are overdrawn. This is an example of:

1. Abandonment
2. Self-neglect
3. Psychological abuse
4. Financial and material exploitation

d

What are the different types of elder abuse? Select All That Apply.

1. Physical
2. Sexual
3. Exploitation
4. Neglect
5. Psychological
6. Financial
7. Abandonment

a,b,c,d,e,f,g

The prevalence of elder abuse was drastically affected during the pandemic. According to the text “High Prevalence of Elder Abuse During the COVID-19 Pandemic: Risk and Resilience Factors,” which subtype of elder abuse increased the most in prevalence during COVID-19?

1. Physical abuse
2. Financial abuse
3. Verbal abuse
4. All of the above.

a

The 50-year-old son of an elderly widow brings his mother to the clinic for an examination. He states that she is becoming confused and is falling in the home. When left to be examined by the nurse, the female widow appears fearful and lucid, and says that she has never fallen down in her own home. What type of situation might this elderly widow be experiencing?

1. Psychological abuse
2. Financial abuse
3. Social abuse
4. Physical abuse

d

The nurse observes bilateral bruises on the arms of an elderly client in a long-term care facility. Which of the following questions should the nurse ask this client?

1. "How did you get those bruises?"
2. "Did someone grab you by your arms?"
3. "Do you fall often?"
4. “What did you bump against?"

b

What mental disorders are isolated older adults at risk of developing? (select all that apply)

1. Depression
2. Anxiety
3. PTSD
4. Schizophrenia

a,b

A nurse believes that the 71-year-old widow she is working with is at risk of social isolation. Which of the following behaviors would this client most likely demonstrate with a nursing diagnosis of Social Isolation? (Select all that apply)

1. Stated doubts about an ability to survive alone.
2. Expressed feelings of abandonment or loneliness.
3. Feelings of uselessness.
4. A decreased desire to be around others.
5. A sense that time is passing too quickly.

a,b,c

An 82 year old female client being treated for stage 4 lung cancer expressed to the nurse feelings of isolation and anxiety about the spread of COVID-19, what would be the best recommendation the nurse can give to their client:

1. Suggest the client invite her family over for dinner to facilitate family bonding.
2. Tell the client she should walk 3 miles a day to help maintain physical fitness.
3. Work with the client to address any misgivings about COVID-19, then help set up a FaceTime session with family.
4. Assure the client she is doing fine and there is no need to change anything.

c

Which of the following would help promote a healthy lifestyle for older adults in isolation? (Select all that apply)

1. Encourage them to continue eating meals until satiated
2. Give them books and art materials to read and draw with as activities
3. Suggest regular times for lunch and dinner with periods of rest
4. Encourage them to stand from their chair and walk about periodically, if they are able.

b,c,d

The nurse in the long term care facility notes the patient never attends social events in the facility despite encouragement from staff. What is the best intervention for this patient?

1. Schedule time to sit with the patient
2. Allow the patient to spend time alone
3. Continue to encourage the patient to attend each event
4. Call the patient's family and request help getting the patient to participate

a

A client who reported “a problem sleeping” shows an understanding of good sleep hygiene by:

1. doing 10 pushups before bed to encourage a “pleasant tiredness.”
2. seldom eating a bedtime snack.
3. engaging in computer games as a pre-bed activity.
4. limiting the afternoon nap to just 30 minutes.

D

When an older adult client is diagnosed with restless leg syndrome (RLS), the nurse is confident that client education on the condition’s contributing factors has been effective when the client states:

A. “A warm bath at night instead of in the morning is my new routine.”

B. “Eating a banana at breakfast assures me the potassium I need.”

C. “I’ve cut way back on my caffeinated coffee, teas, and sodas.”

D. “I elevate my legs on a pillow so as to improve circulation.”

C

A nurse in a long-term care facility notes that an older resident with Alzheimer’s disease awakens frequently at night and is restless and agitated. Which of the following interventions will be most effective to help manage this resident’s sleep problems?

1. Taking the resident outside in the garden for 45 minutes daily
2. Limiting fluid intake for the resident
3. Educating the resident on the association between Alzheimer’s Disease and insomnia
4. Administering a mild sedative hypnotic at bedtime

A

An older patient asks a nurse, “I really have trouble sleeping and my doctor does not want to prescribe a sleeping pill for me. He says they are not good for older people. I really don’t understand his response. Can you help me?” The best response by the nurse is:

1. “Sleeping medications have many adverse effects in older people and only have minimal effects in improving sleep.”
2. “Prescription sleeping medications have many adverse effects in older people. Why don’t you try using an over-the-counter medication?”
3. “Sleeping medications do not provide any improvement in sleep for older people.”
4. “Sleep problems are common in older people. There really is nothing that you can do to help with that.”

A

An older adult’s diagnosis of sleep apnea is supported by nursing assessment and history data that include: (Select all that apply.)

1. followed a vegetarian diet for last 28 years.
2. male gender.
3. a smoking history of 1 pack a day for 45 years.
4. 30 pounds over ideal weight.
5. history of Crohn’s disease.

B,C,D

An older patient asks a nurse, “It seems like all of my friends and I have difficulty sleeping. Is it common among older people?” The nurse formulates a response based on the knowledge that normal age-related changes in sleep include: (Select all that apply.)

1. total sleep time and sleep efficiency are reduced.
2. rapid eye movement (REM) sleep is shorter, less intense, and more evenly distributed.
3. sleep requirements for older adults are less than that of younger adults.
4. daytime napping is common.
5. sleep tends to be deeper in older adults than in younger adults.

A,B,D

An older adult tells a nurse that he is experiencing difficulty falling asleep, he routinely gets into bed at 8:30 PM and watches his favorite television shows until 11:00 PM, and often lies awake for hours after. Which of the following suggestions are appropriate for the nurse to give to this patient? (Select all that apply.)

1. Go to bed only when sleepy.
2. If unable to sleep within a reasonable time (15-20 minutes), get out of bed and pursue relaxing activities.GRADESMORE.COM
3. Engage in moderate exercise to induce fatigue.
4. Do not watch television or work in bed.
5. If unable to sleep, engage in enjoyable activities on the computer.

A,B,D

An older patient is diagnosed with RLS. Which of the following nonpharmacologic interventions should the nurse include in the plan of care? (Select all that apply.)

1. Engage in regular mild to moderate physical activity including stretching activities for the lower extremities.
2. Avoid caffeine, alcohol, and tobacco.
3. Avoid hot baths.
4. Relaxation techniques may be helpful.
5. A mild sleeping medication such as diphenhydramine (Benadryl) might be helpful.

A,B,D

A long term care facility has selected sleep promotion as its quality improvement project. Which of the following interventions would be appropriate to implement on this unit? (Select all that apply.)

1. Ensuring that all residents receive evening care and are in bed by 8:00 PM
2. Taking as many residents as possible outside for 30 minutes daily
3. Instituting quiet time (keep noise down, speak in hushed tones, no overhead paging) between 9:00 PM and 6:00 AM
4. Avoiding waking residents for routine care during the night
5. Limiting caffeine and fluids before bedtime

B,C,D,E

The nurse is preparing educational material concerning fire safety in the home. What research data will be included in the material?

1. Most fires occur during the daytime hours.
2. Fire mortality is highest in adults older than 80 years of age.
3. Most people who die in fires are killed by the flames.
4. Most fires occur outside the home.

B

The nurse is recommending that a client diagnosed with moderate stage Alzheimer’s disease attend a support group when he becomes defensive about not driving his automobile and the effects it will have on “being stuck at home.” Which is the priority outcome expected for this client when attending the group sessions?

a. Facilitates socialization thus minimizing the effects of social isolation

b. Helps with minimizing the loss as a factor in causing depression

c. Provides caregivers with respite while assuring the client is well attended to d. Allows for the opportunity for a mental health professional to assess the client

b

A 79-year-old client resides independently in the community. The visiting home health nurse finds that despite it being 90 degrees Fahrenheit outside, the windows are closed and the client is wearing a sweater. The nurse initially recognizes that this behavior may be related to:

1. cognitive changes that diminish the individual’s awareness of temperature changes.
2. age-related neurosensory changes that diminish awareness of temperature changes.
3. a delirium-related acute illness that is affecting body heat production.
4. age-related motor deficiencies that result in self-neglect.

B

A homecare nurse in an area of the country that is prone to tornadoes routinely discusses disaster preparedness with older adult clients. What is the primary rationale for this intervention?

1. Older adults are less likely to seek formal and informal help when affected by natural disasters.
2. The older adult is more likely to live in a communal environment that provides assistance in times of natural disasters.
3. Most older adults have insurance to help them recover from material losses due to a natural disaster.
4. Federal and private assistance agencies generally provide older adults with priority attention in time of natural disasters.

A

A homecare nurse visits an older patient who lives in a Naturally Occurring Retirement Community (NORC). The nurse understands that NORCs are:

1. purpose-built senior housing communities.
2. neighborhoods or buildings where a large segment of the residents are older adults.
3. communities where volunteers coordinate access to services for older adults.
4. intentional collaborative housing where residents participate in the design and operation of the neighborhood.

B

What information should be included in an informational program to be presented on burn prevention to a senior citizens group? (Select all that apply.)

1. Do not smoke in bed or when sleepy
2. Wear well-fitted clothing when cooking or when grilling outdoors
3. Establish a meeting place for all family members outside of the home in case of a fire
4. Establish a plan for exiting each room of your home in the case of a fire
5. Have a fire extinguisher readily available in the kitchen

A,B,E

Which precaution would be beneficial in minimizing an older adult’s risk of being a victim of fraud? (Select all that apply.)

1. Do not allow uninvited salespersons into your home.
2. Never provide personal information to telephone sales solicitors.
3. Rely on the advice of people who only friends have recommended.
4. Contact the local Medicare or Medicaid service office for information whenneeded.

E. Keep your bank account and credit card numbers with you at all times.

A,B,D