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A gerontologic nurse is aware of the demographic changes that are occurring in the United States, and this affects the way that the nurse plans and provides care. Which of the following phenomena is currently undergoing the most rapid and profound change?
- A. More families are having to provide care for their aging members.
- B. Adult children find themselves participating in chronic disease management.
- C. A growing number of people live to a very old age.
- D. Elderly people are having more accidents, increasing the costs of health care.
Correct Answer: C
Rationale: As the older population increases, the number of people who live to a very old age is dramatically increasing. The other options are all correct, but none is a factor that is most dramatically increasing in this age group.
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You are the nurse caring for an elderly patient with cardiovascular disease. The patient comes to the clinic with a suspected respiratory infection and is diagnosed with pneumonia. As the nurse, what do you know about the altered responses of older adults?
- A. Treatments for older adults need to be more holistic than treatments used in the younger population.
- B. The altered responses of older adults reinforce the need for the nurse to monitor all body systems to identify possible systemic complications.
- C. The altered responses of older adults define the nursing interactions with the patient.
- D. Older adults become hypersensitive to antibiotic treatments for infectious disease states.
Correct Answer: B
Rationale: Older people may be unable to respond effectively to an acute illness, or, if a chronic health condition is present, they may be unable to sustain appropriate responses over a long period. Furthermore, their ability to respond to definitive treatment is impaired. The altered responses of older adults reinforce the need for nurses to monitor all body system functions closely, being alert to signs of impending systemic complication. Holism should be integrated into all patients care. Altered responses in the older adult do not define the interactions between the nurse and the patient. Older adults do not become hypersensitive to antibiotic treatments for infectious disease states.
For several years, a community health nurse has been working with a 78-year-old man who requires a wheelchair for mobility. The nurse is aware that the interactions between disabilities and aging are not yet clearly understood. This interaction varies, depending on what variable?
- A. Socioeconomics
- B. Ethnicity
- C. Education
- D. Pharmacotherapy
Correct Answer: A
Rationale: Large gaps exist in our understanding of the interaction between disabilities and aging, including how this interaction varies, depending on the type and degree of disability, and other factors such as socioeconomics and gender. Ethnicity, education, and pharmacotherapy are not identified as salient influences on this interaction.
The admissions department at a local hospital is registering an elderly man for an outpatient diagnostic test. The admissions nurse asks the man if he has an advanced directive. The man responds that he does not want to complete an advance directive because he does not want anyone controlling his finances. What would be appropriate information for the nurse to share with this patient?
- A. Advance directives are not legal documents, so you have nothing to worry about.
- B. Advance directives are limited only to health care instructions and directives.
- C. Your finances cannot be managed without an advance directive.
- D. Advance directives are implemented when you become incapacitated, and then you will use a living will to allow the state to manage your money.
Correct Answer: B
Rationale: An advance directive is a formal, legally endorsed document that provides instructions for care (living will) or names a proxy decision maker (durable power of attorney for health care) and covers only issues related specifically to health care, not financial issues. They do not address financial issues. Advance directives are implemented when a patient becomes incapacitated, but financial issues are addressed with a durable power of attorney for finances, or financial power of attorney.
A nurse is caring for an 86-year-old female patient who has become increasingly frail and unsteady on her feet. During the assessment, the patient indicates that she has fallen three times in the month, though she has not yet suffered an injury. The nurse should take action in the knowledge that this patient is at a high risk for what health problem?
- A. A hip fracture
- B. A femoral fracture
- C. Pelvic dysplasia
- D. Tearing of a meniscus or bursa
Correct Answer: A
Rationale: The most common fracture resulting from a fall is a fractured hip resulting from osteoporosis and the condition or situation that produced the fall. The other listed injuries are possible, but less likely than a hip fracture.
The nurse is providing patient teaching to a patient with early stage Alzheimers disease (AD) and her family. The patient has been prescribed donepezil hydrochloride (Aricept). What should the nurse explain to the patient and family about this drug?
- A. It slows the progression of AD.
- B. It cures AD in a small minority of patients.
- C. It removes the patients insight that he or she has AD.
- D. It limits the physical effects of AD and other dementias.
Correct Answer: A
Rationale: There is no cure for AD, but several medications have been introduced to slow the progression of the disease, including donepezil hydrochloride (Aricept). These medications do not remove the patients insight or address physical symptoms of AD.