Nokea
A gerontologic nurse is basing the therapeutic programs at a long-term care facility on Millers Functional Consequences Theory. To actualize this theory of aging, the nurse should prioritize what task?
- A. Attempting to control age-related physiological changes
- B. Lowering expectations for recovery from acute and chronic illnesses
- C. Helping older adults accept the inevitability of death
- D. Differentiating between age-related changes and modifiable risk factors
Correct Answer: D
Rationale: The Functional Consequences Theory requires the nurse to differentiate between normal, irreversible age-related changes and modifiable risk factors. This theory does not emphasize lowering expectations, controlling age-related changes, or helping adults accept the inevitability of death.
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A home health nurse makes a home visit to a 90 -year-old patient who has cardiovascular disease. During the visit the nurse observes that the patient has begun exhibiting subtle and unprecedented signs of confusion and agitation. What should the home health nurse do?
- A. Increase the frequency of the patients home care.
- B. Have a family member check in on the patient in the evening.
- C. Arrange for the patient to see his primary care physician.
- D. Refer the patient to an adult day program.
Correct Answer: C
Rationale: In more than half of the cases, sudden confusion and hallucinations are evident in multi-infarct dementia. This condition is also associated with cardiovascular disease. Having the patients home care increased does not address the problem, neither does having a family member check on the patient in the evening. Referring the patient to an adult day program may be beneficial to the patient, but it does not address the acute problem the patient is having, the nurse should arrange for the patient to see his primary care physician.
An 83-year-old woman was diagnosed with Alzheimers disease 2 years ago and the disease has progressed at an increasing pace in recent months. The patient has lost 16 pounds over the past 3 months, leading to a nursing diagnosis of Imbalanced Nutrition: Less than Body Requirements. What intervention should the nurse include in this patients plan of care?
- A. Offer the patient rewards for finishing all the food on her tray.
- B. Offer the patient bland, low-salt foods to limit offensiveness.
- C. Offer the patient only one food item at a time to promote focused eating.
- D. Arrange for insertion of a gastrostomy tube and initiate enteral feeding.
Correct Answer: C
Rationale: To avoid any playing with food, one dish should be offered at a time. Foods should be familiar and appealing, not bland. Tube feeding is not likely necessary at this time and a reward system is unlikely to be beneficial.
Based on a patients vague explanations for recurring injuries, the nurse suspects that a community-dwelling older adult may be the victim of abuse. What is the nurses primary responsibility?
- A. Report the findings to adult protective services.
- B. Confront the suspected perpetrator.
- C. Gather evidence to corroborate the abuse.
- D. Work with the family to promote healthy conflict resolution.
Correct Answer: A
Rationale: If neglect or abuse of any kind including physical, emotional, sexual, or financial abuse is suspected, the local adult protective services agency must be notified. The responsibility of the nurse is to report the suspected abuse, not to prove it, confront the suspected perpetrator, or work with the family to promote resolution.
A nurse will conduct an influenza vaccination campaign at an extended care facility. The nurse will be administering intramuscular (IM) doses of the vaccine. Of what age-related change should the nurse be aware when planning the appropriate administration of this drug?
- A. An older patient has less subcutaneous tissue and less muscle mass than a younger patient.
- B. An older patient has more subcutaneous tissue and less durable skin than a younger patient.
- C. An older patient has more superficial and tortuous nerve distribution than a younger patient.
- D. An older patient has a higher risk of bleeding after an IM injection than a younger patient.
Correct Answer: A
Rationale: When administering IM injections, the nurse should remember that in an older patient, subcutaneous fat diminishes, particularly in the extremities. Muscle mass also decreases. There are no significant differences in nerve distribution or bleeding risk.
You are providing care for an 82-year-old man whose signs and symptoms of Parkinson disease have become more severe over the past several months. The man tells you that he can no longer do as many things for himself as he used to be able to do. What factor should you recognize as impacting your patients life most significantly?
- A. Neurologic deficits
- B. Loss of independence
- C. Age-related changes
- D. Tremors and decreased mobility
Correct Answer: B
Rationale: This patients statement places a priority on his loss of independence. This is undoubtedly a result of the neurologic changes associated with his disease, but this is not the focus of his statement. This is a disease process, not an age-related physiological change.