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A gerontologic nurse is overseeing the care that is provided in a large, long-term care facility. The nurse is educating staff about the significant threat posed by influenza in older, frail adults. What action should the nurse prioritize to reduce the incidence and prevalence of influenza in the facility?
- A. Teach staff how to administer prophylactic antiviral medications effectively.
- B. Ensure that residents receive a high-calorie, high-protein diet during the winter.
- C. Make arrangements for residents to limit social interaction during winter months.
- D. Ensure that residents receive influenza vaccinations in the fall of each year.
Correct Answer: D
Rationale: The influenza and the pneumococcal vaccinations lower the risks of hospitalization and death in elderly people. The influenza vaccine, which is prepared yearly to adjust for the specific immunologic characteristics of the influenza viruses at that time, should be administered annually in autumn. Prophylactic antiviral medications are not used. Limiting social interaction is not required in most instances. Nutrition enhances immune response, but this is not specific to influenza prevention.
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The home health nurse is making an initial home visit to a 76-year-old widower. The patient takes multiple medications for the treatment of varied chronic health problems. The patient states that he has also begun taking some herbal remedies. What should the nurse be sure to include in the patients teaching?
- A. Herbal remedies are consistent with holistic health care.
- B. Herbal remedies are often cheaper than prescribed medication.
- C. It is safest to avoid the use of herbal remedies.
- D. There is a need to inform his physician and pharmacist about the herbal remedies.
Correct Answer: D
Rationale: Herbal remedies combined with prescribed medications can lead to interactions that may be toxic. Patients should notify the physician and pharmacist of any herbal remedies they are using. Even though herbal remedies are considered holistic, this is not something that is necessary to include in the patients teaching. Herbal remedies may be cheaper than prescribed medicine, but this is still not something that is necessary to include in the patients teaching. For most people, it is not necessary to wholly avoid herbal remedies.
An occupational health nurse overhears an employee talking to his manager about a 65 -year-old coworker. What phenomenon would the nurse identify when hearing the employee state, He should just retire and make way for some new blood.?
- A. Intolerance
- B. Ageism
- C. Dependence
- D. Nonspecific prejudice
Correct Answer: B
Rationale: Ageism refers to prejudice against the aged. Intolerance is implied by the employees statement, but the intolerance is aimed at the coworkers age. The employees statement does not raise concern about dependence. The prejudice exhibited in the statement is very specific.
A gerontologic nurse has been working hard to change the perceptions of the elderly, many of which are negative, by other segments of the population. What negative perceptions of older people have been identified in the literature? Select all that apply.
- A. As being the cause of social problems
- B. As not contributing to society
- C. As draining economic resources
- D. As competing with children for resources
- E. As dominating health care research
Correct Answer: B,C,D
Rationale: Retirement and perceived nonproductivity are responsible for negative feelings because a younger working person may falsely see older people as not contributing to society and as draining economic resources. Younger working people may actually feel that older people are in competition with children for resources. However, the older population is generally not seen as dominating health care research or causing social problems.
After a sudden decline in cognition, a 77-year-old man who has been diagnosed with vascular dementia is receiving care in his home. To reduce this mans risk of future infarcts, what action should the nurse most strongly encourage?
- A. Activity limitation and falls reduction efforts
- B. Adequate nutrition and fluid intake
- C. Rigorous control of the patients blood pressure and serum lipid levels
- D. Use of mobility aids to promote independence
Correct Answer: C
Rationale: Because vascular dementia is associated with hypertension and cardiovascular disease, risk factors (e.g., hypercholesterolemia, history of smoking, diabetes) are similar. Prevention and management are also similar. Therefore, measures to decrease blood pressure and lower cholesterol levels may prevent future infarcts. Activity limitation is unnecessary and infarcts are not prevented by nutrition or the use of mobility aids.
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.