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A gerontologic nurse practitioner provides primary care for a large number of older adults who are living with various forms of cardiovascular disease. This nurse is well aware that heart disease is the leading cause of death in the aged. What is an age-related physiological change that contributes to this trend?
- A. Heart muscle and arteries lose their elasticity.
- B. Systolic blood pressure decreases.
- C. Resting heart rate decreases with age.
- D. Atrial-septal defects develop with age.
Correct Answer: A
Rationale: The leading cause of death for patients over the age of 65 years is cardiovascular disease. With age, heart muscle and arteries lose their elasticity, resulting in a reduced stroke volume. As a person ages, systolic blood pressure does not decrease, resting heart rate does not decrease, and the aged are not less likely to adopt a healthy lifestyle.
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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.
Gerontologic nursing is a specialty area of nursing that provides care for the elderly in our population. What goal of care should a gerontologic nurse prioritize when working with this population?
- A. Helping older adults determine how to reduce their use of external resources
- B. Helping older adults use their strengths to optimize independence
- C. Helping older adults promote social integration
- D. Helping older adults identify the weaknesses that most limit them
Correct Answer: B
Rationale: Gerontologic nursing is provided in acute care, skilled and assisted living, community, and home settings. The goals of care include promoting and maintaining functional status and helping older adults identify and use their strengths to achieve optimal independence. Goals of gerontologic nursing do not include helping older adults promote social integration or identify their weaknesses. Optimal independence does not necessarily involve reducing the use of available resources.
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.
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.
Nurses and members of other health disciplines at a states public health division are planning programs for the next 5 years. The group has made the decision to focus on diseases that are experiencing the sharpest increases in their contributions to the overall death rate in the state. This team should plan health promotion and disease prevention activities to address what health problem?
- A. Stroke
- B. Cancer
- C. Respiratory infections
- D. Alzheimers disease
Correct Answer: D
Rationale: In the past 60 years, overall deaths, and specifically, deaths from heart disease, have declined. Recently, deaths from cancer and cerebrovascular disease have declined. However, deaths from Alzheimers disease have risen more than 50% between 1999 and 2007.