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A home health care nurse is planning an exercise program with an older client who lives at home independently but whose mobility issues prevent much activity outside the home. Which exercise regimen would be most beneficial to this adult?
- A. Building strength and flexibility
- B. Improving exercise endurance
- C. Increasing cardiovascular capacity
- D. Enhancing balance and coordination
Correct Answer: A
Rationale: This older adult is mostly homebound. Exercise regimens for homebound clients include activities to increase functional ability for activities of daily living. Strength and flexibility exercises will help the client maintain independent living. The other options are beneficial but do not specifically address the client's functional abilities.
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A nurse is delegating care of an older client with a high risk for skin breakdown to unlicensed assistive personnel (UAP). Which statements by the nurse are appropriate? (Select all that apply.)
- A. Assess the client's skin daily and report any redness
- B. Order a special mattress if you notice skin breakdown
- C. Keep the client's skin dry and free of moisture
- D. Turn the client every 2 hours to prevent pressure ulcers
- E. Reassess the Braden Scale results every shift
Correct Answer: C,D,E
Rationale: The nurse's aide or UAP can assist in keeping the client's skin dry, order a special mattress on direction of the RN, and turn the client on a schedule. Assessing the skin is a nursing responsibility, although the aide should be instructed to report any redness noticed. Reassessing the Braden Scale results is the RN's responsibility, as the RN is the one who performs the main assessment.
An older adult recently retired and reports being depressed and lonely. What information should the nurse assess as a priority?
- A. History of previous depression
- B. Previous stressful events
- C. Role of work in the adult's life
- D. Usual leisure time activities
Correct Answer: C
Rationale: Often older adults lose support systems when their roles change. For instance, when people retire, they may lose their entire social network, leading to feelings of depression and loneliness. The nurse should first assess the role that work played in the client's life. The other factors can be assessed as well, but this circumstance is commonly seen in the older population.
An older adult client is in the hospital. The client is ambulatory and independent. What intervention by the nurse would be most helpful for preventing falls in this client?
- A. Keep the light on in the bathroom at night
- B. Order a wheelchair for the client
- C. Put the client on a toileting schedule
- D. Use side rails to keep the client in bed
Correct Answer: A
Rationale: Although this older adult is independent and ambulatory, being hospitalized can create confusion. Getting up in a dark, unfamiliar environment can contribute to falls. Keeping the light on in the bathroom at night helps ensure the client can see their surroundings, reducing the risk of falls.
A home health care nurse has conducted a home safety assessment for an older adult. There are five concrete steps leading out from the home. Which statement would be most helpful to keeping the older adult safe on the steps?
- A. Have the client use a walker or cane on the steps
- B. Install contrasting color strips at the edge of each step
- C. Advise the client to avoid the steps altogether
- D. Tell the client to use a two-footed gait on the steps
Correct Answer: B
Rationale: As a person ages, they may experience a decreased sense of touch. The older adult may not be aware of where their foot is on the step. Installing contrasting color strips at the edge of each step will help increase visibility and safety for the older adult.
An older client is concerned about dehydration. What is the best advice for this client?
- A. Cut some sodium out of your diet
- B. Dehydration can cause incontinence
- C. Have something to drink every 1 to 2 hours
- D. Take your diuretic in the morning
Correct Answer: C
Rationale: Older adults often lose their sense of thirst. Since they should drink 1 to 2 liters of water a day, the best remedy is to have the older adult drink something each hour or two, whether or not they are thirsty. Cutting some sodium from the diet will not address this issue. Although dehydration can cause incontinence from the urine irritation of concentrated urine, this information will not help prevent the problem of dehydration. Instructing the client to take a diuretic in the morning rather than in the evening also will not directly address this issue.