Nokea
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.
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You are the nurse caring for a 91-year-old patient admitted to the hospital for a fall. The patient complains of urge incontinence and tells you he most often falls when he tries to get to the bathroom in his home. You identify the nursing diagnosis of risk for falls related to impaired mobility and urinary incontinence. The older adults risk for falls is considered to be which of the following?
- A. The result of impaired cognitive functioning
- B. The accumulation of environmental hazards
- C. A geriatric syndrome
- D. An age-related health deficit
Correct Answer: C
Rationale: A number of problems commonly experienced by the elderly are becoming recognized as geriatric syndromes. These conditions do not fit into discrete disease categories. Examples include frailty, delirium, falls, urinary incontinence, and pressure ulcers. Impaired cognitive functioning, environmental hazards in the home, and an age-related health deficit may all play a part in the episodes in this patients life that led to falls, but they are not diagnoses and are, therefore, incorrect.
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.
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 planning discharge teaching for an 80 -year-old patient with mild short-term memory loss. The discharge teaching will include how to perform basic wound care for the venous ulcer on his lower leg. When planning the necessary health education for this patient, what should the nurse plan to do?
- A. Set long-term goals with the patient.
- B. Provide a list of useful Web sites to supplement learning.
- C. Keep visual cues to a minimum to enhance the patients focus.
- D. Keep teaching periods short.
Correct Answer: D
Rationale: To assist the elderly patient with short-term memory loss, the nurse should keep teaching periods short, provide glare-free lighting, link new information with familiar information, use visual and auditory cues, and set short-term goals with the patient. The patient may or may not be open to the use of online resources.
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.