Nokea
A nurse caring for an older adult has provided education on high-fiber foods. Which menu selection by the client demonstrates a need for further review?
- A. Barley soup
- B. Black beans
- C. White rice
- D. Whole wheat bread
Correct Answer: C
Rationale: Older adults need 25 to 50 grams of fiber a day. White rice is low in fiber. Foods high in fiber include barley, beans, and whole wheat products.
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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 nurse caring for an older client on a medical-surgical unit notices the client reports frequent constipation and only wants to eat softer foods such as rice, bread, and puddings. What assessment should the nurse perform first?
- A. Auscultate bowel sounds
- B. Palpate the abdomen
- C. Review the client's medication list
- D. Assess dietary fiber intake
Correct Answer: D
Rationale: Assessing dietary fiber intake is critical as the client's preference for softer, low-fiber foods like rice, bread, and puddings may contribute to constipation. This assessment should be prioritized to identify potential causes before proceeding to other assessments like auscultating bowel sounds or palpating the abdomen.
A nurse is assessing coping in older women in a support group for recent widows. Which statement by a participant indicates strong social network coping?
- A. I have had the same best friend for decades
- B. I think I am coping very well on my own
- C. My kids come to see me over the weekend
- D. Oh, I have lots of friends at the senior center
Correct Answer: A
Rationale: Friendship and support enhance coping. The quality of the relationship is most important. People who have close, intimate, stable relationships with others in whom they confide are more likely to cope with crises.
An older adult client takes medication three times a day and becomes confused about which medication should be taken at which time. The client refuses to use a pill sorter with slots for different times, saying 'Those are for old people.' What action by the nurse would be most helpful?
- A. Arrange medications by time in a drawer
- B. Encourage the client to use easy-open tops
- C. Place color-coded stickers on the bottle caps
- D. Write a list of which medications to take when
Correct Answer: C
Rationale: Color-coded stickers are a fast, easy-to-remember system. One color is for morning meds, one for evening meds, and the third color is for nighttime meds. Arranging medications by time in a drawer might be helpful if the person doesn't accidentally put them back in the wrong spot. Easy-open tops are not related. Writing a list is helpful, but it may be misplaced. With stickers on the medication bottles themselves, the reminder is always with the medication.
A nurse caring for an older client in the hospital is concerned the client is not competent to give consent for upcoming surgery. What is the best action by the nurse?
- A. Call Adult Protective Services
- B. Discuss concerns with the health care team
- C. Assist with Adult Protective Services
- D. Have the client's family sign the consent
Correct Answer: B
Rationale: In this situation, each facility will have a policy designed for assessing competence. The nurse should bring these concerns to an interdisciplinary care team meeting. There may be physiologic reasons for the client's perceived incompetence, and the team can evaluate and determine the appropriate course of action.