Nokea
A nurse in a long-term care facility is using the TimeSlips program with a group of cognitively impaired older adults. The nurse is using which of the following techniques?
- A. Provides a picture for all group members to look at and use to create a story
- B. Records the responses of all participants
- C. Compliments each member for his or her contribution to the story
- D. Reads the story back during the session, noting the contributions of each participant
Correct Answer: A
Rationale: The correct answer is A because the TimeSlips program involves providing a picture as a creative prompt for group members to collaboratively create a story. This technique stimulates imagination and communication in cognitively impaired individuals. Choice B is incorrect as recording responses is not specific to the TimeSlips method. Choice C is incorrect as complimenting contributions is not a core component of the TimeSlips program. Choice D is incorrect as reading back the story during the session does not align with the collaborative, creative process of TimeSlips.
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The nurse designs a group exercise program at a senior center. Which room should the nurse choose?
- A. Room with a hardwood floor and throw rugs
- B. Spacious room with no windows and a natural stone floor
- C. Room with a hardwood floor and large windows overlooking a garden area
- D. End room with linoleum floor and a fan for ventilation
Correct Answer: C
Rationale: The correct answer is C because a room with hardwood floor and large windows overlooking a garden area offers a safe, non-slip surface for exercise and natural light for a pleasant environment. Hardwood floors are ideal for exercise to prevent slipping, and the large windows provide a view of the garden area, which can enhance motivation and mood. The other choices are incorrect because A has throw rugs, which can cause tripping hazards, B lacks natural light and ventilation, and D has a linoleum floor which may not be as safe for exercise compared to hardwood.
Mr J., an 80 yr old who has had flu like symptoms with diarrhea and has vomited 4 times in the last 24 hours is seen in the ED. Mr. J seems confused and is lethargic. The nurse notes that Mr. J has dry skin, a brown tongue, sunken cheeks and concentrated urine. This array of symptoms indicates:
- A. congestive heart failure
- B. dehydration
- C. urinary tract infection
- D. bowel obstruction
Correct Answer: B
Rationale: The correct answer is B: dehydration. Mr. J's symptoms of flu-like illness, diarrhea, vomiting, confusion, lethargy, dry skin, brown tongue, sunken cheeks, and concentrated urine are indicative of severe dehydration. Dehydration can lead to electrolyte imbalances, decreased blood volume, and impaired organ function, resulting in confusion and lethargy. Skin changes, dry mucous membranes, and concentrated urine are also classic signs of dehydration. The other choices (A, C, D) do not align with the constellation of symptoms presented by Mr. J and are less likely based on the information provided.
What is the most effective intervention to prevent skin breakdown in immobile older adults?
- A. Frequent use of powder to keep skin dry
- B. Application of a thick layer of moisturizer
- C. Regular repositioning and use of pressure-relieving devices
- D. Ensuring complete bed rest to limit movement
Correct Answer: C
Rationale: The correct answer is C because regular repositioning and the use of pressure-relieving devices are essential to prevent skin breakdown in immobile older adults. Repositioning helps redistribute pressure, maintaining blood flow to the skin and preventing tissue damage. Pressure-relieving devices such as cushions or special mattresses further reduce pressure on vulnerable areas. Choices A and B do not address the root cause of skin breakdown and may even exacerbate the issue. Choice D is incorrect as complete bed rest can lead to further complications like pressure ulcers. In summary, choice C is the most effective intervention as it directly targets the risk factors for skin breakdown in immobile older adults.
The holistic health movement has impacted health care in which of the following ways?
- A. It has focused health care on disease prevention.
- B. It has reshaped how health and health care are perceived.
- C. It has improved access to health care.
- D. It has introduced numerous alternative modalities into health care.
Correct Answer: B
Rationale: The correct answer is B because the holistic health movement emphasizes treating the whole person - mind, body, and spirit. This shifts the focus from merely treating symptoms to considering individual well-being and lifestyle factors. Choice A is not the best answer because while disease prevention is part of holistic health, it is not the primary impact on health care. Choice C is incorrect as the movement does not directly improve access to health care. Choice D is also incorrect as while alternative modalities are part of holistic health, they are not the main impact on health care.
The gerontological nurse collaborates with the wound care team about an older patient who has an ulcer. How is this nurse demonstrating leadership in the care of older people?
- A. Assessing older adults effectively
- B. Facilitating access to eldercare programs
- C. Coordinating members of the health care team
- D. Empowering older adults to manage chronic illness
Correct Answer: C
Rationale: The correct answer is C: Coordinating members of the health care team. This demonstrates leadership as the nurse is taking charge of organizing and communicating with various healthcare professionals to ensure the best care for the older patient. By collaborating with the wound care team, the nurse shows effective coordination and communication skills, which are crucial in managing complex cases in older adults. Assessing older adults effectively (choice A) is important but does not specifically address leadership in coordinating care. Facilitating access to eldercare programs (choice B) is important but does not directly demonstrate leadership in coordinating care. Empowering older adults to manage chronic illness (choice D) is important for patient education but does not directly show leadership in coordinating the healthcare team.