Nokea
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.
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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.
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.
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 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 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.