Nokea
A nurse is caring for an 86-year-old female patient who has become increasingly frail and unsteady on her feet. During the assessment, the patient indicates that she has fallen three times in the month, though she has not yet suffered an injury. The nurse should take action in the knowledge that this patient is at a high risk for what health problem?
- A. A hip fracture
- B. A femoral fracture
- C. Pelvic dysplasia
- D. Tearing of a meniscus or bursa
Correct Answer: A
Rationale: The most common fracture resulting from a fall is a fractured hip resulting from osteoporosis and the condition or situation that produced the fall. The other listed injuries are possible, but less likely than a hip fracture.
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As the population of the United States ages, research has shown that this aging will occur across all racial and ethnic groups. A community health nurse is planning an initiative that will focus on the group in which the aging population is expected to rise the fastest. What group should the nurse identify?
- A. Asian-Americans
- B. White non-Hispanics
- C. Hispanics
- D. African-Americans
Correct Answer: C
Rationale: Although the older population will increase in number for all racial and ethnic groups, the rate of growth is projected to be fastest in the Hispanic population that is expected to increase from 6 million in 2004 to an estimated 17.5 million by 2050.
The case manager is working with an 84-year-old patient newly admitted to a rehabilitation facility. When developing a care plan for this older adult, which factors should the nurse identify as positive attributes that benefit coping in this age group? Select all that apply.
- A. Decreased risk taking
- B. Effective adaptation skills
- C. Avoiding participation in untested roles
- D. Increased life experience
- E. Resiliency during change
Correct Answer: B,D,E
Rationale: Because changes in life patterns are inevitable over a lifetime, older people need resiliency and coping skills when confronting stresses and change. It is beneficial if older adults continue to participate in risk taking and participation in new, untested roles.
A nurse will conduct an influenza vaccination campaign at an extended care facility. The nurse will be administering intramuscular (IM) doses of the vaccine. Of what age-related change should the nurse be aware when planning the appropriate administration of this drug?
- A. An older patient has less subcutaneous tissue and less muscle mass than a younger patient.
- B. An older patient has more subcutaneous tissue and less durable skin than a younger patient.
- C. An older patient has more superficial and tortuous nerve distribution than a younger patient.
- D. An older patient has a higher risk of bleeding after an IM injection than a younger patient.
Correct Answer: A
Rationale: When administering IM injections, the nurse should remember that in an older patient, subcutaneous fat diminishes, particularly in the extremities. Muscle mass also decreases. There are no significant differences in nerve distribution or bleeding risk.
A gerontologic nurse has been working hard to change the perceptions of the elderly, many of which are negative, by other segments of the population. What negative perceptions of older people have been identified in the literature? Select all that apply.
- A. As being the cause of social problems
- B. As not contributing to society
- C. As draining economic resources
- D. As competing with children for resources
- E. As dominating health care research
Correct Answer: B,C,D
Rationale: Retirement and perceived nonproductivity are responsible for negative feelings because a younger working person may falsely see older people as not contributing to society and as draining economic resources. Younger working people may actually feel that older people are in competition with children for resources. However, the older population is generally not seen as dominating health care research or causing social problems.
Older people have many altered reactions to disease that are based on age-related physiological changes. When the nurse observes physical indicators of illness in the older population, that nurse must remember which of the following principles?
- A. Potential life-threatening problems in the older adult population are not as serious as they are in a middle-aged population.
- B. Indicators that are useful and reliable in younger populations cannot be relied on as indications of potential life-threatening problems in older adults.
- C. The same physiological processes that indicate serious health care problems in a younger population indicate mild disease states in the elderly.
- D. Middle-aged people do not react to disease states the same as a younger population does.
Correct Answer: B
Rationale: Physical indicators of illness that are useful and reliable in young and middle-aged people cannot be relied on for the diagnosis of potential life-threatening problems in older adults. Option A is incorrect because a potentially life-threatening problem in an older person is more serious than it would be in a middle-aged person because the older adult does not have the physical resources of the middle-aged person. Physical indicators of serious health care problems in a young or middle-aged population do not indicate disease states that are considered mild in the elderly population. It is true that middle-aged people do not react to disease states the same as a younger population, but this option does not answer the question.