Nokea
A nurse is caring for older adults in a senior adult day services (ADS) center. Which findings require follow up with the health care provider?
- A. Skin pigmentation caused by exposure to sun over the years
- B. Thin toenails with a bluish tint to the nail beds
- C. Using a walker while healing from a hip fracture related to brittle bones
- D. Bruising on forearms due to fragile blood vessels in the dermis
Correct Answer: B
Rationale: A bluish tint to the nail beds may indicate hypoxemia, which requires follow-up with a health care provider. Skin pigmentation from sun exposure, using a walker for a hip fracture, and bruising due to fragile blood vessels are common in aging and typically do not require immediate follow-up unless severe or accompanied by other symptoms.
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A patient is admitted to the acute care medical center with change in mental status, dehydration, and electrolyte imbalances. Which of these reflects a reversible cause of the changes in mental status?
- A. Alzheimer's disease
- B. Delirium
- C. Dementia
- D. Delirium superimposed on dementia
Correct Answer: B
Rationale: Delirium is a reversible cause of changes in mental status, often triggered by factors like dehydration or electrolyte imbalances, which can be treated. Alzheimer's disease and dementia are progressive and irreversible, while delirium superimposed on dementia includes a reversible component (delirium) but is complicated by underlying irreversible dementia.
A nursing student caring for older adults in a skilled nursing facility is completing an assignment identifying physical changes that are part of normal aging. What changes will the student include in this assignment? Select all that apply.
- A. Fatty tissue is redistributed.
- B. Skin is drier and wrinkles appear.
- C. Cardiac output increases.
- D. Muscle mass increases.
- E. Hormone production increases.
- F. Visual and hearing acuity diminishes.
Correct Answer: A,B,F
Rationale: Physical changes occurring with aging include redistribution of fatty tissue, drier skin with wrinkles, and diminished visual and hearing acuity. Cardiac output decreases, muscle mass decreases (sarcopenia), and hormone production decreases, causing menopause or andropause.
A nurse researcher interviews adults to validate Erikson's theory that middle-aged adults who do not achieve their developmental tasks may be in the stage of stagnation. Which patient statement will the nurse correlate to this theory?
- A. I am helping my parents move into an assisted-living facility.
- B. I spend all of my time going to the doctor to be sure I am not sick.
- C. I have enough money to help my son and his wife when they need it.
- D. I earned this gray hair and I like it!
Correct Answer: B
Rationale: According to Erikson, middle adulthood involves generativity versus stagnation. The tasks include guiding the next generation and adjusting to aging parents. A statement indicating excessive concern about personal health, such as spending all time at the doctor, reflects stagnation, where the individual becomes self-absorbed rather than generative.
A nursing instructor teaching a gerontology class to nursing students discusses myths related to the aging of adults. Which statement will the students identify as a myth about older adults?
- A. Most older adults live in their own homes.
- B. Healthy older adults enjoy sexual activity.
- C. Aging results in mental deterioration.
- D. Older adults want to be attractive to others.
Correct Answer: C
Rationale: The myth that aging results in mental deterioration is incorrect, as intelligence does not normally decrease with aging, though response time may be slower. Most older adults do live in their own homes, healthy older adults enjoy sexual activity, and older adults often want to be attractive to others.
The nurse in a long-term care facility states in report that an older adult resident is quite frail. The oncoming caregiver prioritizes prevention of what problem?
- A. Confusion
- B. Falls
- C. Delirium
- D. Dementia
Correct Answer: B
Rationale: Frailty in older adults increases the risk of falls due to reduced strength, balance, and mobility. Preventing falls is a priority to avoid injuries such as fractures. Confusion, delirium, and dementia are important but are not as directly linked to frailty as falls.