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A nurse supervises APs in a long-term care facility where many residents have presbycusis. What directions will the nurse give the APs to best promote communication with these patients?
- A. Provide patients with large-print written menus.
- B. Speak clearly and distinctly, using a lower tone of voice.
- C. Decrease tactile stimulation.
- D. Remind all patients to "call, not fall."
Correct Answer: B
Rationale: Presbycusis is an expected decrease or loss of hearing as a result of the aging process. Speaking distinctly in lower frequencies is indicated. Obtaining large-print written material is appropriate for visual alterations. Decreasing tactile stimulation is appropriate for a patient with a sensory overload, and initiating a safety program to prevent falls is appropriate for a patient experiencing kinesthetic/visceral alterations.
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A home care nurse is visiting an older adult with long-standing diabetes who reports pain and numbness in their feet. What education is most appropriate for this patient?
- A. Take acetaminophen or over-the-counter analgesic when pain occurs.
- B. Increase intake of foods containing vitamins B6, B12, and folate.
- C. Explain that phantom limb pain can become chronic, but psychosocial support can help.
- D. Validate the patient's understanding of foot care for patients with diabetes.
Correct Answer: D
Rationale: Patients with diabetes can develop peripheral neuropathy resulting in loss of sensation and reduced blood flow. The loss of sensation can promote injury the patient does not readily notice. Therefore, those with diabetes must perform special foot care and visual inspection.
When caring for an older adult who repeatedly states their food does not taste as good as it used to, a nurse explains that which factors can contribute to loss of taste as patients age? Select all that apply.
- A. Decreased sense of smell
- B. Presbycusis
- C. Medications
- D. Diseases
- E. Tobacco use
- F. Presbyopia
Correct Answer: A,C,D,E
Rationale: As the patient ages, gustatory senses, along with sense of smell, some medications, and smoking can blunt the taste (gustatory sense). Presbycusis refers to the reduced ability to hear, and presbyopia refers to the inability of the lens to accommodate to near (or far) objects.
A patient is in the late stages of AIDS, which has affected their brain function and memory. The patient reports loneliness because his friends "are afraid to visit." Based on this data, what nursing intervention would best help meet the patient's need for sensory stimulation?
- A. Providing stimulation through music, television, or movies
- B. Assessing the patient's hearing and vision to ensure optimal function
- C. Ensuring the patient is able to transmit their message to others
- D. Arranging for a volunteer to sit with the patient each day
Correct Answer: D
Rationale: This patient is receiving decreased environmental stimuli (e.g., from lack of visitors) and may experience problems with reception because of brain involvement. Arranging for a volunteer to sit with the patient provides social interaction, addressing the loneliness and sensory deprivation.
During shift report, a nurse is told that their patient admitted with an electrolyte imbalance is experiencing delirium. For which finding consistent with delirium will the nurse assess?
- A. Statements that they plan to harm themselves or take their own life
- B. Chronic memory loss and personality changes
- C. Acute confusion, disorientation, restlessness, or agitation
- D. Ability to be aroused by extreme and/or repeated stimuli
Correct Answer: C
Rationale: Delirium is a state of acute confusion manifested by disorientation, restlessness, hallucinations, and agitation. Dementia is a chronic progressive illness characterized by difficulties with spatial orientation, memory, language, and changes in personality.
A school nurse is teaching a group of high school students about preventing hearing loss. What preventative actions does the nurse recommend? Select all that apply.
- A. Use earphones when listening to music, podcasts, or other programs.
- B. Do not insert objects such as cotton-tipped applicators into the ear.
- C. Avoid playing contact sports.
- D. Use ear protection when performing tasks with loud sounds.
- E. It is best to begin screening for hearing loss at age 18 years.
Correct Answer: B,D
Rationale: To prevent hearing loss, the nurse teaches students to avoid concentrating sound in the ear canal, such as when using earphones, and to use ear protection for loud activities. Inserting objects into the ear canal can cause damage.