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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.
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The presence of a gerontologic advanced practice nurse in a long-term care facility has proved beneficial to both the patients and the larger community in which they live. Nurses in this advanced practice role have been shown to cause what outcome?
- A. Greater interaction between younger adults and older adults occurs.
- B. The elderly recover more quickly from acute illnesses.
- C. Less deterioration takes place in the overall health of patients.
- D. The elderly are happier in long-term care facilities than at home.
Correct Answer: C
Rationale: The use of advanced practice nurses who have been educated in geriatric nursing concepts has proved to be very effective when dealing with the complex care needs of an older patient. When best practices are used and current scientific knowledge applied to clinical problems, significantly less deterioration occurs in the overall health of aging patients. This does not necessarily mean that patients are happier in long-term care than at home, that they recover more quickly from acute illnesses, or greater interaction occurs between younger and older adults.
A nurse is planning discharge teaching for an 80 -year-old patient with mild short-term memory loss. The discharge teaching will include how to perform basic wound care for the venous ulcer on his lower leg. When planning the necessary health education for this patient, what should the nurse plan to do?
- A. Set long-term goals with the patient.
- B. Provide a list of useful Web sites to supplement learning.
- C. Keep visual cues to a minimum to enhance the patients focus.
- D. Keep teaching periods short.
Correct Answer: D
Rationale: To assist the elderly patient with short-term memory loss, the nurse should keep teaching periods short, provide glare-free lighting, link new information with familiar information, use visual and auditory cues, and set short-term goals with the patient. The patient may or may not be open to the use of online resources.
The admissions department at a local hospital is registering an elderly man for an outpatient diagnostic test. The admissions nurse asks the man if he has an advanced directive. The man responds that he does not want to complete an advance directive because he does not want anyone controlling his finances. What would be appropriate information for the nurse to share with this patient?
- A. Advance directives are not legal documents, so you have nothing to worry about.
- B. Advance directives are limited only to health care instructions and directives.
- C. Your finances cannot be managed without an advance directive.
- D. Advance directives are implemented when you become incapacitated, and then you will use a living will to allow the state to manage your money.
Correct Answer: B
Rationale: An advance directive is a formal, legally endorsed document that provides instructions for care (living will) or names a proxy decision maker (durable power of attorney for health care) and covers only issues related specifically to health care, not financial issues. They do not address financial issues. Advance directives are implemented when a patient becomes incapacitated, but financial issues are addressed with a durable power of attorney for finances, or financial power of attorney.
After a sudden decline in cognition, a 77-year-old man who has been diagnosed with vascular dementia is receiving care in his home. To reduce this mans risk of future infarcts, what action should the nurse most strongly encourage?
- A. Activity limitation and falls reduction efforts
- B. Adequate nutrition and fluid intake
- C. Rigorous control of the patients blood pressure and serum lipid levels
- D. Use of mobility aids to promote independence
Correct Answer: C
Rationale: Because vascular dementia is associated with hypertension and cardiovascular disease, risk factors (e.g., hypercholesterolemia, history of smoking, diabetes) are similar. Prevention and management are also similar. Therefore, measures to decrease blood pressure and lower cholesterol levels may prevent future infarcts. Activity limitation is unnecessary and infarcts are not prevented by nutrition or the use of mobility aids.
You are the nurse planning an educational event for the nurses on a subacute medical unit on the topic of normal, age-related physiological changes. What phenomenon would you include in your teaching plan?
- A. A decrease in cognition, judgment, and memory
- B. A decrease in muscle mass and bone density
- C. The disappearance of sexual desire for both men and women
- D. An increase in sebaceous and sweat gland function in both men and women
Correct Answer: B
Rationale: Normal signs of aging include a decrease in the sense of smell, a decrease in muscle mass, a decline but not disappearance of sexual desire, and decreased sebaceous and sweat glands for both men and women. Cognitive changes are usually attributable to pathologic processes, not healthy aging.