Nokea
A nurse working with older adults in the community plans programming to improve morale and emotional health. This a group potential. What a group would best meet this goal?
- A. Exercise program to improve physical function
- B. Financial planning seminar series for older adults
- C. Social events such as dances and group victim
- D. Workshop on prevention from becoming an abuse victim
Correct Answer: A
Rationale: All activities would be beneficial for the older population in the community. However, failure in performing ones own activities of daily living and participating in society has direct effects on morale and life satisfaction. Those who have the ability to function independently direct food wellnesses and empty. An exercise program designed to maintain and/or improve physical functioning would best address this need.
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A nurse caring for an older client in the hospital is concerned the client is not competent to give consent for upcoming surgery. What is the best action by the nurse?
- A. Call Adult Protective Services
- B. Discuss concerns with the health care team
- C. Assist with Adult Protective Services
- D. Have the client's family sign the consent
Correct Answer: B
Rationale: In this situation, each facility will have a policy designed for assessing competence. The nurse should bring these concerns to an interdisciplinary care team meeting. There may be physiologic reasons for the client's perceived incompetence, and the team can evaluate and determine the appropriate course of action.
An older client is concerned about dehydration. What is the best advice for this client?
- A. Cut some sodium out of your diet
- B. Dehydration can cause incontinence
- C. Have something to drink every 1 to 2 hours
- D. Take your diuretic in the morning
Correct Answer: C
Rationale: Older adults often lose their sense of thirst. Since they should drink 1 to 2 liters of water a day, the best remedy is to have the older adult drink something each hour or two, whether or not they are thirsty. Cutting some sodium from the diet will not address this issue. Although dehydration can cause incontinence from the urine irritation of concentrated urine, this information will not help prevent the problem of dehydration. Instructing the client to take a diuretic in the morning rather than in the evening also will not directly address this issue.
A nurse is caring for an older adult who reports not eating well. What actions by the nurse are most appropriate? (Select all that apply.)
- A. Ask about transportation to buy food
- B. Inquire about access to dentures
- C. Encourage the client to continue the current exercise plan
- D. Have the client complete a 3-day diet recall diary
- E. Teach the client about proper nutrition in the older population
Correct Answer: A,B,D
Rationale: Assessment is the first step of the nursing process and should be completed prior to intervening. Asking about transportation, dentures, and normal food patterns would be part of an appropriate assessment for the client. There is no information in the question about the older adult needing to lose weight, so encouraging them to continue the current exercise plan is premature and may not be appropriate. Teaching about proper nutrition is a good idea, but teaching needs to be tailored to the client's needs, which the nurse does not yet know.
A nurse caring for an older client on a medical-surgical unit notices the client reports frequent constipation and only wants to eat softer foods such as rice, bread, and puddings. What assessment should the nurse perform first?
- A. Auscultate bowel sounds
- B. Palpate the abdomen
- C. Review the client's medication list
- D. Assess dietary fiber intake
Correct Answer: D
Rationale: Assessing dietary fiber intake is critical as the client's preference for softer, low-fiber foods like rice, bread, and puddings may contribute to constipation. This assessment should be prioritized to identify potential causes before proceeding to other assessments like auscultating bowel sounds or palpating the abdomen.
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.