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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.
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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.
Following a fall that left an older adult temporarily bedridden, the nurse is using the SPICES assessment tool to evaluate for cascade iatrogenesis. Which are correct aspects of this tool? Select all that apply.
- A. Senility
- B. Problems with feeding
- C. Irritability
- D. Confusion
- E. Edema of the legs
- F. Skin breakdown
Correct Answer: B,D,F
Rationale: The SPICES acronym identifies common problems in older adults: S-Sleep disorders, P-Problems with eating or feeding, I-Incontinence, C-Confusion, E-Evidence of falls, S-Skin breakdown. Senility is not a specific term used in the SPICES tool, and irritability is not part of the acronym.
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.
A nurse is helping to prepare a calendar for an older adult patient with cognitive impairment. Which type of cognitive impairment is non-reversible?
- A. Post-stroke speech issues
- B. Malnutrition
- C. Alzheimer's disease
- D. Loss of cardiac reserve
Correct Answer: C
Rationale: Alzheimer's disease causes progressive, irreversible cognitive impairment and is the most common degenerative neurologic illness. Post-stroke speech issues, malnutrition, and loss of cardiac reserve can often be managed or improved with therapeutic interventions.
The charge nurse in a long-term care facility discusses ageism with new nurse employees. Nurses are asked to intervene if they observe which of these examples demonstrating ageism?
- A. The AP encourages older adults to apply makeup or aftershave to promote positive self-image.
- B. The activity director explains to an older adult they could learn to use video conferencing to speak to their grandchildren.
- C. A nurse colleague states that older adult should not think about having a boyfriend or girlfriend after age 70 years.
- D. A nurse recognizes the patient who lost their partner of 45 years may be experiencing loneliness.
Correct Answer: C
Rationale: Ageism involves stereotyping older adults based on characteristics not universal to their age group. Stating that older adults should not pursue romantic relationships after age 70 is an example of ageism, as it dismisses their capacity for relationships. The other options promote positive self-image, resilience, or acknowledge emotional needs.