Nokea
An elderly patient with diabetes is admitted with low blood sugar and a syncopal episode. He is confused and unable to give clear answers to most questions. He is noted to have multiple decubiti, poor hygiene, and several old and new lacerations with varying areas of ecchymosis. Which is of most concern to you, the nurse?
- A. The possibility that elder abuse is occurring
- B. Obtaining an accurate medical history
- C. The need for diabetic teaching
- D. The need for a tetanus shot because of his lacerations
Correct Answer: A
Rationale: Signs of decubiti, poor hygiene, and multiple injuries suggest possible elder abuse, requiring immediate investigation.
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An elderly client with dementia is brought to the primary health-care provider's office. The client's daughter asks the nurse, 'What is dementia?' Which nursing response is appropriate?
- A. It is the deterioration of all cognitive functions
- B. It is the inability to think with usual clarity, speed, and coherence
- C. It is a feeling of intense sadness, helplessness, and hopelessness
- D. It is a perceptual disorder characterized by dreams and hallucinations
Correct Answer: B
Rationale: Dementia is characterized by impaired cognitive function, including memory, thinking, and reasoning.
Which comment by the caregiver of an older adult patient with Alzheimer's disease would concern you the most?
- A. I get tired, but my daughter comes to relieve me each day
- B. I can't sleep because I am afraid he will get out of the house
- C. This illness has affected the entire family, not just him
- D. The disease is progressing about the way we were told to expect that it would
Correct Answer: B
Rationale: Fear of the patient wandering due to lack of sleep indicates caregiver stress and a safety risk for the patient.
An 80-year-old patient is hospitalized with a UTI and peripheral vascular disease. In addition, he has glaucoma and diabetes. Which nursing actions would be appropriate for him?
- A. Assess finger stick blood sugar as ordered
- B. Assess peripheral pulses, capillary refill, warmth, and color of extremities
- C. Assess risk for suicide or self-harm
- D. Perform mouth care every 8 hours or more often as needed
- E. Protect from injury due to impaired vision
- F. Encourage weight-bearing exercise and increased calcium intake
- G. Scan the bladder to detect urinary retention
Correct Answer: A,B,D,E,G
Rationale: These actions address the patient's specific conditions: diabetes, PVD, glaucoma, and UTI.
A nurse working in the hospital complains about his assignment, saying, 'I don't have a single patient younger than 70 years old. I'll be babbling and confused by the end of my shift!' These comments reflect:
- A. humor in the workplace
- B. the practice of ageism
- C. an honest assessment of the assignment
- D. caregiver burnout
Correct Answer: B
Rationale: The comment stereotypes elderly patients, reflecting ageism by assuming they are inherently confusing.
An elderly clients states, 'I can't afford to eat and buy all these medications.' What nursing intervention would be most appropriate?
- A. Refer the client to chaplain's services
- B. Refer the client to available social services
- C. Help the client choose between food and medicine
- D. Give the client $100 of your money to help buy medicine
Correct Answer: B
Rationale: Referring to social services can connect the client with resources for food and medication assistance.