Nokea
An occupational health nurse overhears an employee talking to his manager about a 65 -year-old coworker. What phenomenon would the nurse identify when hearing the employee state, He should just retire and make way for some new blood.?
- A. Intolerance
- B. Ageism
- C. Dependence
- D. Nonspecific prejudice
Correct Answer: B
Rationale: Ageism refers to prejudice against the aged. Intolerance is implied by the employees statement, but the intolerance is aimed at the coworkers age. The employees statement does not raise concern about dependence. The prejudice exhibited in the statement is very specific.
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An 84-year-old patient has returned from the post-anesthetic care unit (PACU) following hip arthroplasty. The patient is oriented to name only. The patients family is very upset because, before having surgery, the patient had no cognitive deficits. The patient is subsequently diagnosed with postoperative delirium. What should the nurse explain to the patients family?
- A. This problem is self-limiting and there is nothing to worry about.
- B. Delirium involves a progressive decline in memory loss and overall cognitive function.
- C. Delirium of this type is treatable and her cognition will return to previous levels.
- D. This problem can be resolved by administering antidotes to the anesthetic that was used in surgery.
Correct Answer: C
Rationale: Surgery is a common cause of delirium in older adults. Delirium differs from other types of dementia in that delirium begins with confusion and progresses to disorientation. It has symptoms that are reversible with treatment, and, with treatment, is short term in nature. It is patronizing and inaccurate to reassure the family that there is nothing to worry about. The problem is not treated by the administration of antidotes to anesthetic.
A gerontologic nurse is overseeing the care that is provided in a large, long-term care facility. The nurse is educating staff about the significant threat posed by influenza in older, frail adults. What action should the nurse prioritize to reduce the incidence and prevalence of influenza in the facility?
- A. Teach staff how to administer prophylactic antiviral medications effectively.
- B. Ensure that residents receive a high-calorie, high-protein diet during the winter.
- C. Make arrangements for residents to limit social interaction during winter months.
- D. Ensure that residents receive influenza vaccinations in the fall of each year.
Correct Answer: D
Rationale: The influenza and the pneumococcal vaccinations lower the risks of hospitalization and death in elderly people. The influenza vaccine, which is prepared yearly to adjust for the specific immunologic characteristics of the influenza viruses at that time, should be administered annually in autumn. Prophylactic antiviral medications are not used. Limiting social interaction is not required in most instances. Nutrition enhances immune response, but this is not specific to influenza prevention.
The nurse is providing patient teaching to a patient with early stage Alzheimers disease (AD) and her family. The patient has been prescribed donepezil hydrochloride (Aricept). What should the nurse explain to the patient and family about this drug?
- A. It slows the progression of AD.
- B. It cures AD in a small minority of patients.
- C. It removes the patients insight that he or she has AD.
- D. It limits the physical effects of AD and other dementias.
Correct Answer: A
Rationale: There is no cure for AD, but several medications have been introduced to slow the progression of the disease, including donepezil hydrochloride (Aricept). These medications do not remove the patients insight or address physical symptoms of AD.
You are caring for a patient with late-stage Alzheimers disease. The patients wife tells you that the patient has now become completely dependent and that she feels guilty if she takes any time for herself. What outcomes would be appropriate for the nurse to develop to assist the patients wife?
- A. The caregiver learns to explain to the patient why she needs time for herself.
- B. The caregiver distinguishes essential obligations from those that can be controlled or limited.
- C. The caregiver leaves the patient at home alone for short periods of time to encourage independence.
- D. The caregiver prioritizes her own health over that of the patient.
Correct Answer: B
Rationale: For prolonged periods, it is not uncommon for caregivers to neglect their own emotional and health needs. The caregiver must learn to distinguish obligations that she must fulfill and limit those that are not completely necessary. The caregiver can tell the patient when she leaves, but she should not expect that the patient will remember or will not become angry with her for leaving. The caregiver should not leave the patient home alone for any length of time because it may compromise the patients safety. Being thoughtful and selective with her time and energy is not synonymous with prioritizing her own health over that of the patient; it is more indicative of balance and sustainability.
A 47-year-old patient who has come to the physicians office for his annual physical is being assessed by the office nurse. The nurse who is performing routine health screening for this patient should be aware that one of the first physical signs of aging is what?
- A. Having more frequent aches and pains
- B. Failing eyesight, especially close vision
- C. Increasing loss of muscle tone
- D. Accepting limitations while developing assets
Correct Answer: B
Rationale: Failing eyesight, especially close vision, is one of the first signs of aging in middle life. More frequent aches and pains begin in the early late years (between ages 65 and 79). Increase in loss of muscle tone occurs in later years (ages 80 and older). Accepting limitations while developing assets is socialization development that occurs in adulthood.