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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.
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A nurse is assessing coping in older women in a support group for recent widows. Which statement by a participant indicates strong social network coping?
- A. I have had the same best friend for decades
- B. I think I am coping very well on my own
- C. My kids come to see me over the weekend
- D. Oh, I have lots of friends at the senior center
Correct Answer: A
Rationale: Friendship and support enhance coping. The quality of the relationship is most important. People who have close, intimate, stable relationships with others in whom they confide are more likely to cope with crises.
A nurse admits an older client from a home environment where she lives with her adult son and daughter-in-law. The client has urine burns on her skin, no dentures, and several pressure ulcers. What action by the nurse is most appropriate?
- A. Ask the family how these problems occurred
- B. Call the police department and file a report
- C. Assist with Adult Protective Services
- D. Report the findings as per agency policy
Correct Answer: D
Rationale: These findings are suspicious for abuse. Health care providers are mandatory reporters for suspected abuse. The nurse should notify social work, case management, or whomever is designated in policies. This person can then assess the situation further. If the police need to be notified, that is the person who will notify them. Adult Protective Services is notified in a community setting.
An older adult recently retired and reports being depressed and lonely. What information should the nurse assess as a priority?
- A. History of previous depression
- B. Previous stressful events
- C. Role of work in the adult's life
- D. Usual leisure time activities
Correct Answer: C
Rationale: Often older adults lose support systems when their roles change. For instance, when people retire, they may lose their entire social network, leading to feelings of depression and loneliness. The nurse should first assess the role that work played in the client's life. The other factors can be assessed as well, but this circumstance is commonly seen in the older population.
A home health care nurse is planning an exercise program with an older client who lives at home independently but whose mobility issues prevent much activity outside the home. Which exercise regimen would be most beneficial to this adult?
- A. Building strength and flexibility
- B. Improving exercise endurance
- C. Increasing cardiovascular capacity
- D. Enhancing balance and coordination
Correct Answer: A
Rationale: This older adult is mostly homebound. Exercise regimens for homebound clients include activities to increase functional ability for activities of daily living. Strength and flexibility exercises will help the client maintain independent living. The other options are beneficial but do not specifically address the client's functional abilities.
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.