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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.
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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 home health care nurse has conducted a home safety assessment for an older adult. There are five concrete steps leading out from the home. Which statement would be most helpful to keeping the older adult safe on the steps?
- A. Have the client use a walker or cane on the steps
- B. Install contrasting color strips at the edge of each step
- C. Advise the client to avoid the steps altogether
- D. Tell the client to use a two-footed gait on the steps
Correct Answer: B
Rationale: As a person ages, they may experience a decreased sense of touch. The older adult may not be aware of where their foot is on the step. Installing contrasting color strips at the edge of each step will help increase visibility and safety for the older adult.
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.