Nokea
An older women tells the nurse that her husband seldom brushes his teeth as he did in the past. A reason why older clients stop participating in daily oral hygiene, such as brushing the teeth, include:
- A. Decreased manual dexterity and inability to hold a tooth brush
- B. Malocclusion of teeth
- C. Decrease in taste acuity
- D. Lack of dental insurance
Correct Answer: A
Rationale: The correct answer is A: Decreased manual dexterity and inability to hold a toothbrush. As people age, they may experience decreased hand strength and motor skills, making it difficult to hold and manipulate objects like a toothbrush. This can lead to a decline in oral hygiene practices. Malocclusion of teeth (B) does not directly impact the ability to brush teeth. Decrease in taste acuity (C) may affect appetite but not tooth brushing habits. Lack of dental insurance (D) is a financial barrier and may affect access to dental care, but it does not directly impact the physical ability to brush teeth.
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Which of the following is a sign of frailty in older adults?
- A. Increased muscle mass
- B. Unexplained weight gain
- C. Difficulty walking and balance issues
- D. Improved cognitive function
Correct Answer: C
Rationale: The correct answer is C - Difficulty walking and balance issues. Frailty in older adults is characterized by physical weakness, decreased muscle strength, and reduced functional capacity. Difficulty walking and balance issues are key indicators of frailty as they reflect a decline in physical capabilities. Increased muscle mass (A) is not a sign of frailty but rather a positive indicator of strength. Unexplained weight gain (B) may not necessarily be related to frailty. Improved cognitive function (D) is unrelated to physical frailty.
Nursing interventions for the client with CHF include all of the following except_____
- A. education about daily weights, correct procedure and meaning of changes
- B. monitoring of clients as medications are introduced or titrated to therapeutic levels
- C. education about food esp. sodium levels
- D. assisting with upper endoscopy
Correct Answer: D
Rationale: The correct answer is D because assisting with upper endoscopy is not a standard nursing intervention for CHF. Nursing interventions for CHF focus on managing symptoms, medication adherence, and lifestyle modifications. Choices A, B, and C are correct as they address important aspects of CHF management such as monitoring symptoms, educating on medications, and promoting a low-sodium diet. Helping with an upper endoscopy is unrelated to the management of CHF and falls outside the scope of nursing care for this condition.
The holistic health movement has impacted health care in which of the following ways?
- A. It has focused health care on disease prevention.
- B. It has reshaped how health and health care are perceived.
- C. It has improved access to health care.
- D. It has introduced numerous alternative modalities into health care.
Correct Answer: B
Rationale: The correct answer is B because the holistic health movement emphasizes treating the whole person - mind, body, and spirit. This shifts the focus from merely treating symptoms to considering individual well-being and lifestyle factors. Choice A is not the best answer because while disease prevention is part of holistic health, it is not the primary impact on health care. Choice C is incorrect as the movement does not directly improve access to health care. Choice D is also incorrect as while alternative modalities are part of holistic health, they are not the main impact on health care.
An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg and refuses to remain in the bed. Which intervention should the nurse use to promote and maintain his health?
- A. Have the health care provider speak to him.
- B. Use principles of the holistic health system.
- C. Ask about his perceptions and treatment ideas.
- D. Consult with a practitioner of Chinese medicine.
Correct Answer: C
Rationale: Rationale:
C is correct as it involves understanding the patient's beliefs and preferences, crucial in culturally competent care. A would not address the patient's perspective directly. B is broad and lacks specificity. D assumes all traditional Chinese individuals seek Chinese medicine, which may not be the case.
The home care nurse is visiting an older female client whose husband died 6 months ago. What behavior by the client indicates ineffective coping?
- A. Neglecting personal grooming
- B. Looking at old pictures
- C. Participating in senior citizens' program
- D. Visiting her husband's grave
Correct Answer: A
Rationale: The correct answer is A because neglecting personal grooming indicates a lack of self-care, which is a common sign of ineffective coping after the loss of a loved one. This behavior suggests the client may be struggling emotionally and unable to engage in basic self-care tasks. Looking at old pictures, participating in social activities, and visiting the husband's grave are all healthy coping mechanisms that can help the client process her grief and maintain connections with her late husband.