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The 62-year-old client is diagnosed with osteoporosis. Which medication, if taken by the client, should the nurse identify as posing a secondary risk factor for the client’s osteoporosis?
- A. Baby aspirin daily for past 4 years
- B. Escitalopram 5 mg daily for past 7 months
- C. Multivitamin for many years
- D. 10-year use of budesonide nostril spray bid
Correct Answer: D
Rationale: Long-term corticosteroid use, like budesonide, is a risk factor for osteoporosis. Aspirin, escitalopram, and multivitamins (with calcium/vitamin D) do not contribute to bone loss.
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The nurse is caring for the 55-year-old client. Which statement by the client related to psychosocial changes should the nurse most definitely explore?
- A. I really don’t want to color my hair, even though it seems to be getting grayer every day.'
- B. I can’t see as sharp anymore. I get frustrated by the small lettering on the medicine bottles.'
- C. My husband and I have a more active sexual life now that the children are out of the house.'
- D. My house is empty; I thought I’d be happy when my children finally left, but I feel lonely.'
Correct Answer: D
Rationale: The client’s statement suggests empty nest syndrome, a psychosocial concern requiring further exploration. Graying hair is a normal physiological change, vision issues are physiological, and an active sexual life indicates a healthy relationship.
The nurse is reviewing a laboratory report for a 61-year-old client. Which finding is most important for the nurse to address with the HCP?
- A. Total cholesterol 180 mg/dL; was 140 at age 50
- B. Erythrocyte sedimentation rate (ESR) increased
- C. Alkaline phosphatase increased
- D. AST, ALT, and serum bilirubin increased
Correct Answer: D
Rationale: Elevated liver function tests (AST, ALT, bilirubin) are not age-related and suggest liver pathology, requiring immediate HCP notification. Cholesterol, ESR, and alkaline phosphatase increases are normal with aging.
The older adult client is experiencing relocation stress after being admitted to a nursing home. Which intervention is best for the nurse to implement?
- A. Ask family members to explore placing the client in another nursing home
- B. Change the client’s room every week until a compatible roommate is found
- C. Place the client’s favorite items, such as a family picture, at the client’s bedside
- D. Ask that family members avoid talking to the client about being in the nursing home
Correct Answer: C
Rationale: Familiar items like a family picture reduce relocation stress. Moving facilities, changing rooms, or avoiding discussion may increase stress.
The nurse completes teaching for the 80-year-old female client. Which statement made by the client indicates further teaching is needed?
- A. Instead of using sodium seasonings, I plan to try one with herbs and lemon.'
- B. Although I find my lavender-scented hand cream relaxing, I should not use it.'
- C. I should place a towel on the floor outside my shower so I don’t slip when getting out.'
- D. Rather than relying on laxatives, I should increase my intake of fruits and vegetables.'
Correct Answer: C
Rationale: Placing a towel on the floor increases fall risk; a slip-resistant mat is needed. Nonsodium seasonings, avoiding scented lotions, and increasing roughage are correct.
The nurse is planning a health promotion program for a group of middle-aged adults. Which topic is most appropriate for the nurse to include?
- A. Methods of contraception
- B. Stress management skills
- C. Reduction of caloric intake
- D. A safe home environment
Correct Answer: B
Rationale: Stress management skills are most important for middle-aged adults facing stressors like aging, family support, and retirement planning, which contribute to stress-related diseases. Contraception is more relevant for young adults, caloric reduction is secondary, and home safety suits families or older adults.