Nokea
The 83-year-old tells the nurse, 'I’m not taking my medication because it’s too expensive and I really don’t need it anymore.' Before responding to the client, the nurse should consider that the most common reason for older clients to discontinue their medications is which of the following?
- A. Information about the medications is insufficient
- B. Medications alter the taste of foods that they enjoy
- C. Fear they will live longer than their resources will last
- D. They want the attention from others when they are sick
Correct Answer: C
Rationale: Fear of outliving resources is a common reason older adults stop medications, reflecting financial concerns. Lack of information, taste changes, and seeking attention are less common.
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The nurse is caring for the 50-year-old client who reports having difficulty falling asleep. Which recommendations should the nurse make to this client? Select all that apply.
- A. Drink a glass of wine or a beer before bedtime
- B. Avoid exercising 2 to 3 hours before bedtime
- C. Go to bed at the same time each night
- D. Watch television in bed just before bedtime
- E. Avoid eating large or spicy meals in the evening
Correct Answer: B;C;E
Rationale: Avoiding exercise near bedtime, maintaining a consistent bedtime, and avoiding large/spicy meals promote sleep. Alcohol and TV in bed can disrupt sleep.
The 73-year-old client receiving palliative care comments to the nurse, 'I am such a feeble old man. My life is such a waste, and I hate having my wife see me like this. just wish I could die now.' Which statement is the nurse’s best interpretation of the client’s comments?
- A. The client is feeling ashamed and ready to die
- B. The client is feeling anxious knowing that he is terminally ill
- C. The client is facing Havighurst’s developmental tasks of later maturity
- D. The client is in Erikson’s developmental state of integrity versus despair
Correct Answer: D
Rationale: The client’s contempt for self and desire to die reflect despair in Erikson’s integrity versus despair stage. No shame or anxiety is evident, and Havighurst’s tasks involve positive adjustments.
The nurse is assessing a healthy middle-aged adult. Which finding should the nurse expect?
- A. Weight gain of 20 pounds in the past year
- B. Tactile fremitus is absent at the apex of the lungs
- C. Counts backward from 100 subtracting 7 each time
- D. Percussion shows heart is larger than at last checkup
Correct Answer: C
Rationale: The nurse should expect a middle-aged adult to perform mental tasks like serial 7s. A 20-pound weight gain is excessive, absent tactile fremitus suggests pneumothorax, and heart enlargement indicates a medical issue, not a normal finding.
The nurse observes the NA providing a stuffed animal to the hospitalized older adult client who is experiencing delirium. Which action by the nurse is most appropriate?
- A. Reprimand the NA for treating the client like a child
- B. Remove the stuffed animal before anyone else sees it
- C. Report the NA’s action to the unit’s nurse manager
- D. Thank the NA for providing it for the client’s fidgeting
Correct Answer: D
Rationale: A stuffed animal can occupy a delirious client’s hands, preventing line removal, and may be comforting. Thanking the NA is appropriate; other actions are unnecessary or punitive.
The nurse is assessing the chest of the normally healthy adult male client without chest abnormalities. Which chest curvature illustrated should the nurse expect to observe?
- A. Illustration A
- B. Illustration B
- C. Illustration C
- D. Illustration D
Correct Answer: C
Rationale: The normal adult chest has an anteroposterior-to-lateral ratio of approximately 1:2 and a costal angle less than 90 degrees. Illustration A is pectus excavatum, B is pectus carinatum, and D is barrel chest associated with COPD.