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The elderly client is complaining of abdominal discomfort. Which scientific rationale should the nurse remember when addressing an elderly client's perception of pain?
- A. Elderly clients react to pain the same way any other age group does.
- B. The elderly client usually requires more pain medication.
- C. Reaction to painful stimuli may be decreased with age.
- D. The elderly client should use the Wong scale to assess pain.
Correct Answer: C
Rationale: Age-related sensory decline reduces pain perception in the elderly, affecting reporting. Pain reaction varies, more medication is not standard, and the Wong scale is pediatric.
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A client asks the nurse what causes Parkinson's disease. The nurse's correct reply would be that Parkinson's disease is thought to be due to:
- A. a deficiency of dopamine in the brain.
- B. a demyelinating process affecting the central nervous system.
- C. atrophy of the basal ganglia.
- D. insufficient uptake of acetylcholine in the body.
Correct Answer: A
Rationale: Parkinson's disease is caused by a deficiency of dopamine in the brain, leading to motor symptoms.
A resident of a long-term care facility tells the nurse, 'I'm having a hard time hearing people talk and can't understand the voices on TV.' Which action is most appropriate?
- A. Teach the client about eliminating background noises in the room.
- B. Assess the client's hearing and use an otoscope for examination.
- C. Schedule an appointment with the HCP for bilateral ear irrigations.
- D. Instruct the client to look at the speaker's lips to decipher words.
Correct Answer: B
Rationale: The nurse should assess the client's hearing and perform an otoscopic examination to verify symptoms and identify the cause. Other actions follow assessment.
The client is postoperative retinal detachment surgery, and gas tamponade was used to flatten the retina. Which intervention should the nurse implement first?
- A. Teach the signs of increased intraocular pressure.
- B. Position the client as prescribed by the surgeon.
- C. Assess the eye for signs/symptoms of complications.
- D. Explain the importance of follow-up visits.
Correct Answer: B
Rationale: Positioning as prescribed (e.g., face-down) is critical to maintain gas tamponade efficacy and retinal reattachment. Teaching, assessment, and follow-up are secondary.
The client is receiving treatment with gentamicin ophthalmic solution for bacterial conjunctivitis. Which symptom, described by the client, indicates that the medication is ineffective?
- A. Eyes feel strained
- B. Yellowish eye drainage
- C. Twitching of the eye
- D. Unable to read small print
Correct Answer: B
Rationale: Mucopurulent eye drainage, especially yellowish or greenish, is associated with bacterial conjunctivitis; continuing with eye drainage indicates gentamicin is ineffective in treating the infection. Eyestrain, twitching, and inability to read small print are not associated with an infectious process.
What should the nurse include when teaching the client with Parkinson's disease?
- A. He should try to continue working as long as he can remain sitting most of the day.
- B. Drooling may be reduced somewhat if he remembers to swallow frequently.
- C. He should return monthly for lab tests, which will predict the progression of the disease.
- D. Emotional stress has no effect on voluntary muscle control in clients with Parkinson's disease.
Correct Answer: B
Rationale: Frequent swallowing can reduce drooling, a common symptom in Parkinson's disease, improving comfort and social interaction.