Nokea
The elderly male client tells the nurse, 'My wife says her cooking hasn't changed, but it is bland and tasteless.' Which response by the nurse is most appropriate?
- A. Would you like me to talk to your wife about her cooking?
- B. Taste buds change with age, which may be why the food seems bland.
- C. This happens because the medications sometimes cause a change in taste.
- D. Why don't you barbecue food on a grill if you don't like your wife's cooking?
Correct Answer: B
Rationale: Age-related taste bud decline reduces taste perception, a common issue in the elderly. Talking to the wife, blaming medications, or suggesting grilling are less appropriate.
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When planning care for a woman with myasthenia gravis, the nurse asks her what time of day she feels strongest. The nurse would expect which of the following replies?
- A. I can wash up and comb my hair before breakfast because I feel best in the morning.'
- B. I only feel good for about an hour after I take my medication.'
- C. I feel strongest in the evening, so I would prefer to take a shower before bedtime.'
- D. I feel best after lunch after I've been moving around a little.'
Correct Answer: A
Rationale: Muscle strength in myasthenia gravis is typically best in the morning, with weakness worsening throughout the day.
The client tells the nurse about being diagnosed with 'wet type' macular degeneration. Which finding should the nurse expect to observe when examining the client's eyes using an ophthalmoscope?
- A. Growth of abnormal blood vessels in the macula has occurred.
- B. Structures in the macula have atrophied.
- C. The lens of the eye has become cloudy.
- D. The edge of the cornea has a thin grayish arc.
Correct Answer: A
Rationale: The 'wet type' of macular degeneration results from the growth of abnormal blood vessels in the macula. The blood vessels often leak fluid and blood. Atrophy occurs in dry macular degeneration, cloudy lens indicates cataract, and corneal arcus is a normal finding in older clients.
The 65-year-old male client who is complaining of blurred vision reports he thinks his glasses need to be cleaned all the time, and he denies any type of eye pain. Which eye disorder should the nurse suspect the client has?
- A. Corneal dystrophy.
- B. Conjunctivitis.
- C. Diabetic retinopathy.
- D. Cataracts.
Correct Answer: D
Rationale: Blurred vision and a sense of dirty glasses without pain suggest cataracts, common in older adults. Corneal dystrophy is rarer, conjunctivitis causes redness, and diabetic retinopathy involves floaters or spots.
Which statement best describes the scientific rationale for the nurse holding the otoscope with the hand in a pencil-hold position when examining the client's ear?
- A. It is usually the most comfortable position to hold the otoscope.
- B. This allows the best visualization of the tympanic membrane.
- C. This prevents inserting the otoscope too far into the external ear.
- D. It ensures the nurse will not cause pain when examining the ear.
Correct Answer: C
Rationale: The pencil-hold prevents deep insertion, protecting the ear canal and tympanic membrane. Comfort, visualization, and pain avoidance are secondary.
The client with diminished sight has problems with the glare from light. Which recommendation should the nurse make?
- A. Install fluorescent lighting throughout the home.
- B. Wear sunglasses and hats with brims when outdoors.
- C. Avoid going outdoors on days that are sunny.
- D. Use direct sunlight from windows rather than lights.
Correct Answer: B
Rationale: Wearing sunglasses and hats with brims while outdoors blocks direct light, reducing glare. Fluorescent lighting and direct sunlight increase glare, and avoiding sunny days is unnecessary.