Nokea
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.
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Which of the following is a common side effect of benzodiazepines in older adults?
- A. Increased alertness
- B. Increased risk of falls
- C. Improved memory
- D. Enhanced muscle strength
Correct Answer: B
Rationale: The correct answer is B: Increased risk of falls. Benzodiazepines are central nervous system depressants that can cause drowsiness, dizziness, and impaired coordination, leading to an increased risk of falls in older adults. This is due to the sedative effects of benzodiazepines, which can affect balance and motor skills. Increased alertness (choice A) is not a common side effect of benzodiazepines, as they typically have a calming and sedating effect. Improved memory (choice C) is also unlikely, as benzodiazepines are more commonly associated with memory impairment. Enhanced muscle strength (choice D) is not a known side effect of benzodiazepines, as they do not directly affect muscle strength. In summary, the correct answer is B because benzodiazepines can increase the risk of falls in older adults due to their sedative properties.
The home care nurse is performing an environmental assessment in the home of an older adult. Which of the following requires immediate nursing action?
- A. Unsecured scattered rugs
- B. Operable smoke detector
- C. Prefilled medication cassette
- D. Unsecured scattered rugs
Correct Answer: A
Rationale: The correct answer is A: Unsecured scattered rugs. This requires immediate nursing action as it poses a significant fall risk for the older adult. Rugs can cause tripping hazards, leading to potential injuries. The nurse should secure or remove the rugs to ensure the safety of the patient.
Summary of other choices:
B: Operable smoke detector - While important for safety, it does not require immediate nursing action as it is already in working condition.
C: Prefilled medication cassette - This is not an immediate safety concern and can be addressed during routine medication management.
D: Unsecured scattered rugs (repeated) - This choice is the same as the correct answer, so it is incorrect.
Which physiological change in the brain is the reason the nurse allows more time for answering questions with older adults?
- A. Increased secretion of cholinesterase
- B. Decreased secretion of neurotransmitters
- C. Loss of spinal cord and brainstem neurons
- D. Atrophy of dendrites in the cerebral cortex
Correct Answer: D
Rationale: The correct answer is D: Atrophy of dendrites in the cerebral cortex. With aging, there is a natural decline in brain volume and synaptic connections, leading to reduced dendritic branching and synaptic density in the cerebral cortex. This affects processing speed and cognitive functions, requiring more time for older adults to respond to questions.
Rationale:
A: Increased secretion of cholinesterase is not a physiological change associated with aging that would require more time for answering questions.
B: Decreased secretion of neurotransmitters may occur with aging but is not the primary reason for slower processing speed in older adults.
C: Loss of spinal cord and brainstem neurons is not the main factor influencing older adults' response time to questions compared to atrophy of dendrites in the cerebral cortex.
Which of the following interventions has been shown to delay the onset of dementia in older adults?
- A. Strict dietary restrictions
- B. Consistent mental and physical activity
- C. Regular social isolation for mental clarity
- D. Pharmacologic interventions to control hypertension
Correct Answer: B
Rationale: The correct answer is B: Consistent mental and physical activity. Engaging in mental and physical activities can help improve cognitive function, increase brain plasticity, and reduce the risk of cognitive decline. Regular stimulation of the brain through activities like puzzles, reading, and learning new skills can help delay the onset of dementia. Physical activity also promotes overall brain health by improving circulation and reducing inflammation.
Choices A, C, and D are incorrect:
A: Strict dietary restrictions may have some benefits for overall health, but there is limited evidence to suggest that it directly delays the onset of dementia.
C: Regular social isolation can actually increase the risk of cognitive decline and dementia, as social interaction is important for brain health.
D: Pharmacologic interventions to control hypertension may be important for overall health, but they are not specifically shown to delay the onset of dementia in older adults.
Mr J., an 80 yr old who has had flu like symptoms with diarrhea and has vomited 4 times in the last 24 hours is seen in the ED. Mr. J seems confused and is lethargic. The nurse notes that Mr. J has dry skin, a brown tongue, sunken cheeks and concentrated urine. This array of symptoms indicates:
- A. congestive heart failure
- B. dehydration
- C. urinary tract infection
- D. bowel obstruction
Correct Answer: B
Rationale: The correct answer is B: dehydration. Mr. J's symptoms of flu-like illness, diarrhea, vomiting, confusion, lethargy, dry skin, brown tongue, sunken cheeks, and concentrated urine are indicative of severe dehydration. Dehydration can lead to electrolyte imbalances, decreased blood volume, and impaired organ function, resulting in confusion and lethargy. Skin changes, dry mucous membranes, and concentrated urine are also classic signs of dehydration. The other choices (A, C, D) do not align with the constellation of symptoms presented by Mr. J and are less likely based on the information provided.