Nokea
The nurse is caring for a 65 -year-old patient who has previously been diagnosed with hypertension. Which of the following blood pressure readings represents the threshold between high-normal blood pressure and hypertension?
- A. 140 / 90 mm Hg
- B. 145 / 95 mm Hg
- C. 150 / 100 mm Hg
- D. 160 / 100 mm Hg
Correct Answer: A
Rationale: Hypertension is the diagnosis given when the blood pressure is greater than 140 / 90 mm Hg. This makes the other options incorrect.
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A home health nurse makes a home visit to a 90 -year-old patient who has cardiovascular disease. During the visit the nurse observes that the patient has begun exhibiting subtle and unprecedented signs of confusion and agitation. What should the home health nurse do?
- A. Increase the frequency of the patients home care.
- B. Have a family member check in on the patient in the evening.
- C. Arrange for the patient to see his primary care physician.
- D. Refer the patient to an adult day program.
Correct Answer: C
Rationale: In more than half of the cases, sudden confusion and hallucinations are evident in multi-infarct dementia. This condition is also associated with cardiovascular disease. Having the patients home care increased does not address the problem, neither does having a family member check on the patient in the evening. Referring the patient to an adult day program may be beneficial to the patient, but it does not address the acute problem the patient is having, the nurse should arrange for the patient to see his primary care physician.
A gerontologic nurse is making an effort to address some of the misconceptions about older adults that exist among health care providers. The nurse has made the point that most people aged 75 years remains functionally independent. The nurse should attribute this trend to what factor?
- A. Early detection of disease and increased advocacy by older adults
- B. Application of health-promotion and disease-prevention activities
- C. Changes in the medical treatment of hypertension and hyperlipidemia
- D. Genetic changes that have resulted in increased resiliency to acute infection
Correct Answer: B
Rationale: Even among people 75 years of age and over, most remain functionally independent, and the proportion of older Americans with limitations in activities is declining. These declines in limitations reflect recent trends in health-promotion and disease-prevention activities, such as improved nutrition, decreased smoking, increased exercise, and early detection and treatment of risk factors such as hypertension and elevated serum cholesterol levels. This phenomenon is not attributed to genetics, medical treatment, or increased advocacy.
Mrs. Harris is an 83-year-old woman who has returned to the community following knee replacement surgery. The community health nurse recognizes that Mrs. Harris has prescriptions for nine different medications for the treatment of varied health problems. In addition, she has experienced occasional episodes of dizziness and lightheadedness since her discharge. The nurse should identify which of the following nursing diagnoses?
- A. Risk for infection related to polypharmacy and hypotension
- B. Risk for falls related to polypharmacy and impaired balance
- C. Adult failure to thrive related to chronic disease and circulatory disturbance
- D. Disturbed thought processes related to adverse drug effects and hypotension
Correct Answer: B
Rationale: Polypharmacy and loss of balance are major contributors to falls in the elderly. This patient does not exhibit failure to thrive or disturbed thought processes. There is no evidence of a heightened risk of infection.
Based on a patients vague explanations for recurring injuries, the nurse suspects that a community-dwelling older adult may be the victim of abuse. What is the nurses primary responsibility?
- A. Report the findings to adult protective services.
- B. Confront the suspected perpetrator.
- C. Gather evidence to corroborate the abuse.
- D. Work with the family to promote healthy conflict resolution.
Correct Answer: A
Rationale: If neglect or abuse of any kind including physical, emotional, sexual, or financial abuse is suspected, the local adult protective services agency must be notified. The responsibility of the nurse is to report the suspected abuse, not to prove it, confront the suspected perpetrator, or work with the family to promote resolution.
A nurse is planning discharge teaching for an 80 -year-old patient with mild short-term memory loss. The discharge teaching will include how to perform basic wound care for the venous ulcer on his lower leg. When planning the necessary health education for this patient, what should the nurse plan to do?
- A. Set long-term goals with the patient.
- B. Provide a list of useful Web sites to supplement learning.
- C. Keep visual cues to a minimum to enhance the patients focus.
- D. Keep teaching periods short.
Correct Answer: D
Rationale: To assist the elderly patient with short-term memory loss, the nurse should keep teaching periods short, provide glare-free lighting, link new information with familiar information, use visual and auditory cues, and set short-term goals with the patient. The patient may or may not be open to the use of online resources.