Nokea
The nurse is planning a health promotion program for a group of middle-aged adults. Which topic is most appropriate for the nurse to include?
- A. Methods of contraception
- B. Stress management skills
- C. Reduction of caloric intake
- D. A safe home environment
Correct Answer: B
Rationale: Stress management skills are most important for middle-aged adults facing stressors like aging, family support, and retirement planning, which contribute to stress-related diseases. Contraception is more relevant for young adults, caloric reduction is secondary, and home safety suits families or older adults.
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The nurse is caring for the chronically ill middle-aged adult who has had numerous hospitalizations. Which behaviors may interfere with the client’s achievement of the developmental task associated with middle adulthood? Select all that apply.
- A. Writes thank-you notes to friends
- B. Stays at home and refuses visitors
- C. Self-absorbed in own psychological needs
- D. Attempts to perform own personal cares
- E. Continually relays feelings of inadequacy
Correct Answer: B;C;E
Rationale: Staying home, self-absorption, and feelings of inadequacy interfere with maintaining social relationships and generativity. Thank-you notes and self-care support generativity.
The nurse is admitting the older adult client to a nursing home. Which is the nurse’s best approach when obtaining information during the admission interview?
- A. Direct questions to the family member accompanying the client
- B. Speak clearly and slowly to the client using high-pitched vocal tones
- C. Take the client and family members to a private room without distractions
- D. Speak to the client loudly about familiar topics before asking questions
Correct Answer: C
Rationale: A private, distraction-free room respects confidentiality and aids focus. Directing questions to family, high-pitched tones, or loud familiar topics are inappropriate.
Pre-hospital admission medications for the older adult client include warfarin and atenolol. Which statement made by the client should prompt the nurse to initiate a referral to a social worker?
- A. I crush my medications and take them with applesauce because they are hard to swallow.'
- B. I stopped taking my blood pressure pill; I can’t afford it, and my blood pressure is normal.'
- C. I feel more alert after starting to take ginkgo, but I forgot to ask my doctor if it were okay.'
- D. I have my daughter set up my medications for two weeks at a time in a medication bar.'
Correct Answer: B
Rationale: Stopping medication due to cost indicates a financial concern, warranting a social worker referral. Swallowing issues, ginkgo use, and medication setup require different interventions.
The nurse is interviewing an 80-year-old client who has urinary incontinence. The client is taking furosemide. When asked about daily fluid intake, the client states, 'I drink 2 glasses of water, 1 glass of milk, and a half glass of juice. I don’t drink coffee or tea.' Which responses by the nurse are appropriate? Select all that apply.
- A. Your fluid intake should be 6 to 8 glasses of water, plus other fluids.'
- B. Your fluid intake is adequate and may help to reduce your incontinence.'
- C. Caffeine increases urination; it is good that you avoid drinking coffee.'
- D. Your fluid intake is limited; this increases your risk for dehydration.'
- E. Your fluid intake is sufficient to maintain a fluid and electrolyte balance.'
Correct Answer: A;C;D
Rationale: The client’s 3.5 glasses of fluid are inadequate, increasing dehydration risk, especially with furosemide. Older adults need 6-8 glasses of water plus other fluids, and avoiding caffeine reduces diuresis. Inadequate fluid may worsen incontinence.
After performing an assessment and determining that there are no other causes, the nurse concludes that the older adult’s recent hearing loss in one ear may be from cerumen accumulation from age-related changes. The nurse’s conclusion was based on which age-related changes that contribute to the cerumen accumulation?
- A. Reduced sweat gland activity; thinning and drying of the skin lining the ear canal
- B. Ossicular bone calcification; longer and thicker hair growth in the ear canal
- C. Degenerative structural changes of the eardrum preventing cerumen passage
- D. Over activity of the sweat glands contributing to the development of presbycusis
Correct Answer: A
Rationale: Reduced sweat gland activity and thinning/drying of the ear canal skin cause cerumen buildup, affecting sound perception. Ossicular calcification, eardrum changes, and presbycusis are unrelated.