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The nurse is providing patient teaching to a patient with early stage Alzheimers disease (AD) and her family. The patient has been prescribed donepezil hydrochloride (Aricept). What should the nurse explain to the patient and family about this drug?
- A. It slows the progression of AD.
- B. It cures AD in a small minority of patients.
- C. It removes the patients insight that he or she has AD.
- D. It limits the physical effects of AD and other dementias.
Correct Answer: A
Rationale: There is no cure for AD, but several medications have been introduced to slow the progression of the disease, including donepezil hydrochloride (Aricept). These medications do not remove the patients insight or address physical symptoms of AD.
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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.
The home health nurse is making an initial home visit to a 76-year-old widower. The patient takes multiple medications for the treatment of varied chronic health problems. The patient states that he has also begun taking some herbal remedies. What should the nurse be sure to include in the patients teaching?
- A. Herbal remedies are consistent with holistic health care.
- B. Herbal remedies are often cheaper than prescribed medication.
- C. It is safest to avoid the use of herbal remedies.
- D. There is a need to inform his physician and pharmacist about the herbal remedies.
Correct Answer: D
Rationale: Herbal remedies combined with prescribed medications can lead to interactions that may be toxic. Patients should notify the physician and pharmacist of any herbal remedies they are using. Even though herbal remedies are considered holistic, this is not something that is necessary to include in the patients teaching. Herbal remedies may be cheaper than prescribed medicine, but this is still not something that is necessary to include in the patients teaching. For most people, it is not necessary to wholly avoid herbal remedies.
A gerontologic nurse is overseeing the care that is provided in a large, long-term care facility. The nurse is educating staff about the significant threat posed by influenza in older, frail adults. What action should the nurse prioritize to reduce the incidence and prevalence of influenza in the facility?
- A. Teach staff how to administer prophylactic antiviral medications effectively.
- B. Ensure that residents receive a high-calorie, high-protein diet during the winter.
- C. Make arrangements for residents to limit social interaction during winter months.
- D. Ensure that residents receive influenza vaccinations in the fall of each year.
Correct Answer: D
Rationale: The influenza and the pneumococcal vaccinations lower the risks of hospitalization and death in elderly people. The influenza vaccine, which is prepared yearly to adjust for the specific immunologic characteristics of the influenza viruses at that time, should be administered annually in autumn. Prophylactic antiviral medications are not used. Limiting social interaction is not required in most instances. Nutrition enhances immune response, but this is not specific to influenza prevention.
An 83-year-old woman was diagnosed with Alzheimers disease 2 years ago and the disease has progressed at an increasing pace in recent months. The patient has lost 16 pounds over the past 3 months, leading to a nursing diagnosis of Imbalanced Nutrition: Less than Body Requirements. What intervention should the nurse include in this patients plan of care?
- A. Offer the patient rewards for finishing all the food on her tray.
- B. Offer the patient bland, low-salt foods to limit offensiveness.
- C. Offer the patient only one food item at a time to promote focused eating.
- D. Arrange for insertion of a gastrostomy tube and initiate enteral feeding.
Correct Answer: C
Rationale: To avoid any playing with food, one dish should be offered at a time. Foods should be familiar and appealing, not bland. Tube feeding is not likely necessary at this time and a reward system is unlikely to be beneficial.
Gerontologic nursing is a specialty area of nursing that provides care for the elderly in our population. What goal of care should a gerontologic nurse prioritize when working with this population?
- A. Helping older adults determine how to reduce their use of external resources
- B. Helping older adults use their strengths to optimize independence
- C. Helping older adults promote social integration
- D. Helping older adults identify the weaknesses that most limit them
Correct Answer: B
Rationale: Gerontologic nursing is provided in acute care, skilled and assisted living, community, and home settings. The goals of care include promoting and maintaining functional status and helping older adults identify and use their strengths to achieve optimal independence. Goals of gerontologic nursing do not include helping older adults promote social integration or identify their weaknesses. Optimal independence does not necessarily involve reducing the use of available resources.