The nurse is teaching an 86-year-old about glaucoma and how...

The nurse is teaching an 86-year-old about glaucoma and how to administer eye drops. Which interventions should the nurse implement? Select all that apply.

A. Plan the session at a time when a support person can attend
B. Provide an environment that is private, quiet, and well lit
C. Be detailed with the explanations to ensure understanding
D. Engage as many of the client’s five senses as possible
E. Give extensive written materials and a schedule to follow

Correct Answer: A;B;D

Rationale: A support person aids learning with vision issues, a private environment enhances focus, and engaging senses improves retention. Detailed explanations may overwhelm, and written materials should be concise.

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The nurse is caring for the 50-year-old client who reports having difficulty falling asleep. Which recommendations should the nurse make to this client? Select all that apply.

A. Drink a glass of wine or a beer before bedtime
B. Avoid exercising 2 to 3 hours before bedtime
C. Go to bed at the same time each night
D. Watch television in bed just before bedtime
E. Avoid eating large or spicy meals in the evening

Correct Answer: B;C;E

Rationale: Avoiding exercise near bedtime, maintaining a consistent bedtime, and avoiding large/spicy meals promote sleep. Alcohol and TV in bed can disrupt sleep.

The nurse is interviewing a family member of the hospitalized 90-year-old client to assess for common problems associated with an increased risk for falling. Which questions should the nurse ask? Select all that apply.

A. Has your mother fallen within the past year?'
B. Has your mother had her annual influenza vaccine?'
C. When was the last time your mother took a pain pill?'
D. Does your mother have any problems with urination?'
E. Does your mother have difficulty falling asleep at night?'

Correct Answer: A;C;D;E

Rationale: Questions about past falls, pain medication, urination issues, and sleep disorders assess fall risk factors. Influenza vaccine is unrelated.

The 18 year-old tells the clinic nurse, 'Thinking about college is stressing me out. I am used to getting A’s and B’s.' Which statement should the nurse reserve until a follow-up visit with the client?

A. Expressing your feelings of anxiety to a friend or nurse helps you cope emotionally.'
B. I will check with the provider about prescribing paroxetine hydrochloride.'
C. Exercise increases the release of endorphins and can enhance your sense of well-being.'
D. If you like drawing or painting, register for an art class during your first semester in college.'

Correct Answer: B

Rationale: The nurse should reserve suggesting an antidepressant until other interventions have been tried. Paroxetine influences neurotransmitters related to anxiety, but non-pharmacological coping strategies like expressing feelings, exercise, and art therapy should be prioritized initially.

The 32-year-old has been trying to get pregnant for the past 10 years- The client consults a family planning clinic after being unsuccessful with the calendar and basal body temperature methods in determining the time of ovulation. Which statement by the nurse would be most appropriate?

A. Let me review the methods with you; maybe you have not been using them correctly.'
B. Have you considered that you might not be ovulating and that adoption is an option?'
C. Test kits are available that will detect an enzyme in cervical mucus that signals ovulation.'
D. If your spouse wears restrictive underwear, this can reduce your chance of conception.'

Correct Answer: C

Rationale: Suggesting an ovulation test kit, which detects guaiacol peroxidase in cervical mucus to signal ovulation, is most appropriate after 10 years of unsuccessful methods. Reviewing methods is less helpful, adoption is premature, and male underwear addresses sperm count, not ovulation timing.

The nurse is caring for the 87-year-old hospitalized client. The nurse should assess for which age-related changes to best protect the client from friction injury?

A. Increased tissue vascularity
B. Increase in subcutaneous tissue
C. Increased rate of cellular replacement
D. Loss of skin thickness and elasticity

Correct Answer: D

Rationale: Loss of skin thickness and elasticity increases friction injury risk due to a thinner epidermis and reduced strength. Vascularity, subcutaneous tissue, and cellular replacement decrease with aging.