Nokea
The nurse is teaching newly hired NAs in a long term care facility. What information about skin care for older adults should the nurse emphasize?
- A. Avoid skin products purchased for the resident by family that contain alcohol
- B. Apply perfumed skin lots after the resident’s bath when the skin is still moist
- C. When taking residents outdoors, apply sunscreen with a sun protection factor of 8
- D. Apply a strong detergent to clothing with food stains before sending to laundry
Correct Answer: A
Rationale: Avoiding alcohol-containing products prevents skin drying in older adults with fragile skin. Perfumed lotions, low SPF, and strong detergents increase irritation risk.
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The nurse has limited time to teach the middle-aged adult client. The nurse should initially plan to take which action?
- A. Provide brochures and handouts that the client can discuss with family members
- B. Make a referral to outpatient resources for the client to receive the needed teaching
- C. Establish the highest-priority learning needs and teach with each client or family contact
- D. Answer the client’s questions and leave the extensive teaching for the nurse on the next shift
Correct Answer: C
Rationale: Prioritizing learning needs ensures important teaching is completed efficiently during limited time. Brochures alone, referrals, or deferring teaching are less effective initially.
The older adult client is experiencing relocation stress after being admitted to a nursing home. Which intervention is best for the nurse to implement?
- A. Ask family members to explore placing the client in another nursing home
- B. Change the client’s room every week until a compatible roommate is found
- C. Place the client’s favorite items, such as a family picture, at the client’s bedside
- D. Ask that family members avoid talking to the client about being in the nursing home
Correct Answer: C
Rationale: Familiar items like a family picture reduce relocation stress. Moving facilities, changing rooms, or avoiding discussion may increase stress.
The nurse is assessing the 50-year-old female client who is hospitalized. The nurse should assess the client for which physical changes associated with aging? Select all that apply.
- A. Increased sweat gland activity
- B. Decreased ability to read smaller print
- C. Weight loss due to hypermetabolism
- D. Increased sebaceous gland activity
- E. Absence of a menstrual cycle
Correct Answer: B;E
Rationale: Visual acuity declines, affecting near vision, and menopause causes absence of menstruation in middle-aged women. Sweat and sebaceous gland activity decrease, and weight gain, not loss, occurs due to slower metabolism.
The nurse is caring for the hospitalized 60-year-old client of Korean American ethnicity. Which statement, if made by the client, correctly reflects the Korean American culture and should alert the nurse that intervention is needed?
- A. Since 60 is considered old age, I retired as expected. I’m now worried about insurance.'
- B. Value is on youth and beauty; so little attention is paid to problems of the elderly.'
- C. Fathers are expected to continue to contribute financially even for their adult children.'
- D. Grandchildren are raised by the grandparents until school age, so we have a full house.'
Correct Answer: A
Rationale: In Korean American culture, 60 is considered old age, and retirement is expected, but this client’s concern about insurance requires a social worker consult for coverage options. Other statements reflect different cultural norms or lack specific cultural ties.
The nurse’s assessment findings of the hospitalized older adult include: BP 96/64 mm Hg, P 118 bpm, RR 20/minute, weight 110 lb with an 8-lb weight loss in the last 3 months due to severe loss of appetite from chemotherapy, and BMI of 19. The client reports fatigue so does not go out, but is able to get around the house. Though tired, the client responds appropriately and clearly to questions and denies psychological issues. What score should the nurse assign to the client when completing the Geriatric Mini Nutrition Assessment?
Correct Answer: 4
Rationale: Score: Severe appetite loss = 0; >3 kg weight loss = 0; mobility (bed/chair but not out) = 1; acute disease (cancer) = 0; no psychological issues = 2; BMI 19 = 1. Total = 4.