Nokea
The nurse overhears a person say, 'I’m having a senior moment because I forgot.' How should the nurse interpret this statement?
- A. This phrase is a comical statement without age bias and is acceptable to others
- B. This phrase is a stereotypical reference to older adults that can be termed ageism
- C. This phrase admits that the older adult’s ability to learn new information is limited
- D. This phrase recognizes that all older adults have short- and long-term memory issues
Correct Answer: B
Rationale: The phrase is a stereotypical reference to older adults, perpetuating ageism. It’s not comical, doesn’t imply learning limits, and not all older adults have memory issues.
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The nurse teaches the 18-year-old diabetic client to perform self-administration of insulin. Each time the client makes even a small mistake, the client apologizes for getting it wrong- The client also profusely apologizes when making a minimal mistake in other activities. Based on Erikson’s developmental stages, the nurse concludes that the client may have an unresolved developmental task of which age period?
- A. Infancy
- B. Early childhood
- C. School-aged childhood
- D. Adolescence
Correct Answer: B
Rationale: The behavior indicates an unresolved conflict of 'autonomy versus shame and doubt' associated with the 18-month to 3-year-old age group. When parents are overly critical, the child may develop an overly critical superego, manifesting as constant apologizing for small mistakes.
The 62-year-old client is diagnosed with osteoporosis. Which medication, if taken by the client, should the nurse identify as posing a secondary risk factor for the client’s osteoporosis?
- A. Baby aspirin daily for past 4 years
- B. Escitalopram 5 mg daily for past 7 months
- C. Multivitamin for many years
- D. 10-year use of budesonide nostril spray bid
Correct Answer: D
Rationale: Long-term corticosteroid use, like budesonide, is a risk factor for osteoporosis. Aspirin, escitalopram, and multivitamins (with calcium/vitamin D) do not contribute to bone loss.
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 caring for the 55-year-old client. Which statement by the client related to psychosocial changes should the nurse most definitely explore?
- A. I really don’t want to color my hair, even though it seems to be getting grayer every day.'
- B. I can’t see as sharp anymore. I get frustrated by the small lettering on the medicine bottles.'
- C. My husband and I have a more active sexual life now that the children are out of the house.'
- D. My house is empty; I thought I’d be happy when my children finally left, but I feel lonely.'
Correct Answer: D
Rationale: The client’s statement suggests empty nest syndrome, a psychosocial concern requiring further exploration. Graying hair is a normal physiological change, vision issues are physiological, and an active sexual life indicates a healthy relationship.
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.