Nokea
You are caring for an 82-year-old man who was recently admitted to the geriatric medical unit in which you work. Since admission, he has spoken frequently of becoming a burden to his children and staying afloat financially. When planning this patients care, you should recognize his heightened risk of what nursing diagnosis?
- A. Disturbed thought processes
- B. Impaired social interaction
- C. Decisional conflict
- D. Anxiety
Correct Answer: D
Rationale: Economic concerns and fear of becoming a burden to families often lead to high anxiety in older people. There is no clear indication that the patient has disturbed thought processes, impaired social interaction, or decisional conflict.
You may also like to solve these questions
After a sudden decline in cognition, a 77-year-old man who has been diagnosed with vascular dementia is receiving care in his home. To reduce this mans risk of future infarcts, what action should the nurse most strongly encourage?
- A. Activity limitation and falls reduction efforts
- B. Adequate nutrition and fluid intake
- C. Rigorous control of the patients blood pressure and serum lipid levels
- D. Use of mobility aids to promote independence
Correct Answer: C
Rationale: Because vascular dementia is associated with hypertension and cardiovascular disease, risk factors (e.g., hypercholesterolemia, history of smoking, diabetes) are similar. Prevention and management are also similar. Therefore, measures to decrease blood pressure and lower cholesterol levels may prevent future infarcts. Activity limitation is unnecessary and infarcts are not prevented by nutrition or the use of mobility aids.
The admissions department at a local hospital is registering an elderly man for an outpatient diagnostic test. The admissions nurse asks the man if he has an advanced directive. The man responds that he does not want to complete an advance directive because he does not want anyone controlling his finances. What would be appropriate information for the nurse to share with this patient?
- A. Advance directives are not legal documents, so you have nothing to worry about.
- B. Advance directives are limited only to health care instructions and directives.
- C. Your finances cannot be managed without an advance directive.
- D. Advance directives are implemented when you become incapacitated, and then you will use a living will to allow the state to manage your money.
Correct Answer: B
Rationale: An advance directive is a formal, legally endorsed document that provides instructions for care (living will) or names a proxy decision maker (durable power of attorney for health care) and covers only issues related specifically to health care, not financial issues. They do not address financial issues. Advance directives are implemented when a patient becomes incapacitated, but financial issues are addressed with a durable power of attorney for finances, or financial power of attorney.
An elderly patient, while being seen in an urgent care facility for a possible respiratory infection, asks the nurse if Medicare is going to cover the cost of the visit. What information can the nurse give the patient to help allay her concerns?
- A. Medicare has a copayment for many of the services it covers. This requires the patient to pay a part of the bill.
- B. Medicare pays for 100% of the cost for acute-care services, so the cost of the visit will be covered.
- C. Medicare will only pay the cost for acute-care services if the patient has a very low income.
- D. Medicare will not pay for the cost of acute-care services so the patient will be billed for the services provided.
Correct Answer: A
Rationale: The two major programs that finance health in the United States are Medicare and Medicaid, both of which are overseen by the Centers for Medicaid and Medicare Services (CMS). Both programs cover acute-care needs such as inpatient hospitalization, physician care, outpatient care, home health services, and skilled nursing care in a nursing. Medicare is a plan specifically for the elderly population, and Medicaid is a program that provides services based on income.
A gerontologic nurse practitioner provides primary care for a large number of older adults who are living with various forms of cardiovascular disease. This nurse is well aware that heart disease is the leading cause of death in the aged. What is an age-related physiological change that contributes to this trend?
- A. Heart muscle and arteries lose their elasticity.
- B. Systolic blood pressure decreases.
- C. Resting heart rate decreases with age.
- D. Atrial-septal defects develop with age.
Correct Answer: A
Rationale: The leading cause of death for patients over the age of 65 years is cardiovascular disease. With age, heart muscle and arteries lose their elasticity, resulting in a reduced stroke volume. As a person ages, systolic blood pressure does not decrease, resting heart rate does not decrease, and the aged are not less likely to adopt a healthy lifestyle.
A 47-year-old patient who has come to the physicians office for his annual physical is being assessed by the office nurse. The nurse who is performing routine health screening for this patient should be aware that one of the first physical signs of aging is what?
- A. Having more frequent aches and pains
- B. Failing eyesight, especially close vision
- C. Increasing loss of muscle tone
- D. Accepting limitations while developing assets
Correct Answer: B
Rationale: Failing eyesight, especially close vision, is one of the first signs of aging in middle life. More frequent aches and pains begin in the early late years (between ages 65 and 79). Increase in loss of muscle tone occurs in later years (ages 80 and older). Accepting limitations while developing assets is socialization development that occurs in adulthood.