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You are the nurse caring for a 91-year-old patient admitted to the hospital for a fall. The patient complains of urge incontinence and tells you he most often falls when he tries to get to the bathroom in his home. You identify the nursing diagnosis of risk for falls related to impaired mobility and urinary incontinence. The older adults risk for falls is considered to be which of the following?
- A. The result of impaired cognitive functioning
- B. The accumulation of environmental hazards
- C. A geriatric syndrome
- D. An age-related health deficit
Correct Answer: C
Rationale: A number of problems commonly experienced by the elderly are becoming recognized as geriatric syndromes. These conditions do not fit into discrete disease categories. Examples include frailty, delirium, falls, urinary incontinence, and pressure ulcers. Impaired cognitive functioning, environmental hazards in the home, and an age-related health deficit may all play a part in the episodes in this patients life that led to falls, but they are not diagnoses and are, therefore, incorrect.
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As the population of the United States ages, research has shown that this aging will occur across all racial and ethnic groups. A community health nurse is planning an initiative that will focus on the group in which the aging population is expected to rise the fastest. What group should the nurse identify?
- A. Asian-Americans
- B. White non-Hispanics
- C. Hispanics
- D. African-Americans
Correct Answer: C
Rationale: Although the older population will increase in number for all racial and ethnic groups, the rate of growth is projected to be fastest in the Hispanic population that is expected to increase from 6 million in 2004 to an estimated 17.5 million by 2050.
The presence of a gerontologic advanced practice nurse in a long-term care facility has proved beneficial to both the patients and the larger community in which they live. Nurses in this advanced practice role have been shown to cause what outcome?
- A. Greater interaction between younger adults and older adults occurs.
- B. The elderly recover more quickly from acute illnesses.
- C. Less deterioration takes place in the overall health of patients.
- D. The elderly are happier in long-term care facilities than at home.
Correct Answer: C
Rationale: The use of advanced practice nurses who have been educated in geriatric nursing concepts has proved to be very effective when dealing with the complex care needs of an older patient. When best practices are used and current scientific knowledge applied to clinical problems, significantly less deterioration occurs in the overall health of aging patients. This does not necessarily mean that patients are happier in long-term care than at home, that they recover more quickly from acute illnesses, or greater interaction occurs between younger and older adults.
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.
You are the nurse caring for an elderly patient who is being treated for community-acquired pneumonia. Since the time of admission, the patient has been disoriented and agitated to varying degrees. Appropriate referrals were made and the patient was subsequently diagnosed with dementia. What nursing diagnosis should the nurse prioritize when planning this patients care?
- A. Social isolation related to dementia
- B. Hopelessness related to dementia
- C. Risk for infection related to dementia
- D. Acute confusion related to dementia
Correct Answer: D
Rationale: Acute confusion is a priority problem in patients with dementia, and it is an immediate threat to their health and safety. Hopelessness and social isolation are plausible problems, but the patients cognition is a priority. The patients risk for infection is not directly influenced by dementia.
Nurses and members of other health disciplines at a states public health division are planning programs for the next 5 years. The group has made the decision to focus on diseases that are experiencing the sharpest increases in their contributions to the overall death rate in the state. This team should plan health promotion and disease prevention activities to address what health problem?
- A. Stroke
- B. Cancer
- C. Respiratory infections
- D. Alzheimers disease
Correct Answer: D
Rationale: In the past 60 years, overall deaths, and specifically, deaths from heart disease, have declined. Recently, deaths from cancer and cerebrovascular disease have declined. However, deaths from Alzheimers disease have risen more than 50% between 1999 and 2007.