Elders Final Review - Full Chapter Questions

Questions and Answers

Which of the following conditions is signaled by bleeding from the nose?

Retinopathy

Telangiectasia

Rhinitis

Epistaxis (correct)

Which of the following conditions may Mr. Jones be experiencing?

Uveitis

Hyphema

Conjunctivitis

Acute glaucoma (correct)

Which of the following is the correct term for the eye condition that presents a sterile mass on the eyelid that is painless and has no reddening?

Entropion

Blepharitis

Hordeolum

Chalazion (correct)

Which of the following statements applies to an oral cancer diagnosis?

It involves unexplained lymph node swelling in the head and neck area. Signup and view all the answers

Which of the following is true about the types of rhinitis?

NAR is a condition of adulthood and is more common in the older adult. Signup and view all the answers

For which of the following evaluations should the patient be referred when sleep impairment is involved with chronic rhinitis?

Obstructive sleep apnea Signup and view all the answers

Evaluation for head and neck disorders should include which of the following? (Select all that apply)

Inspecting patient's features for any abnormalities. Signup and view all the answers

Why might Mrs. Williams' botanical supplement therapy not be covered by Medicare?

Medicare only covers treatments that are approved according to the stringent guidelines of the U.S. Preventive Services Task Force. Signup and view all the answers

When a patient is seen by a nurse practitioner, which objective is kept in mind for the care plan?

Increasing use of the Welcome to Medicare visit. Signup and view all the answers

What is defined as the focus of primary care by advanced nurse practitioners?

Preventing the occurrence of a disease or condition. Signup and view all the answers

Which physical activity options are good recommendations for a 75-year-old male? (Select all that apply)

Whatever the patient is willing and able to do Signup and view all the answers

What should the nurse practitioner consider when planning a patient's health promotion given a life expectancy of 79 years? (Select all that apply)

Present levels of function. Signup and view all the answers

What are some benefits of exercise explained by the nurse practitioner? (Select all that apply)

Increased muscle mass. Signup and view all the answers

Which considerations should be included in a treatment plan for Albert?s health concerns? (Select all that apply)

Teaching that frequent testing and screening is needed if he continues to be sexually active. Signup and view all the answers

What should the nurse practitioner teach Mary about senior immunizations? (Select all that apply)

Persons over the age of 50 years should have a yearly influenza vaccine. Signup and view all the answers

What teaching should be included for Mr. and Mrs. Jones about their trip to Europe? (Select all that apply)

Plan to fill your prescriptions when you are in a larger city. Signup and view all the answers

For a person with chronic degenerative conditions, what health promotion should the nurse suggest?

Increase physical activity. Signup and view all the answers

Which of the following is an example of a patient barrier to exercise?

High body mass index (BMI). Signup and view all the answers

The factors affecting Mr. Osorio's motivation to start a wellness program are examples of what?

Facilitators Signup and view all the answers

What is the correct phrase for the ACSM designed program that incorporates exercise into patient encounters?

Exercise is Medicine Signup and view all the answers

Which suggestion should nurse practitioners make to counter common patient excuses for not exercising?

Take a 10-minute walk every day. Signup and view all the answers

What should older adults with chronic conditions do regarding their physical activity?

Consult a healthcare provider to help set physical activity goals that are realistic and safe. Signup and view all the answers

Vertigo causes wandering.

False Signup and view all the answers

What is the best response regarding Mrs. Williams' concern?

Wound healing for older people may take up to four times longer than it does for younger people. Signup and view all the answers

Why does Mrs. Jones need frequent assessment of her skin?

Fat has redistributed to the abdomen and thighs, leaving bony surfaces in areas such as the face, hands, and sacrum. Signup and view all the answers

Why did the nurse practitioner assure the daughter regarding Mr. James?

Bruises and lacerations can indicate inadequate care. Signup and view all the answers

What defines a secondary lesion?

Arises from changes to a primary lesion. Signup and view all the answers

What is the most relevant question the nurse practitioner should ask regarding Ms. Rose's growth?

Has this growth changed, bled, or is it painful? Signup and view all the answers

What degree of burn does the patient with erythematous and blistered skin have?

First and second degree Signup and view all the answers

What primary prevention strategies can be implemented for an 80-year-old male patient who smokes?

Review home fire safety protocols, including the proper use of smoke alarms, and discuss smoking cessation. Signup and view all the answers

Which of the following are risks of burns for older adults? (Select all that apply)

Diminished nerve function. Signup and view all the answers

What does it mean when a burn is classified as both second degree and some third degree?

It hurts because the nerve endings are exposed in the second-degree area. Signup and view all the answers

What initial treatment should be chosen for Mrs. Thomas's burns? (Select all that apply)

Remove any loose tissue but allow the blisters to remain. Signup and view all the answers

What condition is suspected in Mr. Watson based on his symptoms? (Select all that apply)

Cellulitis of upper left arm Signup and view all the answers

What treatments are included for cellulitis? (Select all that apply)

One drug of choice is dicloxacillin, 500 mg four times a day. Signup and view all the answers

What causes itching, burning, and tingling pain before the breakout of herpes zoster?

We are not certain at this point, however, these symptoms often occur before a breakout of herpes zoster. Signup and view all the answers

Why would the nurse practitioner suggest a biopsy for Mrs. Person's ear growth? (Select all that apply)

The patient is 82 years old and reports having lived in the south of the United States for many years. Signup and view all the answers

Which cranial nerve should be assessed in the examination for disorders of the face?

Cranial nerve VII Signup and view all the answers

Which medical specialist deals with the diagnosing of visual impairments and conditions?

Ophthalmologist Signup and view all the answers

In conducting a physical assessment of an older person, which of the following should be assessed? (Select all that apply)

Presence of pain Signup and view all the answers

During an eye examination of Mrs. Parsons, which of the following findings is concerning? (Select all that apply)

Abnormality in the six cardinal fields of gaze Signup and view all the answers

Before ordering tests for a patient with multiple morbidities, which considerations should be made? (Select all that apply)

Will the results alter management of her health regimen? Signup and view all the answers

When assessing functionality, which activities of daily living (ADLs) should be considered? (Select all that apply)

Basic self-care Signup and view all the answers

Which options are appropriate to assess spiritual needs? (Select all that apply)

Use the HOPE assessment tool Signup and view all the answers

What factor is commonly used to address differential diagnosis in geriatric assessments?

Change in function and impact of symptoms Signup and view all the answers

Which term refers to conditions that have multiple underlying factors and may involve multiple organs?

Geriatric syndrome Signup and view all the answers

Which condition may be a possible diagnosis for Mrs. Rizzo who is experiencing chest pain, weakness, and lightheadedness?

Costochondritis Signup and view all the answers

What condition could be caused by Steven's medications for Parkinson's disease?

Constipation Signup and view all the answers

Which statement best describes 'cough'?

It is often isolated to the respiratory system Signup and view all the answers

Which condition could be diagnosed in Tina, who has cough, shortness of breath, and purulent sputum?

Chronic bronchitis Signup and view all the answers

In the mnemonic PRICE, what does the 'E' stand for?

Elevation Signup and view all the answers

From which condition may a patient with dry, itchy skin and jaundice be suffering?

Pruritus Signup and view all the answers

Which reasons might Mr. Thomas have for ignoring his worsening symptoms? (Select all that apply)

Fear of loss of independence Signup and view all the answers

Which elements should be included in the assessment of Mrs. Lee's leg pain? (Select all that apply)

Character of symptom Signup and view all the answers

What diagnoses are being ruled out when evaluating a patient with constipation? (Select all that apply)

IBS Signup and view all the answers

Which etiologies could cause dizziness in a patient? (Select all that apply)

Psychiatric conditions Signup and view all the answers

From which etiologies may joint pain arise? (Select all that apply)

Gout Signup and view all the answers

What focus questions should be asked when assessing patients with pruritus? (Select all that apply)

Did it come on suddenly or gradually? Signup and view all the answers

From which conditions can wandering in older adults arise? (Select all that apply)

Dementia Signup and view all the answers

As relates to increasing physical activity, what are examples of patient barriers?

Patient barriers Signup and view all the answers

Which of the following is the focus of additional studies about the relationship between physical activities and cognitive changes?

Diet and supplements Signup and view all the answers

Which of the following programs is dedicated to health promotion in older adults? Select all that apply.

The Center for Medicare and Medicaid Signup and view all the answers

Which of the following is a contraindication for exercise therapy and prevents patients from joining an exercise program? Select all that apply.

Unstable aortic aneurysm Signup and view all the answers

Which of the following may be included in the healthy lifestyle counseling during the initial Welcome to Medicare visit? Select all that apply.

Level of physical activity assessment Signup and view all the answers

Incorporating exercise into patients' lifestyles can be effectively achieved by including which of the following in discussions with patients? Select all that apply.

Encouraging goal setting and self-monitoring by the patient Signup and view all the answers

Which of the following options help reduce the risk of injuries? Select all that apply.

Choosing physical activities appropriate for current fitness levels Signup and view all the answers

Which of the following is an example of patient facilitators? Select all that apply.

Frequent contact with prescriber Signup and view all the answers

Which of the following are advisable for performing physical activity safely and reducing the risk of injuries? Select all that apply.

Follow rules and policies Signup and view all the answers

Why does the nurse practitioner conduct a comprehensive geriatric assessment of the older individual?

Health of older people is affected by several factors Signup and view all the answers

For which of the following groups is conducting a comprehensive geriatric assessment (CGA) more beneficial?

People classified as vulnerable older adults Signup and view all the answers

What does frail older adult refer to?

An older person already exhibiting signs of decline Signup and view all the answers

What is the purpose of a comprehensive geriatric assessment (CGA)?

Identify care needs and plans of care for older people Signup and view all the answers

Which domains of life does the CGA assess?

Physical and psychological health, as well as other facets of life Signup and view all the answers

What should be included when a new concern is identified in an assessment? Select all that apply.

Quantity and quality Signup and view all the answers

Which criteria are used to adjust Adam's medications? Select all that apply.

STOPP/START Criteria Signup and view all the answers

What does testing for orthostatic hypotension include? Select all that apply.

Having the patient lie down for 5 minutes, then measuring blood pressure and pulse Signup and view all the answers

Why is a thorough assessment necessary for Mrs. Smith, 75 years old, who reports weakness, difficulty urinating, and dehydration?

All body systems interact, and symptoms could indicate a variety of diagnoses. Signup and view all the answers

What laboratory value should the nurse practitioner know before ordering medications for a patient with elevated serum creatinine?

Creatinine clearance Signup and view all the answers

Which statement is true regarding diagnostic testing?

A test is ordered for a specific purpose. Signup and view all the answers

Why might Janey, 25 years old, experience arthritis differently than 65-year-old Mrs. Johnson?

The body undergoes physiological changes with aging. Signup and view all the answers

Which is the most likely condition to be tested for in an 85-year-old man with abdominal pain, weakness, and loss of appetite?

Neoplasms and carcinomas Signup and view all the answers

For individuals over 65 years old, which is the most common morbidity?

All of these are common morbidities. Signup and view all the answers

Why does a gerontological patient undergo a thorough systemic examination?

Older patients with one morbidity often express difficulties in general. Signup and view all the answers

What possible diagnosis would be considered for a patient reporting diarrhea and pain in the upper left quadrant of the abdomen?

Gastrointestinal inflammatory bowel disease (GIBD) Signup and view all the answers

Which statements should the nurse practitioner make when discussing a care plan with a 70-year-old man feeling weak and dizzy?

I will order a blood sugar test to check for diabetes. Signup and view all the answers

What is a helpful response regarding nutritional needs for seniors feeling weaker?

I suggest that you see your primary caregiver for extensive testing. Signup and view all the answers

How should the clinician respond to an older woman asking about the difference in her blood work results compared to last year's?

Your results may be different because the body changes with disease and medications you are taking. Signup and view all the answers

What should the nurse practitioner say regarding a couple discussing differing blood studies results?

Many factors affect an individual's chemical make-up. Signup and view all the answers

What response should the nurse practitioner give to Adam, 70 years old, regarding concerns about myasthenia gravis (MG)?

Older people often experience weakness, and we must rule out other conditions. Signup and view all the answers

What should the nurse practitioner say to Mrs. Smith regarding her unchanged type 2 diabetes treatment despite abnormal lab values?

Normal values for laboratory tests differ as one gets older. Signup and view all the answers

What factors should the nurse practitioner consider regarding Mr. Adams' noncompliance to his health care plan?

Treatment burden Signup and view all the answers

What does health promotion include according to the nurse practitioner?

Includes activities that an individual performs proactively to increase health and well-being. Signup and view all the answers

How is health promotion achieved on a broader scale?

Encouraging healthy lifestyle and healthy public policy formulation. Signup and view all the answers

Why are nurse practitioners qualified to conduct health evaluations?

Is prepared to assess health holistically. Signup and view all the answers

Study Notes

Patient Assessment and Diagnostics

Comprehensive assessments are crucial in older adults, as symptoms may indicate various diagnoses due to the interaction of body systems.
Elevated serum creatinine levels in patients with renal disease necessitate an understanding of creatinine clearance for accurate medication management.
Diagnostic testing should have a clear purpose, and results must be communicated to patients, considering their physiological changes.

Aging and Disease Presentation

Age significantly influences disease manifestation; younger individuals may experience different symptoms compared to older adults due to physiological changes.
Common conditions in elderly patients include neoplasms and carcinomas, which necessitate careful evaluation during assessments.
Various morbidities like heart disease, arthritis, respiratory issues, and diabetes are prevalent among individuals over 65.

Functional and Nutritional Considerations

Assessing functional abilities in older patients is essential for tailoring care plans that account for the complexities of aging and multiple morbidities.
Nutritional needs in seniors may not solely correlate with dietary standards, as physiological changes can impact health despite proper nutrition.
Health promotion strategies in the elderly should focus on increasing well-being and proactive health activities.

Health Promotion and Holistic Care

Health promotion includes proactive measures to enhance health potential and is influenced by lifestyle choices, community environment, and public policy.
Nurse practitioners adopt a holistic approach to patient care, emphasizing prevention, early diagnosis, and overall health rather than isolated disease management.

Medicare and Alternative Therapies

Medicare coverage is restricted to treatments validated by specific guidelines, highlighting the importance of evidence-based medicine.
Patients may inquire about alternative treatments, but it is critical to communicate the limitations of coverage and effectiveness based on clinical evidence.

Compliance and Care Management

Factors such as polypharmacy, treatment burden, and financial constraints significantly affect compliance with health plans in elderly patients.
Regular evaluation of laboratory results comparing them to past values is crucial for understanding individual health status changes over time.
Noncompliance should be assessed considering more than just cognitive ability, as various systemic factors contribute to the patient's ability to follow healthcare plans.

Professional Roles and Responsibilities

Nurse practitioners are qualified to perform holistic health assessments and manage many conditions, focusing on the overall health continuum rather than solely on disease.
It is important to ensure that patients understand why thorough evaluations are necessary, especially when presenting age-related symptoms that may mimic other health conditions.

Key Takeaways

Understanding individual biochemical and physiological variations is vital in geriatric care, as results can significantly differ from generalized norms.
Patient-centered care requires ongoing communication, education, and consideration of the unique circumstances surrounding older adults and their health concerns.### Healthy People 2020 & Preventive Health in Older Adults
Healthy People 2020 highlights specific objectives for preventive measures in older populations, emphasizing the importance of the Welcome to Medicare visit.

Primary Care Focus of Nurse Practitioners

Primary care aims to prevent disease occurrence, not just treat symptoms and improve patient recovery.
Strategies include immunization, regular health checks, and promoting overall wellness.

Health Promotion Recommendations

Physical activity recommendations for older adults should include swimming, dancing, and activities suited to the patient's abilities.
Risky activities (like skydiving or horseback riding) should be avoided due to potential health hazards.

Patient-Centered Health Promotion

Health promotion plans should consider patients' health beliefs, current function levels, and potential treatment benefits.
Collaborative planning engages patients in their health goals.

Benefits of Exercise

Regular exercise promotes flexibility, muscle mass, weight maintenance, and lowers blood pressure.
Understanding exercise benefits aids in motivating older adults who may feel it drains their energy.

Individualized Activity Plans

A personalized activity prescription that considers the patient's preferences and strengths is essential.
Activities can include alternative options like yoga or gentle movements for those with limited mobility.

Nutrition Counseling Importance

Nutritional assessments should include current diet, activity levels, height, weight, and health status to create effective plans.
Holistic approaches to health promotion include understanding a patient's lifestyle and dietary habits.

Safety Concerns for Older Adults

Address safety issues such as home hazards, fear of falls, strength evaluations, and health conditions like urinary incontinence.
Assessing for firearms and mental health is crucial to prevent accidents and injuries.

Health Education on Sexual Health

Older adults should receive education on safe sex practices and the importance of screenings for STIs.
Awareness of sexual health risks increases with age, necessitating periodic reassessment.

Importance of Senior Immunizations

Recommended vaccines include annual influenza, pneumococcal vaccines, and Shingrix for shingles to combat decreased immunity.
Immunizations are vital for older adults due to greater infection susceptibility.

Travel Health Considerations

Educate older adults on health maintenance while traveling, including the need for mobility during flights and immunizations specific to destinations.
Encourage discussing prescriptions prior to travel to ensure medication availability.

Health Promotion for Arthritis & Exercise Barriers

Increased physical activity is crucial for patients with chronic conditions like arthritis, promoting better health outcomes.
Barriers such as high BMI and lack of functional limits should be identified to tailor health plans.

Facilitators of Health Promotion

Family support, motivation, and a solid care network can enhance an older adult's commitment to health initiatives.

Exercise Recommendations from ACSM

The American College of Sports Medicine encourages incorporating exercise discussions in all patient interactions to enhance health awareness.

Addressing Patient Excuses for Exercise

Suggesting simple, manageable actions like taking daily walks can help patients overcome barriers and excuses related to physical activity.

Contraindications for Exercise Therapy

Conditions such as uncontrolled hypertension and unstable aortic aneurysm are contraindications for exercise programs.
Understanding medical restrictions ensures safe exercise practices for older adults.

Medicare Visit Components

Assessing physical activity levels and needs is essential during the Welcome to Medicare visit to inform health management and intervention strategies.### Medicare Visit and Referrals
Initial Welcome to Medicare visit includes assessment of physical activity.
Physical therapy may be recommended for patients with disabilities or functional limitations.
Referrals to health coaches are suggested to enhance patient engagement.
Referrals to herbalists and acupuncturists are not part of the initial visit.

Incorporating Exercise into Lifestyle

Effective methods to encourage exercise include goal setting and patient self-monitoring.
Informing patients about community resources for group exercise is beneficial.
Handing exercise programs and illustrations may enhance understanding but are less emphasized.

Reducing Injury Risk

Selecting activities suited to individual fitness levels and health goals minimizes injury risk.
Chronic condition management under a healthcare provider's supervision is vital.
It's unwise to follow friends’ activity choices without considering personal health differences.

Facilitators for Increasing Physical Activity

Frequent contact with healthcare providers fosters proactive engagement in physical activity.
Having a planned program supports motivation among older adults.
Factors like making time or purchasing equipment are personal choices, not facilitators.

Safe Physical Activity Practices

Using appropriate protective gear and following existing rules and policies aid in safe exercise.
Starting exercises at a measured pace is crucial; sudden efforts can lead to injuries.

Geriatric Assessment Importance

Comprehensive geriatric assessments (CGAs) are critical for understanding multifaceted health needs of older adults.
Vulnerable older adults benefit the most from CGAs due to their higher risk of complications.

Frailty in Older Adults

Frailty indicates an older person showing signs of health decline without being linked to specific symptoms or size.

Activities of Daily Living (ADLs)

ADLs include basic self-care tasks, mobility, and continence, essential for assessing functional capability in older adults.

Assessing Spiritual Needs

Tools like the HOPE and FICA assessments effectively evaluate spiritual health and needs.
Direct questions about peace can uncover spiritual distress and inform care plans.

Differential Diagnosis in Geriatric Care

Change in functional ability serves as a significant indicator for differential diagnosis in older patients.

Geriatric Syndromes

Geriatric syndromes encompass conditions with multiple underlying factors affecting various organ systems, emphasizing the complexity of older adult health management.

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Prepare for your Elders Final Exam with these comprehensive flashcards. This quiz covers essential knowledge about elder care, focusing on symptoms, assessments, and diagnostic approaches. Deepen your understanding of key concepts that will aid in providing quality care to elderly patients.