Geriatric Quiz (PDF)

Dinabelle is a 35 year old woman who doesnt like to attend her grand mothers ball party due to the reason that invited guests are commonly individuals aged 65 and above. The disliking of aging and older adults based on the belief that aging makes people unattractive, unintelligent and unproductive....

Dinabelle is a 35 year old woman who doesnt like to attend her grand mothers ball party due to the reason that invited guests are commonly individuals aged 65 and above. The disliking of aging and older adults based on the belief that aging makes people unattractive, unintelligent and unproductive. It is an emotional prejudice or discrimination against people based solely on age * gerontophobia gerontics ageism Nurse Lester has been assigned to take care of client Maria, a 75 year old female. Nurse Lester has witnessed neglect and abuse with several aging clients in home care. Nurses like nurse Lester, are _______ of elder abuse, which means it is against the law health care professionals suspect elder abuse and do not report it. * mandate reporters paid reporters professional reporters The police bring Bonifacio, an older adult patient, to the hospital because Bonifacio was wandering in the street and unable to remember his address. Bonifacio's clothing is soiled and he appears malnourished and dehydrated. What would nurse Jasmin do first? * Attempt to locate the patient Bonifacio's family or friends Nurse Jasmin should notify social services about potential abuse and/or neglect Nurse Jasmin should offer food and fluids and assist with hygiene needs Correct answer Antonette has been taking oral meds she ordered online to make her look younger. The fear of aging and the refusal to accept older adults into the mainstream of society * gerontophobia gerontics ageism Marites is an older adult widow who lives alone in her own home. Marites is having difficulty with driving, grocery shopping, cooking, and home maintenance. What type of living arrangement would be most suitable for Marites? * Extended care facility Assisted living Hospitalization Correct answer Assisted living Teresa is a 65 year old female who is admitted to the hospital due to severe constipation. Upon hospital discharge, Teresa was very happy of her bill because she was given discount. ________ is the government program that provides health care funding for older adults and disabled persons * Insurance Medicare Medicard Nurse Jasmin is facilitating activity related to Aging with her nursing students. Several nursing students are discussing career options. Which student statement demonstrates ageism? * "Nurse Jasmin, I would work in a clinic that serves a mixture of older and younger patients" "Nurse Jasmin, If I were to care for older patients, I would need knowledge about chronic health problems" "Nurse Jasmin, Working with older adults could be rewarding, but I couldn't really use all of my skills" Correct answer "Nurse Jasmin, Working with older adults could be rewarding, but I couldn't really use all of my skills" Anabelle, is an older adult patient who is having an argument with her daughter Ariana. Which statement shows the most significant issue that older adult patients and their families must face? * "Ariana, You can't tell me what to do. I'm your mother" "Ariana, I can't afford my medication. You should lend me money" "Ariana, You never come and visit me except on holidays" Correct answer "Ariana, You can't tell me what to do. I'm your mother" Chapter 1 of Aging overview discussed about population size, distribution, and vital statistics. These would be included in the statistical study of human populations known as _______. * demographics impacts generations Nurse Lester is a nurse supervisor who is assigned in geriatric ward. Nurse Lester has been observing behavior of individual with gerontophobia. Which personal behavior is a demonstration of gerontophobia? * Ally, a 16-year-old girl decides to dye her hair a darker color Maria, a 63-year-old woman takes a Caribbean cruise with a friend Luisa, a 44-year-old woman wears her teenage daughter's clothes Telma, a senior care giver in home care facility, has been taking care with client Juana, 80 years old for 2 straight weeks with out taking a break. When the home care facility hired additional manpower, Telma was very happy that she can now have her requested day off. ______ allows the primary caregiver to have time away from the demands of care giving, thereby decreasing stress and the risk of abuse. * resignation respite retirement Nurse Jasmin has been lecturing newly hired care givers assigned in geriatric ward. Nurse Jasmin includes that intentional _____ occurs when any person deliberately plans to mistreat or harm another person. * neglect abuse intervention Mario is a 73 year old man, brisk and healthy man, who applied for a part time gardener in the neighborhood. Older adults, like Mario who happened to be refused with the work he tried to applied with, are treated differently simply because of their age. Examples are refusing to hire older people, not approving home loans and limiting the type or amount of health care the received is define as * ageism age descrimination gender descrimination Nurse Paul has been differentiating with her student nurses the difference between Geriatrics, gerontology and gerontic nursing. What is the medical specialty that deals with the physiology of aging with the diagnosis and treatment of diseases affecting older adults. * gerontic nursing gerontology geriatrics Nurse Paul is a professional geriatric nurse Trainor who gives lecture discussion with care givers assigned in home care facilities for Aging individuals. Nurse Paul explained that ______ is a passive form of abuse in which caregivers fail to provide for the needs of the older person under their care. * neglect malpractice Abuse Juana is an 80-year-old woman who enjoyed having her gray hair naturally growing. She said she will no longer dye her hair since it grows super fast. One biological theory states that an individual experienced predictable changes such as Juana's gray hair. * Somatic Mutation Theory Programmed Theory Error Theory This theory proposes that every individual has a limited amount of genetic material that will run out eventually. * Run out of program Running out of proportion Run in out of program This theory suggest that human life span is inherited. That identical twin dies at same compared to fraternal twins. * Error Theory Crosslink Theory Gene Theory This theory states that RNA protein synthesis cause inaccuracy to occur in cells in the body, resulting in a progressive decline in biologic function * error theory wear and tear theory reliability theory These are compounds that can cause harm if their levels become too high thus an individual may take anti oxidants to avoid these harmful compounds. They are suspected to cause damage to the cells, DNA, and the immune system. * virus es free radicals allerge ns The theory that proposes aging results from DNA damage caused by exposure to chemicals or radiation and that this damage causes chromosomal abnormalities that lead to disease or loss of function later in life. * Psychosomatic mutation theory Somatic mutation theory Somatic emission theory This is a free radical that has been identified to result a buildup of fatty pigment granules that cause age spots in older adults. * Lipofus cin Liposucti on Lipid profile This theory combines the somatic mutation, free radical, and crosslink theories to suggest that chemicals produced by metabolism accumulate in normal cells and cause harm to body organs. * Error theory Clicker theory Clinker theory This theory states that our body is like a machine, which loses function when its parts wear out. * Wear-and-tear theory Wear-and-gear theory Where-and-tear theory This theory is used as a model to describe the bodily diseases and death of human body systems. * Reliability theory of aging and Diseases Reliability theory of aging and longevity Longevity and Diseases theory Belle is a 10 year-old child asking her grandmother Susan, a 75-year old woman, about the spots in her skin. Redness. Dilated superficial blood vessels, and small "pimples" on the nose and center of face are commonly seen with aged individuals. * a.Melano ma b.Rosac ea c.Impeti go Lina, a 65 year old woman joins her family at the beach. Dina her daughter was applying her lotion with sunscreen because at Lina’s age * a.Production of melanin is decreasing b.Production of natural glutathione is decreasing c.Keratin is diminishing at Lina’s age Anabella, 73 year old, is the grand mother of nures Maritess whom she really adored. As a gift to her birthday, nurse Maritess gave Anabella a bunch of powdered milk packs. Milk is a good source of calcium which is significant to the following functions, EXCEPT * a.necessary for bone strength b.Necessary for muscle contraction c.Necessary to liver function Antonia, a 68 year old woman, stops coloring her hair black. She just let her natural color grow. Antonia starts to love her natural gray colored hair. Antonia’s hair * a.losses its shine b.Losses its pigment c.losses its growth Nurse Lina, a geriatric nurse, has been with with the family of client Monique for years, taking care of Monique’s parents. When Monique’s parents died, nurse Lina transferred to another family who needs her expertise. After 10 years, nurse Lina once again served Monique’s husband who is now very ill. Nurse Lina have seen a huge difference of Monique's appearance the last time she saw her. What body system physically change in first due to aging? * a.Integument system b.Skeletal system c.Respiratory system Maria a 65 year old client came in due to skin itchiness and dryness. At Maria’s age dry skin is due to a decrease in the function of sebaceous and sweat gland secretion causing itchiness and dryness in the skin. * a.Scero sis b.xeros is c.scabi es Nurse Jasmin is turning her unconscious, bedridden 80 year old patient in the ICU every 2 hours. Shrinkage in the cushion provided by subcutaneous tissue along with vascular changes places the nurse Jasmin’s older adult patient at risk for * a.pneumon ia b.peptic ulcer c.pressure ulcer Isabelle last seen her grand father Teddy when she was still 16 years old. Grand father Teddy is a strong, muscled and tall man. After 20 years, Isabelle visited her grand father Teddy and have seen big difference on how her granpa looks like after 2 decades. As a person ages, changes on the following is expected and natural EXCEPT * a.muscle mass decreases b.adipose tissues increases c.muscle mass increases Patient Luis a 70 year old male has lungs that are congested and edema appears to develop because his heart's pumping action is ineffective. Luis probably has * a.Congested heart failure b.Chronic kidney disease c.Liver cirrhosis Manuel, a 78 year old male client has been taking metformin and lipitor medications for his DM type 2 and Dyslipidemia management. He was rushed in the Emergency room due to increased blood pressure. Patient Manuel’s hypertension occurs as a result of a coexisting disease process or other known cause and is treated by treating the underlying condition. * a.Essential hypertension b.hypertensive urgency c. secondary hypertension Helena, a 60 year old retired stage actress, has been looking in the mirror for hours she has observed areas of deepened pigmentation, trying to embraced this thing called age spots * a.dermati tis b.melano ma c.senile lentigo Nurse Jasmin is discussing Basic Geriatrics to her nursing students emphasizing that physiologic changes become more apparent during what times? * a.Fifth to sixth decade of life b.Sixth to eighth decade of life c.Third to fourth decade of life On Nurse Jasmin’s lecture on Basic Geriatric Nursing, she includes the following factors that significantly affect the timing and magnitude of age-related changes, EXCEPT * a.economic status b.heredi ty c.health maintenance Patient Tommy is diagnosed with rheumatoid arthritis. Which signs and symptoms nurse Paul most likely to assess for patient Tommy? * a.Tenderness and pain on rest b.Pain and stiffness on rest c.Coldness and tenderness at rest Nurse Jasmin is giving discharge instructions with her 75 year old patient who suddenly raised concerns that she experienced nowadays with blurry vision.Nutrition therapy of specific doses of vitamins C and E, beta carotene, zinc, and copper could reduce the risk for which eye disorder? * a.Age-related papuar degeneration b.Age -related hypertrophy c.age-related macular degeneration Sarita, 73 year old woman has been thinking about her newly diagnosed Gastro Esopheal Reflux. She believed that because she has not been good to her husband, her illness is her punishment, she cant do anything about it but accept the consequence. This patients belief may promote health maintenance or interfere with good health practices and result in increase health risks * a.Illness belief b.Religious belief c.Sinful belief Theresa, a 65 year old woman, who lives alone in the apartment has been on strict low sugar diet due to her DM type 2 and also been using cane to aid her limitations. Theresa would like to replace her brand of sugar to a non-caloric one however the store selling non-caloric sugar is far from her place. At Theresa’s age her ________ has a significant factor on maintaining her health. * a.tas te b.mobil ity c.budg et These age-related changes can increase the risks for personal neglect or injury from falls, poisoning, fire, and other traumatic events * a.Cognitive and sensory b.Personal and emotional c.Emotional and Sensory Nurse Lester has been an expert geriatric nurse. He had been observing clients aged 60-80 years old. Aged individuals are likely to have more problems accessing and services than younger people. Access may be limited by decreased physical mobility, lack of transportation, or limited finances. * a.impact of changes related to mobilization b.impact of Changes Related to Accessibility c.impact related to socio-economic status The following are considerations in the Nursing Process for Ineffective Health Maintenance, EXCEPT * a.Asse ss b.Arran ge c.Tea ch Nurse Jasmin is formulating her Nursing process for her 80 year old client. Nursing process for __________________________ includes Identify, Provide, Plan, Emphasize, Acknowledge * a.nursing process for compliance b.nursing process for non compliance c.independent nursing process Nurse Lester is assigned to take care of patient Zenaida, a 69 year old female, admitted in the Geriatric ward. Zenaida has been very difficult on her medication regimen. The following are priority nursing intervention for a patient admitted for noncompliance with medications, EXCEPT * a.teaching the Zenaida the importance of prescribed medications b.May threaten Zenaida of more health complications for her to develop fear and become compliant to her medication regimen. c.Advising the Zenaida that if the noncompliance continues, Medicare will not pay for future hospital stays Nurse Jasmin is discussingvto her geriatric clients the role of home health as it relates to health promotion and health maintenance for older adults including the Identification and factors to consider when seeking home health care assistance. Nurse Jasmin is emphasizing the * a.Classification of Health promotion and health maintenance b.Objectives of Health promotion and health maintenance c.Disadvantages of Health promotion and health maintenance Charissa is celebrating her mother’s 60th birthday and thinking of something to give her mom a health gift check. For a healthy older adult, with no known chronic health conditions, what diagnostic testing should occur on an annual bases? * a.glaucoma screening b.fatty liver screening c.Cbc test Paul is a home health nurse assessing Tonia, an older patient who has a history of chronic obstructive pulmonary disease and hypertension. Which finding is most likely to prompt nurse Paul to immediately call the health care provider? * a.Tonia reports an increase pigmentation on her skin b.Tonia reports itchiness and dryness on her skin c.Tonia reports a severe unremitting headache Jesse, an older adult, says to nurse Jasmin, " Why should I bother to see the doctor about my problems? It's just old age." what would nurse Jasmin’s response be? * a.Follow your belief. If you think like not going to the doctor then you have the right to do so. b.When your starting to get old, debilitating and chronic illnesses including cancers may develop. c. Your symptoms could be an early sign of illness Analiza, the patient's daughter tells nurse Jasmin that her mother, Judith a 71 year old woman, does not take her medication as frequently as prescribed. Which intervention would nurse Jasmin perform first? * a.Nurse Jasmn should insist Judith to take her medication asap. b.Nurse Jasmin should try to determine the patient's reasons for medication noncompliance c.Nurse Jasmin may inform Judith that non compliance will result to death. When nurse Paul asks patient Mary Ann if she has been performing the mobility and balance exercises as directed by the physical therapist, patient Mary Ann responds, "That type of exercise wasn't really helping, so I stopped." What is the nurse Paul’ best response? * a.”Mary Ann, what do you think would help you to maintain your ability to walk independently?” b.” Mary Ann, don’t be too hard on this, other patients are still waiting for my help.” c.“ Mary Ann, if that’s what God plans for you then acceptance is necessary.” Patient Marcos, 75 year old, has been in and out of the hospital due to his Diabetes and Hypertension. According to her daughter, patient Mario is not taking his medication religiously.Noncompliance is * a.following medication regiment in different frequency b.failing to follow through with recommended health practices c.Following recommended medications in different dosage Patient Maritess, a senior citizen, has been on diet modification for 1-2 month to treat her increase blood sugar level. She has been following her nutritionist’s prescribed diet instructions. However during week ends, Maritess would cheat and eat a huge amount of food that are restricted to her. A less negative term compared to noncompliance, is used to describe the behavior of patients who have difficult adhering 100% to every aspect of a treatment regimen: exercise, diet, medications, or annual screening procedures. * a.Non prioritization b. Non reactive c.Non adherence MIDTERM Nurse Lester has been working in the geriatric ward for 20 years. He always emphasized that communicating with older adults includes empathetic listening. * Emphatic listening is inactively trying to understand the other person, not just knowing many facts about the person. Requires sensitivity to the weaknesses and limitations of the aging individual. Emphatic listening is actively trying to judge the other person, not just knowing many facts about the person. Requires insensitivity to the strengths and limitations of the aging individual. Emphatic listening is actively trying to understand the other person, not just knowing many facts about the person. Requires sensitivity to the strengths and limitations of the aging individual. In nurse patient relationship the nurse would carry respect and understanding in order to establish trust and what with the patient? * Security confidence rapport 60 year old Thelma will be seeing her charity mates for the first time. Thelma is excited at the same time anxious to meet these people whom she really are not close with. Thelma and her new found friends will meet in the City park for the first time. What is the appropriate distance for public space? * 12 feet or more away 12 kilometers or more away 12 inches or more away Nurse Paul is attending Anna, a patient transferred from the opposite ward. The previous nurse who took care of Anna has endorsed that the patient had a hearing disorder. How should nurse Paul talk to Anna with hearing impairment? * Nurse Paul should minimize background noise, stand at eye level in front of the patient, keep his mouth clearly visible, slowly and at a lower pitch, use visual cues, avoid exaggerated mouth motions. Nurse Paul should minimize background noise, stand at the shoulder level in front of the patient, keep his mouth clearly visible, fast and at a higher pitch, use visual cues, avoid exaggerated mouth motions Nurse Paul should maximize background noise, stand at eye level in front of the patient, keep his mouth clearly visible, slowly and at a lower pitch, use visual cues, avoid exaggerated mouth motions Nurse Paul is incharge to admit older adults from age 55-70 years of age. How should nurse Paul address an older adult?* Nurses Paul should suggest names from hollywood starts that has the same age with the patient. It is better to start by using the older adults proper title and name and clarifying which form of address the person prefers. Nurses Paul should determine how each older adult wishes to be addressed. It is better to start by using the older adults proper title and name and clarifying which form of address the person prefers. Nurses Paul should determine how each older adult wishes to be addressed. It is not suggested to use the older adults title and name and clarifying which form of address the person prefers. Is the resulting difference in rate of speech and movement * Pace or speed of communication quality of communication behavior of communication Nurse Jasmin is attending a patient who just had a head injury and has developed Aphasia. What is the recommended method of communication for a patient with aphasia? * open ended interview structured communication body language In communication, this is used when there are inconsistencies in information or when verbal and nonverbal messages appear incompatible. * Direct questioning Confrontation Information Nurse Jasmin admits a geriatric patient for the first time. She introduce herself on the first day and immediately gain the patients cooperation. Atmosphere of mutual respect and understanding helps build trust and? * security safety rapport The human face is most expressive, and have been shown to communicate across cultural and age barriers. * facial actions facial barrier facial expression Nurse Paul hears a report that patient Juana with a stroke has aphasia. Which intervention will nurse Paul most likely to use? * Nurse Paul will praise Juana on her attempt to speak and will avoid correcting errors Nurse Paul will prompt Juana on her attempt to speak and will correcting errors Nurse Paul will praise Juana on her attempt to speak and will correcting errors This involves sending and receiving messages using words. It can be formal, structured, and precise; some is informal, unstructured, and flexible. * structural communication non verbal communication verbal communication A Blood pressure apparatus, a white nursing cap or uniform, and a name tag are examples of what that help patients differentiate nurses from other health care professionals? * signs symbols character This type of communication technique allow the patient more leeway, establish a more empathetic climate, allow verification of accuracy, reflective statements, clarifying statements, and paraphrasing. * open ended communication close ended communication direct information communication The analysis of the use of personal space in communication * proxemics prosthetics Spaceiology This is a form of ageism. Calling the patient "sweetie" or "honey". Which includes in the "Dont's" when communicating with older adults. * old talks elder speak talking old Physical problems, pain or extreme fatigue, disease processes, diverse social and cultural back ground are among the * barriers of communication risk for infection due to poor communication factors of communication malfunctions Nurse Lester has given the older adult patient Antonia her routine medications. Nurse Lester asks if patient Antonia needs anything else. Patient Antonia looks at nurse Lester, but does not immediately reply. What is nurse Lester's best response? * Mrs. Antonia, I'm in a bit hurry since I got more patient like you who needs my help. Il get back to you. Mrs. Antonia take your time; it looks like you want to say something? Mrs. Antonia take your time to remember and please don't forget to remember these medications. A conscious and intentional process used to gather information corresponding to a patient's overall health status and to respond with verbal and nonverbal approaches that encourage the patient's well-being or improve the patient's understanding of ongoing care. A skill that requires time, effort, and practice to develop. * Therapeutic Skills Therapeutic Communication Therapeutic Management Nurse Lester is having a small talk, pleasantries, and conversations about the weather and talks about favorite television show and the latest news to her newly admitted client. Nurse Lester thinks of her newly admitted patient as a real person, not just a patient. * Formal communication Social communication Structured communication Is one of the most influential elements of communication. There are a factors in the sound of your voice that give meaning (conscious and unconscious) to the message you’re sending. * Tone of voice Voice of tone Melotonic voice Tonio is 55 year old man who is invited to join their grade school grand reunion after 43 years. What is the appropriate distance for social space? * Between 12 and 4 feet Between 4 meters and 12 Between 4 and 12 feet Correct answer Between 4 and 12 feet Nurse Jasmin is caring for Mariano, an older adult patient who speaks a different language than nurse Jasmin. Mariano's adult daughter is present at the bedside and is willing to translate. For which situation would it be most appropriate to have the daughter translate? * Explaining the routines of nursing care and orientation to the hospital room Explaining the hospital protocols of down payment Explaining the achievements of patients with the same case Looking someone in the eye is perceived in our culture and other cultures as a measure of honesty. In some cultures turning away their eyes communicates respect. * Eye support Eye consistency Eye contact Nurse Paul is attending a critical patient who was rushed in the emergency room due to heart attack. This for of communication is helpful nurses like nurse Paul need to obtain specific information or in emergency situations when time is precious. This tends to include the words who, what, when, where, do you, and don't you. * Indirect questioning Direct questioning Technical questioning Describe as the willingness to attempt to understand the unique world of another person * Sympathy Apathy Empathy This are helpful for people who cannot use words. (APHASIA) * gestures eye contact lip reading Nurse Jasmin is assigned to interview newly admitted geriatric patient name Maria. Patient Maria says, "no I am not having any pain" What nonverbal cues would support the verbal message of patient Maria? * Patient Maria appears unrelaxed and speaks with a melodic tone of voice Patient Maria appears relaxed and speaks with a aggressive tone of voice. Patient Maria appears relaxed and speaks with a melodic tone of voice This is one of the most difficult communication techniques to use and should be used only after good rapport has been established by the nurse from the client. * Direct information confrontation open ended questions Nurse Jasmin never forgets to placed her nursing cap, wear her apron and bring her nursing paraphernalia's before she makes her rounds in the geriatric ward. This is one way to help older adults distinguish nurses from other caregivers.* Signs Symbols Character Chapter 6 These are the general recommendations for nutrition by the dept of agriculture. Select 7 correct answers * avoid oversized portions sleep at least 10-13 hours a day include low-density lipoprotein rich food on your diet increase intake of fruits, veggies, and whole grains choose low fat or fat free dairy products reduce intake of sodium enjoy food but eat less of it drink water instead of sugary drinks processed foods are good source of nutrition make physical activity an everyday occurrence Patient Ben has been admitted in the hospital for almost a month now. He has been battling with his peptic ulcer disease. Ben's nutrition played a great role in helping him attain his optimum health. Disorder of nutrition resulting from unbalanced, insufficient, or excessive diet or from impaired absorption, assimilation, or use of food is * malabsorption indigestion malnutrition Patient John has been very religious on his diet starting age 60. He picks the food he take according to the recommended meal plan his nutritionist advised him. He was scared to developed Cardio vascular diseased just like his siblings. Patient John is very strict on foods containing fats. Good fats that is primarily composed of protein that appears to protect against blood vessel disease is* high density lipoprotein Low density lipoprotein saturated fats Patient Marites, 68 years old, was advised by her nutritionist to take protein rich food to help her on her protein deficiency. Protein consumption can be affected by the following factors (Select all that apply)* the ability to drive effectively and purchase food anytime anywhere the ability to procure and prepare food the high costs of food containing protein the cheaper cost of commodities the ability to chew common high protein foods Arthur, an 80 year old admitted patient has been managed by his medical team due to his nutritional problem. The following are factors affecting nutrition in older adults (Select 7 correct answers) * sensory changes pain blurring of vision chronic health factors alcoholism hallucination medications problems w/ chewing, swallowing, or digesting malabsorption Manuela is a client who recently become a widow. Her husband just died due to cardiac arrest. Manuela now is not eating well after the death of her husband. Social risk factors affecting nutrition includes the following (select 3 correct answers) * full appetite depression loneliness satisfaction lack of motivation Nurse Lester is assessing Mario, a 73-year-old client admitted to an extended care facility. Assessment to Mario reveals dry, scaly skin, and poor skin turgor in the client. Further assessment reveals that the Mario's fluid intake is less than normal. Mario states they do not feel thirsty. What nutritional assessment and planning would be required for Mario? (Select all that apply) * Provide a huge amount of fluids at bedside monitor Mario's fluid intake (I&O; intake and output) Provide patient his/her favorite food monitor nutritional content state the importance of keeping hydrated COMPLETE NAME (LAST NAME, FIRST NAME)* ALMANZOR, AYEN THERESSE B. Patient Anabelle is an 80 year old malnourished elderly client taken care by nurse Jasmin. Nurse Jasmin has been monitoring patients Anabelle's intake, ensuring enough macronutrients are included in patient Anabelle's diet. Macronutrients includes?* carbohydrates Magnesium proteins fats Patient Elizabeth, 70 years old, is recommended to include foods consist of simple carbohydrates on her diet. She is now drinking milk, eating fruits and milky products. * Simple Carbs used most readily by the body because their bonds are easily unbroken Simple Carbs used most readily by the body because their bonds are easily broken Simple Carbs are not used most by the body because their bonds are easily broken Nurse Lester is assessing Mario, a 73-year-old client admitted to an extended care facility. Assessment to Mario reveals dry, scaly skin, and poor skin turgor in the client. Further assessment reveals that the Mario's fluid intake is less than normal. Mario states they do not feel thirsty. What are risks that nurse Lester should note for Mario? * Risk for aspiration Risk for Dehydration Risk for Malnutrition Nurse Jasmin is aware that data derived from a pharmaceutical company's drug testing to establish therapeutic dose ranges may not be appropriate for the older adult because testing: * a) is not done long enough. b)does not require adequate follow-up. c)is not well regulated by the U.S. Food and Drug Administration. d) is usually tested on healthy young persons. Nurse Paul assesses Teresita, an older adult patient, for evidence of the onset of the effectiveness of an oral preparation because age-related changes in the concentration of gastric acid can: * a)change the chemical composition of the drug. b)increase the distribution. c)decrease the strength of the drug. d)delay absorption. Nurse Lester is aware that age-related changes in the stomach that can cause increased drug absorption and possibly toxicity include: * a)decreased gastric motility. b)gastric reflux disease. c)inability of gastric cells to transport the drug. d)decreased peristalsis. To help prevent lithium toxicity in the older adult, nurse Lorraine modifies the nursing care plan to include interventions to: * a)increase fluid intake to 3500 mL daily. b)have the patient ambulate for 10 minutes after the drug is administered. c)prohibit citrus fruit in the diet. d)administer a prescribed stool softener to ensure a daily bowel movement Nurse Jasmin takes into consideration that as adipose tissue replaces muscle mass in the older adult, a person taking a fat-soluble drug such as diazepam (Valium) several times a day would exhibit: * a)Tachycardi a b)A hangover effect c)Agitatio n d)Hypertentio n Nurse Paul cautions the older adult who is taking the protein-bound drug warfarin (Coumadin) that, with age-related reduced plasma protein levels, the risk of an adverse reaction is high because: * a)unbound active drug molecules continue to circulate in the bloodstream. b)the bleeding and clotting times will decrease, as evidenced by the PT and INR. c)the drug becomes ineffective and does not deliver its intended therapeutic action. d)renal damage can occur from the altered drug molecules. Nurse Lorraine frequently assesses the older adult who is on a psychotropic drug for an overdose because: * a)older adults are less active. b)the older adult has fewer cognitive capabilities. c)brain receptors have become hypersensitive. d) receptor sites have lower perfusion. Nurse Paul’s topic with the nursing students is about Medication and older adults. The major risk of polypharmacy for the older adult is: * a)ignorance about his or her prescriptions. b)taking over-the-counter preparations. c) being treated by more than one physician. d)taking old prescriptions rather than consulting a physician. Lester is a home health nurse would be most concerned about self-medicating errors for the older adult living alone who is a type 1 diabetic and is: * a)afflicted with early Parkinson disease. b)visually impaired. c)a rheumatoid arthritis with stiffened hands. d)paralyzed from the waist down. Jasmin, a medicating nurse is aware that the most reliable method of patient identification for administration of medications is: * a)a photograph of the patient. b)an identification bracelet. c)asking the patient to repeat his or her name. d)use of the patient's room number. Dr. Sam, a physician, has written an order to convert an enteric-coated medication from the pill form to the liquid form. Nurse Lorraine should: * a)transcribe the order and change the medication administration record to show the liquid form. use up the rest of the tablets by crushing them and giving them dissolved in water c)order the liquid form from the pharmacy as ordered. d) inquire if the physician wants the dose to be the same as the pill. When patient Susan complains that several pills at the 8 AM dose stick in her throat, nurse Jasmin could facilitate administration by: * a)suggesting that she take all the pills at one time with a mouthful of water. b)offering the patient one pill at a time. c)crushing all the pills and mixing them in the patient's breakfast cereal. d)offering a sip of water before and after each pill. Nurse Paul is aware that medicating with transdermal patches requires that the nurse should: * a)apply the patch at the same site every day and carry out documentation. b)fold and dispose of the used patch in the sharps container. c)warm the patch in his or her hands before application. d)cover the patch with a light gauze dressing to prevent dislodgement. When Lester, the medicating nurse offers a pill to the older adult patient, the patient asks, "What is this and what is it for?" The nurse Lester's best response would be: * a)"I'm not at liberty to discuss your medication. You need to talk to your doctor." b)"That's a 'feel good' pill that will make you feel better." c) "It's a cephalosporin that has been ordered to treat your URI." d) "It's an antibiotic for the infection in your urine." When Katherine, an 80-year-old female patient, refuses to take a medication because it burns her stomach, the Paul, the medicating nurse should: * a)crush the pill and mix it with the dessert on her meal tray. b)insist that she take it "for her own good." c)circle and initial the dose time to show nonadministration. d) document the reason for refusal and report the refusal to the charge nurse. For Zenia, an older adult patient receiving the bronchodilator theophylline, nurse Jasmin would assess for __________ as evidence of an overdose. * a)Tachycardi a b)Confusio n c)Diaphoresis d)Letharg y When Dennis, a 75-year-old man who has been on a protocol of chlorpromazine (Thorazine) begins to _______ and complain of difficulty swallowing, nurse Paul notifies the physician. * a)Cough b)Wheeze c)Drool d)Gag Nurse Lorraine is preparing to administer 1 mL of vitamin B12 intramuscularly to Leni, an emaciated 82-year-old patient would choose a _____-inch needle to inject into the _____ site. * a)1.5; upper outer quadrant of the gluteus maximus b)1.5; ventral gluteal c)1; deltoid d)1; ventral gluteal Nurse Jasmin explains that the Beers criteria provide guidelines for: * a)medications best avoided by the elderly independent of diagnosis. b)diagnostic procedures that are considered inappropriate for a diagnosis. c)penalties for extended care facilities that allow administration of particular drugs. d)assessments necessary before the prescription of particular drugs. Nurse Lester is preparing to crush a patient Dina's oral medications can crush the: * a)plain antihypertensive medication tablet. b)sublingual tablet of nitroglycerin. c)timed-release capsule for gastric reflux. d)enteric-coated aspirin. Nurse Paul is planning to set up a self-medication program for Marian, a 70-year-old resident in an extended-care facility will ensure the provision of the following EXCEPT * a)delivery of adequate supply of medication b)payment for medication c)locked medication storage at bedside d)medication administration record Nurse Lorraine includes information in the nursing care plan pertinent to the patient Sofia's needs as they relate to drug administration, which include the following EXCEPT * a)schedule for drawing blood values b)patient's need for crushing medication c)patient's preference as to the use of medium in which to give crushed medicines d)schedule of medication and dose times Nurse Paul, a home health nurse reviews all medications of a patient because nurse Paul is aware that with the high cost of prescription drugs, older adults will probably do the following EXCEPT * a)simply not fill a new prescription b)take less than prescribed to preserve their supply c) fill all prescriptions at once to get a discount d)save old prescription drugs for later use Nurse Lester is aware that the older adult is more at risk for medication-related problems related to the following EXCEPT * a)drug-testing methodology b)age-related changes c)cognitive and sensory changes d)lack of adequate medical follow-up Nurse Lorraine reminds Tomas, an older adult that self-medication with OTC drugs can be hazardous because OTC drugs can result to the following EXCEPT * a)interfere with the efficacy of a prescribed drug b)mask significant symptoms of primary disease c)may decrease the effect of a prescribed drug d)create symptomatology of their own Illness developed due to medical treatment is commonly to older adults than young ones * Iatrogenic complications Ageis m Pathophysiologic disorders These two are both use to identify potential problems in older adult prescriptions> select all that apply * STOP ✓ STOPP ALCOHOL ✓ BEER'S CRITERIA BEER TOOL This is the actual amount of an individuals existence * Chronologic age Physiologic age Age doesnt matter Is your age measurement of how much life you are likely to live * Chronologic age Physiologic age Age doesnt matter PREFINAL Chapter 9 Patient Bruce, 89-year-old patient, preferred to stay home, watch TV or read news paper due to fear that he might meet an accident again. His family was very eager to accompany him if he wish to go out to have some fresh air. When can falls be reduced for patients such as Bruce? * When an older individual engages in exercise focusing on balance, strength, endurance, and flexibility. When an older individual listens to his or her instinct not to go out and stayed rather safely home will keep them away form injury. When an older individual push himself/herself to engage in strenuous activity, high impact sports to maintain flexibility and muscle strength. Nurse Jasmin is admitting Maria, an 82-year-old client found to be at risk for fall. Where should fall risk be communicated? (Select and complete all correct answers) * via patients gown ✓ via the medical record patients Intravenous tubings ✓ handoff report ✓ signs on the door or wall ✓ patient wristband Nurse Lester is assigned to geriatric ward, upon his rounds, nurse Lester is tacking down the loose edges of the rug and ensure that rubber skid-proofing is secure. Nurse Lester is trying to * ensure that he see's the patient room according to his style. ensure that the decoration is very aesthetic. ensure that all rugs are firmly fixed to the floor. To provide and maintain electric safety for his older adult clients ? Nurse Paul ensures the following. (Select and complete all correct answers) * uninstall electric sockets to prevent clients in using electricity thus avoiding injury. electric wires should be upon reached and near the older adult for easy access. ✓ check regularly to ensure that there are no broken or frayed electric cords or plugs ✓ Have defective electric plugs or cords repaired by an approved repair person discard all electric appliances that cannot be repaired ✓ install ground fault interrupt (GFI) electric sockets near water sources to prevent accidental shocks with appliances use To decrease clutter and other hazards? The following are nurse Jasmin's interventions for her geriatric clients. (Select and complete all correct answers) * ✓ never place or store anything on stairs place urinal/bedpan on the foot stool beside the bed for easy accessibility ✓ keep shoes, wastebaskets, and electric or telephone cords out of traffic areas dim the light to provide conducive environment for rest and sleep. ✓ discard unnecessary items such as old newspapers ✓ clear ice promptly from sidewalks and outside staircases ✓ cat litter can be used to provide traction on icy surfaces The following interventions should be done by nurse Lester in providing adequate lighting, particularly in stairwells of the geriatric institution where nurse Lester is assigned. (Select and complete all correct answers) * ✓ use high beam lights to ensure safety in the bedroom, bathroom and hallways use appropriate nightlights in the bedroom, bathroom, and hallways ✓ ensure adequate lighting in food preparation areas of the kitchen to facilitate label reading and to reduce the risk for injury when sharp object are used ✓ switches should be located at both the top and bottom of stairs As a nurse assigned to cater clients aged 70-95 years old, How can you provide grip assistance wherever appropriate? (Select and complete all correct answers) * ✓ lightweight cooking utensils with large handles and enlarged stove knobs make cooking easier and safer for older adults Apply restrains for the client on bed to ensure safety and security. ✓ grab bars alongside the toilet and in the bathtub and shower also help provide support ✓ install handrails in all stairwells to provide support for stair climbing How can nurse Jasmin place frequently used items at shoulder height or lower where they can be reached easily by the older adult clients? (Select and complete all correct answers) * ✓ keeping frequently used items available decreases the need to use climbing devices ✓ use one approved devices such as step stools when reaching for items that cannot be reached easily hang the frequently use item on the siderails of the clients bed to avoid over reaching. ✓ ladder are not recommended for use by older adults, but if the need arise, ensure that they are fully open and locked ✓ excessive reaching should be avoided, and another person should stand by to steady the ladder, reducing the risk for tipping Nurse Jasmin is providing health instructions to his 78 year old patient Marites and her family members on measure to prevent burns? (Select and complete all correct answers) * ✓ check that the hot water tank setting does not exceed 120 degrees ✓ do not wear loose, long sleeves when cooking on a gas stove smoking area should be at least 2 meter distance from the patients bed ✓ avoid smoking or the use of open flames wherever possible ensure that fire extinguisher is locked and inaccessible to prevent from being lost. ✓ use a mixer valve to prevent sudden burst of hot water ✓ have a plan for leaving the residence in case of fire Chapter 10 Lester is a nurse clinical instruction with lecture regarding perception among older adults. What does perception attribute to in the environment? * memory judgemen t interpretation Nurse Jasmin is a geriatric nurse attending a 75 year-old client named Borno Mars. What observation would cause nurse Jasmin to suspect cataracts in the older adult like Borno? * Borno holds the newspaper a good distance away while attempting to read small print Borno seeks an area in a room that is free from glare in order to read the newspaper Borno holds a hand over one eye while attempting to read small print Nurse Paul is aware that, Angkol, the patient he will be receiving had a problem on hearing. How should nurse Paul approach patient Angkol who has profound hearing loss? * Knock on the door of patient Angkol before entering Touch patient Angkol on the hand to gain attention. Give patient Angkol a list of interventions that the nurse plans to perform Nurse Jasmin is attempting to communicate with patient Hailey Beiberon, who is hearing-impaired, what should nurse Jasmin consider? * Keep the message simple to Hailey Beiberon. Provide lengthy explanations and information to Hailey Beiberon Assume understanding if the patient does not ask for clarification to Hailey Beiberon. Nurse Lester hears a high whistling noise coming from the hearing aids that are lying on the bedside table of the sleeping 80 year-old patient named Judith. What would be the most appropriate action by nurse Lester? * Replace the hearing aids in the Judith's ears. Turn off the hearing aids of Judith Place the hearing aids of Judith in a drawer to prevent loss. Nurse Paul is attending a patient who experienced delirium. What assessment finding would be characteristic of delirium? * The onset of the behavior of the patient was rapid. There is no change in the level of consciousness from the patient The absence of disorientation from the patient. Nurse Jasmin has been working in the geriatric ward for almost 10 years. Which condition could result delirium in the older adult? * Uncontrolled pain Death of a loved one Relocation to a long-term care facility Jan Weak, a physician, states that patient Selenah with Alzheimer disease has progressed from the preclinical stage of the disease to the mild cognitive impairment stage. What would nurse Paul expect to find upon assessment of patient Selenah? * Selenah's inability to communicate Selenah's Incontinent episodes Selenah's forgetfulness How can nurse Jasmin ensure that there is a continuity of care being provided for his demented patient named Luke in the hospital setting? * Keep the patient Luke in the room. Reduce environmental stimuli for patient Luke such as the TV or radio. Assign care to a consistent group of staff for patient Luke. What is an correct response by nurse Lester to a demented resident named Anteh in a long-term care facility who becomes combative when being prepared for a shower? * Call for assistance to complete the shower of Anteh. Say, "I understand you don't want a shower Anteh, so I'll give you a sponge bath." Medicate patient Anteh with a sedative and complete the bath when the patient is more cooperative. What would be the most effective intervention by nurse Jasmin when patient Marimar, with a cognitive disorder, begins to exhibit delusional behavior as a result of excessive stimulation? * Medicate Marimar with a psychoactive drug such as lorazepam or diazepam. Send patient Marimar to his or her room for "time out." Distract patient Marimar with a quiet activity. Paul, a home health nurse is caring for Anabelle, a patient who has been recently diagnosed with a cognitive disorder. How can nurse Paul best prepare the family for the patient Anabelle's care? * Leave them literature about the disorder of Anabelle Instruct them about the physiological changes that cause the disorder of Anabelle Allow them time for expression of their feelings and grief for Anabelle Tiburcio, an older adult has expressive aphasia. What would be the most effective intervention for nurse Lester to use to improve the patient' Tiburcio's communication? * Provide Tiburcio flash cards with text and pictures. Be patient and ask Tiburcio to repeat himself. Encourage Tiburcio to practice slow speech. Nurse Jasmin who is working in an extended-care facility finds Lucia, an 86-year-old female resident in tears and her hearing aids on the floor. The Lucia says, "I'll just be deaf! I can't stand those things in my ears! All I can hear is static, hums, and whistles!" What would be the most helpful response by nurse Jasmin? * "Lucia, Everybody says that. I'm going to put these back in the box in your bedside table." "Lucia, Those are very expensive pieces of equipment. Because you paid for them, it seems to me to just be good sense to use them." "Lucia, It's frustrating to have something not work. Let me help you replace them and after 10 minutes, I'll help you take them out." Nurse Paul is reading the history of a newly admitted 88-year-old man Eustaquio, with dementia sees that this resident is prone to catastrophic reactions. What behavior does the nurse expect to see in patient Eustaquio? * Eustaquio has excessive emotional reactions Eustaquio has combativeness with little stimulus Eustaquio displays of self-destructive behaviors An 84-year-old female resident named Sofia diagnosed with dementia and admitted in an extended-care facility rapidly paces the halls and the common areas from right after breakfast to bedtime. What should be included in the nursing plan of care? * Restrain Sofia from pacing. Apply a bracelet to Sofia that sounds an alarm if she leaves the building. Encourage rest by asking Sofia to sit and have a glass of juice or a snack. Which of the following are indicators of hearing loss? (Select and complete all 4 correct answers) * Understanding the voice of a female better than the male voice ✓ Hesitant to have telephone conversations Becoming grumpy or moody with background noise ✓ Turning the TV's volume to the loudest intensity ✓ Responding with strage answers to a question Nurse Lester is teaching a family member about her mother's memory loss. Which of the following would be added in the teaching regarding memory loss? (Select and complete 3 correct answers) * ✓ Mother's increasing age ✓ Decreases in an individual with more education Increases with the administration of drugs called antihistamines Decreases with the use of vitamin A supplements ✓ Decreases in an individual who have many varied memories What should be emphasized in a teaching plan for a family caring for an older adult who is having pain? (Select and complete 2 correct answers) * ✓ Give medication to the client before the pain becomes severe. Distract the patient every now and then instead of medicating as ordered. Pain verbalized by the older adult may be exaggerated and overreacted Delay administration to lessen the risk of addiction. ✓ Observe the effectiveness of the medication to the patient. Nurse Jasmin explains to her students that the term used to describes the ability to make judgments quickly on the basis of unfamiliar stimuli is called as * fluid intelligence crystallized intelligence intelligence quotient Chapter 12-13 Ben is a 77-year-old retiree who has the role of father, husband, professional businessman, son, and community leader that may experienced * role confusion. isolatio n internal role conflict diminished self-esteem Nurse Jasmin is aware that Mr. Smith, the older man, who retires from his work and changes his role status will have fewer adjustment problems primarily on the basis of whether Mr. Smith: * is financially secure has other roles and relationships is healthy has a supportive family Nurse Lester assesses that although Mr. Santos, the college professor has retired, Mr. Santos still perceives himself as an educator and retains his academic title and professional association membership as a support to his * altered self-image unchanged role as an educator substitution for employment habitual professional behavior Nurse Paul identifies Mang Tomas, an older adult, who is most likely to experience problems with role changes as the * 68-year-old grandfather who cares for her grandchildren while the mother works 72-year-old retired resort owner who comes to help his son run the business 78-year-old retired veterinarian who volunteers at a medical screening clinic for pets 79-year-old retired private school administrator who takes educational foreign cruises several times a year Mario, a recently widowed 65-year-old man has told nurse Jasmin that he is so lost without his wife that he is planning to retire, sell his home, and move to a retirement village in another city. Nurse Jasmin is aware that such a plan is * positive plan, because it represents a new beginning. positive plan, because it allows him more time to resolve his grief risky plan, because he is giving up significant supports to his self-image and grief resolution process negative plan, because he has not thought his plan through Timoy the older adult asks nurse Paul what is meant by the term roleless role. Nurse Paul explains that it refers to persons who * perceive that the roles that gave life meaning are gone perceive "old age" as freedom to design new roles and relationships perceive that roles must be maintained, regardless of their lack of significance perceive that roles can be altered to meet and diminish damage to the self-image. Nurse Lester recognizes that the bereaved widow, Leticia has entered the searching and yearning stage of grief when she * shows renewed interest in social activities exhibits signs of depression shows making plans for the future exhibits denial of the loss of her husband Lester, the home health nurse, suggests a grief resolution group to Thelma, an 80-year old woman who was widowed 6 months ago, Thelma furiously states, "I don't want or need any help! I want my husband back!" Nurse Lester recognizes this behavior as being characteristic of the grief * stage of shock stage of disorientation stage of searching stage of reorganization Nurse Jasmin is concerned about the 79-year-old man Lucio who is exhibiting behaviors characteristic of dysfunctional grieving, such as verbalizing _____ after the death of his wife * despair for 3 months guilt and self-doubt for 4 months a sense of disorganization for 6 months a sense of depression and despair for 12 months Paul, the home health nurse, helps a grieving widow Anna to start grief resolution by * distracting Anna with social conversation encouraging Anna to verbalize her grief pointing out behaviors of Anna that are not helpful to grief resolution focusing on Anna loneliness and loss When are stress-associated physical, behavioral, and cognitive changes more likely to show? * When a stress has a sudden onset When a stress is low level but constant When a stress is varied and cumulative When a stress is suppressed or denied How does an our body respond physically when stressed? * A Decreased in heart rate A Decreased in production of digestive enzymes A Decreased in blood glucose levels A Decreased in blood pressure Analou is a woman rushed in the emergency department after a car wreck. Analou is breathing rapidly and complains of dizziness and tingling in her extremities. Analou says, "I think I'm having a heart attack!" Nurse Jasmin is aware that the symptoms may be related to which of the following? * A transient ischemic episode A Hyperventilation A Hypotension An Asthma Jemboy, the student sitting in his nursing class waiting for the final examination is having nausea and excessive gas. What is a probable cause of these symptoms? * Increase in the blood glucose level of Jemboy Increase in heart rate of Jemboy Reduction of peristalsis of Jemboy Decrease in adrenalin of Jemboy Which statement by John, an 80-year-old patient, could be related to symptoms of stress? * "Nurse, I have to urinate every 10 minutes, and there are only a few drops." "Nurse, I haven't had to urinate for the past 8 hours." "Nurse, I void large amounts of urine every 2 hours." "Nurse, My urine has absolutely no color. It looks like water." FINALS Paul, the home health nurse encourages Bert, an older adult to file an advance directive to indicate: * a.the degree of intervention desired for life support. b.who is to manage medical decisions in case of debilitating illness. c.who will manage finances in case of debilitating illness. d.the mortuary to be used in the case of death. Patient Anna is attempting to make an informed decision about whether to have a life-extending treatment done. The essential piece of information that is significant in the decision is: * a.whether the quality of life will improve after the procedure is done. b.the cost of the treatment. c.the amount of time treatment will take. d.whether insurance will cover the cost of treatment. The totally competent 76-year-old female named Martha, with terminal cancer, is fatigued and tearful about the ineffectiveness of her treatment. Martha tells Jasmin her attending nurse that she wishes she had never started it but now feels obligated to continue. Nurse Jasmin explains that: * a.once treatment has begun, the doctor should decide about any changes. b.she may change her mind about treatment at any time. c.decisions about treatment should be made by the person who is her medical power of attorney. d.cessation of treatment will shorten her life. Professional health care providers may neglect to teach patients about end-of-life care because they: * a.fear that patients will perceive that they are giving up. b. do not want to influence the patient in any decision. c.want to keep up the patient's morale. d.believe that death is a personal failure on their part. Beth, the home health nurse, is firm with Grandpa Bill, an 86-year-old man with terminal illness that he needs to file an advance directive to: * a.demonstrate understanding of his imminent death. b. comply with most hospital policies. c.clarify treatment protocols. d.spare his family the burden of making end-of-life decision Nurse Lester is aware that hospice care can be made available to terminal patients who: * a.have a life expectancy of only 12 months. b.are Medicaid-qualified. c.agree to palliative measures. d.are hospitalized. Manuel is a dying patient with terminal liver cancer says to nurse Lorraine, "I'm going to take a long time to die, aren't I? I'm going to get sicker and weaker every day." Nurse Lorraine's best response would be: * a."Your type of cancer is usually fatal in 4 to 6 months." b."I don't want to hear this kind of negative talk. Make use of the time you have." c. "We have many medications that can make you feel better." d."What concerns you the most about dying? Thelma, the distraught wife of a terminally ill patient Juan, complains to nurse Jasmin, "My husband has not been shaved, and he has that miserable gown on instead of his own pajamas. Don't you people care about things like that?" Nurse Jasmin's best response would be: * a."I delayed his morning care because he was sleeping comfortably. I'll complete his care now that he's awake." b. "We're running late today and I have six other patients to care for. What do you want?" c. "Of course we care! Someone will come to do his care before lunch." d.. "I'm sorry you feel we're doing such a poor job. I'm doing my best." When nurse Jenny becomes tearful at the death of Mario, his long term patient, nurse Jenny should: * a.leave the room so that the family will not witness the unprofessional behavior. b.touch the hand of the daughter and say, "We'll miss your dad." c. become occupied with rearranging a floral bouquet until emotions are under control. d.discontinue the oxygen, turn off the IV, and say, "I'm sorry for your loss." The nurse notes that a cardiovascular sign of impending death is: * a.Cheyne-Stokes respiration. b.bounding pulse. c.bluish mottling of extremities. d.widening pulse pressure. Nurse Abegail was rotated in Geriatric ward for 20 weeks now. Nurse Abegail is aware that sexuality: * a.becomes absent with age. b.remains part of life until death. c.as expressed through intercourse is not possible after the age of 65 years. d. must be expressed in sexual intercourse. Nurse Christian counsels Berta, a 70-year-old female who has remained on hormone replacement therapy (HRT) that she needs to have a: * a. semiweekly douche to wash out cervical debris. b.liver function assessment annually. c.mammogram biannually. d.Pap smear annually. Nurse Lester evaluates a need for further instruction to reduce the symptoms of vaginal dryness when Juana, a 70-year-old patient says: * a."Vaseline was good enough for my mother. It's good enough for me." b. "I use a water-soluble lubricant to aid intercourse." c."I'm trying an estrogen cream to see if it works." d."I'll let you know how wild yams work for vaginal dryness." Nurse Jasmin identifies the person most likely to experience erectile dysfunction as the 65-year-old who has _____ sexually active in earlier years. * a.diabetes and was very b.irritable bowel syndrome and was minimally c.chronic pancreatitis and was very d.osteoarthritis and was moderately Luisito, a 65-year-old male who, although he is having painful symptoms related to a benign enlargement of the prostate, refuses to consider a prostatectomy because he fears that the surgery will make him impotent. Nurse Paul reassures him that: * a.a prostatectomy will enhance sexual function. b.new techniques for a prostatectomy do not damage nerves. c.the prostate has nothing to do with erection or seminal fluid production. d. impotence following a prostatectomy is entirely psychological. The 70-year-old woman who is considering coming off of hormone replacement therapy (HRT) for the reduction of postmenopausal discomfort asks the nurse what advantage is offered by tamoxifen, also called a "designer estrogen." The nurse's best response is that tamoxifen: * a.provides estrogen to some tissues while acting as an antiestrogen to others. b.has no side effects. c. needs to be taken only once a week. d. improves the skin turgor and complexion. Nurse Paul teaches that some persons have found relief from postmenopausal discomfort by using phytoestrogens, which act as estrogens on some tissue and antiestrogens on others. Phytoestrogens are found in: * a.Mangos b.Soybeans c.Brocolli d.Lima beans Nurse Mary recognizes a need for further instruction about sexual activity when Lucas, a 65-year-old man who had a myocardial infarction 6 months ago says: * a."I'm enjoying the same sexual activities now as I did before my heart attack." b. "I'm still pretty cautious, but our sex lives are very satisfactory." c. "I've been told that I'm at risk for another heart attack if we have sex." d."My heart medications have made me impotent, but we've found other methods of sexual expression." Nurse Lester makes it clear to older adults in a long-term care facility that condoms are available from the medicine cart on request to: * a.guarantee safe sex practices. b. reduce the incidence of sexually transmitted diseases (STDs). c.show acceptance of sexual expression. d. prevent soiling bed linens or furniture. Jullie, the home health nurse stresses to Daniel, a the 70-year-old gay man who has been in a monogamous relationship for 20 years that it is especially important to name his partner as his medical power of attorney (POA) and file advance directives because: * a. all persons older than 60 years should have a medical POA and advance directives. b.gay and lesbian couples are estranged from their families. c. life partners frequently abandon unions when terminal illness occurs. d. life partners have no legal standing and can be prohibited from medical decisions by family.