The nurse keeps the environment warmer for older adults because they are more sensitive to cold because of the age-related changes in their:
metabolism rate.
subcutaneous tissue.
musculoskeletal system.
peripheral vascular system.
The nurse reassures the distressed 75-year-old male that the wartlike dark macules with distinct borders are not melanomas, but the skin lesions of:
Senile Lentigo
cutaneous papillomas
seborrheic keratoses
xerosis
The nurse is accompanying a group of older adults on a July 4th outing to monitor heat prostration. Older adults are intolerant of heat because of an age-related reduction of:
Melanin
Perspiration
Body Temperature
Capillary Fragility
The nurse cautions the CNAs to use care when transferring or handling older adults because their vascular fragility will cause:
Altered Blood Pressure
Pressure Ulcers
Pruritus
Senile Purpura
The nurse assesses a stage I pressure ulcer on an older adult’s coccyx by the appearance of a:
Clear Blister
Nonblanchable area of erythema
Scaly Abraded area
Painful reddened area
The CNA caring for an older adult asks if the yellow, waxy, crusty lesions on the patient’s axilla and groin are contagious. The nurse’s most helpful response is:
“Yes. It is cellulitis caused by bacteria.”
“No. It is seborrheic dermatitis caused by excessive sebum.”
“Yes. It is an indication of scabies.”
“No. It is the lesion seen with basal cell carcinoma.”
The nurse leads a group of postmenopausal older women on a daily 15-minute “walking tour” through the long-term care facility to:
improve bone strength
orient them to their surroundings.
improve their socialization.
increase their appetite.
When the perplexed 70-year-old woman asks, “How in the world can my bones be brittle when I eat all the right foods?” the nurse’s most informative reply is:
“Calcium loss is expected in the older adult.”
“Calcium is continuously withdrawn from bone for nerve and muscle function.”
“Smoking and alcohol consumption speed calcium loss from the bones.”
“Walking and standing increase calcium loss from the bone.”
When the 70-year-old woman complains, “I weigh exactly the same as I did when I wore a size 10 and now I can barely squeeze into a size 16,” the nurse explains:
“Metabolism in the older adult creates increased adipose tissue.”
“Postmenopausal women gain adipose tissue related to loss of calcium.”
“Decrease in muscle mass is replaced with adipose tissue.”
“Kyphosis causes a redistribution of weight.”
When the 70-year-old postmenopausal woman asks whether her hormone replacement therapy (HRT) will prevent bone loss, the nurse’s most helpful response is:
“No. HRT is not helpful after the age of 60.”
“Yes. HRT will prevent bone loss but can cause a stroke, heart attack, or breast cancer"
“No. HRT is reliant on some natural estrogen production from the ovaries.”
“Yes. HRT is a widely accepted therapy for prevention of bone loss.”
An 80-year-old-woman who has osteoarthritis complains of how ugly her hands have become since she has developed Heberden nodes, which are:
yellow longitudinal lines in the nails.
thickened discolored fingernails.
darkened areas under the fingernail.
bony enlargements of distal joints of the fingers.
The nurse modifies the nursing care plan for a 62-year-old woman in an extended- care facility who is suffering a flare in her rheumatoid arthritis to include interventions to
increase fluid intake.
schedule several rest periods to balance activity.
reduce salt in the diet.
assist with rigorous finger extension exercises.
The nurse explains that emphysema is a chronic obstructive pulmonary disease characterized by the pathophysiology of:
constriction of the bronchial tree, excessive mucus, and nonproductive cough.
calcification of the alveoli and a dry cough.
overinflation of the alveoli, making them ineffective for gas exchange.
d. inflammation of the trachea and bronchioles, excessive mucus, and productive cough.
The nurse explains that the pathophysiology of a myocardial infarct is that:
a portion of the myocardium necroses and scars over.
the coronary vessels are narrowed during the attack.
the ischemic myocardium causes pain during the attack but is able to regenerate.
there is damage to the myocardium but no serious alteration of cardiac output.
The nurse is aware that the cardinal signs and symptoms of congestive heart failure are:
dyspnea and edema.
myocardial pain and hypotension.
ventricular arrhythmias and cyanosis.
atrial arrhythmias and polycythemia.
The nurse explains that pernicious anemia is caused by:
an iron deficiency
a deficiency of vitamin B12.
inadequate nutrition.
blood loss.
The nurse alters the nursing care plan for a patient with a hiatal hernia and resultant gastrointestinal reflux to include interventions for:
encouraging the patient to lie down after meals.
drinking two full glasses of liquid after the evening meal.
eating smaller, more frequent meals.
using caffeine drinks to assist with digestion.
The nurse suspects that the pale, edematous, listless diabetic patient who has a blood urea nitrogen (BUN) level of 35 mg/dL and a creatinine level of 4 mg/dL has:
diverticulitis.
congestive heart failure.
chronic renal failure.
benign prostatic hypertrophy.
The most appropriate intervention added to the nursing care plan for a person with Parkinson disease with a nursing diagnosis of “Nutrition, less than body requirements related to difficulty swallowing,” would be to:
feed the patient at each meal.
place the patient in a semi-Fowler position for mealtime.
offer a thick, high-nutrition shake as a snack.
encourage the patient to drink a sip of water after each bite of solid food.
The nurse would anticipate that a person with a hemorrhagic CVA to the left hemisphere would exhibit:
language disturbances.
poor impulse control.
inappropriate affect.
confabulation.
When giving written discharge instructions to a person with macular degeneration, the nurse should:
write the instructions in bold print.
adjust the table and light to assist the patient to use peripheral vision to read.
place written document directly in front of the patient to read.
read the document to the patient.
The nurse becomes aware of inadequate insulin coverage in a patient with diabetes mellitus type 1 when the patient exhibits:
diminished urine output.
ketones in the urine.
shallow and slow respirations.
extreme diaphoresis.
An 80-year-old extended-care resident comes to the nurse asking for a bandage for a bleeding, dark pigmented mole with irregular shape and border. The nurse documents this assessment and reports it as a suspected:
melanoma.
basal cell carcinoma.
cutaneous papilloma.
senile lentigo.
The nurse takes into consideration that the factors influencing the timing and extent of age-related changes include __________. (Select all that apply.)
health maintenance
ethnicity
heredity
attitude
environment
The nurse reminds an 82-year-old man with rosacea that he should avoid __________. (Select all that apply.)
stress
dairy products
sun exposure
spicy foods
alcohol consumption
The nurse is aware that in order for a person to support ossification, he or she must have an adequate intake of vitamin(s) __________. (Select all that apply.)
A
B6
C
D
E
The nurse uses a chart to outline the risk factors for osteoporosis, which include __________. (Select all that apply.)
menopause
smoking
white female
excessive high-impact exercise
long-term use of phenytoin (Dilantin)
The nurse outlines age-related changes in the respiratory system that put the older adult at risk for infection, which include __________. (Select all that apply.)
reduced ciliary movement
decrease in alveolar elasticity
pooling of secretions
flattened diaphragm
calcification of costal cartilage
