nur 115

1.The nurse is caring for an older adult who reports severe chronic pain. To best assess age-related physiologic changes that could influence plans for initiating an appropriate drug regimen, the nurse prepares the client for which laboratory evaluation?

An older adult client is being assessed for possible alcohol abuse. To best assess the client's risk potential, the nurse asks:

An older adult client is currently undergoing detoxification for alcohol at a rehabilitation center. When assessing the client using the Clinical Institute Withdrawal Assessment tool the nurse determines the client's current score to be 23. The nurse:

A 68-year-old man with a history of alcohol abuse is admitted to the acute care facility for reports of abdominal pain. Based on your understanding of alcohol withdrawal, the nurse knows that if client is currently abusing alcohol, he will most likely:

Since diagnosing substance abuse in the older adult client can be difficult because symptoms can be subtle and atypical, the nurse is particular interested in determining the cause of a client's:

...A 67-year-old woman presents at the emergency department with symptoms that suggest possible abuse of a narcotic analgesic. To best assure the client's safe care, the nurse asks:

Your 78-year-old client reports that she has frequent constipation as a result of medications she is prescribed and asks the nurse for advice about using a daily over-the-counter laxative. The most appropriate response to her question is that it would be best for her to:

...When initially planning care for the older adult client who is prescribed clonidine patches as part of a smoking cessation program, the nurse:

...The nurse explains to ancillary staff that caffeine abuse is difficult to diagnose in the older adult client because caffeine intoxication symptoms:

11. The nurse prepares to administer PRN diazepam (Valium) to an older client for signs that she is developing impending alcohol withdrawal delirium. These signs include:

.When planning an educational program on cancer for a group of older adults, the nurse includes information regarding racial and ethnic patterns of cancer in the United States that includes:

An older adult client asks the nurse why so many of her friends are developing cancers. The nurse responds best when answering:

An older adult client expresses concern about developing cancer in the future and asks the nurse advice about cancer prevention. The nurse shares that:

An older adult client has rheumatoid arthritis, which limits her manual dexterity and ability to perform breast self-examinations. In order to best address the client's need for breast health promotion, the nurse teaches the client to:

Which statement, if made by an older Caucasian adult man, indicates the need for further teaching about prostate cancer and its prevention?

When obtaining a health history, the nurse recognizes that an older adult client has a risk factor for colorectal cancer when he reports:

While awaiting the results of testing to determine a diagnosis of cancer, an older adult client asks a nurse to explain what happens when cancer metastasizes. The nurse responds:

The family of an older adult diagnosed with cancer asks the nurse to explain how gene therapy might benefit their father. The nurse responds:

The nurse observes a suspicious mole on the back of an older adult who is undergoing palliative radiotherapy for brain metastasis. The nurse suspects that the mole:

10. The family of an older adult client with breast cancer is reluctant to agree to the suggested treatment plan because they "have heard such horrible things about radiation therapy." The nurse responds:

11. After a course of chemotherapy for cancer of the throat, an older adult client is admitted to the hospital with persistent nausea and vomiting. The nurse should initially assess the client for:

12. The daughter of an older adult woman who had a colostomy as a result of colon cancer tells the nurse, "Mom seems to be so withdrawn; she has stopped going out with her friends and I'm really concerned." The most relevant nursing diagnosis for the client's reaction is:

13. An older adult client diagnosed with colon cancer is being evaluated for surgical removal of the tumor. The nurse explains that the primary consideration is the:

14. An older adult client is undergoing palliative surgery for colon cancer metastasis. The nurse explains to the family that this intervention is intended to:

The nurse documents that a newly widowed older adult client is likely experiencing physical grief responses when she:

The nurse is confident that an older adult is successfully completing the tasks associated with mourning his wife's death when he

While the family of a newly widowed older adult client lives several hours away, they are interested in providing their mother with appropriate support. The nurse suggests it would be most helpful if they would:

A 68-year-old client who has recently lost his wife of 50 years shares with the nurse that he'll, "never get over missing her." The nurse is most therapeutic when responding:

The nurse documents that a client is likely experiencing exaggerated grief when she:

The nurse is caring for an older adult who recently lost an adult child as a result of automobile accident. They shared a home and enjoyed a healthy parent-child relationship. The nurse is confident that the client has progressed appropriately through the mourning process when she:

The nurse evaluates how an older adult client will react to the death of a spouse based on how he:

A novice hospice nurse shows the best understanding of the nursing role related to an older adult client's mourning over the loss of her son when stating:

An older adult man has been the primary caregiver for his chronically ill wife for the last 10 years. When his wife dies, the nurse prepares the family for the likely possibility that their father will express:

A hospice nurse shows the best understanding of the personal commitment to the dying client by:

The nurse shows an understanding of the primary factor that facilitates the adjustment to the loss of a spouse when asking:

The nurse determines that the daughter of a widowed older adult client has a poor understanding of the grieving process when she reports that:

.When administering medications to older adults, the nurse shows an understanding of the effect of aging on drug distribution by monitoring the client's:

An older adult client has been ordered to receive the drug warfarin (Coumadin). The nurse's primary intervention involves monitoring the client for drug toxicity by daily review of his:

A 72-year-old client with a history of diabetes and hypothyroidism is being admitted to an assisted living facility. During the admission assessment the client reports difficulty falling asleep. The nurse shows an understanding of sleep dysfunction and the older client when asking:

A 65-year-old client is receiving propranolol (Inderal) for hypertension. Which outcome is the best indicator of goal success when considering the drug's potential effect on the client's quality of life?

The nurse responsible for administering medications to the residence of a long-term care facility shows an understanding of the risk of injury this population experiences when:

An older adult diabetic client is mildly hypertensive. The nurse prepares to educate the client regarding angiotensin II-blocking agents since these drugs are especially useful in older adults because they:

The nurse shows an understanding of medication-related risk factors common to older adults when asking:

An older adult client is having difficulty remembering when to take several of her prescribed medications. To improve the client's compliance with her medication, regimen the nurse:

When preparing information concerning cardiovascular risk factors for a group of older adults, the nurse stresses that cigarette smokers are four times more likely to die of sudden cardiac death than nonsmokers because smoking:

When assessing an older, female African American adult, the nurse notes that she has been a type 2 insulin-dependent diabetic 10 years. The nurse notes that the client's greatest risk for developing secondary hypertension is her:

When administering Lopressor to an older adult client with hypertension, the nurse is careful to have the client's care plan include:

The nurse educates the obese older adult client that the single most important outcome that will affect cardiac health is:

In order to evaluate an older client for possible renal failure as a result of chronic untreated hypertension, nurse prepares to:

The nurse recognizes that the symptoms that have priority for care are:

It is suspected that an older adult client is experiencing severe hypertension. The nurse documents symptoms that support this diagnosis when the client reports:

A novice nurse requires additional education on the assessment findings reflective of arterial vascular deficiency when suggesting the condition's symptoms include:

The nurse shows an understanding of how anemia symptoms present in the older population when:

. When evaluating the effectiveness of discharge teaching for an older adult client who had a pacemaker implanted, the nurse determines the client has an appropriate understanding of the device when stating:

A 76-year-old client has been recently diagnosed with cardiac valvular disease. The nurse assesses the client and recognizes that the medical diagnosis is supported by:

The nurse best maximizes an older adult's potential to avoid developing a postsurgical respiratory infection by:

An older adult's pulmonary function studies indicate that his vital capacity is reduced and his residual volume is increased. The nurse recognizes that these test results are observed in the client's:

The nurse is concerned about an older adult client developing toxic levels of the prescribed theophylline when it is determined that the client has a(n):

The nurse is aware the typical occurrence of comorbidities in the older adult. Motivated by this knowledge the nurse assesses a client with diagnosed respiratory dysfunction for possible:

Because the older adult is not as likely to exhibit the typical signs of ineffective gas exchange, the nurse is particularly suspicious of:

The nurse preparing information for the caregivers of a 79-year-old with chronic respiratory issues will make the greatest impact on their ability to provide quality care while maintaining their own emotional well being by including:

An older client admitted to the hospital with symptoms strongly suggestive of tuberculosis has a negative Mantoux test. The nurse correctly anticipates that:

An older adult client who has tuberculosis is being treated with the drugs isoniazid 300 mg daily, rifampin 600 mg daily, and pyrazinamide 1500 mg daily. The nurse stresses the importance that the client:

An 80-year-old client is concerned about contracting pneumonia. The nurse educates her that the key to prevention is:

Because the diagnosis of asthma can be difficult in that it mimics other conditions, the nurse gives priority to assessing an older client who presents with symptoms of acute respiratory distress for:

The nurse caring for an older adult prescribed corticosteroids for asthma educates the client that the medication is safe and well tolerated when:

The nurse caring for an older adult with type 2 diabetes mellitus places importance on assessing the client for:

The nurse recognizes that an older adult on both antihypertensive and antidepressant drug therapies has a specific need for:

Aware that older adult clients often present with nonclassic symptoms of type 2 diabetes mellitus, the nurse is particularly suspicious of a client reporting:

During the daily assessment of an older adult client 2 days after abdominal surgery, the nurse observes signs that the client may have an underactive thyroid. The data supporting this suspicion includes:

The nurse is preparing to provide an older newly diagnosed diabetic client with information regarding type 2 diabetes. The nurse initially:

The nurse shows an understanding of the effective assessment of an older adult diabetic client's cardiac status when documenting:

The nurse teaching a 79-year-old with type 2 diabetes about the importance of regular exercise suggests that the client:

A 66-year-old is being evaluated for an underactive thyroid gland. The diagnosis of hypothyroidism is supported when the nursing assessment notes:

A 73-year-old is being admitted to an assisted living facility. During the admission assessment and history, the nurse suspects the client may be experiencing primary osteoporosis when noting:

An 80-year-old client has nausea and vomiting related to a gastrointestinal disorder. The nursing intervention most likely to help the client is to:

.When preparing to discharge an older client who has begun to experience dysphagia, the nurse suggests that the problem can minimize by:

An older client is being taught about oral gingivitis. The nurse has included instruction about maintaining an oral hygiene program, signs and symptoms of oral infection, and the importance of maintaining regular professional dental care. What important teaching has been missed

Which statement, if made by the older adult with recently diagnosed gastritis, indicates the need for further teaching about the condition or its treatment?

You have been assigned to teach a 75-year-old client about her newly diagnosed diverticulitis. When planning for the teaching session, you want to make certain that you explain that:

The nurse caring for an older adult diagnosed with hyperplastic polyps instructs him that:

An older adult reports chronic constipation. When asked why this problem has gotten worse with age, the nurse responds:

An elderly client reports episodes of fecal incontinence. The nurse provides appropriate emotional support when assuring the client that:

The daughter of a dependent older client reports to the nurse that her mother requires regular soapsuds enemas to manage her chronic constipation. The nurse responds that:

A 68-year-old client is reporting symptoms that suggest a peptic ulcer. The nurse shows an understanding of the risk factors for this condition when asking whether:

To best identify a risk for injury resulting in hospitalization of an older adult client who has experienced evidence of musculoskeletal aging, the nurse assesses for:

When caring for the older adult client who underwent knee replacement surgery 8 days ago, the nurse assesses for symptoms of the complication that the client is at greatest risk for when:

An effective nursing activity to reduce the risk of hip dislocation after hip replacement surgery in the older adult client is for the nurse to:

An older adult client has experienced a left knee replacement asks the nurse, "When will I be back to normal?" The nurse responds that:

The nurse caring for an older client diagnosed with spl stenosis encourages the client to notify his physician if he experiences:

The nurse is assisting a 65-year-old female client with planning an exercise program to prevent osteoporosis. The nurse shows an understanding of appropriate exercise when stating:

An older adult client has been casted for fractured left wrist. The nurse shows an understanding of the client's risk for the development of compartment syndrome when:

An older adult client has been admitted to the hospital with suspected Paget's disease. What clinical manifestation will the nurse want to monitor for in an attempt to differentiate Paget's disease from other types of musculoskeletal diseases?

An older confused client is recovering from a stage IV sacral pressure ulcer. The nurse shows an understanding of this client's risk for developing osteomyelitis by:

An older adult is diagnosed with rheumatoid arthritis. When discussing exercise with the client, the nurse makes the greatest positive impact on the client's quality of life when stating:

The nurse caring for an older adult client prescribed allopurinol (Zyloprim) minimizes the client's risk for developing a serious outcome of this therapy by:

When caring for older adults, the nurse expects to encounter the normal urinary age-related outcome of:

An 87-year-old client who does not have a history of urinary incontinence has suddenly become incontinent. In dealing with this problem, the nurse's first action should be to:

An older adult client reports "losing urine" when she bends over or gets out of a chair. In light of her symptoms, the nurse edits the client's care plan to include Altered urinary function, __________ incontinence.

When assessing the client for urinary incontinence, which client symptom best supports the nursing diagnosis of overflow incontinence?

An older cognitively impaired adult client is being prepared for discharge to be cared for by her daughter. The nurse knows that the continued success of the client's bladder training for urinary incontinence primarily rests upon the:

An older adult client is hospitalized for surgery to treat injuries he received in an automobile accident. The nurse recognizes symptoms suggestive of an upper urinary tract infection when the client:

An older adult woman has a resistant strain of pneumonia. To best minimize her risk of developing acute renal failure, the nurse:

An older client is admitted with possible chronic renal failure (CRF). The nurse notifies the attending physician with the results showing the client's:

The nurse is completing an admission assessment on an older client who has been diagnosed with benign prostate hyperplasia. The nurse's priority questioning focuses on:

An older adult who is experiencing age-related postural hypotension shares with the nurse that he fears "something is really wrong" because he is the only one in his social group experiencing the problems. The nurse responds:

The nurse educates the older client on the possible risks for injury related to the common age-related changes to the senses by stressing the importance of:

The nurse is conducting an admission assessment on a mildly confused older client. The nurse best assures an accurate history by first:

A nurse caring for an older client diagnosed with acute depression shows an understanding of the client's risk for developing delirium when:

When assessing an older client displaying symptoms reflective of delirium, the nurse focuses the assessment on:

An 80-year-old client exhibiting signs of dementia representative of Alzheimer's disease (AD). The nurse supports that possibility when determining that the client:

When planning care for the older adult with advanced dementia, the nurse recognizes that the best way to implement reality orientation is to:

A 73-year-old client diagnosed with vascular dementia is admitted for exacerbation of asthma. The nursing history determines that has been treated for 2 years with benzodiazepines to manage her increasingly aggressive behavior. The nurse's initial responds is to:

Which of the following statements, when made by family members caring for an older client with dementia, indicates peaceful acceptance of the situation?

The son of a 78-year-old suspected of experiencing Alzheimer's disease (AD) asks the nurse if there is a diagnostic test that can confirm the diagnosis. The nurse responds that:

An 89-year-old diagnosed with dementia was until recently responding well to cognitive cueing techniques. The nurse shows an understanding of dementia when sharing with staff that:

The nurse explains that the plan of care for an older adult client with seborrheic dermatitis of the scalp should include:

An older adult client reports simple xerosis with mild pruritus. The nurse educates her on the importance of:

The nurse plans to assess for candidiasis as a priority intervention for a:

An 87-year-old client developed herpes zoster after surgical repair of a hip fracture. The priority nursing diagnosis is:

The presence of which skin assessment finding, if noted on an older adult client, should cause the nurse to suspect a premalignancy?

An older adult client has been taught measures to prevent the development of skin cancer. Which statement, if made by the client, indicates that he needs more teaching?

When assessing the older adult client's skin for indications of melanoma, the nurse should inspect for a(n):

An older adult client newly diagnosed with peripheral vascular disease is being educated on the possibility of developing a foot ulcer. The nurse describes the possible lesion as being:

An older adult client has an open, draining wound on the medial aspect of his right leg. The skin surrounding the wound is reddish-brown with surrounding erythema and edema. Based on this information, the nurse edits the client's care plan to include Impaired skin integrity:

When assessing for squamous cell cancer, a home health nurse is particularly concerned about a suspicious lesion on the:

The nurse of a bedridden 74-year-old woman is evaluating whether the family members understand how to position the client correctly. The nurse is confident the family is capable of effective positioning when it is observed that the client's:

An older adult client reports burning and itching eyes. On assessment, the nurse notes swelling of the eyelid margins bilaterally. What additional data are necessary to confirm the nurse's suspicion of blepharitis?

The morning of his scheduled cataract extraction and intraocular lens placement of the right eye, an older adult client expresses concern that he will not remember his instructions for home care. Which statement is the best response to the client's concern?

Your 88-year-old client is hospitalized for a retinal detachment. He is on bed rest, and both eyes are covered with patches. Which nursing diagnosis takes priority at this time?

A 66-year-old client has been diagnosed with type 2 insulin-dependent diabetes mellitus. When discussing vision related complications the nurse recognizes that the client has an understanding of symptom management when she states that she lost most of her vision as a result of diabetic retinopathy. Which behavior indicates that she may be having difficulty adapting to her diminished vision?

A 77-year-old client who is quiet and withdrawn may have a hearing deficit related to impacted cerumen. During the nursing assessment the nurse confirms supporting evidence of the condition when noting:

An older adult client reports "ringing" in her ears. What additional data should the nurse gather to help determine the cause of the client's problem?

An older client with presbycusis has been advised to purchase a hearing aid and asks about its function and use. Which information is most accurate to give the client about the function of hearing aids?

A 96-year-old client reports symptoms xerostomia. The nurse attempts to minimize the effects of the condition by:

. The preferred way for the nurse to communicate with a 72-year-old hearing-impaired client is to:

To educate clients on health promotion measures to minimize the effect of normal age-related changes in immunity, the geriatric nurse:

An older adult client who is generally in good health starts experiencing numerous colds and now pneumonia. What factor from her nursing history most likely has placed her at increased risk for the development of these infections?

A 65-year-old man has smoked tobacco most of his adult life. When planning health promotion education for him, the nurse includes information that such smoking:

An older adult client is experiencing problems with chewing while recovering from extensive oral surgery. The nurse best affects this client's risk for infection by:

The nurse caring for a cognitively impaired older adult admitted to an acute care facility best minimizes this particular client's risk for developing a nosocomial infection by:

The nurse caring for an older adult client currently receiving traditional drug therapy for methicillin-resistant Staphylococcus aureus (MRSA) recognizes that the client is at risk for developing:

The nurse preparing an educational facts sheet on human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome AIDS for older adults includes reference to which of the following?

The geriatric nurse caring for the older female immunosuppressed client is particularly concerned when the client reports which of the following? Select all that apply.