ATI Gerontology Quiz 1 Latest Update with Verified Solutions

ATI Gerontology Quiz 1 Latest Update with Verified Solutions A nurse is admitting an older adult client who fell at home and was unable to get up. The client was not discovered until 3 days later by a family member. The client is admitted with a fractured hip, malnutrition, and dehydration. Which of the following lab values, noted on admission, should indicate to the nurse that the malnutrition is a long standing problem? A. Increased Sodium B. Decreased Albumin C. Increased BUN D. Decreased blood sugar B. Decreased Albumin A nurse is caring for an older adult client who has osteoarthritis of the right hip and lower lumbar vertebrae. Which of the following client statements should indicate to the nurse that further instruction is necessary? A. "A warm shower will help me to relieve morning stiffness when I first get up out of bed." B."To relieve the pressure on my back and spine I can use a cane while ambulating." C."I will take my NSAID every 6 hours, as prescribed, to help control my pain." D."I will remain consistently active throughout the day to prevent stiffness in my joints." D."I will remain consistently active throughout the day to prevent stiffness in my joints." A nurse is orienting a newly hired home health assistant, and explaining the assistant's role in helping clients with their ADLs. The nurse should explain that the most common reason older adult clients have difficulty performing ADLs is which of the following? A. Social withdrawal B. Physical disability C. Emotional impairment D. Cognitive dysfunction B. Physical disability A nurse is caring for an older adult client who is on bedrest following development of deep vein thrombosis (DVT). Which of the following food choices should the nurse recommend to the client to help meet the goal of increased peristalsis? A. Bran muffin B. Hash brown potatoes C. Egg and cheese omelet D. Banana A. Bran muffin A nurse is preparing to admit an older adult client to the postsurgical unit. The nurse anticipates that the client will most likely require supplemental oxygen. The nurse should understand that hypoxemia occurs in older adult clients as a result of which of the following physiologic change normally associated with aging? A. Decreased anterior-posterior diameter B. Increased diameter of the small airways C. Increased number of cilia D. Decreased alveolar surface area D. Decreased alveolar surface area A nurse is obtaining a health history from a client admitted following a cerebrovascular accident (CVA). The nurse notes that the client has a history of GERD. The nurse should understand that this past medical history puts the client at increased risk of which of the following? A. Duodenal ulcer disease B. Aspiration pneumonia C. Viral Pneumonia D. Esophageal varices B. Aspiration pneumonia A nurse in a post-surgical unit is admitting an older adult client from the recovery department following abdominal surgery for a bowel obstruction. Of which of the following information regarding pain management should the nurse be aware? Older adult clients A. have a diminished capacity to perceive pain. B. are sensitive to the analgesic effect of opiates. C. require higher doses of opiates for analgesia. D. possess an increased tolerance for pain. B. are sensitive to the analgesic effect of opiates. A nurse is writing a plan of care for a client who had a cerebrovascular accident (CVA). Which of the following should the nurse identify as a priority goal for a client following a CVA? A. Client will maintain intact skin during hospitalization. B. Client will verbalize one new word per week. C. Mobility will improve when client begins to help turn self in bed. D. Airway will remain clear as evidenced by clear breath sounds. D. Airway will remain clear as evidenced by clear breath sounds A nurse is administering an antihistamine to an older adult client. Which of the following is an appropriate nursing statement? A. "Antihistamines should be used cautiously in clients who have glaucoma." B. "Older adult clients require increased doses of antihistamines." C. "Sustained-release preparations are contraindicated in older adult clients." D. "You may experience paradoxical hyperexcitability." A. "Antihistamines should be used cautiously in clients who have glaucoma." A nurse is part of a committee that is developing age-appropriate care standards. Which of the following should the nurse know is the focus for older adult clients, based on Erikson's developmental tasks? A. Intimacy B. Identity C. Integrity D. Initiative C. Integrity A nurse is caring for a client who has Alzheimer's disease. The client has been oriented to name and place and is able to perform ADLs with minimal supervision. When the client refuses to take morning anti hypertensive medications, the nurse's first action should be to do which of the following? A. Crush the pills, if not contraindicated, and feed them to the client in applesauce. B. Ask the client to express her reasons for refusing the morning medications and document the event. C. Try to convince the client to comply by telling her the possible implications of missing a dose. D. Notify the primary care provider of the need for further evaluation of the client's level of competence. B. Ask the client to express her reasons for refusing the morning medications and document the event. A nurse working in a medical unit is caring for a male client who has dementia. The nurse notes that the client becomes agitated and confused in his room at night. The client, who has an unsteady gait, removes all of his clothes and wanders about naked in his room and the hallway. Which of the following actions should the nurse take first? A. Move the client to a room closer to the nurse's station. B. Play soft, soothing music or leave the television on. C. Dress the client and return him to his bed. D. Check on the client frequently throughout the night. A. Move the client to a room closer to the nurse's station. A nurse is assessing an older adult client who states, "I haven't seen a doctor in years. I walk 5 miles a day and I'm as healthy as a horse." Which of the following findings, obtained while taking the client's history and performing a physical examination, should the nurse explain to the client requires further evaluation? A. The client's blood pressure (BP) is 128/76 mm Hg. B. The client's fingerstick blood glucose is 160 mg/dL. C. The client wakes to void two to three times per night. D. The client has a bowel movement every 3 days. B. The client's fingerstick blood glucose is 160 mg/dL. A nurse at an assisted living center is conducting an orientation session for newly hired assistive personnel (AP). Because several of the older adult residents are hearing impaired, the nurse includes instruction for promoting communication. Which of the following instructions should the nurse include? A. Maintain eye contact with the clients and speak slowly. B. Stand to one side of the clients and speak into their good ears. C. Stand close to the clients and speak loudly with exaggerated enunciation. D. Maintain a position in front of the clients and ask only questions with yes or no answers. A. Maintain eye contact with the clients and speak slowly. A nurse is caring for an overweight, older adult resident who has gout. The client has been refusing to eat stating, "I can't stand the food." The client's primary care provider has approved the family to bring food from home if they maintain a purine restricted diet. Which of the following foods, if brought by the client's family, should the nurse realize is unsafe for the client to eat? A. Lentil soup B. Cheese sandwich C. Yogurt D. Dried fruits A. Lentil Soup A nurse is caring for an older adult client. Which of the following should the nurse recognize as a physiologic change normally associated with aging that could affect drug dosage in this client? A. Increased glomerular filtration rate B. Decreased body fat C. Decreased gastric motility D. Decreased gastric pH C. Decreased gastric motility A nurse at a community outreach clinic should recognize which of the following as an example of co morbidity in an older adult client who is homeless? A. Inadequate shelter and clothing for the weather B. Malnutrition and poverty C. Dementia and tuberculosis D. Lack of preventative health care and immunizations C. Dementia and tuberculosis A nurse at a community center is speaking to a group of healthy older adult clients about health promotion. Which of the following examinations should the nurse recommend that all clients over 50 years of age have performed annually? A. Electrocardiogram (EKG) B. Colonoscopy examination C. Chest x-ray D. Glaucoma examination D. Glaucoma examination A nurse at an ophthalmology clinic is caring for a client. The nurse is interviewing a client who was referred by her primary care provider for suspicion of cataract. Which of the following client reports should the nurse recognize is consistent with the primary care provider's suspicion? A. Halos and rainbows when looking at lights B. Loss of peripheral vision C. Bright flashes of light and floaters D. Eyestrain and headache with close work A. Halos and rainbows when looking at lights A nurse at a geriatric clinic is assessing a client who is at the clinic for the second time this week reporting a decreased energy level, insomnia, and anorexia. Diagnostic tests performed at the prior visit failed to reveal an organic reason for the client's reports. The nurse should assess the client for symptoms of which of the following? A. Dystonia B. Dementia C. Depression D. Diabetes C. Depression A nurse is conducting an admission health history and assessment with an older adult client. Which of the following is an appropriate action by the nurse? A. Leave the client a written questionnaire to fill out in private. B. Allow sufficient time for the client to respond to the questions. C. Use family members to obtain the client's health history. D. Obtain the health history from the client's medical record. B. Allow sufficient time for the client to respond to the questions. A nurse is evaluating morning laboratory test results obtained for several clients. The nurse should understand that which of the following explanations accounts for fasting blood glucose test values being elevated in older adult clients? A. Decreased production of insulin by the aging pancreas B. Consumption of a high-carbohydrate diet C. Increased rate of glucose metabolism D. Decreased release of glycogen by the aging liver A. Decreased production of insulin by the aging pancreas A nurse is assessing an older adult client for signs of dehydration. Which of the following findings should the nurse consider a normal part of the aging process? A. Elevation of urine specific gravity B. Thin skin and spidery veins of the hands C. Dry oral mucous membranes D. Poor turgor over the sternum B. Thin skin and spidery veins of the hands A nurse volunteering at a health fair is approached by an older adult client who states, "I am always forgetting things. I cannot even remember where I parked my car! Do you think I have Alzheimer's disease?" Which of the following is a therapeutic response from the nurse? A. "Maybe. Perhaps you should discuss your concerns with your doctor." B. "I am forgetful too. I can't remember where I parked my car either!" C. "You're probably just having 'senior moments.' Everyone has memory lapses." D. "That must be very upsetting. Can you tell me about your forgetfulness?" D. "That must be very upsetting. Can you tell me about your forgetfulness?" A nurse is addressing a group of women who are postmenopausal on the subject of dietary requirements. A client asks what role, if any, folic acid (Folate) has in the health of older adult women. Which of the following is an appropriate response by the nurse? A. "Women who are postmenopausal need to limit their intake of folic acid to reduce their risk of stroke." B. "Dietary folic acid is not of significant importance after the childbearing years." C. "Healthy women who are postmenopausal require a daily folic acid supplement." D. "Adequate folic acid intake is associated with a reduced risk for heart disease." D. "Adequate folic acid intake is associated with a reduced risk for heart disease." A nurse in an emergency department is caring for an older adult female client who is of Asian descent and appears thin. The client came to the emergency department following a fall and was found to have a simple fracture of her right wrist. The client states that she has never had a broken bone before and denies any history of osteoporosis. However, the client does report that in the last year she had to fix the hems on some of her clothes because they were getting too long, and she has had some back pain. The client says she eats "well enough" and takes an "oyster shell pill" every day with breakfast. She asks if this is okay. Which of the following is an appropriate response by the nurse? A. "Natural supplements can vary considerably as to strength and purity. You should discuss the one you are taking with your doctor." B. "Your current regimen is adequate for someone your age. You should continue with your current diet and oyster shell pill." C. "You should take calcium three times a day, so take the oyster shell pill two more times in addition to the one you take with breakfast." D. "At your age, you are already postmenopausal, so the additional calcium in your oyster shell pills is not going to be of any benefit." A. "Natural supplements can vary considerably as to strength and purity. You should discuss the one you are taking with your doctor." A nurse is caring for a client who is postmenopausal and just had a bone scan that has confirmed osteopenia. The nurse is screening the client's chart to see if she is a candidate for treatment with alendronate sodium (Fosamax). Which of the following conditions in the client's history should the nurse recognize is a contraindication to alendronate sodium? A. Duodenal ulcer B. Paget's disease C. Esophageal achalasia D. Long-term corticosteroid use C. Esophageal achalasia A nurse at a long-term care facility is conducting an instructional session with a group of adolescent volunteers. The nurse should explain to the adolescents that older adult clients are most likely to exhibit a decrease in which of the following? A. Short-term memory B. Creative ability C. Decision-making skills D. Cognitive capacity A. Short-term memory A nurse is promoting reminiscence among the older adult residents at a long-term care facility. Which of the following actions should the nurse take to best assist residents to meet this goal? A. Establishing a weekly pet therapy visitation program B. Placing a calendar and clock in each resident's room C. Instituting a daily storytelling hour about "the good old days" D. Encouraging all clients to eat their meals in the dining room C. Instituting a daily storytelling hour about "the good old days" A visiting nurse is asked to make a home visit to an older adult client who has anemia and was recently discharged from the hospital. The nurse should suggest that the client eat which of the following to optimize the client's diet for the creation of new red blood cells? A. Yogurt for bedtime snack B. Bran muffin with breakfast C. Peanut butter sandwich for lunch D. Green, leafy salad with dinner D. Green, leafy salad with dinner