NUR 303 - Older Adults(A+ Guaranteed Answers)
An older client is agitated and develops new-onset confusion on admission to the long-term care
unit. What is the best action for the nurse to take to minimize relocation stress syndrome for this
client?
a. Provide reorientation during hourly rounding.
b. Obtain a certified sitter to remain with the client.
c. Speak to the client as little as possible to avoid overstimulation.
d. Provide adequate sedation to lessen fear-provoking situations. correct answersA. provide
reorientation during hourly rounding
Which intervention would best support a client who relates a feeling of "loss of control" after
having a mild stroke?
a. Explain that such feelings are normal, but that expectations for rehabilitation must be realistic.
b. Encourage the client to perform as many tasks as possible and to participate in decision
making.
c. Further assess the client's mental status for other signs of denial or psychopathology.
d. Obtain an order for physical and occupational therapy evaluations. correct answersB.
encourage the client to perform as many tasks as possible and to participate in decision making
What will the nurse teach the older client with hypertension who complains that "food does not
taste good without salt"?
a. Salt can be used as long as blood pressure remains controlled.
b. All salt should be removed from the diet to preserve kidney function.
c. Table salt can be used in small amounts in conjunction with diuretics.
d. Herbs and spices can be substituted to season food. correct answersD. herbs and spices can be
substituted to season food
What is a priority nursing intervention to prevent falls for an older adult client with multiple
chronic diseases?
a. Providing assistance to the client in getting out of the bed or chair
b. Placing the client in restraints to prevent movement without assistance
c. Keeping all four siderails up while the client is in bed
d. Requesting that a family member remain with the client to assist in ambulation correct
answersA. providing assistance to the client in getting out of the bed or chair
An older adult client is in physical restraints. Which intervention by the nurse is the priority?
a. Assess the client hourly while keeping the restraints in place.
b. Assess the client every 30 to 60 minutes, releasing restraints every 2 hours.
c. Assess the client once each shift, releasing the restraints for feeding.
d. Assess the client twice each shift while keeping the restraints in place. correct answersB.
assess the client every 30 to 60 minutes, releasing restraints every 2 hours
An older adult client has become agitated and combative toward health care personnel on the
unit. What is the first action that the nurse will take?
a. Obtain an order for a sedative-hypnotic medication to reduce combative behavior.
b. Attempt to soothe the client's fears and reorient the client to surroundings.
, c. Obtain an order to place the client's arms in restraints to protect personnel.
d. Arrange for the client to be transferred to a mental health facility. correct answersB. attempt to
soothe the client's fears and reorient the client to surroundings
An older adult client presents with signs and symptoms related to digoxin toxicity. Which age-
related change may have contributed to this problem?
a. Increased total body water
b. Decreased renal blood flow
c. Increased gastrointestinal motility
d. Decreased ratio of adipose tissue to lean body mass correct answersB. decreased renal blood
flow
A nurse is assessing a client's understanding of medication therapy. Which statement indicates
that the client needs further instruction?
a. "My husband is on the same medication, so we always take our medications together in the
morning."
b. "I prepare all my medication for the week and place the pills in a container labeled for each
day."
c. "When I don't sleep well at night, I take two thyroid pills the next day instead of just one."
d. "I take my Coumadin every day when the noon news comes on the television." correct
answersC. "When I don't sleep well at night, I take two thyroid pills the next day instead of just
one."
An older adult client is being discharged from the hospital on several medications. Which
intervention best reinforces medication teaching for this client?
a. Have the client actively participate in drug administration during hospitalization.
b. Include the client's children in discussions regarding medication administration.
c. Give the client a pamphlet with the actions, side effects, and doses of all drugs.
d. Make a chart showing which drugs should be taken at specified times during the day. correct
answersA have the client actively participate in drug administration during hospitalization
An older adult client's spouse has died, and the family expresses concern that the client has lost
weight recently and now refuses to attend the annual family reunion. The nurse should assess this
client further for what clinical condition?
a. Psychosis
b. Depression
c. Dementia
d. Delirium correct answersB. depression
Which behavior exhibited by an older adult client alerts the nurse to the possibility that the client
is experiencing delirium?
a. Becoming confused within 24 hours after hospital admission
b. Displaying a cheerful attitude despite a poor prognosis
c. Becoming withdrawn and sleeping most of the day
d. Beginning to use slurred speech and losing coordination correct answersA. becoming confused
within 24 hours after hospital admission
An older client is agitated and develops new-onset confusion on admission to the long-term care
unit. What is the best action for the nurse to take to minimize relocation stress syndrome for this
client?
a. Provide reorientation during hourly rounding.
b. Obtain a certified sitter to remain with the client.
c. Speak to the client as little as possible to avoid overstimulation.
d. Provide adequate sedation to lessen fear-provoking situations. correct answersA. provide
reorientation during hourly rounding
Which intervention would best support a client who relates a feeling of "loss of control" after
having a mild stroke?
a. Explain that such feelings are normal, but that expectations for rehabilitation must be realistic.
b. Encourage the client to perform as many tasks as possible and to participate in decision
making.
c. Further assess the client's mental status for other signs of denial or psychopathology.
d. Obtain an order for physical and occupational therapy evaluations. correct answersB.
encourage the client to perform as many tasks as possible and to participate in decision making
What will the nurse teach the older client with hypertension who complains that "food does not
taste good without salt"?
a. Salt can be used as long as blood pressure remains controlled.
b. All salt should be removed from the diet to preserve kidney function.
c. Table salt can be used in small amounts in conjunction with diuretics.
d. Herbs and spices can be substituted to season food. correct answersD. herbs and spices can be
substituted to season food
What is a priority nursing intervention to prevent falls for an older adult client with multiple
chronic diseases?
a. Providing assistance to the client in getting out of the bed or chair
b. Placing the client in restraints to prevent movement without assistance
c. Keeping all four siderails up while the client is in bed
d. Requesting that a family member remain with the client to assist in ambulation correct
answersA. providing assistance to the client in getting out of the bed or chair
An older adult client is in physical restraints. Which intervention by the nurse is the priority?
a. Assess the client hourly while keeping the restraints in place.
b. Assess the client every 30 to 60 minutes, releasing restraints every 2 hours.
c. Assess the client once each shift, releasing the restraints for feeding.
d. Assess the client twice each shift while keeping the restraints in place. correct answersB.
assess the client every 30 to 60 minutes, releasing restraints every 2 hours
An older adult client has become agitated and combative toward health care personnel on the
unit. What is the first action that the nurse will take?
a. Obtain an order for a sedative-hypnotic medication to reduce combative behavior.
b. Attempt to soothe the client's fears and reorient the client to surroundings.
, c. Obtain an order to place the client's arms in restraints to protect personnel.
d. Arrange for the client to be transferred to a mental health facility. correct answersB. attempt to
soothe the client's fears and reorient the client to surroundings
An older adult client presents with signs and symptoms related to digoxin toxicity. Which age-
related change may have contributed to this problem?
a. Increased total body water
b. Decreased renal blood flow
c. Increased gastrointestinal motility
d. Decreased ratio of adipose tissue to lean body mass correct answersB. decreased renal blood
flow
A nurse is assessing a client's understanding of medication therapy. Which statement indicates
that the client needs further instruction?
a. "My husband is on the same medication, so we always take our medications together in the
morning."
b. "I prepare all my medication for the week and place the pills in a container labeled for each
day."
c. "When I don't sleep well at night, I take two thyroid pills the next day instead of just one."
d. "I take my Coumadin every day when the noon news comes on the television." correct
answersC. "When I don't sleep well at night, I take two thyroid pills the next day instead of just
one."
An older adult client is being discharged from the hospital on several medications. Which
intervention best reinforces medication teaching for this client?
a. Have the client actively participate in drug administration during hospitalization.
b. Include the client's children in discussions regarding medication administration.
c. Give the client a pamphlet with the actions, side effects, and doses of all drugs.
d. Make a chart showing which drugs should be taken at specified times during the day. correct
answersA have the client actively participate in drug administration during hospitalization
An older adult client's spouse has died, and the family expresses concern that the client has lost
weight recently and now refuses to attend the annual family reunion. The nurse should assess this
client further for what clinical condition?
a. Psychosis
b. Depression
c. Dementia
d. Delirium correct answersB. depression
Which behavior exhibited by an older adult client alerts the nurse to the possibility that the client
is experiencing delirium?
a. Becoming confused within 24 hours after hospital admission
b. Displaying a cheerful attitude despite a poor prognosis
c. Becoming withdrawn and sleeping most of the day
d. Beginning to use slurred speech and losing coordination correct answersA. becoming confused
within 24 hours after hospital admission
