A family member brings their aging father to the clinic because he has been alert and
oriented during the day but agitated and disoriented in the evening. The registered
nurse (RN) reviews the client's list of current medications with the client and family.
Which action taken by the RN is most important?
A. Medication review with family caregivers is the RN's responsibility
B. Multiple medications can contribute to sundowner-like symptoms
C. Medication recall is the best way to evaluate the client's memory
D. Reviewing medication actions is a component of effective client care
Give this one a try later!
B. Multiple medications can contribute to sundowner like symptoms.
Rationale: Older clients may see a variety of HCP which can increase the
chance of polypharmacy that compounds the workload of metabolic
pathways that may be less efficient due to the aging process. Multiple
medication interactions may contribute to sundowner like symptoms;
reviewing medication actions and interactions provides the information that
may indicate polypharmacy leading to sundowner syndromes.
,After a recent total hip replacement, an older female client, who transferred to a
rehabilitation facility placement, asks the registered nurse (RN) if she broke her hip
because she is old. How should the RN best respond?
A. Hip fractures can occur in any age group and require strength conditioning
B. With aging, everything tends to break down more easily the older one gets
C. Older people tend to look down instead of ahead, increasing the risk of falls
D. Older women commonly lose bone calcium, which increases the risk of fracture
Give this one a try later!
(D) Older women commonly lose bone calcium which increases the risk of
fracture.
Rationale: The best response is to provide the client with an explanation
based on aging and demineralization of the bone (D) in older females,
especially after menopause. (A, B and C) offer other responses but are not
client centered in response to her expressed self-concern.
An older male client with Parkinson's disease (PD) is discharged home with levodopa-
carbidopa (Sinemet) and instructions to his wife for his care. What statement best
indicates to the registered nurse (RN) that the wife understands her husband's needs?
A. "It is important to keep my husband in a chair or in bed as much as possible and
prevent him from falling."
B. "I will notify the healthcare provider if my husband has increasing involuntary
movements of his extremities."
C. "Since it is difficult for my husband to eat, we should stay in the house instead of
going out to dine."
D. "I should expect that my husband will be incontinent of bowel and bladder as his
disease advances."
Give this one a try later!
, (B) "I will notify the healthcare provider if my husband has increasing
involuntary movements of his extremities."
Rationale: Increasing involuntary movements (B) should be reported during
the use of levodopa; it is an indicator that the body is failing to readjust to
the changes in the level of the intracerebral neurotransmitter dopamine.
The client should be encouraged to engage in exercise and regular daily
activities (A). Socialization and activities as tolerated help to prevent the
client from becoming depressed, so (C) is not indicated. Clients with PD
usually are constipated due to muscle weakness, lack of exercise, and
decreased fluid intake, but incontinence should not be an expectation
related to PD.
An older female client who is a new resident at an assisted living facility cannot
remember how to get to her room. What action should the registered nurse (RN)
implement?
A. Schedule therapy and social activities in her room
B. Ask another resident to help the client
C. Show client how to follow hallway signs to her room
D. Move client to a room close to nurses station
Give this one a try later!
(C) Show client how to follow hallway signs to her room
Rationale: Teaching the client how to follow hallway signs to her room (B)
provides cues and reminders that foster independence. (A) limits social
stimulation in her residential environment. (B) may be helpful and fosters
peer relationships and trusts, but the client's independence should be
fostered first. (D) often contributes to further confusion.
A frail, elderly client is admitted to the unit with a diagnosis of pneumonia. Which
finding is most important for the registered nurse (RN) to report to the healthcare
provider?
oriented during the day but agitated and disoriented in the evening. The registered
nurse (RN) reviews the client's list of current medications with the client and family.
Which action taken by the RN is most important?
A. Medication review with family caregivers is the RN's responsibility
B. Multiple medications can contribute to sundowner-like symptoms
C. Medication recall is the best way to evaluate the client's memory
D. Reviewing medication actions is a component of effective client care
Give this one a try later!
B. Multiple medications can contribute to sundowner like symptoms.
Rationale: Older clients may see a variety of HCP which can increase the
chance of polypharmacy that compounds the workload of metabolic
pathways that may be less efficient due to the aging process. Multiple
medication interactions may contribute to sundowner like symptoms;
reviewing medication actions and interactions provides the information that
may indicate polypharmacy leading to sundowner syndromes.
,After a recent total hip replacement, an older female client, who transferred to a
rehabilitation facility placement, asks the registered nurse (RN) if she broke her hip
because she is old. How should the RN best respond?
A. Hip fractures can occur in any age group and require strength conditioning
B. With aging, everything tends to break down more easily the older one gets
C. Older people tend to look down instead of ahead, increasing the risk of falls
D. Older women commonly lose bone calcium, which increases the risk of fracture
Give this one a try later!
(D) Older women commonly lose bone calcium which increases the risk of
fracture.
Rationale: The best response is to provide the client with an explanation
based on aging and demineralization of the bone (D) in older females,
especially after menopause. (A, B and C) offer other responses but are not
client centered in response to her expressed self-concern.
An older male client with Parkinson's disease (PD) is discharged home with levodopa-
carbidopa (Sinemet) and instructions to his wife for his care. What statement best
indicates to the registered nurse (RN) that the wife understands her husband's needs?
A. "It is important to keep my husband in a chair or in bed as much as possible and
prevent him from falling."
B. "I will notify the healthcare provider if my husband has increasing involuntary
movements of his extremities."
C. "Since it is difficult for my husband to eat, we should stay in the house instead of
going out to dine."
D. "I should expect that my husband will be incontinent of bowel and bladder as his
disease advances."
Give this one a try later!
, (B) "I will notify the healthcare provider if my husband has increasing
involuntary movements of his extremities."
Rationale: Increasing involuntary movements (B) should be reported during
the use of levodopa; it is an indicator that the body is failing to readjust to
the changes in the level of the intracerebral neurotransmitter dopamine.
The client should be encouraged to engage in exercise and regular daily
activities (A). Socialization and activities as tolerated help to prevent the
client from becoming depressed, so (C) is not indicated. Clients with PD
usually are constipated due to muscle weakness, lack of exercise, and
decreased fluid intake, but incontinence should not be an expectation
related to PD.
An older female client who is a new resident at an assisted living facility cannot
remember how to get to her room. What action should the registered nurse (RN)
implement?
A. Schedule therapy and social activities in her room
B. Ask another resident to help the client
C. Show client how to follow hallway signs to her room
D. Move client to a room close to nurses station
Give this one a try later!
(C) Show client how to follow hallway signs to her room
Rationale: Teaching the client how to follow hallway signs to her room (B)
provides cues and reminders that foster independence. (A) limits social
stimulation in her residential environment. (B) may be helpful and fosters
peer relationships and trusts, but the client's independence should be
fostered first. (D) often contributes to further confusion.
A frail, elderly client is admitted to the unit with a diagnosis of pneumonia. Which
finding is most important for the registered nurse (RN) to report to the healthcare
provider?
