Elder Practice Questions

A Big Variety

Mr. A, an 87 year old client who has no history of urinary incontinence, has suddenly become incontinent. Your first action in dealing with this problem should be to: A. Review Mr. A’s medication administration record

to see if he is on a medication that can cause urinary incontinence.

B. Seek an order from the physician for an indwelling urinary catheter to prevent skin breakdown.

C. Limit Mr. A’s fluid intake to reduce his feeling of having to void so frequently.

D. Remind Mr. A every 2-3 hours that he needs to void and assist him to a bedside commode or toilet.

You are reviewing your older adult client’s bowel elimination diary. What data provides evidence that the outcome of “normal bowel elimination” has been met? A. Laxative taken on Monday, Wednesday

and Friday B. Large hard-formed stool every other day C. Three to four loose stools per day D. Patient verbalizes satisfaction with own

elimination pattern

Which subjective or objective data, if noted upon assessment of your 79 year old male client, would indicate the need for adding the nursing diagnosis of “risk for hypothermia” to his plan of care? A. “I walk at least a mile every morning after

breakfast.” B. “Sometimes I get so warm at night I have

to take the blanket off my bed.” C. Blood pressure 140/88; pulse 88 with

regular rhythm; respirations 24 per minute D. Height 5’10”, weight 140 pounds

An important nursing intervention for older clients receiving any type of psychotropic medication would be to: A. Give frequent oral care B. Caution the client to rise slowly from a

sitting position C. Monitor for sign/signs of tardive

dyskinesia D. Assess for nausea, vomiting, loss of

appetite

Your older adult client, Mrs. M, has undergone surgery to remove a tumor from her colon. She has an indwelling urinary catheter, is receiving intravenous fluids, and has a midline abdominal incision. What nursing action can most benefit Mrs. M at this time? A. Irrigating her urinary bladder with a 10%

hydrogen peroxide solution twice daily. B. Taping the urinary catheter to her leg so that it

cannot become dislodged. C. infusing her IV fluids at a rate high enough to

assure at least 75 ml. of urine output per hour. D. Using meticulous hand washing and aseptic

technique when changing her surgical dressing.

Mr. W, 67, is 5’ 10” tall and weighs 156 pounds, or 70 kg. He is receiving enteral feedings. You recognize that his intake needs to be altered to correct his nutritional status. Which adjustment should be made to his caloric intake to correct his problem? A. Increase his caloric intake by 25 kcal/kg

per day B. Decrease his caloric intake by 25 kcal/kg

per day C. Provide 35 kcal/kg per day D. Provide 25 kcal/kg per day

You are assisting Mrs. C, a 65 year old female client, to plan an appropriate exercise program to decrease the pain of her rheumatoid arthritis. Of the exercises she most enjoys, which would be most beneficial for Mrs. C? A. Mountain climbing B. Bicycling C. Hiking D. Rowing

During a screening clinic for skin cancer, you see four older clients with different skin lesions. Which client takes priority in physician referral? A. A 55 year old with numerous small,

reddish-brown papules on the chest and back

B. A 63 year old with a 2 cm, brown, wart-like lesion on the neck

C. A 70 year old with a slightly raised, irregularly shaped lesion on the lower lip

D. A 68 year old with a small, scaly pink patch on the left ear

You realize that there are many forms of elder abuse. Which data, if noted, supports the nursing diagnosis of domestic elder abuse? A. Caregiver refuses to dry client as

punishment because client failed to ask to be taken to the bathroom.

B. Client complains that she is not happy living with her adult daughter, who has three teenage children.

Caregiver states that the client is physically difficult to care for.

D. Client is withdrawn and refuses to communicate when approached.

A common theme in all the proposed theories of aging is that: A. Persons age at different rates. B. There is a biologic basis for aging. C. Older people are more vulnerable to

disease. D. The aging process involves change.

Which of the following represents a normal age-related factor that places the older adult at high risk for pressure ulcer development? A. Protein deficiency B. Urinary incontinence C. Low blood pressure D. Reduced blood flow

You assess an older adult male client and observe that he has withdrawn from his customary circle of friends. This observation supports which of the following theories? A. Activity theory B. Life-course theory C. Continuity theory D. Disengagement theory

An older adult client is concerned that some of the changes he has experienced as he has aged may not be normal. Which statement, if made by the client, represents a normal, age-related change? A. “I need frequent daytime naps in order to

stay awake.” B. “I need fewer hours of sleep at night than

when I was younger.” C. “I need to take a mild sedative in order to

go to sleep.” D. “I wake up more often during the night

than I used to.”

While visiting an older adult client, the home care nurse discovers a problem with incontinence. The client is taking a daily diuretic. What essential question should the nurse ask in order to plan appropriate intervention(s)? A. How often is the client incontinent? B. What is the diuretic dosage? C. How is the client’s appetite? D. What time of day does the client take the

diuretic?

An older adult client in a chronic confusional state repeatedly calls out for “Mary”. Of the following response by the nurse, which would be most therapeutic? A. “Who is Mary?” B. “Do you need help with something?

Perhaps a drink of water?” C. “You are in a nursing home and Mary isn’t

here right now.” D. “Why are you always calling for Mary?”

A visiting nurse makes the following notations regarding an older client with an arterial ulcer on the left heal. The client has diabetes mellitus, is taking daily insulin, and has diminished vision. Which notation indicates the need for further client teaching? A. Client reclines in chair with feet in

dependent position B. Client’s nicotine patch is in place and

client states he has not smoked for 2 weeks C. Client has clipped his toe nails D. Client is wearing foot pads with soft

house slippers

Of the following questions, which would be most helpful in eliciting information about the presence of glaucoma in an older adult client? A. “Do you see rings around lights?” B. “Are you having any problems driving a

car?” C. “When was your last ophthalmologic

examination?” D. “Is your vision better at a particular time

of day?”

You have been ordered to catheterize your client for suspected urinary retention. Which finding would verify that retention does exist? A. The presence of 25 ml of dark,

concentrated urine. B. The presence of 75 ml of highly dilute

urine C. The presence of 110 ml of normal

appearing urine D. The presence of any amount of urine that

is cloudy and contains sediment

Mrs. H is a 65 year old client who has been in generally good health. Recently, however, she has had numerous colds, pneumonia, and other infections. What factor could have had a negative effect on her immune system? A. Her husband of 50 years died 3 months

ago. B. She attends senior activity groups at a

community center. C. She receives Meals on Wheels daily. D. She plays bridge with other women at

least weekly.

A nursing assistant in a long term care facility reports to you that a resident is complaining of impaired hearing. What essential piece of data should you obtain before drawing a conclusion? A. Performing an otoscopic examination for

cerumen build-up B. Asking how long the resident has been

having difficulty C. Asking if the resident is depressed D. Determining the resident’s attitude toward

a hearing aid.

The plan for skin care for an older client following radiation therapy treatment of a cancerous lesion on the back should include: A. Keeping the area warm and dry. B. Frequently applying skin lotion. C. Washing the area daily with a strong

soap. D. Covering the radiated area with an

adhesive dressing.

During assessment of an older adult patient suspected of having arterial peripheral vascular disease, the nurse is interested in whether the client is experiencing intermittent claudication. Which of the following questions would elicit this information? A. “How far can you walk without getting

short of breath?” B. “Are you experiencing any numbness in

your toes?” C. “Do your legs ache when you walk a

certain distance?” D. “Can you feel a pulse in your feet?”

A 69 year old client with hypertension is being treated with Lasix 40 mg daily. Given the client’s age, the client should be advised to: A. Eat low potassium foods B. Reduce fluid intake to prevent edema C. Drink 3-4 liters of water daily D. Drink extra juices during exercise and

periods of sweating

An older adult man taking pilocarpine eye drops for glaucoma begins to experience shortness of breath. Nursing interventions should be based on an understanding that: A. The occurrence of respiratory problems is

unrelated to this drug. B. Shortness of breath is generally short-

lived. C. Pilocarpine should be suspected of

causing bronchospasm. D. Shortness of breath is likely correlated

with age-related respiratory changes.

As part of a class project, three nursing students decide to design a teaching plan to assist older clients with preventing respiratory infections. This decision is based on an understanding that older adults: A. Tend to retain carbon dioxide because of

shallow breathing patterns. B. Tend to be hypoxic because of ineffective

breathing patterns. C. Have difficulty mobilizing secretions

because of reduction in ciliary function. D. Have fewer alveoli available for effective

gas exchange.