C475-WGU, Care of the Older Adult -2022

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Which element is part of psychosocial well-being for an older adult? - ANSWER Engagement with others How should a nurse greet Estelle Bartlett, a petite, widowed elder, on the first home visit? - A... NSWER "Mrs. Bartlett, I'm your nurse Clara Jones." What might be an important aspect of an individualized care plan for a low income, depressed community-dwelling elder who is treated with an antidepressant and has favorite pastimes of reading, cooking, and spending time with grandchildren? - ANSWER A library card A talented, accomplished, and very active elder wanted to take up painting after retirement. A recent stroke compromised the elder's short-term memory severely. Which community-based program should the nurse suggest to the elder and family first? - ANSWER Taking painting classes at the senior center An elder patient missed an arthritis clinic appointment because the patient could not afford the pain medication. After first meeting the patient's immediate medication needs, which two steps should the nurse take in order to prevent a recurrence? Choose 2 answers - ANSWER Ask the drug company for help Investigate eligibility for the Medicaid program An 85-year-old widow, living alone, tripped over her beloved dog and broke her leg. Which action should the home-care nurse recommend regarding the dog? - ANSWER Find out the elder's ideas What is an effective way to communicate with an older adult living with dementia? - ANSWER Approach in a non-threatening manner Older women experience bone loss, which makes them more susceptible to hip fracture. How should an environment change after a hip-fracture repair? - ANSWER Raise the toilet seat A vigorous recent widower visited his primary care team and stated that he was lonely. Which recommendation should the team make for this patient? - ANSWER Finding a new relationship Which lighting feature in most nursing homes compromises elder adults' ability to function? - ANSWER Glare The assessment of which factor in the home environment is required for a client with mobility problems? - ANSWER Presence of stairs or other obstacles A home-care nurse visits an elder living with dementia whose spouse is providing care. The nurse notices a restraint sitting in the chair. What is the most important thing the nurse should do? - ANSWER Help the spouse plan care without using restraints Which is considered to be a permanent, progressive reduction in mental capacity? - ANSWER Dementia When evaluating an older patient, a nurse finds the patient to be highly depressed and suffering from low self-esteem. What psychosocial problem can the nurse deduce from these symptoms? - ANSWER The patient is at risk for suicide. Which question included in the assessment questionnaire will help the nurse to teach appropriate coping skills to the client with prostate cancer? - ANSWER "What do you do to reduce stress?" Which patient statement is indicative of a midlife crisis? - ANSWER "I feel I have not achieved anything noteworthy in my life. What can I do to give my life more meaning?" A spiritual African American elder has terminal HIV. Based on knowledge of spiritual beliefs common in African American communities, why might this patient require careful assessment and monitoring for pain? - ANSWER The patient may understate pain levels because of a belief that the illness is God's plan. Which assessment tool can be used to determine activities of daily living (ADL) independence in older adults? - ANSWER The Katz index Functional incontinence refers to problems from factors external to the lower urinary tract. Which is the least likely item to contribute to incontinence? - ANSWER Environmental barriers How often is tetanus vaccination recommended for older adults? - ANSWER Every 10 years Which nonpharmacologic interventions should nurses counsel patients on when they complain of occasional heartburn, constipation, and low energy? - ANSWER Adequate consumption of whole grains, fruits, and vegetables Which factor best describes the cornerstone of an individualized plan of care for an older adult? - ANSWER Comprehensive assessment What is the most important discussion of the interdisciplinary team at regularly scheduled meetings? - ANSWER Risk reduction assessments When calculating BMI, the nurse notes an older adult's score is 30. What does this score indicate? - ANSWER Falls risk Which statement is true regarding the use of interdisciplinary teams? - ANSWER They bring better quality services for clients What is the primary reason for having the older adult bring all medications with every office visit, including prescription and nonprescription medicines, vitamins, and herbal supplements? - ANSWER So the health provider can reduce potential polypharmacy in the older adult. Which medications should the nurse cautiously review from the Beer's List of medications when documenting the patient's drug profile? - ANSWER Benzodiazepines What should be the nurse's primary consideration while allowing for patient autonomy and reducing risk when dealing with end of life care? - ANSWER Cognitive impairment Which statement from a nurse would indicate good judgment when considering common myths regarding physical restraint use? - ANSWER Risk of falls exists when restraints are used. Harriett is a 92-year-old who lives in assisted living; she recently fell and broke her hip. Harriet and her family would like to keep Harriet safe and at the highest level of independence on her return to her accommodations from the hospital. Which action should the nurse take to help Harriet and her family? - ANSWER Counsel about home safety assessments Ruth is a 75-year-old residing in an assisted living facility and is at risk for fluid volume deficit. Which nursing actions would ensure the most accurate monitoring of Ruth's fluid status in a co-created plan of care? Choose 2 answers - ANSWER Measure and record fluid intake and output. Ask Ruth to weigh each day at the same time. An 81-year-old patient is a new resident in Hill Side Nursing Home. Upon admission the patient had a Braden score of 17. Which statement would indicate that the RN on duty lacks understanding that the patient is at risk for pressure ulcers? - ANSWER The primary risk factor is polypharmacy. Agnes is a 77-year-old who lost her husband last year and has congestive heart failure. She has moved in with her son Alex. She has been brought to the ER by Alex who says she is short of breath. He does not know how long she has been in the state, nor does he know the medication she should be on. What is the nursing priority? - ANSWER Admit and stabilize the patient A 66-year-old patient lives alone and has a BMI of 32, as well as diabetes. As the nurse begins to encourage the patient to increase current levels of physical activity, the nurse should recognize common barriers identified by the elderly. Which barrier to physical activity is least common for the elderly? - ANSWER Swelling of ankles Research indicates more than 90% of the deaths occur in older adults 65 and older due to lack of appropriate immunizations. On which annual vaccination should the nurse counsel the patient? - ANSWER Influenza What are common risk factors that contribute to functional decline in the older adult population? Choose 2 answers - ANSWER Physical inactivity Tobacco use Which activity would be helpful for older adults to engage in to prevent or interrupt the course of frailty? - ANSWER Maintaining social relationships What should the nurse first instruct the older adult to do when the older adult is beginning an exercise program? - ANSWER Proceed with low intensity and moderate impact What should the nurse first instruct the older adult to do when the older adult is starting an aerobics program? - ANSWER Start with low intensity and moderate impact. What principle is least related to promoting health and preventing certain disabilities in older adults? - ANSWER Continue activities of daily living (ADLs) When focusing on the psycho-social needs of older adults, author Virginia Satir recommends that healthcare providers get back to the basics of communication. What are the five basic principles Satir describes? Choose 5 answers - ANSWER Invite Follow through Maximize communication Arrange environment Maximize understanding Rick, a 91-year-old male, has a history of chronic otitis media and is experiencing mild hearing loss in his right ear. What type of assistive technology would Rick use to improve communicative function? - ANSWER Behind the ear (BTE) hearing aid An elderly patient has suffered a stroke and is currently in the process of transitioning out of the hospital and into an assisted living facility. The patient's primary difficulty after the stroke is dealing with dysarthria, which has limited the patient's ability to speak. What communication technology would appropriately promote an optimal transition of care for the patient? - ANSWER An augmentative and alternative communication (AAC) device What must the nurse inform the patient and family or caregivers about assistive devices? Choose 2 answers - ANSWER They may enable independent performance and reduce risk of injury. They may limit complications of an illness or disability. A goal of the national health initiative Healthy People 2010 is to increase the quality and extend the years of healthy life. What are two ways that this initiative can achieve its goal? Choose 2 answers - ANSWER By trying to spread the view that aging is natural and need not include illness and disease By helping people overcome views of denial and foreboding as old age approaches Match each government program with its description. Answer options may be used more than once or not at all. - ANSWER YOUR ANSWER CORRECT ANSWER Provides health insurance for low-income families Medicaid Medicaid Offers a payment system for long-term care (LTC) for eligible older Americans and persons with disabilities Social Security Medicaid Bases basic benefits on a worker's average indexed monthly earnings in covered employment Social Security Social Security Is a health insurance program for those 65 or other people with disabilities Medicare Medicare The Independence at Home Demonstration was created by the Affordable Care Act. Which statement is true regarding primary care teams participating in this initiative? - ANSWER The teams can be lead by a nurse practitioner. Which important facts about Medicare should nurses know? Choose 2 answers - ANSWER Medicare covers certain disabled Americans who have not reached age eligibility. Medicare recipients range from those simply needing wellness services to those who are profoundly frail. A senior is being cared for by her daughter. The daughter works a full-time job and is only able to care for her mother before she goes to work, on her lunch break, and after she gets off work. The senior expresses to a nurse that she gets lonely during the day and sometimes cannot perform tasks by herself. Which community resource should the nurse recommend looking into? - ANSWER Daycare services for seniors What is a standard caseload for most transitional care nurses? - ANSWER 15 to 20 cases It has been concluded that an 83-year-old male is no longer suitable to operate a motor vehicle. Which decision should this elderly man take to preserve his quality of life and independence? - ANSWER He should look into and sign up for a local senior transportation program. What are important areas of knowledge to apply as a nurse practicing in a transitional care role? Choose 2 answers - ANSWER There is a growing demand for transitional care because nearly 50% of Americans are dealing with at least one chronic illness. Medicare beneficiaries with five or more chronic illnesses account for 75% of Medicare spending. What is a common preventable error that can occur during the transition of care for older adults? - ANSWER Inaccurate medication reconciliation How is communication further facilitated? Choose 2 answers - ANSWER Through active engagement of patients and family caregivers with a focus on meeting the patient's goals Through communication to, between, and among the patient, family caregivers, and healthcare providers A critical competency in geriatric nursing is the ability to assess family knowledge of the skills necessary in the care of older adults. What broad caregiver competencies are included in this assessment? Choose 2 answers - ANSWER Allowing the active participation of the patient in all aspects of care Balancing the patient's autonomy with safety What communication techniques promote safe transition of care in patients with aphasia? Choose 2 answers - ANSWER Give the patient time to speak Use nonverbal gestures to communicate What roles of the nurse protect the patient from harm in a care transition? - ANSWER Symptom manager, educator, collaborator, care coordinator What important areas need to be addressed when considering nurse practicing in a transitional care role? Select all that apply - ANSWER There is a high demand for transitional care because nearly 50% of Americans are dealing with one or more chronic illness. Medicare beneficiaries with five or more chronic illnesses are accredited for over 75% of Medicare spending. The End-of-Life Nursing Education Consortium (ELNEC) is a resource targeted to nurses providing end-of-life care that supports evidence-based care of dying patients and their families, as well as self-care that lessens stress and anxiety and sustains nurses in providing excellent end-of-life care. Which of the following are self-care principles? Choose 2 answers - ANSWER Making good use of the expertise and support of the interprofessional care team Developing expertise in symptom management, which not only helps patients and their families, but increases satisfaction and lessens anxiety among professional caregivers Which statements are true regarding health-related quality of life? Choose 2 answers - ANSWER Can be measured by an instrument developed by the Center for Disease Control (CDC) Is measured by individual's perceived healthy days per month Which roles of the nurse keep the patient safe from harm in a care transition? - ANSWER Symptom manager, educator, collaborator, care coordinator A nurse caring for people at the end of their lives knows that dyspnea is relatively common and interferes with patients' comfort and rest. What is the evidence-based intervention for shortness of breath? - ANSWER 5 mg of liquid morphine every 4 hours, along with lorazepam 0.5-2.0 mg every 4-6 hours PRN for anxiety and restlessness Several options are available as care approaches to chronic illness care. Which method best describes palliative care? - ANSWER A combination of active treatment and comfort measures What do dying persons typically experience grief over? - ANSWER Loss of bodily function and independence that occurs as illness becomes more prevalent Which of the following is often the biggest barrier to overcome in crucial conversations related to death and dying? - ANSWER Societal attitudes about death In addition to a living will, advanced directives may also include a durable power of attorney that encompasses healthcare-related decision making. Which two of the following are accurate statements regarding the legal instrument known as the durable power of attorney? Choose 2 answers - ANSWER The living will remains a useful tool in providing direction to the alternate decision maker. It allows for an alternative decision maker in the event that the dying person is incapacitated and no longer able to make healthcare decisions. Which of the following is a person-centered method to using alternate health modalities to meet patient needs? - ANSWER Conversing about an array of alternate options with the patient to determine selections. Many options are available as care approaches to chronic disease care. Which technique best portrays palliative care? - ANSWER A blending of effective treatment and comfort procedures When do dying individuals normally encounter mourning? - ANSWER Lack of bodily function and freedom that occurs as sickness grows more widespread Which of the following is often the largest obstacle to overcome in important conversations related to death and perishing? - ANSWER Public mindsets about passing away [Show More]

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