1.
An older adult patient with a history of osteoporosis is hospitalized for wrist surgery. Which medication that is currently being prescribed would be most likely to interfere with bone integrity?
Correct Answer
A. A. Heparin
Explanation
ANS: A
Long-term use of the anticoagulant heparin can cause secondary osteoporosis. Premarin is a form of estrogen, which is used to treat osteoporosis. Although the exact mechanism is not known, calcitonin slows bone resorption and treats osteoporosis-related pain. Tums are calcium.
2.
When answering an older client’s questions about diet, exercise, and bone integrity, which exercise would the nurse identify as ineffective at meeting the need for moderately intense aerobic activity?
Correct Answer
D. D. Yoga for 45 minutes twice a week
Explanation
ANS: D
Moderately intense aerobic results are best achieved through exercise intended to raise heart rate and respiratory rate by such activities as biking, jumping rope and swimming, Yoga is considered excellent as a stretching, flexibility, and balance activity
3.
In planning discharge teaching for a client with diabetes, which precaution related to fall prevention is particularly important for the nurse to include?
Correct Answer
B. B. Rising slowly from the table after meals
Explanation
ANS: B
All older persons should be cautioned against sudden rising from sitting or supine positions, particularly after eating. Postprandial hypotension (PPH) occurs after ingestion of a carbohydrate meal and may be related to the release of a vasodilatory peptide. PPH is more common in people with diabetes and Parkinson’s disease. The remaining options while appropriate are not focused on this particular client’s needs.
4.
Which nursing assessment will best identify the older adult individual who is at greatest risk for a muscle weakness related fall?
Correct Answer
C. C. Determining if the client taking thyroid medication
Explanation
ANS: C
Muscle weakness is often experienced in hyperthyroidism and hypothyroidism. Poor hand grip may not be a result of generalized muscle weakness. The inability to stand erect on one foot may be influenced by neurological causes. A history of falls does not identify the cause of those falls
5.
Which client statement indicates an understanding of a primary benefit to be derived from moderately intense aerobic exercise?
Correct Answer
B. Exercise will help keep my heart strong.”
Explanation
ANS: B
Aerobic exercise improves and helps maintain cardiovascular functioning while strengthening the heart muscle. While the client may experience the other effects, they are secondary to the primary benefit
6.
When discussing sarcopenia with an older adult, the nurse shares that it:
Correct Answer
D. D. is responsible for fragility in women more often than in males
Explanation
ANS: D
Sarcopenia, a condition prevalent in older people and a marker of frailty, contributes to mobility impairments and disability approximately 3 times more often in older women than in men. Rheumatoid arthritis is an inflammatory condition that includes systemic manifestations as well as the characteristic bilateral joint deformity. Pannus, a proliferation of tissue in the synovial space, can be observed on x-ray studies after rheumatoid arthritis has progressed. Osteomalacia is caused by a deficiency of vitamin D.
7.
Which attempt by the family to prevent an older, frail adult from falling causes the home health nurse concern?
Correct Answer
C. C. keeping the side rails up on the client’s bed at night
Explanation
ANS: C
Keeping side rails up have proven to be a risk factor for falls rather than a positive intervention. The remaining interventions are appropriate and generally affective.
8.
When preparing an educational program on the minimizing the effects of aging to a “seniors group,” the nurse’s discussion on exercise is based upon the fact that:
Correct Answer
B. B. Losses experienced with age related mobility are associated with pHysical inactivity
Explanation
ANS: B
The frail health and loss of function we associate with aging is in large part due to physical inactivity. While the remaining options are true statements they are not as related to the positive relationship activity has on mobility
9.
A nurse in the geriatric outpatient clinic frequently receives questions from clients about exercise. The nurse answers their questions based on the knowledge that regular exercise:
Correct Answer
B. B. prevents muscle atropHy and improves mobility, thus reducing the risk of falls
Explanation
ANS: B
Exercise is especially important for older clients. Exercise slows muscle atrophy that occurs with normal aging and promotes flexibility and strength, which improves mobility and decreases the likelihood of falls. Weight-bearing exercises help build bone strength and prevent osteoporosis. It is important that clients with rheumatoid arthritis follow an exercise program to maintain range of motion in joints.
10.
Which principle is the basis for the nurse’s plan of care regarding exercise for an older adult who is non-ambulatory?
Correct Answer
D. D. Appropriate exercise will positively affect the individual’s quality of life
Explanation
ANS: D
Non-ambulatory older people can also engage in physical activity and may benefit most from an exercise program in terms of function and quality of life. Muscle weakness and atrophy are probably the most functionally relevant and reversible aspects to exercise in non-ambulatory older adults. Passive range of motion is not the best suited exercise unless the client is incapable of any voluntary movement. The remaining options concerning willingness to participate and understanding of importance are not necessarily true nor are they particularly relevant to such care planning
11.
An 88-year-old woman is admitted to the hospital with a diagnosis of pneumonia. She has a history of hypertension and congestive heart failure and is on a total of five different medications for these chronic conditions. The nurse caring for the woman develops a care plan that includes the diagnosis Risk for falls. A priority nursing intervention for this client is to:
Correct Answer
A. A. perform a fall assessment
Explanation
ANS: A
Completing a fall assessment will enable the nurse to identify and correct the risk factors for this patient. Side rails have not been found to be effective in keeping a client in bed and may actually lead to injury. Maintaining a patient on bedrest can lead to deconditioning and actually contribute to falls. Assessing the client’s dietary intake of calcium is a good intervention for this age group, but it is not a priority and will not prevent falls
12.
Which assessment finding is a contributor to an older client’s risk for falls? Select all that apply.
Correct Answer(s)
A. A. client is awaiting cataract surgery on right eye
B. B. client’s type 2 diabetes is poorly controlled with diet and exercise alone
C. C. client reports a fall in the last year
Explanation
ANS: A, B, C
The correct options are those that affect the client’s vision, presence of factors affecting sensations in the legs and feet, and a history of falls. There is no research to connect the risk of falls with either of the skin conditions mentioned or early emotional childhood traumas