ATI 2.0 GERONTOLOGY EXAM 2020 | N212
1. A nurse is providing teaching to an older adult client who has osteoarthritis of the right hip and lower lumbar vertebrae. Which of the following statements by the client indicates an understanding of the teaching?
A- I should avoid the use of a heating pad...
1 a nurse is providing teaching to an older adult client who has osteoarthritis of the right hip and lower lumbar vertebrae which of the following statements by
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ATI 2.0 GERONTOLOGY EXAM 2020 | N212
1. A nurse is providing teaching to an older adult client who has osteoarthritis of
the right hip and lower lumbar vertebrae. Which of the following statements by
the client indicates an understanding of the teaching?
A- I should avoid the use of a heating pad on my back
B- to relieve the pressure on my hip, I can use a cane while ambulating
C- I will have steroid injections to my joint has the first medication of choice to treat my
pain
D- I will exercise even when it causes pain Answer- b
Using a cane as an assistive device enables the client to compensate for weakness in the
spine by providing some relief of hip pressure. Use of a cane can provide joint support
and safety for self-care activities.
A- The use of heat and cold are therapeutic treatments in the management of arthritic
pain. The preference of the client drives the decision between the two therapies.
C- Acetaminophen is the first medication of choice to treat the older adult client’s pain
from osteoarthritis. The nurse should instruct the client to take the medication as
prescribed and not to wait until the pain is severe. Steroid joint injections are used for
persistent and disabling pain in the joints.
D- The nurse should teach the client to not exercise if exercise causes pain. Goals for
clients who have osteoarthritis include balancing rest with activity and avoiding
activities that cause pain or discomfort. Consistent activity is not beneficial for a client
who has an arthritic joint disease because it can produce further damage to the joints
and tissues.
2. A nurse is admitting an older adult client who fell at home 3 days ago. The client
has a fractured hip, malnutrition, and dehydration. Which of the following
laboratory values, noted on admission, should indicate to the nurse prolonged
malnutrition?
A- Increased sodium
B- decreased albumin
C- increased BUN
D- decrease blood glucose
Answer- b
,Decreased albumin is indicative of inadequate protein intake, which is a common
finding in a client who has prolonged malnutrition.
A- Increased sodium is indicative of dehydration, which is due to a fluid volume deficit.
C- Increased BUN is indicative of renal failure, or dehydration, which is due to a fluid
volume deficit.
D- Decreased blood glucose is indicative of inadequate intake of glucose, which is a
manifestation that can occur rapidly in any client who has not eaten in several days. It is
not indicative of prolonged malnutrition.
3. A nurse is planning care for an older adult client following abdominal surgery
for a bowel obstruction. Which of the following information about pain
management should the nurse consider when planning care?
A- Older adult clients have a diminished capacity to perceive pain
B- older adult clients should not take narcotics for pain control
C- older adult clients have increased pain as a normal part of aging
D- older adult clients are sensitive to the analgesic effects of opiates
Answer- d
An older adult client is likely to require a decreased dose of opiates to provide the same
level of analgesia as a younger client, with a reduced risk of side effects.
A- Older adults do not have a diminished capacity to perceive pain. However, older
adult clients might have developed excellent coping skills that make it difficult to
observe for cues of pain.
B- The nurse can administer narcotic medications safely to older adult clients. Although
older adult clients might be more sensitive to narcotics, it does not justify withholding
narcotic medication for pain control.
C- Pain is not an expected finding of the aging process. The nurse should assess,
diagnose, and manage pain in older adult clients similar to any other client, regardless
of age.
4. A nurse and Ophthalmology Clinic is assessing a client referred by the provider
for a potential cataract. Which of the following clients report should the nurse
recognize is consistent with cataracts?
A- Halos when looking at lights
B- loss of peripheral vision
C- bright flashes of light and floaters
, D- eye strain and headache with close work
Answer- a
A cataract is a cloudy or opaque area in the lens of the client's eye. Cataracts in adults
usually develop with advancing age and can be hereditary. Cataracts develop slowly
and painlessly with a gradual onset of difficulty with vision.
Visual problems include difficulty seeing at night, halos around lights or glare
sensitivity, and decreased visual acuity, even in daylight.
Cataracts are accelerated by environmental factors, such as cigarette smoke or other
toxic substances, or in response to metabolic diseases, such as diabetes mellitus.
B- Loss of peripheral vision is an initial report by a client who has open-angle
glaucoma. Glaucoma is a condition characterized by increased fluid pressure inside the
eye, called intraocular pressure. This increased pressure damages the optic nerve,
causing partial vision loss, with blindness as a possible outcome.
C- Bright flashes of light, especially in the peripheral visual field, and floaters are
associated with retinal detachment. Retinal detachment refers to the separation of the
light-sensitive membrane in the back of the eye from its supporting layers. Trauma, the
aging process, severe diabetes mellitus, or an inflammatory disorder can cause retinal
detachment, but it frequently occurs spontaneously.
D- Eyestrain and headache with close work is associated with decreased visual acuity.
Both nearsightedness, which is an error of visual focusing that makes distant objects
appear blurred, and farsightedness, which is an age-associated progressive loss of the
focusing power of the lens that results in difficulty seeing objects close-up, can cause
eyestrain and headache. Changes in visual acuity may represent primary eye disease,
aging, eye trauma, or a generalized, systemic, illness, but whatever the cause, the nurse
should not ignore visual changes. Decreased vision is a significant threat to the quality
of life of older adult clients.
5. The nurse at an assisted living center is conducting an orientation session for a
group of newly hired assistive Personnel AP. Which of the following instructions
should the nurse include regarding clients who are hearing impaired?
A- Maintain eye contact with the clients
B- stand to one side of the clients and speak into their good ears
C- speak loudly with exaggerated enthusiasm
D- ask only questions with yes or no answers
Answer- a
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