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Terms in this set (70)Which is true regarding restraint use for patients in nursing homes? The law gives patients the right to be restraint-free. What should the nurse include in the assessment when looking for signs of skin breakdown including pressure ulcers? Tissue integrity Which member of the health care team would the nurse consult when caring for a patient who has difficulty chewing or swallowing? Dietician Nurses must know about the special needs of older adults, especially as that segment of the population grows. By 2050, it is expected that what percentage of people in the United States will be over 65 years old? 25% Which condition can be treated with thiothixene? Acute psy If a person retires between the ages of 55 and 65, by what age are funds most likely to become depleted, causing strain on health care? 80-85 years Which tool uses nine open-ended questions and a diagnostic algorithm to identify delirium? Confusion Assessment Method (CAM) Which older adult population is at a higher risk for disability from chronic disease and mental distress? LGBTQ Which group of drugs is most likely to be prescribed to a patient diagnosed with schizophrenia? Antipsychotic Anticholinergic effects, orthostatic hypotension, and Parkinsonism are some of the consequences of the group of medications that are considered antipsychotics. Under which category would this be labeled? Adverse effects The nurse is helping a new resident transition to an assisted-living facility. Which actions are effective for minimizing relocation stress? Select all that apply. Noting what foods the patient likes and dislikes Encouraging the patient's family and friends to visit often Providing opportunities for the patient to assist in decision making What adverse effect can risperidone cause? Hyperglycemia What term is used for waking up at night to urinate? Nocturia What would the nurse use to prevent a patient from falling out of a wheelchair? Restraint What percentage of ambulatory care services is reimbursed in Medicare Part B?____% 80 Which physical restraint can cause serious injury and even death? Vests The Fulmer SPICES framework, which was developed as part of the NICHE project, identified many serious "marker conditions" that can lead to longer hospital stays, higher medical costs, and even deaths. How many marker conditions were identified? 6 Which condition in older adult patients is assessed for thorough completion of a nutritional screening? Malnutrition Which nursing interventions should the nurse implement for a patient who is at a higher risk for falls? Use technological devices to alert staff about the patient getting out of bed. For which patient is the use of the drug haloperidol appropriate? A 72-year-old patient who suffers from delusions Which is an appropriate way for an older adult patient's family to minimize relocation stress syndrome? Visiting the patient often Since 1996, the Hartford Institute for Gerontological Nursing has worked to ensure that all hospitalized patients be given quality care. What is the age limit mentioned by the institute? 65 years and above Which manifestation of neglect does the nurse identify as most common in older adults? Depression What problems prevent older patients from receiving adequate nutrition? Eating and feeding problems Which assessment tool is used for older adults when predicting pressure sore risk? Braden Scale What is also referred to as chronic confusion? Dementia What was developed to limit the use of physical restraints in hospitals and nursing homes? The National Patient Safety Goals (NPSGs) What term is used for the mismanagement or misuse of an older adult's property or resources? Financial abuse Which tool is available to help the nurse focus on factors that increase an older person's risk for falling? STRATIFY Which nursing student response about frequent sources of stress and anxiety in older adult patients confirms the need for further teaching by the nursing instructor? "Insurance" The caregiver of a 65-year-old patient reports that the patient has lost interest in eating and social and recreational activities and is not sleeping well. Which condition does nurse anticipate? Depression What is another term for the SPICES framework? Geriatric marker conditions The nurse is caring for an older adult. When must the nurse act as a mandatory reporter of suspected elder abuse? When the nurse assesses that there is evidence to indicate high potential of abuse An 85-year-old patient has fallen twice in the past two weeks getting out of bed at night and wandering the hall. What does the nurse suggest to the health care team to prevent subsequent falls? Reminding the patient to call for assistance and reorienting him or her to the location of the call button What nursing interventions should be implemented for all patients, regardless of a high risk for falls? Select all that apply. Place objects that the patient needs within his or her reach. Place the patient's bed in the lowest position with the brakes locked. Observe the patient for side effects and toxic effects of drug therapy. Remind the patient to call for help before getting out of bed or a chair. Which drugs are considered antipsychotic drugs? Select all that apply. Haloperidol Thiothixene What should the nurse include in the plan of care for a patient suffering from a sleep disorder? Select all that apply. Refrain from making loud noises such as slamming the doors. Manage the pain by giving the pain medication before bedtime. Keep staff conversations as quiet as possible and away from patient's rooms. An older adult who underwent recent knee-replacement surgery is suspected of experiencing delirium. What assessment tools can be used to evaluate the patient for delirium? Select all that apply. Delirium Index (DI) NEECHAM Confusion Scale Confusion Assessment Method (CAM) What tasks can be assigned to unlicensed assistive personnel (UAP)? Select all that apply. Apply moisture barriers to the patient's skin. Place pressure-relieving mattresses on the bed. Which reporting action is mandated by U.S. laws regarding abuse or neglect of older adults? Reporting suspected abuse or neglect in the hospital or nursing home to a social worker Which adverse drug event increases the risk of falls in an older adult receiving antipsychotic drugs? Orthostatic hypotension Which evidence-based nursing interventions should the nurse include in a plan of care in order to prevent agency-associated pressure ulcers, as per the National Patient Safety Goals (NPSGs)? Select all that apply. Offer nutritional support. Reposition and provide support surfaces. Avoid skin injury caused by friction or shearing forces. Which statement about older adults and incontinence is correct? A bladder training program is often helpful in its management. Which statement does the nurse recognize as accurate regarding depression and its management in older adult patients? Stroke can lead to secondary depression. Which assessment findings does the nurse identify as associated with depression in older adults? Select all that apply. Fatigue Change in appetite Early morning insomnia Which factors contribute to insomnia in the acute and long-term care setting? Select all that apply. Lighting Excessive pain Chronic disease Staff conversations Environmental noise What medication side effect causes constipation, dry mouth, and urinary retention? Anticholinergic Which nursing interventions are beneficial to a patient with insomnia? Select all that apply. Keeping conversations quiet Dimming or turning off the lighting in the room Administering pain medication before bedtime The nurse working in a nursing home is supervising unlicensed assistive personnel (UAP). The UAP are reporting their activities over the past 24 hours. They repositioned four immobile patients on the floor every two hours, assessed the patients' skin for redness three times during this period, checked the patients' skin to make sure it was clean and dry, and helped the patients get into absorbent briefs before bedtime. What feedback does the nurse give? "Patients should not be put in absorbent briefs at bedtime." According to the Healthy People 2020 initiative, what questions regarding medication use should be included during the interview of an older adult? Select all that apply. "Do you live alone?" "Do you have poor eyesight or hearing?" "Do you take your medications more than once a day?" "Do you take any herbs, vitamins, or other dietary supplement Which assessment tools would help a nurse focus on factors that increase an older person's risk for falling? Select all that apply. STRATIFY Morse Fall Scale Hendrich II Fall Risk Model (HIIFRM) Which nursing intervention is most important in preventing injury in an older adult patient who is at high risk for falls? Use low beds or futon-type beds for the patient. Why should a patient who is in a restraint be checked every 30 to 60 minutes and have that restraint released at least every 2 hours? Select all that apply. Turning Toileting Repositioning A nursing instructor asks a nursing student about delirium. What nursing student statement indicates a need for further teaching by the nurse? "Delirium is a chronic, progressive disorder." A patient with end-stage lung cancer and metastasis to the brain has been admitted to the medical-surgical unit. After trying all options to provide a safe environment, the nursing staff is required to apply restraints. Which nursing intervention is required for this patient? Releasing the restraints at least every 2 hours The nurse is teaching a 65-year-old patient about Medicare benefits. Which patient statement indicates adequate teaching? "Part A covers inpatient hospital and hospice care expenses." Which skin care precautions would the nurse take when caring for older adult patients on long-term steroid therapy? Use gentle touch and report any open areas. What serious "marker conditions" are listed under the Fulmer SPICES framework that can lead to longer hospital stays, higher medical costs, and even death in older adults? Select all that apply. Confusion Incontinence Sleep disorders Skin breakdown What may listlessness in an older adult in a family indicate? Neglect A nursing student is learning about health care law regarding the use of chemical restraints. Which psychoactive drug class will the student identify as most potent, which means it must be used with extreme caution? Antipsychotic A patient is unsure about the services covered by Medicare. The patient tells the nurse the services he or she believes are covered. Which indicates a need for further education? Private Medi-Gap insurance The nurse is conducting a medication assessment on an older adult patient who is being admitted to a long-term care facility for rehabilitation following a hip replacement. With Beers Criteria used as a resource, which drug poses a potential risk for this patient? D What should the nurse incorporate in the plan of care for a patient who has fragile skin? Reduce friction and shearing when moving the patient. The registered nurse is teaching a nursing student about interventions to prevent sleep disorders in an older patient. Which nursing student statement indicates a need for further teaching by the nurse? "I should encourage the patient to sleep longer during the daytime." What factors are responsible for the lag in the health of Hispanic older adults? Select all that apply. Language barrier Lack of health care access Inadequate health insurance Which does the nurse recognize as the likely cause of an older adult patient's constipation, dry mouth, and urinary retention? Antipsychotic therapy A 70-year-old patient admitted to the hospital with heart failure has a history of a fractured hip caused by a previous fall. The patient is taking oxycodone-acetaminophen as needed for pain secondary to a recent dental procedure. Which risk factor puts this patient at greatest risk for a fall? History of a previous fall Which group of medications is appropriate for the control of certain behavioral problems, such as delusions, acute psychosis, and schizophrenia? Anti-psychotic drugs Which statement regarding delirium and dementia is correct? Delirium is a short-term disorder, and dementia is a long-term illness. Which group of drugs may cause delirium as an adverse side effect? 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Which step of the nursing process does this nursing action reflect? 15 answers QUESTION A client is scheduled to have a contraction stress test (CST) to determine fetal well-being. Which type of fetal heart rate (FHR) decelerations constitutes a non-reassuring outcome? 2 answers Which intervention would the nurse implement for all older adult patients regardless of their risk for falls Select all that apply one some or all responses may be correct?This is a specific nursing intervention needed for patients who are at high risk for falls. Reminding the patient to call for help before getting out of bed, cleaning up spills immediately, and placing objects the patient needs within reach are nursing interventions for all patients, irrespective of their fall risk.
Which intervention would the nurse implement for all patients to decrease the risk for falls Select all that apply?Secure locks on beds, stretcher, & wheel chair. Keep floors clutter/obstacle free (especially the path between bed and bathroom/commode). Place call light & frequently needed objects within patient reach. Answer call light promptly.
Which nursing intervention is most important in preventing injury in an older adult patient who is at high risk for falls?Which nursing intervention is most important in preventing injury in an older adult patient who is at high risk for falls? Use low beds or futon-type beds for the patient.
What should a nurse do if a patient falls?Stay with the patient and call for help. Check the patient's breathing, pulse, and blood pressure. If the patient is unconscious, not breathing, or does not have a pulse, call a hospital emergency code and start CPR. Check for injury, such as cuts, scrapes, bruises, and broken bones.
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Which intervention would the nurse implement for all older adult patients regardless of their risk for falls?
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