Nursing Care for Older Clients - Worksheet

The nurse is providing medication instructions to an older client with chronic heart failure who is taking digoxin daily. The nurse explains to the client that decreased lean body mass and decreased glomerular filtration rate, which are age-related body changes, could place the client at risk for which complication with medication therapy?

• Decreased absorption of digoxin

• Increased risk for digoxin toxicity

• Decreased therapeutic effect of digoxin

• Increased risk for side effects related to digoxin

The nurse is caring for an older client in a long-term care facility. Which action does the nurse plan that will contribute to encouraging autonomy in the client?

• Planning meals

• Decorating the room

• Scheduling haircut appointments

• Allowing the client to choose social activities

The home care nurse is visiting an older client whose spouse died 6 months ago. Which behaviors by the client indicate effective coping? Select all that apply.

• Neglecting personal grooming

• Looking at old snapshots of family

• Participating in a senior citizens program

•  Visiting the spouse’s grave once a month

•  Decorating a wall with the spouse’s pictures and awards received

The nurse is providing instructions to the assistive personnel (AP) regarding care of an older client with hearing loss. What would the nurse tell the AP about older clients with hearing loss?

• They are often distracted.

• They have middle ear changes.

• They respond to low-pitched tones.

• They develop moist cerumen production.

The nurse is providing an educational session to new employees, and the topic is abuse of the older client. The nurse helps the employees identify which client as most typically a victim of abuse?

• A person who has moderate hypertension

• A person who has newly diagnosed cataracts

• A person who has advanced Parkinson’s disease

• A person who has early diagnosed Lyme disease

Which statement by an older client having difficulty sleeping at night indicates the need for further teaching regarding measures to improve sleep?

• I drink a cup of coffee every evening before bed.

• I keep my bedroom quiet and dark at night.

• I avoid heavy meals close to bedtime.

• I try to go to bed at the same time each night.

The visiting nurse observes that an older client is confined by their child to the room. When the nurse suggests that he walk to the den and join the family, he says, “I’m in everyone’s way; my child needs me to stay here.” Which is the most important action for the nurse to take?

• Say to the child, “Confining your parent to their room is inhumane.”

• Suggest to the client and child that they consider a nursing home for the client.

• Say nothing, because it is best for the nurse to remain neutral and wait to be asked for help.

• Suggest appropriate resources to the client and child, such as respite care and a senior citizens center.

The nurse is performing an assessment on an older adult client. Which assessment data would indicate a potential complication associated with the skin?

• Crusting

• Wrinkling

• Deepening of expression lines

• Thinning and loss of elasticity in the skin

The home health nurse is visiting a client for the first time. While assessing the client’s medication history, it is noted that there are 19 prescriptions and several over-the-counter medications that the client has been taking. Which intervention would the nurse take first?

• Check for medication interactions.

• Determine whether there are medication duplications.

• Determine whether a family member supervises medication administration.

• Call the prescribing primary health care provider (PHCP) and report polypharmacy.

The long-term care nurse is performing assessments on several of the residents. Which are normal age-related physiological changes the nurse would expect to note? Select all that apply.

• Decline in visual acuity

• Decline in long-term memory

• Decline in respiratory Rate

• Increased susceptibility to urinary tract infections

• Increased incidence of awakening after sleep onset