Meeting Safety Needs of Older Adults: Basic Geriatric Nursing, Exams of Geriatrics

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Chapter 09: Meeting Safety Needs of Older Adults.

Basic Geriatric Nursing.

MULTIPLE CHOICE

1. An older adult man has been diagnosed as having diminished depth perception. What does

the nurse expect him to have difficulty with in his everyday activities?

a. Judging the height of steps.

b. Reading small print on food labels.

c. Reading street signs.

d. Seeing in dim light.

ANS: A

2. The home health nurse is assessing the home environment of an 85-year-old patient with

Parkinson disease. What symptom of Parkinson disease makes the patient at an

increased risk of falls?

a. Postural hypotension

b. Cognitive changes

c. Altered vision

d. Altered

gait ANS: D

3. In order to decrease fall risk due to orthostatic hypotension, what advice should be given to

an older adult who is taking N

me R

dic I

atio G

n fo B

r .

hy C

per M

tension?

a. Ambulate with a walker. b. Avoid hot baths.

c. Avoid climbing stairs.

d. Sit on the side of the bed for a moment before

ambulation. ANS: D

4. What is a common reason that an older adult may deny that he has fallen?

a. Fear that he will fall again

b. Fear of being hospitalized for treatment

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c. Afraid of being seen as frail and dependent

d. Fear of being considered

clumsy ANS: C

5. Why is it important for the home health nurse to interview an 82-year-old patient following

the patient’s fall in the home?

a. So that the incident can be reflected in the home health nurse’s documentation

b. To help the patient gain insight into the cause of the fall

c. In order to guarantee no further falls

d. To collect data for research

purposes ANS: B

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6. What is the primary focus of a fall prevention program in a long-term care facility?

a. Improving balance

b. Improving muscle mass

c. Improving circulation

d. Increase in the knowledge base about

falls ANS: A

7. The daughter of an 80-year-old woman asks the home health nurse for advice in selecting a

cane for her mother, who has an unsteady gait. What cane would be a poor choice?

a. Wooden cane with a rubber tip

b. Four-footed cane with a rubber grip

c. Clear acrylic cane with a nonslip tip

d. Colorful carved cane with a wooden

tip ANS: D

8. Why does the home health nurse give his 90-year-old patient a framed poster that says

“We need each other.”?

a. Insure that the patient will take care not to fall.

b. Remind the patient to ask for assistance when needed.

c. Encourage the patient to take pride in his independence.

d. Reinforce that the patient should not attempt any activity without help.

ANS: B

9. What does the nurse hope to achieve by teaching tai chi daily in the long-term care facility?

a. Stimulate intellectual aNcti U

vRity

b. Encourage interaction

c. Improve coordination

d. Demonstrate cultural

awareness ANS: C

10. The home health nurse conducts a safety assessment in a patient’s home. Which of

the following would be identified as a fire hazard?

a. Baking soda near the stovetop

b. A smoke detector in the kitchen

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c. Multiple appliances plugged into one outlet

d. A metal container for

cigarettes ANS: C

11. What would be an appropriate suggestion for an 80-year-old woman who recently placed

a deadbolt lock on her door?

a. Keep the door securely locked.

b. Apply similar locks on the windows.

c. Leave the door unlocked, with the key in place.

d. Replace the lock with a security

chain. ANS: C

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12. Which of the following would least improve home security?

a. Peephole in the door at a convenient height

b. Brightly lit porch

c. Large dog with a loud bark

d. Hook and eye latch on the screen door

ANS: D

13. The home health nurse counsels a family in making safe driving “rules” for their

85-year-old father. Which rule would not be effective in promoting safety?

a. Limit driving to nearby areas with easy access.

b. Plan ahead and know where you are going.

c. Wear prescribed glasses and hearing aids.

d. Drive below the speed limit to maintain control of the car.

ANS: D

14. Which of the following may be a thermoregulation risk in the older adult?

a. Inactivity

b. Eating highly spiced foods

c. Being overweight

d. Mental illness

ANS: A

15. What is an expected assessment finding in an older adult suffering from hyperthermia?

a. Excessive perspiration

b. Bradycardia

c. Temperature of 100 F

d. Leg cramps

ANS: D

16. The nurse is aware that the older adult is at greater risk for hypothermia than a

younger person because the older adult has a diminished ability to:

a. convert glycogen to glucose.

b. select appropriate clothing or bed linen.

c. shiver.

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d. constrict vessels.

ANS: C

17. The nurse is volunteering at a homeless shelter. What intervention should be taken for a

patient admitted with severe hypothermia?

a. Give the person hot coffee or soup.

b. Place the person in a warm bath.

c. Briskly rub the person’s hands.

d. Wrap the person in blankets.

ANS: D

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18. What would be the initial choice of interventions to help prevent a fall in a

confused 85-year-old extended-care facility patient?

a. Use of a vest restraint

b. Use of an electronic sensor alarm

c. Placement of a wheelchair between the wall and dining table

d. A tray table attached to the arms of the wheelchair

ANS: B

19. What should the home health nurse suggest in the case of a fire in the home of the

older adult?

a. Keep a flashlight at the bedside

b. Use an appropriate fire extinguisher to control fire

c. Keep the doors open for an easy escape route

d. Call 911 before exiting the home

e. Open the windows to decrease

smoke ANS: A

MULTIPLE RESPONSE

1. What are internal factors that threaten the safety of the older adult? ( Select all that apply. )

a. Decrease in flexibility

b. Slowed reaction time

c. Gait changes

d. Thermal hazards

e. Postural changes

ANS: A, B, C, E

2. The nurse in a long-term care facility awards stickers to certified nursing assistants who

consistently. ( Select all that apply. )

a. report broken tiles in the shower room and bathrooms

b. mop up spills

c. assist residents to hurry

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d. remind residents to use walkers

e. retie residents’

shoelaces ANS: A, B, D, E

3. The home health nurse is assessing the patient’s home. Which of the following would be

identified as a fall risk? ( Select all that apply. )

a. Brightly lit rooms

b. Pantry food at an accessible level

c. Colorful scatter rugs marking doorways and steps

d. Wearing comfortable laced tennis shoes

e. Attractive, low, magazine rack beside a

chair ANS: C, E

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4. What are external factors that may be a safety threat to the older adult? ( Select all that

apply. )

a. Fire hazards

b. Lack of home security

c. Vehicular accidents

d. Thermal hazards

e. Sensory deficit

ANS: A, B, C, D

5. What telephone modifications would increase safety for the older adult? ( Select all that

apply. )

a. Placement of phones at bedside and next to a favorite chair

b. Programming an auto dial function for quick dialing

c. Using an answering machine with a male voice

d. Replacing the phone cord with a 15-foot cord for ease in carrying around the

phone

e. Selecting a phone with large

numbers ANS: A, B, C, E

6. The home health nurse has evaluated the community for measures that support pedestrian

safety. What safety measures would be appropriate modifications to increase safety in

the community? ( Select all that apply. )

a. Pedestrian-controlled crosswalks

b. Safety islands on wide street intersections

c. Decreased time to cross N

at R

walk I

s

d. Clearly marked crosswalkUs aSt intNerseTctions

e. Overhead crossings over busy streets

ANS: A, B, D, E

7. What factors increase the risk of vehicular accidents for the older adult? ( Select all that

apply. )

a. Increased reflex time

b. Cognitive disorders

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c. Altered depth perception

d. Changes in night vision

e. Reduced

flexibility ANS: B, C,

D, E

8. The daughter of a home health patient is concerned about her 92-year-old father who

continues to drive regularly. Which observations would indicate deteriorated driving skills?

( Select all that apply. )

a. Paint scrapes on the mailbox at the curb

b. Friends calling him to get rides to the grocery store

c. Choosing not to drive at night because of night blindness

d. Difficulty turning his head

e. Carefully planning routes to avoid heavy traffic

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ANS: A, D

COMPLETION

1. The nurse takes into consideration that the most common injuries to the older adult are the

result of.

ANS: falls