Chapter 07 Pearson Custom For Older Adult Nursing Care By Nancy J.Brown And Linda

Chapter 07 Pearson Custom For Older Adult Nursing Care By Nancy J.Brown And Linda

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

A healthy older adult client complains to the parish nurse at a health fair about a need to “get up to urinate” once or twice a night and asks the nurse for an explanation. Which of the following information should the nurse include in the response?

1. “This is known as nocturia, and it is most likely due to aging. Older adults tend to produce more urine at night.”
2. “This is not normal. You need to get checked for a kidney problem as soon as possible.”
3. “You are most likely drinking too much at night. Hold off on any liquids for two hours before bedtime, and it shouldn’t be a problem.”
4. “You are losing too much water at night which could lead to dehydration. Dehydration can make you more prone to falling, especially at night.”

Correct Answer: 1

Rationale 1: Correct. More nocturnal production of urine is an expected change in the urinary system of old adults.

Rationale 2: Nocturia is common in older adults and is not a sign of a kidney problem.

Rationale 3: The client may or may not be drinking too much at night. The client may still have to get up at night due to increased urine production at night.

Rationale 4: This answer does not address the client’s concern. If the client is well-hydrated, the nocturia will not dehydrate the client.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging in the genitourinary (GU) system.

 

Question 2

Type: MCMA

The nurse is teaching a group of nursing assistants about age-related changes in the urinary system that predispose older adult clients to incontinence. The nurse needs to include which of the following information in the teaching?

Standard Text: Select all that apply.

1. Thickening of the urethral walls in females
2. Prostate enlargement in males
3. Hypoactive detrusor muscles in the bladder
4. An overall decrease in bladder capacity
5. Weakening of pelvic floor muscles in women

Correct Answer: 2,4,5

Rationale 1: The urethral walls actually thin with aging in females and lose tonicity, leading to problems with incontinence.

Rationale 2: Correct. Prostate enlargement in aging males can lead to urinary retention with overflow incontinence.

Rationale 3: The detrusor muscles become hyperactive , not hypoactive, with aging, causing discharge of urine from the bladder before it has reached capacity.

Rationale 4: Correct. A decrease in capacity coupled with hyperactive detrusor muscles can lead to incontinence in aging adults.

Rationale 5: Correct. Pelvic floor muscle weakening occurs with aging in females, leading to stress incontinence. It is also associated with multiple pregnancies.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging in the genitourinary (GU) system.

 

Question 3

Type: MCSA

An older adult client presents to the emergency room with nausea and vomiting, dizziness, weakness, and fever. The client’s family states that the client has also been acting “confused” over the past few hours. A physician-ordered catheter is inserted with return of dark amber-colored urine. The admitting nurse suspects that the client is suffering from which of the following conditions?

1. Kidney failure
2. Dehydration
3. Bladder infection
4. Low oxygen level

Correct Answer: 2

Rationale 1: There is not enough information to support a diagnosis of kidney failure.

Rationale 2: Correct. This client shows several signs of dehydration, such as dizziness, weakness, fever, confusion, and dark-colored urine. The client has also had nausea and vomiting, which would contribute to dehydration.

Rationale 3: There is insufficient information to determine a bladder infection.

Rationale 4: The only symptom suggestive of hypoxia is confusion, but there is not any objective information indicating low oxygen levels.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging in the genitourinary (GU) system.

 

Question 4

Type: MCSA

A female older adult client expresses concern to the nurse practitioner that she is having difficulty “having relations” with her husband due to extreme discomfort with intercourse. The nurse is aware that the client is describing which one of the following conditions associated with age-related changes to the reproductive system?

1. Cystocele
2. Dysuria
3. Vaginitis
4. Dyspareunia

Correct Answer: 4

Rationale 1: Cystocele describes herniation of the bladder into the vaginal vault.

Rationale 2: Dysuria describes painful urination.

Rationale 3: Vaginitis describes inflammation of the vagina caused by bacteria, fungus, parasite, or aging.

Rationale 4: Correct. Dyspareunia describes painful sexual intercourse due to loss of tone and elasticity in vaginal walls and lessened secretions within the vagina, which are expected changes associated with aging.

Global Rationale:

 

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: Describe the normal changes of aging in the genitourinary (GU) system.