Growth and Development Stages

Every question here, with the answer

1. A 77-year-old client with a history of mild forgetfulness becomes newly disoriented on the second night after hip surgery. Vital signs are normal. What should the nurse do?

   1. Wait until morning to see whether it resolves.
   2. Tell the family the client has developed dementia.
   3. Report the new-onset confusion to the provider as possible delirium.
   4. Document the confusion as the client's usual cognitive decline.

   Answer: Report the new-onset confusion to the provider as possible delirium.

   New, sudden-onset confusion may be delirium related to a physical illness or infection, so the nurse raises the concern with the provider. Attributing it to baseline decline or waiting may delay treatment, and there is no basis for a dementia diagnosis.

2. A nurse is caring for an older adult whose adult daughter now provides daily care. Which approach by the nurse best preserves the client's dignity?

   1. Provide respectful care rather than "parenting" the older adult.
   2. Direct all questions to the daughter instead of the client.
   3. Encourage the daughter to parent the client as she would a child.
   4. Use simplified speech with the client to avoid confusion.

   Answer: Provide respectful care rather than "parenting" the older adult.

   Thinking of care as role reversal can remove dignity from an older adult, so the nurse provides respectful care rather than parenting. Bypassing the client or using oversimplified speech that is not needed is disrespectful and reflects ageism.

3. An older adult with several chronic conditions says she sometimes cuts her pills in half to make her prescriptions last longer. What is the nurse's priority concern?

   1. Cutting pills to save money may worsen her disease.
   2. Pill cutting shows she has mild cognitive impairment.
   3. This is an acceptable way to reduce costs.
   4. She is taking too many medications.

   Answer: Cutting pills to save money may worsen her disease.

   Some older adults struggling with costs cut pills in half to save money, which can worsen their illness, so the nurse addresses the financial barrier. Pill cutting does not by itself indicate cognitive impairment, and it is not a safe way to reduce costs.

4. An older adult with mild cognitive impairment (MCI) asks whether it will turn into dementia. Which response is accurate?

   1. MCI cannot be influenced by lifestyle.
   2. MCI is a normal change that never affects daily life.
   3. MCI always progresses to dementia.
   4. Not all MCI is progressive, and staying active, social, and learning can minimize its effects.

   Answer: Not all MCI is progressive, and staying active, social, and learning can minimize its effects.

   MCI may progress in some people, especially those with multiple chronic conditions, but not all MCI is progressive; an active lifestyle, social interaction, reading, and learning can minimize its effects. MCI can affect self-esteem, independence, and self-care.

5. A nurse is teaching an older adult how to maintain bone health. Which recommendations should the nurse include? Select all that apply.

   1. Leafy green vegetables and fortified foods
   2. Avoiding weight-bearing activity to prevent falls
   3. Resistance training
   4. Walking
   5. Adequate intake of calcium and vitamin D

   Answer: Leafy green vegetables and fortified foods, Resistance training, Walking, Adequate intake of calcium and vitamin D

   Weight-bearing activities such as walking and resistance training stimulate bone remodeling, and calcium and vitamin D from dairy, leafy greens, fortified foods, or supplements maintain bone. Avoiding weight-bearing activity would promote bone and muscle loss.

6. A nurse is assessing nutritional risk in an older adult. Which age-related changes can affect nutrition? Select all that apply.

   1. Decreased hunger sensation
   2. Decline in oral health
   3. Decreased thirst response
   4. Decreased taste sensation
   5. Increased gut motility

   Answer: Decreased hunger sensation, Decline in oral health, Decreased thirst response, Decreased taste sensation

   Changes affecting nutrition include decreased hunger, appetite, taste, and thirst, changes in nutrient absorption, and declining oral health. Gut motility decreases rather than increases in older adults.