nursing.elitecme.com Page 97 Complete Your CE Test Online - Click Here 31. Molton, I. R., and Terrill, A. L. (2014). Overview of persistent pain in older adults. American Psychologist, 69(2), 197-207. 32. Geriactricpain.org. (no date given). Pain assessment in advanced dementia: PAINAD. Retrieved January 16, 2016 from: http://www.geriatricpain.org/Content/Assessment/Impaired/Pages/ PAIDADTool.aspx. 33. American Psychological Association (2013). Mental and behavioral health and older Americans. Retrieved January 16, 2016 from: http://www.apa.org/about/gr/issues/aging/mental-health.aspx. 34. World Health Organization (2015). Mental health and older adults. Retrieved January 16, 2016 from: http://www.who.int/mediacentre/factsheets/fs381/en/#. 35. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, D. C.: American Psychiatric Association. 36. MedicineNet.com (2012). Drugs that cause depression. 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NCHS Data Brief, No. 133. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, US Dept. of Health and Human Services. 49. Mozzafarian, D., et al. (2015). Heart Disease and Stroke Statistics-2015 Update: A report from the American Heart Association. Circulation., e29-322. 50. American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society (2014). 2014 AHA/ACC/HRS guideline for the management of patients with Atrial Fibrillation: Executive summary. Journal of the American College of Cardiology, 64(21), 2246-2280. 51. Centers for Disease Control and Prevention (2016). Women and heart disease fact sheet. Retrieved February 18, 2016 from: http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart.htm. 52. MedicineNet.com (2010). Heart attack symptoms: Different in women! Retrieved August 30, 2010 from: www.medicinenet.com/script/main/art.asp?articlekey=19561. 53. Fields, L. (2015). 6 symptoms of women’s heart attacks. Retrieved February 18, 2016 from: http:// www.webmd.com/heart-disease/features/womens-heart-attack-symptoms. 54. Comerford, K. (Ed.). (2013). Anatomy & physiology made incredibly easy (4th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. 55. Cleveland Clinic (2016). Laryngopharyngeal reflux (LPR). Retrieved February 6, 2016 from: https:// my.clevelandclinic.org/services/head-neck/diseases-conditions/hic-laryngopharyngeal-reflux-lpr. 56. WebMD (2014). Laryngopharyngeal reflux (silent reflux). Retrieved February 6, 2016 from: http:// www.webmd.com/heartburn-gerd/guide/laryngopharyngeal-reflux-silent-reflux. THE OLDER ADULT: CHALLENGES FOR NURSING ASSESSMENT AND CARE Self-Evaluation Exercises Select the best answer for each question and check your answers at the bottom of the page. You do not need to submit this self-evaluation exercise with your participant sheet. 1. When educating colleagues about the growth of the older adult population, nurses should explain that: a. The proportion of the world’s population over 60 years of age will nearly triple between 2015 and 2015. b. Older adults make up the majority of those who use healthcare services, and most of them are living in long-term care facilities. c. About 92% of older adults have one or more chronic health problems. d. In 2014, the United States Census Bureau reported that 25% of the population was 65 years of age or older. 2. When providing nursing care to a male patient who is visiting from a Middle Eastern country it may be important to: a. Realize that they may be overt and loud when expressing feelings of pain. b. Assign same-sex caregivers whenever possible. c. Anticipate that they will be stoic and reluctant to share information. d. Avoid direct eye contact at all times. 3. When advising the older adult patient about good nutrition nurses should: a. Explain the importance of adding trans-fats to the diet. b. Encourage the older adult patient to routinely take vitamin C and E supplements. c. Explain that older adults have increased caloric needs due to the decreased efficiency of the immune system. d. Encourage using olive oil for cooking and adding foods such as salmon and walnuts to the diet. 4. Which of the following statements about the pharmacology assessment of the older adult is true? a. The older adult can add herbal supplements to his or her medication regimen without fear of harmful side effects. b. The effects of fat-soluble drugs may be increased due to an increase in body fat in the older adult patient. c. Acid drugs are usually better absorbed due to an increase in gastric motility. d. Liver metabolic activity increases with age, so medication dosage may need to be increased. 5. During __________ respirations, the heart rate and blood pressure increase, and there is increased brain activity and dreaming. a. Stage 2. b. Stage 3. c. Slow-wave sleep. d. REM. 6. Mrs. Abbot is 70 years old and arrives at the emergency department accompanied by her husband and daughter. Her daughter, who is a nurse, is afraid that her mother is having a heart attack. Mrs. Abbot tells her daughter, “You are being silly. It’s probably just that infected wisdom tooth that’s giving me this pain in my jaw and making me light-headed.” What should the nurse do first in this situation? a. Agree with Mrs. Abbot since she is not exhibiting typical symptoms of a heart attack. b. Perform an ECG and alert the physician that she has a possible heart attack victim in the department. c. Ask Mrs. Abbot how long she has had an infected tooth. d. Assure Mrs. Abbot that women seldom die of heart disease. 7. The nurse practitioner suspects that 75-year-old Mrs. Jamison has hyperthyroidism. Assessment findings that support her suspicions include: a. Mental deterioration and new incontinence patterns. b. Excessive thirst, polyuria, poor skin turgor, and dry mucous membranes. c. Jaw discomfort, extreme fatigue, and dizziness. d. Sleep pattern changes, visual disturbances, weakness, and apathy. 8. It is most likely that older adults suffer what type of stroke? a. Hemorrhage. b. Embolism. c. Thrombosis. d. TIA. 9. Appropriate interventions for the treatment of age-related musculoskeletal diseases include: a. Administering 1,500 mg of calcium and at least 800 international (IU) units of vitamin D on a daily basis. b. Encourage moderate amounts of caffeine to increase energy for mobility. c. Administer antibiotic therapy as the major treatment for primary osteoarthritis. d. Treat falls in the older adult patient as a disease condition. 10. The effects of age-related immune system conditions include: a. The relationship between stress and the effectiveness of immune system functioning has been shown to be non-existent. b. The manufacture of antibodies that fail to differentiate between the person’s own body and foreign substances increases. c. Cellular immunity increases slightly helping older adults to fight off communicable diseases. d. Research shows that nothing may slow the rate or prevent age- associated decline in the immune system. Answers: 1.C 2.B 3.D 4.B 5.D 6.B 7.D 8.C 9.A 10.B