CARE OF OLDER ADULT ( RLE )

TOPICS
Spirituality

F- Faith and Belief - assessing types of beliefs and faiths patient holds “ do you
consider yourself spiritual or religious?
I - importance - how important is spirituality to them. “ what importance does your
spirituality have in our life”? Has your spirituality influenced how you take care of
yourself , your health?
C- community - if they are part of a spiritual community and exploring this. Are you part
of a spiritual community? Communities such as churches, temples, or a group of like-
minded friends, family. Is this of support to you and how?
A - Address in care - how to address these needs in patient care “ how would you like
me your healthcare provider to address these issues in your healthcare?

- Barriers in spiritual nursing

● Chronic illness
● Cultural diversity
● Retirement associated ( lower income, lower educational attainment)
● Cognitive Barriers ( alzheimer's disease )
● Affective Disorders ( depression )
● Sensory barriers ( cataracts)
● Psychomotor Barriers ( stroke )

- End of life directives Teaching Older Adults

- Barriers of learning of Older Adults

- Techniques in teaching older adults

- Activities to boost learning in older

Adults

Falls
- Morse Fall Scale

- Intervention for the risk assessed

Pressure Ulcer
- Braden scale risk assessment
- Stages of pressure ulcer

- Intervention for different stages of

pressure ulcer

Hypertension, MI and Stroke

- Category of Hypertension

- M-O-N-A-T-A-S-S

- NTG administration

- Types of Angina

- B-E-F-A-S-T

Pneumonia, COPD, PTB

- Types of PNA

GERON QUIZ

1. Identify the category of hypertension- BP=180/90 mmHg

C. HPN Stage 2
2. Bland foods are undesirable, however salt intake for older adults should be limited.
How much is the daily recommended intake of salt?
B. 5mg

3. Observing a DASH diet, which of the following food groups is allowed to take?
B. Chia pudding with pistachio nuts, steamed herring, plantain

4. Type of angina that is commonly unpredictable and can be relieved with rest and
Medications.
B. Unstable angina

5. Which of the following is the best advice a nurse could give a toddler adult with
cardiovascular disease?
B. “One shot of red wine may help reduce the risk of heart attacks.”

6. Pre-cardiac catheterization, what is the appropriate health teaching to the patient who
undergoes the procedure?
D. ( all of the above)

7. Which of the following is an example of a thrombolytics which is given to MI patients?

A. Tissue Plasminogen Activator

8. What is initially given to patients who are anxious during a heart attack?
C. Valium

9. If you are a nurse attending a patient suspected to have myocardial infarction, how
are you going to administer nitrates?
B. Initial dose upod order and repeat every 5 minutes when angina is not
relieved for the first 15 minutes.

10. Cerebrovascular accident is classified as what type of stroke?

B. Hemorrhagic

SESSION 9 - Spiritual assessment

1. Refers more broadly to ideas of belief that encompass personal philosophy and
understanding of meaning and purpose in life.

B. Spirituality
2. When using the FICA tool in assessing the spiritual, what should the nurse asks to
address the role of spirituality to an individual?

D. How would you want the care team should approach concerns?

3. A client's wife asked the nurse to pray for her. What would be the best initial response
for a nurse who believes in prayer?

C. “ I'm happy to do that . for what would you like me to pray”

4. There are many other approaches that can be used to assess and address the
spiritual needs of older people. One is reminiscence therapy, which allows them not
only to discuss spiritual beliefs but also to establish a relationship , thereby allowing
discussion to evolve. Other approaches may include:

D. all of the above ( using music to develop bonds , effective listening, ritualistic
prayer or worship.)

5. Which of the statements is incorrect?

C. The spiritual needs of older people in the care settings are always addressed.

6. According to NHS chaplaincy guidelines, there are plenty evidence that spiritual
needs of older people are nor met due to different factors which may include:

D. all of the above ( lack or training, lack of time , lack of awareness)

7. Sequence of activities involving gestures, words, actions, or objects, performed

according to a set sequence.

B. Rituals

8. You are the nurse assigned to a patient who was terminally ill and has instructions for
his family that upon his demise he will be cremated and his ashes will be kept in the urn
beside his maternal tomb for he believed that they will ghetto see each other again in
the next life. This is an example of ___.

B. End of life directives

9. Transcultural nursing recognizes the importance of spiritual nursing, if you a catholic

nurse and you are assigned to a muslim client, you understand that it is inapprpriate to:

D. Prepare their meal along, with the diet plan of jewish client

10. Which of the following is/ are the elements of spiritual nursing?

D. all of the above ( feeling of connectedness , purpose and meaning in life,

Transcendence)

SESSION 10- teaching older adults

11. The following are the barriers of learning in older adults, except:

D. Advanced age

12. Which of the following is an affective barrier of adult learning?

A. Depression

13. Which of the following modalities would not be effective for older adults with
cognitive barriers in learning?

D. Quizzes

14. As a nurse health educator , teaching the older adults , which of the following is the
appropriate action you should observe?
 A. Speak loudly

15. A nurse is developing a plan of care for an older adult. Which information will the
nurse consider?

B. Needs to be individualized to the patient's unique needs

16. A recently admitted nursing home resident and the residents family only speak
spanish. One evening during a visit, the resident and the family begin to wall and sob
loudly. The gerontological nurse is unable to determine what is wrong the nurses most
appropriate action is to:

A. Ask the supervisor to get an interpreter.

17. Once people reach a certain age, they can no longer learn new information or kills:

B. False

18. The following are activities that can stimulate cognitive skills of older adults, except:

C. Social Dance

19. Which activity would best promote health and maintenance for these senior
citizens?

D. Walking 3 to 5 times a week for 30 minutes

20. In preparing a presentation for older adults, a gerontological nurse keeps in mind
that:
B. older adult learners are heterogeneous due to diverse educational experiences
and learning strategies.
SESSION 11 - FALLS

21. Which of the following is the intrinsic risk factor for falls?

A. Elimination Problems

22. Based on Morse fall scale ( MFS), a score of 27 would fall on what risk level?

B. Low Risk

23. Under the category of NO RISK - for fall, what is the appropriate nursing action?

A. Good basic nursing care

24. What should be the first intervention when a nurse finds that a patient has fallen?

D. Assess the circumstances of the fall and any injuries sustained.

SESSION 12 - PRESSURE ULCERS

25. A score of 5 based on braden scale risk assessment scale for pressure ulcers is:

B. Mild risk

26. The primary reason an older adult client is more likely to develop a pressure ulcer
on the elbow as compared to a middle-age adult is:

C. The older client has less subcutaneous padding on the elbow

27. The primary risk factor for the development of pressure ulcers in older adult patient
is:

A. Immobility
28. What is the treatment for stage IV pressure ulcer?

C. Surgery

29. Full thickness tissue , subcutaneous fat may be visible but bone, tendon or musvle
are not exposed.

C. Stage 3 pressure ulcer

SESSION 13- MANAGEMENT OF COMMON ILLNESSES, DISEASES, AND HEALTH

CONDITIONS CARDIOVASCULAR DISORDERS)

30. Diet intended for hypertensives, foods rich in magnesium, but low in sodium,
cholesterol or fats.

C. DASH diet

31. Which action will the nurse in the hypertension clinic take in order to obtain an
accurate baseline blood pressure (BP) for a new patient?

C. Have the patient sit in a chair with the feet flat on the floor.

32. A 60 year old male client comes into the emergency department with complaints of
crushing chest pain that radiates to his shoulder and left arm. The admitting diagnosis is
acute myocardial infarction. Immediate admission orders include oxygen by NC at
4L/minute, blood work, chest x-ray, an ECG, and 2mg of morphine given intravenously.
The nurse should first:

A. Administer the morphine

33. Lactulose is given to patient who had Mi to:

C. Avoid straining
34. You are suspecting the patient having a brain attack. What is the usual assessment
representing stroke?

D. all of the above ( speech difficulty, blurred vision, lateralization of the arms )

35. A respiratory disease which is the leading cause of death among the elderly. It is an
inflammation or infection in the lungs that can be caused by a variety of factors including
bacteria, viruses, and aspiration. The elderly are considered high risk.

B. Pneumonia

36. When foreign material such as fluids and fluids enter the lung, it causes
inflammation of the bronchioles. What type of pneumonia is this?

D. Aspiration pneumonia

37. A common COPD among older adults. It results from recurrent inflammatiion and
mucus production in the bronchial tubes.

B. Bronchitis

38. An infection that can attack any part of the body, but particularly targets the lungs.
This can spread through the air by coughing, sneezing , laughing, or any activities in
which particles may become airborne.

B. Tuberculosis

39. What is the recommended vaccine given to fight tuberculosis?

D. BCG
40. Which of the following TB drugs has a side effect affecting visual acuity?

C. Ethambutol

41. Sanny, a community health nurse is conducting an educational session with

community members regarding tuberculosis. The nurse tells the group that one of the
first symptoms associated with tuberculosis is:

D. A cough with the expectoration of mucoid sputum

42. What is the priority nursing intervention in helping a patient expectorate thick lung
secretions?

D. Increase fluid intake to 3L/day if tolerated.

43. The nurse is caring for a patient admitted to the hospital with pneumonia. Upon
assessment, the nurse notes a temperature of 101 4f, a productive cough with yellow
sputum, and a respiratory rate of 20. Which nursing diagnosis is most appropriate
based upon this assessment?

A. Hyperthermia related to infection illness

44. Treatment for GERD would include:

C. Endoscopy

45. What is/are the risk factor for peptic ulcer?

E. A,B, C ONLY ( stress, caffeine, h.pylori infection)

46. Clinical judgment is very crucial when assessing presence of indigestion as a

symptom for peptic ulcer as this may be regarded also as a:

A. Cardiac ischemia