A home health nurse is conducting a home visit.
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Nurses' Notes
Client is an older adult client with a history of osteoporosis, hypertension, and depression. Client is living independently with help of an aid for housekeeping and laundry. General appearance is neat, hair combed, clothing appropriate for weather. Skin color appropriate for ethnicity, overall skin is dry with bruising and small skin tear noted on knuckle of right hand. Dentures in glass on table. Client reports dentures don't fit well and make their mouth sore. Cough noted while client was drinking juice. Client reports appetite is decreased due to not being very hungry. Client reports eating mostly dinners that adult child prepares and freezes for them. Client states, "I just have to heat them up." Client also states. "Food just doesn't taste good anymore, and have a hard time chewing anything."
osteoporosis
hypertension
depression
independently
clothing appropriate for weather
Cough
appetite is decreased
have a hard time chewing anything.
The Correct Answer is ["C","D","F","G","H"]
Rationale for Risk Factors of Malnutrition in Older Adults
Decreased appetite: A reduced appetite can lead to decreased food intake, which can contribute to malnutrition.
Difficulty chewing: Problems with teeth or dentures can make it difficult to chew food properly, leading to inadequate nutrient intake.
Denture problems: Ill-fitting dentures can make eating uncomfortable and painful, reducing appetite and food intake.
Living independently: Older adults who live alone may have limited access to healthy food, lack cooking skills, or be unable to prepare meals for themselves. This can lead to inadequate nutrition.
Depression: Depression can affect appetite and motivation to eat, leading to decreased food intake and weight loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Identity vs. role diffusion is focused on adolescents developing a personal identity and sense of self, not on acceptance of death.
B. Integrity vs. despair is the final stage of Erikson's psychosocial development and involves reflecting on one's life and coming to terms with it, which includes accepting the inevitability of death.
C. Generativity vs. stagnation involves concerns about contributing to society and guiding future generations, not the acceptance of death.
D. Autonomy vs. shame and doubt is a stage focused on toddlers developing independence and self-control, rather than on issues related to death.
Correct Answer is B
Explanation
A. The mother usually begins to feel fetal movements, or "quickening," between 16 and 25 weeks of pregnancy, not specifically at 24 weeks.
B. The fetal heartbeat is typically audible by a Doppler stethoscope around 12 weeks of pregnancy, which allows for early detection of the fetal heart rate.
C. Lanugo, the fine hair covering the fetus, is present by around 20 weeks but does not cover the entire body by 36 weeks. By 36 weeks, lanugo starts to thin out and diminish.
D. The sex of the baby is typically identifiable by ultrasound by around 18-20 weeks of pregnancy, not specifically by week 30.
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