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A nurse is assessing an older adult client who has a history of falls.

Which of the following findings should the nurse identify as a risk factor for falls in older adults?

Orthostatic hypotension

Urinary frequency.

Visual impairment

All of the above

Answer and Explanation

The Correct Answer is D

The correct answer is D.

All of the above. All of these findings are risk factors for falls in older adults, according to the literature.

Some explanations for why each choice is a risk factor are:.

A. Orthostatic hypotension: This is a condition where blood pressure drops too much when getting up from lying down or sitting, causing dizziness, lightheadedness, or fainting. This can affect balance and increase the chance of falling.

B. Urinary frequency: This is a condition where one needs to urinate often, sometimes urgently. This can cause rushed movement to the bathroom, especially at night, which can lead to tripping, slipping, or losing balance.

C. Visual impairment: This is a condition where one has reduced or distorted vision, such as due to cataracts, glaucoma, macular degeneration, or diabetic retinopathy. This can affect depth perception, contrast sensitivity, and ability to detect obstacles or hazards in the environment.

Some normal ranges for these conditions are:.

• Orthostatic hypotension: A normal blood pressure change when standing up is less than 20 mmHg systolic (top number) or 10 mmHg diastolic (bottom number).

Orthostatic hypotension is defined as a drop of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing.

• Urinary frequency: A normal urinary frequency is about 4 to 6 times per day, depending on fluid intake and other factors.

Urinary frequency is considered abnormal if it is more than 8 times per day or more than 2 times per night.

• Visual impairment: A normal visual acuity is 20/20 or better with or without correction.

Visual impairment is defined as a visual acuity of 20/40 or worse in the better-seeing eye with best correction possible.

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Free Nursing Study Resources

Correct Answer is ["A","B","E"]

Explanation

The correct answer isA, B, and E.

The nurse should instruct the patient to do the following:.

• Trim nails straight across and file edges smoothly.

• Soak nails in warm water before trimming to soften them.

• Report any signs of infection or inflammation around nails.

These are good practices for nail hygiene and health, especially for the elderly who may have dry, brittle or thickened nails.Trimming nails straight across and filing them prevents ingrown nails and reduces the risk of injury or infection.Soaking nails in warm water makes them easier to cut and less likely to crack or split.Reporting any signs of infection or inflammation around nails is important to prevent complications and get appropriate treatment.

Choice C is wrong because using a metal nail file or scissors to cut nails can damage the nail plate and cause splitting or tearing.Choice D is wrong because applying a clear nail polish to protect nails from cracking is unnecessary and may worsen nail health by trapping moisture and bacteria under the polish.

To maintain healthy nails, the elderly should also scrub the underside of their nails with soap and water, moisturize their nails and cuticles, avoid biting or chewing their nails, eat nutritious foods rich in calcium and vitamins B and C, and use sterilized nail grooming tools.

:Fingernail Care for the Elderly - assisting hands-il-wi.com:Fingernails: Do’s and don’ts for healthy nails - Mayo Clinic:Nail Hygiene | CDC - Centers for Disease Control and Prevention.

A. “Social interaction can help me lower my blood pressure and cholesterol levels.” B. “Social interaction can help me boost my immune system and fight infections.”. C. “Social interaction can help me improve my memory and learning ability.”. D. “Social interaction can help me avoid stress and anxiety.”.

Correct Answer is D

Explanation

The correct answer is D.

“Social interaction can help me avoid stress and anxiety.” This statement indicates a need for further teaching because social interaction does not necessarily help older adults avoid stress and anxiety.

In fact, some social situations may cause or increase stress and anxiety for some people, especially if they are negative, unpleasant, or conflictual.

Therefore, the nurse should explain to the client that social interaction can help them cope with stress and anxiety, but not avoid them altogether.

Choice A is correct because social interaction can help lower blood pressure and cholesterol levels by reducing the effects of stress hormones and promoting physical activity.

Choice B is correct because social interaction can help boost the immune system by enhancing positive emotions, increasing antibody production, and reducing inflammation.

Choice C is correct because social interaction can help improve memory and learning ability by stimulating brain regions involved in cognition, communication, and social perception.

Normal ranges for blood pressure are less than 120/80 mmHg for adults, and normal ranges for cholesterol are less than 200 mg/dL for total cholesterol, less than 100 mg/dL for LDL cholesterol, and more than 40 mg/dL for HDL cholesterol.

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A nurse is assessing an older adult client who has a history of falls. Which of the following findings should the nurse identify as a risk factor for falls in older adults?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching an elderly patient about nail care and hygiene. The nurse should instruct the patient to do which of the following? (Select all that apply.).

Correct Answer is ["A","B","E"]

Explanation

A nurse is teaching an older adult client about the benefits of social interaction for health and well-being. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is D

Explanation

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A nurse is assessing an older adult client who has a history of falls.

Which of the following findings should the nurse identify as a risk factor for falls in older adults?