You notice that your older adult male client frequently knocks his arm or hand against door frames or chair backs and then develops a purpura. What do you advise your client to do? (Select all that apply.)

Protect the skin from trauma.

Remind the health care personnel to be gentle when handling this client’s skin.

Wear a long-sleeved shirt.

Tape a nonadherent dressing over the site of a skin tear.

Answer and Explanation

Correct Answer : A,B,D

Choice A: Protect the skin from trauma. This is a correct answer. Purpura is the discoloration of the skin or mucous membranes due to hemorrhage from small blood vessels¹. It can be caused by various factors, such as blood clotting disorders, medications, infections, or weak blood vessels². Older adults are more prone to develop purpura because their skin becomes thinner and more fragile with age³. Therefore, protecting the skin from trauma, such as knocking against hard surfaces, can help prevent or reduce purpura.

Choice B: Remind the health care personnel to be gentle when handling this client’s skin. This is also a correct answer. Health care personnel should be aware of the risk of purpura in older adults and handle their skin with care. They should avoid applying excessive pressure, friction, or shear forces to the skin, as these can cause damage to the blood vessels and result in purpura. They should also use soft and smooth materials, such as cotton or silk, when dressing or cleaning the skin.

Choice C: Wear a long-sleeved shirt. This is not a correct answer. Wearing a long-sleeved shirt may provide some protection to the skin, but it is not enough to prevent purpura. Moreover, wearing tight or rough clothing can actually worsen the condition by causing irritation or injury to the skin. Therefore, this is not a good advice for the client.

Choice D: Tape a nonadherent dressing over the site of a skin tear. This is another correct answer. A skin tear is a type of wound that occurs when the skin is separated from the underlying tissue, usually due to trauma. Skin tears are common in older adults and can lead to purpura if the blood vessels are damaged. Taping a nonadherent dressing over the site of a skin tear can help protect the wound from infection, promote healing, and prevent further bleeding.

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Correct Answer is A

Explanation

Choice A reason: Skin becomes more vulnerable to sun damage is true because as the skin ages, it loses its elasticity and ability to repair itself from the harmful effects of ultraviolet (UV) radiation. Sun damage can cause wrinkles, age spots, and skin cancer. The nurse would advise the older adult person to protect their skin from the sun by wearing sunscreen, hats, and clothing that covers the skin.

Choice B reason: Sweat gland activity increases is false because as the skin ages, it produces less sweat and oil, which can make the skin dry and prone to itching. The nurse would advise the older adult person to moisturize their skin regularly and avoid hot showers or baths that can dry out the skin.

Choice C reason: Skin becomes darker in unexposed areas is false because as the skin ages, it produces less melanin, the pigment that gives the skin its color. This can make the skin lighter and more sensitive to sunburn. The nurse would advise the older adult person to check their skin for any changes in color, shape, or size of moles or spots that could indicate skin cancer.

Choice D reason: Generous amounts of soap should be used for cleansing is false because as the skin ages, it becomes thinner and more fragile, and can be irritated by harsh chemicals or fragrances. The nurse would advise the older adult person to use mild, unscented soap and water for cleansing, and to pat the skin dry gently.

A. Isolated systolic hypertension B. Atrial fibrillation C. Renal insufficiency D. Stroke E. Cardiac disease

Correct Answer is ["B","C","D","E"]

Explanation

Choice A reason: Isolated systolic hypertension is not a result of end-organ damage from chronic hypertension, but rather a risk factor for it. Isolated systolic hypertension is a condition where the systolic blood pressure is elevated (>140 mmHg) while the diastolic blood pressure is normal (<90 mmHg). It is common in older adults due to the stiffening of the arteries, and can increase the risk of cardiovascular and cerebrovascular events.

Choice B reason: Atrial fibrillation is a result of end-organ damage from chronic hypertension. Atrial fibrillation is an irregular and often rapid heart rate that can cause poor blood flow and increase the risk of stroke and heart failure. Chronic hypertension can damage the heart muscle and the electrical system of the heart, leading to atrial fibrillation.

Choice C reason: Renal insufficiency is a result of end-organ damage from chronic hypertension. Renal insufficiency is a condition where the kidneys are unable to filter waste and fluid from the blood adequately. Chronic hypertension can damage the blood vessels and the nephrons of the kidneys, leading to renal insufficiency.

Choice D reason: Stroke is a result of end-organ damage from chronic hypertension. Stroke is a sudden interruption of blood supply to the brain, causing brain cell death and neurological deficits. Chronic hypertension can damage the blood vessels in the brain, making them prone to rupture (hemorrhagic stroke) or blockage (ischemic stroke).

Choice E reason: Cardiac disease is a result of end-organ damage from chronic hypertension. Cardiac disease is a broad term that encompasses various disorders of the heart, such as coronary artery disease, heart attack, heart failure, and cardiomyopathy. Chronic hypertension can damage the heart by increasing the workload and the oxygen demand of the heart, causing the heart to enlarge and weaken over time.

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You notice that your older adult male client frequently knocks his arm or hand against door frames or chair backs and then develops a purpura. What do you advise your client to do? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following is an important consideration about the skin of an older adult person?

Correct Answer is A

Explanation

Which are potential results of end-organ damage from chronic hypertension? (Select all that apply.)

Correct Answer is ["B","C","D","E"]

Explanation

Which condition is included in the diagnosis of chronic obstructive pulmonary disease (COPD)?

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