A nurse at a provider's office is collecting physical data from an older adult client. Which of the following images should the nurse identify as an example of an expected age-related change?

Answer and Explanation

The Correct Answer is D

A. Close-up of eyes with yellow sclera: Could indicate jaundice or liver dysfunction, which is not an expected part of aging and requires further evaluation.

B. Older adult man with a rounded back and head tilted forward: Suggests kyphosis, which can occur with aging but is usually linked to osteoporosis or vertebral fractures, not considered an inevitable, expected change.

C. Close-up of nose with a reddish-purple spot (possible bruise): Might result from trauma, coagulopathy, or medication side effects like anticoagulants, not a routine age-related change.

D. Hands with prominent veins, thin skin, and wrinkles: Thinning skin due to decreased subcutaneous fat. Wrinkles from reduced skin elasticity. Prominent veins due to loss of skin turgor and connective tissue. These are all normal physical findings in older adults.

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Correct Answer is C

Explanation

A. Wait for 4 hr before sending the specimen to the laboratory: Delaying the transport of stool specimens can affect test results by allowing bacterial growth or degradation of components. Specimens should be sent promptly or refrigerated if there is a delay.

B. Avoid collecting the specimen from areas of the stool that contain blood: If testing for occult blood or infection, areas with blood should be included because they provide important diagnostic information, so avoiding them is incorrect.

C. Transfer the specimen to a cup without it touching the outside of the container: Maintaining specimen integrity and preventing contamination is essential. The nurse should ensure the stool does not contact the outside of the container to avoid spreading pathogens and ensure accurate testing.

D. Collect at least 7.62 cm (3 in) of the client's stool: Collecting such a large amount is unnecessary; usually a smaller amount (about 1 inch or walnut size) is sufficient for testing, so this choice is incorrect.

A. Bear weight on the unaffected leg. B. Stand with the crutch tips against the feet. C. Hold the arms straight when walking. D. Keep the crutches at the level of the axillae.

Correct Answer is A

Explanation

A. Bear weight on the unaffected leg: In a three-point gait, the client bears weight only on the unaffected leg while advancing both crutches and the affected leg together. This gait pattern is used when one leg is non-weight-bearing or injured, ensuring safety and stability during ambulation.

B. Stand with the crutch tips against the feet: Crutch tips should be positioned about 6 inches to the side and slightly in front of the feet to provide a stable base of support. Placing crutches directly against the feet increases the risk of slipping and instability.

C. Hold the arms straight when walking: Arms should be slightly flexed at the elbows when holding crutches to absorb shock and reduce strain. Holding the arms straight can cause fatigue and reduce control during walking.

D. Keep the crutches at the level of the axillae: Crutches should be adjusted to about 1 to 2 inches (2.5 to 5 cm) below the axillae to prevent pressure on the nerves and blood vessels in the armpits, which could cause nerve damage or circulatory problems.

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A nurse at a provider's office is collecting physical data from an older adult client. Which of the following images should the nurse identify as an example of an expected age-related change?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to collect a stool specimen from a client for laboratory testing. Which of the following actions should the nurse take when collecting the specimen?

Correct Answer is C

Explanation

A nurse is reinforcing teaching with a client who has crutches regarding the use of the three-point gait. Which of the following instructions should the nurse include?

Correct Answer is A

Explanation

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