A nurse is assessing an older adult client.
Which of the following findings should the nurse expect?
Increased sensitivity to touch.
Increase in cerumen in the ear canal.
Increased peripheral vision.
Increase in size of pupils.
The Correct Answer is B
Choice A rationale:
Increased sensitivity to touch is not typically an age-related change in older adults. In fact, older adults often experience a decrease in sensitivity due to factors like reduced skin elasticity and changes in nerve function.
Choice C rationale:
Increased peripheral vision is not a common age-related change. Visual changes in older adults usually involve decreased visual acuity, difficulties with night vision, and increased sensitivity to glare.
Choice D rationale:
An increase in the size of pupils is not an expected age-related change. Pupils may become smaller and react more sluggishly to changes in light in older adults, but a consistent increase in pupil size is not a common finding.
Choice B rationale:
An increase in cerumen in the ear canal is a common age-related change. Cerumen, or earwax, can accumulate more in older adults due to changes in the composition of earwax and slower migration of earwax out of the ear canal. It can lead to hearing difficulties and may need management. Moving on to the last question.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice B rationale:
Acute pain is typically associated with a sudden injury or condition, and it is usually short-term and self-limiting. Phantom limb pain is a chronic condition that is often neuropathic in nature.
Choice C rationale:
Cancer pain is generally associated with the presence of a tumor or cancer-related treatment. Phantom limb pain is not directly related to cancer.
Choice D rationale:
Chronic pain is a broad category that includes various types of long-lasting pain, but in the case of phantom limb pain, it is specifically neuropathic in nature. Neuropathic pain originates from damage or dysfunction of the nervous system and is a common characteristic of phantom limb pain. .
Correct Answer is A
Explanation
Choice A rationale:
Administering IV medication via an oral route is a medication error and should be reported.
Choice B rationale:
A client vomiting their morning medications is an adverse event, but not all adverse events require an incident report. The nurse should assess the situation and report if it poses a risk to the patient's health.
Choice C rationale:
Administering a lipid-lowering medication to a client one hour after the scheduled time is a medication error, but again, the need for an incident report depends on the potential harm to the patient. In some cases, reporting this incident may be necessary.
Choice D rationale
An allergic reaction can occur in clients with no known drug allergies. Unless a drug was given in known allergies, it does not require an incident report.
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