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: A shortened warning time between the desire to void and actual micturition is a common sign of urinary incontinence in older adults. It is caused by the decreased bladder capacity, increased bladder irritability, and reduced urethral resistance that occur with aging.

Choice B reason: The first urge to void occurs at the midbladder volume (250-350 mL) is not a correct answer, as this is the normal bladder sensation for adults of all ages. It does not indicate urinary incontinence.

Choice C reason: Diarrhea is the most common gastrointestinal complaint made to the health care provider is not a correct answer, as it is not related to urinary incontinence. It is a separate condition that affects the bowel movements.

Choice D reason: Constipation as a symptom of altered bladder functions is not a correct answer, as it is not a direct cause or effect of urinary incontinence. However, constipation can worsen urinary incontinence by increasing the pressure on the bladder and pelvic floor muscles.

Choice E reason: None of the above is not a correct answer, as there is one choice that is true for urinary incontinence in older adults.

A. Sudden onset of symptoms B. Atrial fibrillation C. Cold intolerance D. Constipation E. Heart failure

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

Explanation

Choice A reason: Sudden onset of symptoms is a sign of hyperthyroidism, as it indicates a rapid increase in thyroid hormone levels that can cause a thyroid storm, a life-threatening condition that requires immediate medical attention. Symptoms of a thyroid storm may include fever, agitation, confusion, sweating, nausea, vomiting, diarrhea, and chest pain.

Choice B reason: Atrial fibrillation is a sign of hyperthyroidism, as it indicates an irregular and fast heartbeat that can result from the excess stimulation of the heart by thyroid hormones. Atrial fibrillation can increase the risk of blood clots, stroke, and heart failure.

Choice C reason: Cold intolerance is not a sign of hyperthyroidism, but rather a sign of hypothyroidism, a condition where the thyroid gland produces too little thyroid hormone. Cold intolerance means feeling cold even in warm environments, due to the reduced metabolic rate and heat production.

Choice D reason: Constipation is not a sign of hyperthyroidism, but rather a sign of hypothyroidism, a condition where the thyroid gland produces too little thyroid hormone. Constipation means having difficulty passing stools, due to the slowed intestinal motility and digestion.

Choice E reason: Heart failure is not a sign of hyperthyroidism, but rather a complication of hyperthyroidism, a condition where the thyroid gland produces too much thyroid hormone. Heart failure means the inability of the heart to pump enough blood to meet the body's needs, due to the increased workload and damage to the heart muscle.

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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

You realize that your client's bladder functions are only slightly altered by the physiological changes of age. What might you expect if an older person is experiencing urinary incontinence?

Correct Answer is A

Explanation

The nurse is caring for a client diagnosed with hyperthyroidism. Which signs and symptoms indicate hyperthyroidism? (Select all that apply.)

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

Explanation

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.)

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