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Question Q: Which statement is true regarding dementia? Onset is sudden Condition worsens during the daytime. The effects of dementia are self-limited. Attention is not affected.

Question Q: As taste buds atrophy and lose sensitivity, which taste is the older adult less able to discern? Spicy and bland foods Salty, sweet, sour, and bitter tastes Hot and cold temps Moist and dry food

Question Q:

Answer A: Attention is not affected. Rationale: Patients with dementia experience no effect on their attention. Delirium, not dementia, is a state of reduced mental ability, severe enough to interfere with daily activities. Dementia starts slowly and is often unrecognized Dementia does not worsen either in the daytime or night. It lasts for months to years. Answer A: Salty, sweet, sour, and bitter tastes Rationale: As people age, salivary secretion is reduced, and taste buds atrophy and lose sensitivity. The older adult is less able to differentiate among salty, sweet, sour, and bitter tastes. Often an adult uses heavy spices because of the inability to taste food. Older adults maintain their ability to differentiate between hot and cold temps and moist and dry food. Answer A: Difficulty with abstraction. Rationale: A patient with dementia may face difficulty with abstraction. Incoherent speech and altered attention may be associated with delirium; however patients with dementia generally have normal attention. Misperceptions are usually absent in dementia. However in delirium, the patient may find it difficult to distinguish between reality and misperceptions.

Question Q:

Answer A: Reduced number of brain cells Rationale: Reduction in the number of brain cells is a characteristic feature of the normal aging process. Poor judgment, loss of language skills, and loss of the ability to calculate are not symptoms of cognitive impairment related to normal aging. These symptoms hint toward an underlying disease condition.

Question Q:

Answer A: Dry vagina, Reduced size of vagina Rationale: The production of estrogen in women declines with age, causing vaginal dryness, reduction in size and firmness of breasts. Aging also is associated with atrophy of the vagina, which here refers to reduction in size. Pubic hair is associated with anyone past puberty.

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Answer A: Sleep/wake cycle is disturbed Rationale: The onset of delirium is sudden or abrupt but not insidious. Alertness in delirium fluctuates and can be lethargic or hypervigilant, but not normal. Progression is abrupt, not gradual over months and years.

Question Q:

Answer A: Hearing

Rationale: Presbycusis is characterized by the presence of a loss of acuity for high-frequency tones and conversational speeches resulting from aging. It is a physiological sensory change. Sensory changes in the eyes include yellowing of the lens and altered color perception. Sensory changes in taste are characterized by fewer taste buds; in touch, caused by fewer skin receptors.

Question Q:

Answer A: Sight Rationale: Sensory changes in the eye are characterized by the presence of decreased accommodation to near or far vision, which is called presbyopia. Sensory changes in the ears - thickening of the tympanic membrane and sclerosis of the ear. Sensory changes of smell - diminished sense of smell. Taste - fewer taste buds.

Question Q:

Answer A: Agitation Rationale: Psychomotor disorientation, or agitation, is commonly seen in patients with depression. Apraxia is a clinical feature associated with dementia but no depression Patients with delirium have increased alertness (hypervigilance). However, the alertness in patients with depression is usually normal. Impaired orientation is associated with delirium, and patients with depression may h l ti di i t ti

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Answer A: Decreased ability to respond to stress

Rationale: Aging decreases the ability to respond to stress b/c the functional ability of the body declines with age, and hormone production is altered. Aging decreases insulin sensitivity b/c of reduced body weight. The thyroid gland becomes nodular with age, resulting in decreased thyroid secretions. Antiinflammatory hormones are increased in older adults b/c of degenerative changes in oxidative stress. Question Q:

Answer A: Increased chest wall rigidity

Rationale: Chest wall rigidity is increased in older adults; it becomes stiffer and more rigid as age progresses as a result of rib and cartilaginous calcification. The number of cilia decreases as age progresses. The number of alveoli is less, and the cough reflex decreases.

Question Q:

Answer A: The patient who has presbycusis Presbycusis refers to an age-related hearing impairment in older adults. THe nurse suspects that the patient who has been diagnosed with presbycusis will have difficulty hearing. Cataracts, macular degeneration, and presbyopia will affect vision.

Question Q:

Answer A: Prostatic hypertrophy Rationale: Difficulty initiating voiding and maintaining a consistent urinary stream may occur because of an enlarged prostate. Stress incontinence is usually seen in women, and the urine is released involuntarily during sneezing, coughing, and laughing because of stress on the urinary bladder. UTIs may not lead to an inconsistent urine stream. Weakened bladder muscles lead to urinary incontinence.

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Answer A: All older adults, whether healthy or frail, need to express sexual feelings. rationale: Secuality is normal throughout the life span, and older adults need to be able to express their sexual feelings. Even when a secual partner passes away, the survivor will still feel the need to epress secual feelings, even if it takes time. Not all older adults experience a decrease in labido. An outward expression of secuality is normal and does not indicate a developmental problem.

Question Q:

Answer A: Most are tolerant toward others. Rationale: Specialists in the field of gerontology consider older adults to have an optimistic outlook on life, a tolerance of others, and good memory recall. The US census bureau states that only 9.5% of older adults are poor, and most of them are well cared for, protected, and financially happy. It is a myth that most older adults are mentally unstable. Most have an intact memory and have more knowledge and experience.

Question Q:

Answer A: Calcification of the costal cartilage Rationale: Decreased mobility of the ribs is caused by calcification of costal cartilage. This occurs with aging. The curvature of the thoracic spine is known as dorsal kyphosis and is caused by vertebral change. A decrease in respiratory muscle strength and an increase in the anteroposterior diameter of the thorax are age-related problems caused by configurational changes in the thorax.

Question Q:

Answer A: They are active They are involved members of their communities rationale: Old age does not mean dependence and disability. The nurse should avoid generalizing and stereotyping. Most older adults are active and participate in activities. Only a small majority may be pessimistic because of an inability to care for themselves and make decisions concerning their needs.

Question Q:

Answer Gynecomastia Rationale: Gynecomastia, or enlarged breasts, is a disorder in men caused by a hormonal imbalance. Presbyopia is impaired vision not caused by hormones. Presbycusis is impaired hearing, and prostatic hypertrophy is enlarged prostate gland, but also not caused by hormonal imbalance.

Answer Diarrhea, Flatulence, Constipation Rationale: Alterations in the lower GI tract lead to diarrhea, flatulence, and constipation. B/c of aging, peristalsis movement becomes slow, and alterations in secretions occur. Alterations in the lower GI tract do not cause vomiting or gastric ulcers. Answer Getting up early in the morning with frequent arousals at night. Rationale: An older-adult patient with depression may have disturbed sleep at night and may wake early as a result of preoccupied personal thoughts and poor appetite. Delirium causes difficulty coping with daily activities (such as dressing), distraction with daily tasks. Dementia causes patients to get tired easily. Answer Drink a glass of milk daily, Eat one boiled egg in the morning. Rationale: Postmenopausal women have low levels of calcium in their body b/d of bone demineralizaion, which can increase osteoporosis. Therefore consuming foods rich in calcium is helpful. Though going for a walk, eating green leafy vegetables, and performing light exercises promote good health, these are less beneficial than high calcium intake in postmeopausal patients....