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A 65-year-old man has smoked tobacco most of his adult life.When planning health promotion education for him, the nurse includes information that such smoking:


A) may produce alterations in his immune response.
B) is a risk factor for community-acquired pneumonia.
C) decreases the production of an immunoglobulin called IgA.
D) increases his risk of gastric cancer.

E) A) and B)
F) A) and C)

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To educate clients on health promotion measures to minimize the effect of normal age-related changes in immunity, the geriatric nurse:


A) describes the effects of low-dosage antibiotic therapy on opportunistic infections.
B) reinforces the usefulness of lymphocyte counts to detect new infections.
C) discusses the need for yearly flu immunization.
D) stresses the importance of maintaining intact skin and mucous membranes.

E) C) and D)
F) A) and B)

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An older adult client who is generally in good health starts experiencing numerous colds and now pneumonia.What factor from her nursing history most likely has placed her at increased risk for the development of these infections?


A) A beloved pet died 6 months ago.
B) She was diagnosed with osteoarthritis 5 years ago.
C) She worked as an oncology nurse before retiring.
D) Her husband is immunosuppressed.

E) All of the above
F) C) and D)

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The nurse caring for a cognitively impaired older adult admitted to an acute care facility best minimizes this particular client's risk for developing a nosocomial infection by:


A) proper hand washing prior to each client contact.
B) admitting the client to a private room.
C) assigning staff to assist the client with eating meals.
D) screening visitors to minimize contract with pathogens.

E) B) and D)
F) C) and D)

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C

The nurse caring for an older adult client currently receiving traditional drug therapy for methicillin-resistant Staphylococcus aureus ( MRSA ) recognizes that the client is at risk for developing:


A) Clostridium difficile infection.
B) vancomycin-resistant Enterococcus ( VRE ) infection.
C) autoimmune hepatitis.
D) systemic lupus erythematosus.

E) A) and B)
F) A) and C)

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The geriatric nurse identifies the client with the greatest risk of immunosuppression as:


A) having a roommate infected with MRSA.
B) having numerous oral mucosal ulcers.
C) receiving treatment for rheumatoid arthritis.
D) being cognitively impaired.

E) All of the above
F) B) and C)

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C

An immunosuppressed older adult client reports symptoms of fatigue, facial rash, intermittent low-grade fever, and painfully swollen finger joints.The nurse anticipates that diagnosis will be confirmed by:


A) the presence of subcutaneous nodules on the hands.
B) a positive antinuclear antibody ( ANA ) blood serum test.
C) a liver biopsy that confirms cirrhosis.
D) the presence of bilateral ocular scleritis.

E) A) and D)
F) A) and C)

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The nurse caring for an older adult client being treated for influenza is especially careful to monitor and document assessment data related to:


A) cognitive function.
B) respiratory function.
C) fluid intake.
D) urinary output.

E) B) and C)
F) All of the above

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The geriatric nurse caring for the older female immunosuppressed client is particularly concerned when the client reports which of the following? Select all that apply.


A) Flulike muscle aching
B) Burning upon urination
C) Nausea
D) Night sweats
E) Constipation

F) D) and E)
G) C) and D)

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An older adult client is experiencing problems with chewing while recovering from extensive oral surgery.The nurse best affects this client's risk for infection by:


A) ordering a mechanical soft diet for the client.
B) monitoring the client regularly for any low-grade fever.
C) providing regular oral care with an antibiotic mouthwash.
D) asking which flavors of protein supplement drink he would prefer.

E) None of the above
F) B) and C)

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The nurse preparing an educational facts sheet on human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome AIDS for older adults includes reference to which of the following? Select all that apply.


A) Tainted blood transfusions are the greatest risk factor.
B) Delayed recognition of HIV contributes to its poor prognosis.
C) Twenty-five percent of AIDS cases in the United States are in persons older than 60 years of age.
D) There is a short interval from HIV infection to AIDS in older adults.
E) HIV and AIDS cases in this age cohort have stabilized in the last 15 years.

F) A) and B)
G) All of the above

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B, D

The nurse caring for an older adult client engages in appropriate cancer-related health screening when which of the following occur? Select all that apply.


A) Preparing a client for a lung biopsy
B) Collecting a 24-hour urine specimen
C) Assisting a client schedule a mammogram
D) Drawing blood for a prostate sensitive antigen ( PSA ) test
E) Keeping a patient NPO for a scheduled colonoscopy

F) C) and D)
G) B) and C)

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A client who is currently being treated for rheumatoid arthritis exhibits symptoms suspicious of tuberculosis ( TB ) .The nurse anticipates that:


A) the symptoms are a result of the client's rheumatoid arthritis.
B) the symptoms are actually side effects of corticosteroid therapy.
C) a chest radiograph will definitively confirm a diagnosis of TB.
D) a purified protein derivative ( PPD ) skin test will likely be negative.

E) B) and C)
F) A) and D)

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