exam4

Which of the following is NOT a sign of possible mistreatment or abuse of an elderly person?

Person is brought for treatment by their usual caregiver

A nurse is conducting a second-level spiritual screen with an older client. Which of the following questions would be part of a second-level spiritual screening?

"How are your energy reserves holding up when you consider your health status at the present time?"

In 1960, 32.6% of the foreign-born population in the United States was age 65 or older. As of 2010, that percentage is

12.4

In a study of changes in sexual function associated with aging, ____ of men reported erectile dysfunctions (ED), which was the most common problem among men.

37%

Adult daycare centers provide supervised daily care in a nonresidential facility for the elderly and disabled. Approximately how many adult daycare centers are currently operating in the United States?

4,600

The pain of those in nursing homes is generally underappreciated, underreported, and undertreated. Research has shown that between ________ of nursing home residents have undertreated, substantial pain.

45% and 80%

Tolerance of opioids and physical dependence on opioids are not the same as addiction to opioids, but these three terms are often confused. Which of the following statements is TRUE of opioid addiction?

A pattern of compulsive drug use characterized by continued craving for an opioid and the need to use the opioid for effects other than pain relief

Which member of the interdisciplinary AD-LIFE team conducts the initial assessment of the older adult prior to his or her discharge from acute care?

APN

There are several options for non-life-prolonging care available to people who are at the ends of their lives and do not desire and cannot benefit from life-prolonging care. Which of the following is an example of life-prolonging care rather than non-life-prolonging care?

Acute care

Urge or stress incontinence in women can lead to vaginal infections and painful intercourse, the term for which is ________.

dyspareunia

The Patient Self-Determination Act (PSDA) is a federal law requiring healthcare providers to routinely make available information about advance directives to their patients. Which of the following advance directives is NOT a legally recognized document for indicating one's healthcare wishes?

Allow natural death (AND)

Which of the following people is most likely to be a victim of elder abuse?

An 80-year-old woman who has been recently widowed and has a long history of alcoholism. Her friends have stopped calling since she angrily refuses their offers to visit or take her out. She is insistent that she is independent and does not need company.

A large percentage of dying patients experience ________ in the last hours or days of life, characterized by fluctuating cognitive disturbance and changes in mental status over a short period of time. This can be very distressing to family members and friends.

Anxiety

What medical intervention should be carefully considered before use with a terminally ill patient because the problems and side effects associated with it can be worse than the help it provides?

Artificial hydration and nutrition

Vaginal dryness is traditionally treated with lubricants or with the oral or cream form of

estrogen

Which of the following is an electronic resource, providing materials through their website to help optimize the discharge process at any institution?

BOOSTing

One way that older couples can overcome the problem of _______ is to plan sexual activity for the time of day when they are most energetic.

fatigue

On occasion, a nurse may be confronted by an older adult who displays sexually inappropriate behavior. Which of the following is the correct response from the nurse in such a situation?

Confront the patient calmly and firmly, saying that the behavior is not appropriate.

Which of the following is a sign or symptom of neglect in an older person?

Dehydration and malnourishment

Which of the following is NOT one of the important questions to ask in the algorithm for choosing the proper end-of-life care provider?

Does the hospice have a special wing to separate those who will recover from those who are dying?

Which of the following is NOT a good way for older adults to reduce the potential for abuse?

Don't tell people that you are going to be traveling or where you are going.

Mrs. Keppler, an elderly woman with dementia, lives with her daughter, Linda, and Linda's husband and three children. Linda brings Mrs. Keppler to her medical appointment. The nurse notices that Mrs. Keppler appears clean, well fed, and well cared for. Linda has dark circles under eyes and speaks sharply to her mother when she makes a mistake answering a question. Which nursing intervention can help prevent a case of elder abuse from developing?

Encourage regular respite for the caregiver.

Which of the following is NOT a nursing intervention that can help prevent elder abuse?

Encourage the older person to trust no-one and to hide valuable papers and items.

There are significant health-related differences among the five major ethnic groups in the United States. Members of which of the following ethnic groups are LEAST likely to turn to religion or spirituality as coping or problem-solving mechanisms?

European Americans

In a systematic review of the literature on the primary prevention of HIV/AIDS in people age 50+, which of the following was NOT found as a major challenge to education in this area?

Peer education

An 82-year-old sits in her bedroom in her son's house by herself all day. Her son works long hours and is rarely home; he brings her meals on a tray in the morning and evening but hurries away to attend to his work rather than sit with her. She does not go out and nobody visits her. In this state of psychological or emotional neglect, she is at risk for what condition?

Failure to thrive

In the EPEC Project Module 2 six-step approach to communicating bad news, the first step is "Get started." What is the second step?

Find out what the patient knows

________ is a model of primary care that focuses on improving the quality of care for low-income seniors by the longitudinal integration of geriatric and primary care services across the continuity of care. It was developed by Dr. Steven Counsell and his colleagues in 2007.

GRACE

The ________ nurse curriculum includes training in such areas as promoting self-management, motivational interviewing, and patient-centered care planning, and techniques for visiting patients, as well as working with physicians and community resources.

Guided Care

Which of the following ethnic groups has recently become the second largest population demographic in the U.S.?

Hispanic Americans

Which of the following is NOT true regarding older adults and HIV?

Homosexual sex is the dominant mode of HIV transmission in older adults.

Which assessment includes three categories for a total of 15 questions, including "violation of personal rights or direct abuse," "characteristics of vulnerability," and "potentially abusive situation"?

Hwalek-Sengstock Elder Abuse Screening Test

Which of the following is a benefit to older adults of the Intergenerational Care model, such as Grand Families House in Dorchester, Massachusetts, or Hope Meadows in Rantoul, Illinois?

Increases emotional support

To identify the causes of nausea and vomiting in a terminally ill patient, it is helpful to use the acronym VOMIT, in which the letter I stands for ________.

Infection and inflammation

Mrs. Chin, a 79-year-old woman of Chinese heritage, is a resident in a nursing home. She has no dietary restrictions but usually doesn't eat much when meals are served. The nurse sees that her family has come for a visit and has brought many containers of home-cooked food, which Mrs. Chin appears to be enjoying. Which of the following would be appropriate for the nurse to say about it?

It looks like you're really enjoying these dishes. Which ones are your favorites?"

An interdisciplinary group or team (IDG/IDT) provides or supervises the care and services offered by a hospice, including ongoing assessment of the needs of the patient, the caregiver, and the family. Which of the following would be considered a complementary therapy provider rather than a primary IDG/IDT team member?

Massage therapist

Which of the following is NOT one of the three dimensions of spirituality?

Multipersonal

________ is a program of the Hartford Institute for Geriatric Nursing at New York University College of Nursing whose mission is to create better care environments for hospitalized older adults by improving nursing care.

NICHE

According to the Centers for Disease Control and Prevention National Center for Health Statistics, the leading causes of death for all five of the United States' major ethnic groups are diseases of the heart and malignant neoplasms. Which ethnic group is most likely to die of diabetes mellitus?

Native Americans

Which of the following is NOT one of the four pillars of Care Transitions Intervention (CTI)?

Non-pharmacological interventions whenever possible

Which of the following is not true about spirituality and the nursing profession?

Nurses are educated to share the personal faith and beliefs with all patients

Which program provides much-needed transportation services to and from the day center as well as to medical appointments as needed?

PACE

The "Three Rs" in detecting and reporting elderly abuse are ________.

Recognize, respond, report

A valuable non-pharmacological technique used in helping a terminally ill patient with dyspnea would be ________.

Relaxation techniques

Which study, conducted between 1989 and 1994, reported that nurses are often the first to recognize the impending death of a patient?

SUPPORT

Which assessment instrument can help measure the caregiver's as well as the patient's adjustments to aspects of the dying experience, but also those of the caregivers?

SWAT

Which of the following is not a general characteristic of perpetrators of elder abuse?

Social support

Most health promotion strategies can potentially make a positive impact on sexual relationships and sexual function. Which of the following is NOT a health promotion strategy?

Taking Viagra

Which of the following is a nursing strategy for older adults regarding HIV infection?

Target HIV prevention efforts to older adults.

________ uses an interdisciplinary team with expertise in geriatric care and training in prevention of geriatric syndromes along with environmental adaptations to support the elderly.

The Acute Care of the Elderly (ACE) Unit

Where once America was described with the metaphor of the "melting pot," where people from different cultures blended together to assimilate into the mainstream culture, what new metaphor describes today's immigrants, who maintain aspects of their original culture while also participating in mainstream culture?

Tossed salad

Which model uses APNs with experience caring for older adults to provide discharge planning and home interventions for older adults who have been hospitalized?

Transitional Care Model

The first premise of the Money Follows the Person (MFP) initiative is that older people living in long-term care facilities would prefer to return to the community. What is the second premise?

Transitioning these individuals back into the community would cost Medicare less than it currently pays for their institutional care.

The introduction of sildenafil in 1998, followed by vardenafil and tadalafil, changed the norms for sexual dysfunction. Sildenafil is the generic name for ________.

Viagra

An elderly man who has always had a difficult temperament lives in a different state from either his daughter or son. He has a room in the home of a middle-age couple, who attend to his needs. His daughter checks in regularly by telephone and thinks well of the couple. After the elderly man's death, the daughter discovers that the couple has systematically taken all of the man's money. This is a case of ________.

Violation of personal rights

What percentage of the older U.S. population will eventually need some level of assistance or health care?

Virtually all

A single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person" is the definition of elder abuse according to ________.

WHO

Which of the following questions would NOT be appropriate to ask as part of a first-level spiritual screening?

When is the last time that you went to church?"

Who said, "When a person is born we rejoice, and when they're married we jubilate, but when they die we try to pretend nothing happened."?

Woody Allen

In the past, Americans often lived in multigenerational households and frequently died at home, especially in rural areas. Since the end of _______, with the increased ability to cure illness and prolong life, dying increasingly happened in a hospital setting, away from the comforts of home and family.

World War II

Sexually inappropriate behavior on the part of an elderly resident of a long-term care facility may reflect a loss of inhibition due to cognitive impairments, ________, or a combination of factors.

a power issue

The ________ model of human sexual response includes desire, excitement, and orgasm.

triphasic

Both erectile dysfunction and vaginal dryness may be early signs of the following diseases EXCEPT ________.

amyotrophic lateral sclerosis

According to an AARP survey conducted in 2004, sexuality was identified as ________ part of life by respondents age 45 and older.

an essential

Mrs. Welk is moving into an independent handicap-accessible apartment with grab bars in the bathrooms and a wall-mounted emergency home response system. She will have access to personal services such as help with her activities of daily living, managing her medications, housekeeping services, and trained medical staff. She will join other residents for meals, encouraging socialization. Mrs. Welk is moving into a(n) ________.

assisted living facility

Healthcare organizations are required to provide translation services for patients with limited English proficiency, and failing to provide adequate interpretation is considered a form of

discrimination

The Eden Alternative is based on the principle of the "three plagues" facing older adults. Which of the following is NOT one of the "three plagues"?

chronic illness

If an elderly patient shows signs of depression, delusions, or poor health, and is socially isolated, the nurse should consider that person as likely to benefit from _________ to prevent elder abuse.

further assessment

The goal of grieving is NOT to ________, as much of society encourages, but to figure out how to go on living without the loved one actively present in one's life.

get over it

By paying attention to and assessing the client from the perspectives of body, mind, and spirit, the nurse is addressing the client in a(n) ________ way.

holistic

Persons who do not maintain adequate physical hygiene, have a poor diet, miss medical appointments, mismanage medication, and don't follow-up with prescribed medical care are considered to be ________.

in a state of self-neglect

The idea that all people need spirituality as a way to provide meaning in their lives, and the idea that spirituality must be tied to formal religious beliefs, are both described in the chapter as

myths

Mr. Ebert is an older man who has been moved to a nursing home for rehabilitation following a stroke. The nurse conducts a spiritual assessment and determines that it would be a good idea to focus on the second dimension of spirituality to strengthen Mr. Ebert's energy levels. To that end, the nurse

schedules visit from Mr. Ebert's family and friends

Healthcare professionals tend to ignore patient's concerns about sexuality and intimacy. One reason is that sexuality is not _______ for the patient.

seen as a priority

Displaying sexually explicit materials in a public place or where others are likely to see them is considered ________.

sexual harassment

The elderly most at risk for abuse are those in a(n) ________ living situation.

shared

For patients who are home-bound, Medicare may pay for ________ services to be provided in the home.

skilled nursing

Assisted living facilities (ALFs) are residential facilities that provide assistance and monitoring of older adults who can no longer live independently but who do not need 24-hour skilled nursing home care. In the United States, ALFs are regulated and licensed at the ________ level.

state

When a nurse obtains admission information on the status of the client's body, mind, and spirit, two important messages are relayed to the older client. First, that the human spirit is an important part of the client's health, and second, that

the nurse is available and interested in helping the client work to improve his health status

Laws about reporting elder abuse ________.

vary from state to state