GERO FINAL

Is the following statement true or false? Secondary symptoms of PD include depression, sleep disturbances, dementia, drooling, and dysphagia.

True Rationale: Secondary symptoms of PD include depression, sleep disturbances, dementia, forced eyelid closure, drooling, dysphagia, constipation, shortness of breath, urinary hesitancy, urinary urgency, and reduced interest in sex.

Is the following statement true or false? Quantity and quality of sleep can determine an older adult's health and well-being.

True Rationale: Sleep is a factor that affects health and well-being, as inadequate quality or quantity of sleep is associated with risks to physical and mental health.

Is the following statement true or false? Room temperatures less than 70°F can lead to hypothermia in an older adult.

True Rationale: The older the person is, the narrower the range of temperatures tolerated without adverse reactions. Recommended room temperature for the older adult should not be lower than 75°F.

Is the following statement true or false? Nearly all women are affected by some degree of osteoporosis by the time they reach their seventh decade of life.

True Rationale: The risk of bone loss is increased by estrogen deficiency, obesity, inactivity, smoking, and the excessive consumption of caffeine and alcohol. By the age of 70, most women have some degree of osteoporosis.

Nurses who understand their own mortality are more comfortable helping individuals through the dying process.

True Rationale: Understanding one's own mortality can be therapeutic to the nurse personally, as well as helpful in the care of dying patients.

Is the following statement true or false? A protein and carbohydrate snack at bedtime may encourage sleep.

True Rationale: Foods high in carbohydrates tend to raise the serotonin levels in the brain, which could have a sedating effect and may promote sleep.

Which of the following best describes a drop attack? a. Fall caused by flaccidity in the legs b. Fall caused by loss of consciousness c. Fall caused by incontinence d. Fall caused by mental instability

A. Fall caused by flaccidity in the legs Rationale: A drop attack is a fall caused by a complete muscular flaccidity in the legs, without an alteration in consciousness.

There are several types of dysphagia. Which type results when there is difficulty moving food from the mouth to the esophagus? Transfer dysphagia Transport dysphagia Delivery dysphagia Digestion dysphagia

A. Transfer dysphagia Rationale: Difficulty moving food from the mouth to the esophagus is transfer dysphagia, down the esophagus is transport dysphagia, and from the esophagus into the stomach is delivery dysphagia.

What are the stages of dying?

1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance Hope - commonly permeates all stages, source of motivation

Which of the following is a normal age-related change of the nervous system? Decline in the weight of the brain Increase in cerebral blood flow Stages I and II sleep are interrupted Higher nerve conduction velocity

A. Decline in the weight of the brain Rationale: There is a decline in brain weight and a reduction in blood flow to the brain. Stages III and IV sleep become less prominent. Nerve conduction velocity is lower, which causes slower reflexes and delayed response to multiple stimuli.

Which statement is false related to the use of restraints with the older adult population? a. Nonuse of physical restraints can cause injury. b. Use of restraints can be reduced without the effect of injury. c. Restraints can be physical or chemical. d. One-to-one supervision is an alternative to restraint use.

A. Nonuse of physical restraints can cause injury. Rationale: Evidence now exists that the use of physical restraints can be significantly reduced without increasing staffing or injuries; therefore, nonuse of physical and chemical restraints is a standard that nurses should promote in all settings.

Which of the following describes somatic pain? a. Well localized, throbbing, or aching b. Generalized or referred pain c. Sharp, stabbing, or burning d. Abrupt onset, lasting a short time

A. Well localized, throbbing, or aching Rationale: Somatic pain is characteristic of pain in the bone or soft tissue and is well localized and described as throbbing or aching.

Is the following statement true or false? Older adults are more sensitive to the extrapyramidal effects of antipsychotic drugs that include tardive dyskinesia, parkinsonism, akinesia, and dystonia.

True Rationale: Older adults who are receiving antipsychotic medications are at a higher risk for the anticholinergic and extrapyramidal effects of this classification of medications.

Which of the following medications should be used cautiously as a sleep aid with an older adult related to the high risk of anticholinergic side effects? a. Alprazolam (Xanax) b. Diphenhydramine (Benadryl) c. Furosemide (Lasix) d. Gabapentin (Neurontin)

B. Diphenhydramine (Benadryl) Rationale: Many of the top nonprescription sleep aids contain diphenhydramine (Benadryl) as a primary ingredient; because Benadryl carries a high risk of anticholinergic side effects in older adults, these should be avoided.

Is the following statement true or false? The physical appearance of an older adult can clearly identify those who are in a malnourished state.

False Rationale: The appearance of older people can be misleading and delay the detection of a malnourished state. Measurement of weight, serum albumin levels, and hemoglobin and hematocrit assists in the identification of malnutrition.

'Asset rich and cash poor' relates to which of the following statements regarding to older adults? A. Net worth of older adults is half the national average of middle-age adults. B. Homes are paid for, but there is not enough money available for monthly expenses. C.The majority of older adults live below the poverty level. D. Financial problems in the older adult population are due to level of debt.

B Homes are paid for, but there isn't enough money available for monthly expenses

Placement of chairs to facilitate social activity would best be accomplished by a. Four chairs together in a small room b. A cluster of chairs in an area where there is activity c. Chairs close to a patient's bed d. Several chairs near the end of a hallway

B. A cluster of chairs in an area where there is activity Rationale: The placement of chairs in clusters or in busy but not heavily trafficked areas is conducive to interaction and involvement with a larger world.

Which nursing intervention is appropriate for the dying person who is in the stage of denial? a. Focus on the conflicting messages that dying people often demonstrate b. Acceptance of the dying individual's reaction c. Suggest that the patient aggressively seeks a second opinion d. Assist in the denial of the reality of impending death

B. Acceptance of the dying individual's reaction Rationale: Perhaps the most important nursing action during the stage of denial is to accept the individual's reactions and to provide an open door for honest dialogue.

Which statement best describes the autoimmune theory of aging? A. Genetic programs determine life expectancy. B. Cells undergo change, and the body identifies them as foreign. C. Organs decline as a result of cellular mutations. D. Failure of the production of a growth substance causes aging cells to die.

B. Cells undergo change, and the body identifies them as foreign. Rationale: One hypothesis regarding the role of autoimmune reactions in the aging process is that the cells undergo changes with age, and the body misidentifies these aged, irregular cells as foreign agents and develops a plan to attack them.

Which statement is true related to acetaminophen (Tylenol)? a. Used for moderate to severe pain b. Lacks anti-inflammatory activity c. Daily dose not to exceed 2,000 mg d. Safe use in people with liver disease

B. Lacks anti-inflammatory activity Rationale: Although acetaminophen does not have anti-inflammatory activity, it is commonly used in the treatment of osteoarthritis. Acetaminophen is used for mild to moderate pain, and the daily dose should not exceed 4,000 mg. It should not be used for people who have liver disease.

Which intervention is most appropriate when caring for a dying patient who is experiencing pain? a. Assess pain every 8 hours b. Prevent pain from developing c. Utilize morphine for any type of pain d. Minimize the pain response of the confused

B. Prevent pain from developing Rationale: For the dying patient, the goal of pain management is to PREVENT pain from developing rather than to treat it once it occurs.

Which of the following statements best describes Creutzfeldt-Jakob disease? a. Neuronal atrophy of the frontal lobes of the brain b. Rare disease with a rapid onset and progression of the disease to death c. Behavioral rather than cognitive impairments in the early stages d. Caused by cerebral infarctions and history of cardiovascular disease

B. Rare disease with a rapid onset and progression of the disease to death Rationale: Creutzfeldt-Jakob disease is an extremely rare brain disorder that causes dementia. It has a rapid onset and progression and is characterized by severe neurological impairment that accompanies the dementia. The disease progresses rapidly, and death typically occurs within 1 year of diagnosis.

Which of the following statements is true related to alcoholism and the older adult? a. Alcoholism is easily treated in the older adult. b. There is a decreased incidence of alcoholism with age. c. Health care professionals can easily detect alcoholism in an older adult. d. The long-term goal for the older adult with alcoholism is limited alcohol intake.

B. There is a decreased incidence of alcoholism with age Rationale: Most older adults who are alcoholics are chronic EtOH abusers who have used it heavily throughout their lives. A significant number of chronic abusers die before reaching old age, contributing to a decreased incidence of alcoholism with age.

Mr. D. suffers from late-stage dementia. Which behavior best indicates that he is in pain? a. Self-report of pain b. Family stating that he is in pain c. Agitation and decreased socialization d. Wandering behavior

C. Agitation and decreased socialization Rationale: Patients with cognitive impairments present special challenges to pain assessment and nurses must assess for nonverbal signs of pain or discomfort.

Which statement best describes a belief usually held by most Jewish Americans? A. Life-sustaining or support measures are denied. B. Sundown Saturday to sundown Sunday is the practiced day of Sabbath. C. Autopsy is usually opposed. D. Modern medical care is discouraged.

C. Autopsy is usually opposed. Rationale: Specific rituals may be practiced at death, such as members of the religious group washing the body and sitting with it until burial, but autopsy is usually opposed.

Is the following statement true or false? The rate of completed suicide among older persons is the lowest of any age group in the United States.

False Rationale: The rate of completed suicide among older persons continues to be the highest of any age group in the United States, with nearly ¼ of all suicides committed by persons aged 65 years and older.

Which of the normal age-related changes in the respiratory system can increase the risk of infection in the older adult population? A. Decrease in the anterior-posterior diameter of the chest. B. Increased strength of the thoracic musculature. C. Increase in residual volume and reduction in vital capacity. D. Decreased calcification of costal cartilage.

C. Increase in residual volume and reduction in vital capacity. Rationale: As residual volume increases, the vital capacity is reduced and maximum breathing capacity decreases, placing older adults at high risk for developing respiratory infections.

Which statement best describes the changes in the stages of sleep that occur with aging? a. Increase in REM sleep b. Increase in NREM sleep c. More shifts into stage I sleep d. More time in stages III and IV sleep

C. More shifts into stage I sleep Rationale: Older adults demonstrate reductions in NREM and REM sleep, more shifts into stage I sleep, and a decline in the proportion of time spent in the deeper stages III and IV sleep.

Which factor is utilized to determine caloric intake for older adults using the Harris-Benedict equation? A. Age and height B. Age and weight C. Age, height, and weight D. Age, height, weight, and gender

D. Age, height, weight, and gender Rationale: One useful way to determine resting caloric needs that considers age, height, weight, and gender is the Harris-Benedict equation, also called the resting energy expenditure.

Which medication, commonly used for pain, is contraindicated in the older adult related to potential side effects? a. Acetaminophen (Tylenol) b. Oxycodone (Percocet) c. Fentanyl (Duragesic) d. Propoxyphene (Darvocet)

D. Propoxyphene (Darvocet) Rationale: Propoxyphene (Darvocet) is contraindicated for older adults, because it does not offer any added benefits but has the potential for central nervous system and cardiac toxicity.

Which of the following classifications of antidepressant medications have the most side effects in the older adult population? a. Monoamine oxidase inhibitors b. Selective serotonin reuptake inhibitors c. Serotonin antagonists d. Tricyclic antidepressants

D. Tricyclic antidepressants Rationale: Although popular, tricyclic antidepressants have side effects that can pose risks to older adults, such as anticholinergic effects, orthostatic hypotension, and arrhythmias, especially in patients with cardiovascular disease.

Is the following statement true or false? The genetic theories of aging best describe how and why a person ages.

False Rationale: No single factor causes or prevents aging; therefore, it is unrealistic to think that one theory can explain the complexities of the aging process.

Is the following statement true or false? Cerebral blood flow decreases by 50% in older adults.

False Rationale: Cerebral blood flow decreases about 20% as fatty deposits gradually accumulate in the blood vessels. Decreases are even greater in persons with small-vessel cerebrovascular disease due to diabetes and hypertension; this contributes to an increased risk of strokes.

Is the following statement true or false? The onset of behavioral problems in a person with dementia indicates the need for medications to suppress the behavior problem identified.

False Rationale: Consideration must be given to the potential inability of the older adult with dementia to communicate their needs and discomforts. A subtle change in behavior or function, a facial grimace, or repeated touching of a body part may give clues that a problem exists. The underlying cause must be determined.

Is the following statement true or false? It is not appropriate for nurses to pray with dying patients and their families.

False Rationale: If nursing staff feel comfortable with religious and spiritual practices of the patient, they can offer to pray with patients or read to them from religious texts. Nurses should ensure that prayers offered are consistent with the patient's belief system.

Is the following statement true or false? Signs and symptoms of a transient ischemic attack can last for several days and complete recovery is usual within 1 week.

False Rationale: Signs and symptoms of a TIA (hemiparesis, hemianesthesia, aphasia, unilateral loss of vision, diplopia, vertigo, nausea, vomiting, and dysphagia) depend on the location of the area of ischemia and can last from minutes to hours and complete recovery is usual within 1 day.

Is the following statement true or false? Decreased intracellular fluid, increased gastric pH, decreased gastric blood flow and motility, reduced cardiac output and circulation, and slower metabolism can slow drug absorption.

Is the following statement true or false? Decreased intracellular fluid, increased gastric pH, decreased gastric blood flow and motility, reduced cardiac output and circulation, and slower metabolism can slow drug absorption.

Is the following statement true or false? Rather than cease driving altogether, some older adults may find it useful to restrict their driving to daylight hours, noncongested areas, and good weather.

True Rationale: Nurses should assist older drivers in identifying risks to safe driving and encourage them to evaluate their continued ability to drive safely. Modifications can be made that allow older adults to continue to be safe drivers.

Which of the following classifications of antibiotics requires close monitoring for hearing loss and renal failure? a. Aminoglycosides b. Penicillins c. Fluoroquinolones d. Cephalosporins

Rationale: Aminoglycosides (amikacin, gentamicin, and tobramycin) require close monitoring due to the risk of hearing loss and renal failure.

What was the first significant step in improving the lives of older adults?

The passage of Federal Old Age Insurance Law under the Social Security Act in 1936

Is the following statement true or false? Atrophy of the small and large intestine, with fewer cells present on the absorbing surface of the intestinal wall, causes certain vitamins and minerals to have a decreased rate of absorption.

True Rationale: Absorption of vitamin B, vitamin B12, vitamin D, calcium, and iron is decreased in the intestine of the older adult.

Is the following statement true or false? There is a lower life expectancy of Black Americans; however, once a black individual reaches the seventh decade of life, survival begins to equal that of a similarly aged white person.

True Rationale: After reaching the seventh decade of life, black older adults can hope to enjoy a life expectancy equal to that of their white counterparts.

Is the following statement true or false? Mean body temperatures of the older adult range from 96.9°F to 98.3°F orally.

True Rationale: Normal body temperatures are lower later in life than in younger years.

Is the following statement true or false? One powerful means to improve nursing care for individuals of different cultures is to learn about cultural influences by asking patients to describe their life stories.

True Rationale: Nurses will be more able to convey sensitivity and caring when they try to recognize and support patients' ethnic and cultural backgrounds.

Is the following statement true or false? Persons who have experienced a cerebrovascular accident may experience depression and irritability toward others.

True Rationale: Personality changes often accompany neurologic problems. Patients may become depressed as they realize their limitations and become frustrated by their need to be dependent on others. Their reactions may be displaced and evidenced by irritability toward others, often their loved ones or immediate caregivers.

Is the following statement true or false? The continuity theory of aging states that personality and basic patterns of behavior are said to remain unchanged as the individual ages.

True Rationale: The continuity theory of aging relates personality and predisposition toward certain actions in old age to similar factors during other phases of the life cycle. For instance, activists at 20 years of age will most likely be activists at 70 years of age.

Is the following statement true or false? An understanding of cultural and ethnic differences can help erase the stereotypes and biases that can interfere with effective care and assist in the demonstration of an appreciation for the unique characteristics of each individual.

True Rationale: The growing diversity of the older population presents challenges for erotological nursing in providing culturally competent care. Essential to the provision of culturally competent care is an understanding of cultural and ethnic differences to help erase stereotypes.

Is the following statement true or false? Several coexisting factors can be responsible for a delirium.

True Rationale: As older adults often have multiple health conditions, it is important to remember that several coexisting factors can be responsible for a delirium.

Is the following statement true or false? The first nursing intervention necessary to address problem behaviors in the older adult population is assessment.

True Rationale: Assessing the cause of the behavior is the first step in assisting the patient who displays behavioral problems. Factors associated with the behavior should be closely observed and documented.

Is the following statement true or false? Chronic disorders most prevalent in the older adult population are ones that can have a significant impact on independence and the quality of life.

True Rationale: Chronic illness is a major problem for the older population and results in limitations in ADLs, IADLs, and quality of life.

Is the following statement true or false? The incidence of major depression declines with age, but the rate of minor depression increases with age.

True Rationale: Depression is the most frequent problem that psychiatrists treat in older adults. Major depression declines with age while minor depression increases in incidence with age.

Is the following statement true or false? Varying degrees of mental dysfunction are often the early signs of adverse reactions to commonly prescribed medications for older adults.

True Rationale: Even the most subtle changes in mental status could be linked to a medication and should be reviewed with a member of the healthcare team.