Gnur 290 exam 1

A gerontological nurse has been providing ongoing care for an older adult who has a diagnosis of dementia. What goal should the nurse prioritize when conducting ongoing assessment of this client? A. Identify strategies used to cure the client's dementia. B. Identify factors affecting the client's functioning and quality of life. C. Identify genetic or lifestyle factors that may have contributed to the client's dementia. D. Determining whether the client has Alzheimer's disease, Lewy body dementia, or Frontotemporal lobe dementia.

B. Identify factors affecting the client's functioning and quality of life.

An older adult client is on broad-spectrum antibiotics for sepsis. The client has a history of rheumatoid arthritis and a recurring problem with pneumonia. Which theory best explains why the client has had these issues? A. Genetic theory B. Immunity theory C. Free radical theory D. Wear-and-tear theory

B. Immunity theory

A nurse hears a colleague make the statement, "The majority of older adults have nothing to worry about financially." Which response is most appropriate? A. "You have to remember that there's a huge economic disparity among older adults." B. "Actually, the number of older people living below the poverty line has ben increasing, not decreasing." C. "This isn't really true now, but it is true that the gaps that disadvantaged groups live with are expected to shrink." D. "This is true for some groups but not for minorities, who are less likely to be living with their relatives."

A. "You have to remember that there's a huge economic disparity among older adults."

A nurse assess the risk of the members of an older adult community. Which individual is most likely to be living at or below the poverty line? A. An 83 year-old single woman B. A couple who are both 72 years old C. A White 73 year-old man D. A Hispanic couple who are both in their 60s

A. An 83 year-old single woman

The child of an older adult client asks the nurse about vitamins, antioxidants, and age-related macular degeneration. Which theory of aging is the most appropriate to this topic? A. Free radical theory B. Immunosenescence theory C. Program theory D. Wear-and-tear theory

A. Free radical theory

An older adult client is depressed that a primary care provider referred the client for a driving evaluation because the client experiences vision problems and slower reaction time. Of the following concepts, which best illustrates this scenario? A. Risk factors B. Age-related changes C. Positive functional consequences D. Wellness outcomes

B. Age-related changes

A client diagnosed 3 years ago with a cognitive impairment worsened and recently died. An autopsy revealed numerous infarcted brain regions resulting from vessel occlusions. The client most likely suffered from which condition? A. Alzheimer's disease B. Vascular dementia C. Lewy body dementia D. Frontotemporal dementia

B. Vascular dementia

A home care nurse assesses the home environment of an older adult client. Which environmental condition positively affects the functioning and quality of life for the client? A. The client shares a bathroom with a teenager. B. The client has thick shag carpeting in the home. C. The client's home has large south-facing windows with blinds. D. The client's 2-year old great grandchild plays in the living room

C. The client's home has large south-facing windows with blinds.

A nurse uses the Functional Consequences Theory to assess older adults. Which situation best demonstrates the effect of physical environment on the older adult? A. A resident of a care facility experiences a fall because there are not grab bars outside the bathtub. B. An older adult cannot afford a wheeled walker and suffers a fall while trying to ambulate using a cane. C. An assisted living resident requires care for emphysema that resulted from a 70 year history of cigarette smoking. D. A hospital client develops Clostridium difficile-related diarrhea because a care provider did not perform adequate handwashing.

A. A resident of a care facility experiences a fall because there are not grab bars outside the bathtub.

An older adult has impaired psychosocial functioning. Which consequence should the nurse monitor? A. Anxiety B. Resilience C. Independence D. Elevated blood sugar

A. Anxiety

A nurse is conducting a comprehensive psychosocial assessment of an older adult who has recently moved to the long-term care facility. How should the nurse best assess the client's motor function? A. Observe the client walking into or out of the room. B. Assess the client's deep tendon reflexes using a hammer. C. Perform passive range of motion exercises on the client's arms and legs. D. Position the client supine and ask the client to perform a leg lift with each leg separately.

A. Observe the client walking into or out of the room.

An older adult client has stopped going out with friends because the client has been experiencing urinary incontinence and is afraid of having an "accident" in public. When the client's child asks the client about it, the client says, "I'm getting too old for such foolishness." The client's child encourages the client to go to the client's provider for an evaluation, but the client refuses to do so. Which is occurring with this older adult? A. The client sees incontinence as an inevitable consequence of aging. B. The client is experiencing learned helplessness and low self-efficicay. C. The client views incontinence as a negative functional consequence of aging. D. The client's provider is sympathetic; however, the client and the provider are unable to find the solution.

A. The client sees incontinence as an inevitable consequence of aging.

Assessment of an older adult's activities of daily living (ADLs) reveals specific functional deficits. Which component should the functional assessment also include? A. Pain B. Mental status C. Previous medical history D. Integumentary assessment

B. Mental status

A nurse interviews a centenarian while gathering data for a large student. In the interview, the centenarian defines aging as not growing older, but growing wiser. Which is the best response to this definition by the nurse? A. "Aging might make you wiser, but leads to eventual death." B. "Healthy maturity is characterized by wisdom." C. "How did you get to live this old?" D. "I will never make it to 100 like you."

B. "Healthy maturity is characterized by wisdom."

A home care nurse admits an older adult with macular degeneration. Which assessment question is most appropriate? A. "What medications do you take each day?" B. "How do you organize your medications?" C. "How many medications do you take each day?" D. "Do you have difficulty opening your medication bottles?"

B. "How do you organize your medications?"

An 80 year-old client, referred to a neurologist after worsening cognitive deficits, received a diagnosis of Alzheimer's disease. Which statement by the nurse to the client's family demonstrates appropriate use of terminology? A. "Its very difficult and stressful when a loved one becomes senile?" B. "The staff is well trained to foster wellness in persons who have dementia." C. "This form of organic brain syndrome is a common health problem in the ninth decade of life." D. "Even though the client is demented, we will do all we can to promote the client's quality of life."

B. "The staff is well trained to foster wellness in persons who have dementia."

An older client who used to go dancing with friends has stopped because of the fear of having an "accident" in public. How can the nurse best assist this client? A. Encourage the client to accept this consequence of growing old. B. Assist the client to view this functional limitation as temporary and treatable. C. Teach the client that the majority of older adults rate their health as good to excellent. D. Rephrase the situation to one of control, and allow the client to make the decisions.

B. Assist the client to view this functional limitation as temporary and treatable.

A nurse has recently begun to provide care to older adults in a large, urban hospital. Having lived until recently in an ethnically homogenous region, the nurse recognizes the significant differences in priorities and perspectives of clients from other cultural groups and has taken action to learn about these groups. What stage of cultural self-assessment is this nurse demonstrating? A. Consciously competent B. Consciously incompetent C. Unconsciously competent D. Unconsciously incompetent

B. Consciously incompetent

A resident of a nursing home has accused several members of the care staff of stealing jewelry. The nurse has responded empathically to the accusations and has explained why this is impossible, to no avail. Which condition is the client experiencing? A. Illusions B. Delusions C. Hallucinations D. Unresolved anger

B. Delusions

An older adult client diagnosed with mild cognitive impairment asked the nurse to help the client remember things better. Which designation is appropriate for this older adult? A. Knowledge deficit B. Health-seeking behaviors C. Altered thought processes D. Altered health maintenance

B. Health-seeking behaviors

A clinic nurse assesses a client who has limited English-speaking ability. The client's child interprets for the client. Which action by the nurse is most appropriate? A. Talk directly to the interpreter. B. Obtain a professional interpreter. C. Teach the family member the appropriate medical terminology. D. Use the family member as a source for improving cultural competence.

B. Obtain a professional interpreter.

Following knee replacement surgery 10 days earlier, an older adult client diagnosed with an infection in the knee has a synovial fluid culture ordered. Obtaining the sample helps to determine the causative microorganism and to select an appropriate antibiotic. The above course of events characterizes what major belief system? A. Holistic paradigm B. Scientific paradigm C. Analytic paradigm D. Magico-religious paradigm

B. Scientific paradigm

A nurse in a nursing home performs assessments and develops client-based problems, so a plan of ongoing care can be developed. Which of these statements is true of the functional assessments the nurse is likely to perform? A. The nurse will utilize various functional assessment models. The nurse will address core ADLs but not more complex instrumental activities of daily living (IADLs). B. The nurse will include both core activities of daily living (ADLs) and more complex (IADLs). C. The nurse will identify the older adult's function at the time of screening. D. The nurse's main goal of the functional assessments will be to ensure older adult safety.

B. The nurse will include both core activities of daily living (ADLs) and more complex (IADLs).

A nurse is teaching an older person about the concept of successful aging. Which of the nurse's questions addresses an important contributor to successful aging? A. "Are you largely free of acute or chronic illnesses?" B. "Do you fell financially secure?" C. "Are you able to engage in activities of daily living, including social activities?" D. "Do you have a reliable support network?"

C. "Are you able to engage in activities of daily living, including social activities?"

A nurse assesses an older adult's insight regarding the care plan. What question may the nurse ask to gauge the client's insight? A. "What are the similarities between a doctor and a nurse?" B. "How would you spend $100 if you were given it today?" C. "Can you tell me the reason that your doctor admitted you to the hospital?" D. "Where would you go if you were discharged from the hospital today?"

C. "Can you tell me the reason that your doctor admitted you to the hospital?"

An older adult expresses frustration about the limitations of aging. Which statement by the nurse promotes wellness? A. "How does living in these conditions compare to your youth?" B. "Have you met any of your neighbors? They seem like nice people." C. "Do you have some words of wisdom to share about that valuable experience?" D. "You are saying that you are frustrated with how they are not listening to you?"

C. "Do you have some words of wisdom to share about that valuable experience?"

A nurse leads a "healthy aging" class at a community health center. Which question should the nurse use to generate discussion among participants in this setting? A. "Could you tell us why your grandson is living with you?" B. "Have you had any tests done on your heart since we last met?" C. "How did you adjust to your move from your house to the assisted living facility?" D. "Are you satisfied with the care that you're getting from your family provider?

C. "How did you adjust to your move from your house to the assisted living facility?"

An older adult is sore from "doing too much in the yard yesterday". Which statement by the nurse best promotes healthy aging? A. "Its time to start exercising and eating right." B. "You need to act your age and let others do that work." C. "Let's look at how we can improve your health so you can do more." D. "Of course you can't do as much as you did before, you need to pace yourself."

C. "Let's look at how we can improve your health so you can do more."

A client, who retired from work this year, asks the nurse the secret to successful aging. Which response by the nurse is most helpful? A. "Life is a bowl of cherries, if you are in the pits, crawl out." B. "The body is senescent and you will find you slow down each year." C. "Studies show that volunteering and helping others improve satisfaction with life." D. "Later life can be a time of engagement, contribution, and well-being; you must work to make it so."

C. "Studies show that volunteering and helping others improve satisfaction with life."

A nurse manager of an extended care facility works to promote psychosocial health. Which intervention should the nurse manager include? A. Dress residents exclusively for ease in going to and from the restroom. B. Plan dining room arrangements according to room and hall assignments. C. Adapt the environment to compensate for residents' sensory impairments. D. Position the residents who are in wheelchairs solely for ease in getting out of the dinning areas

C. Adapt the environment to compensate for residents' sensory impairments.

An older adult admitted to a long-term care facility is diagnosed with Type 2 Diabetes and Coronary Artery Disease. The client takes glipizide and isosorbide mononitrate. The medical history states that the client drank 4 ounces of whiskey per day from many years. Which action should be a priority for the admitting nurse? A. Evaluate the client for renal failure. B. Assess and observe the client for depression. C. Assess the client for hypoglycemia and hypotension. D. Evaluate the client's blood work for changes in electrolytes.

C. Assess the client for hypoglycemia and hypotension.

A nurse is conducting a study on the needs and living situation of older adults in the community to provide quality discharge planning for clients. Which statement should the nurse take into account? A. A majority of older Americans will live in a nursing home at some point. B. More older men live alone than older women. C. Assisted living arrangements have become increasingly common alternative to nursing homes D. Most older Americans reside in some form of institutional arrangement.

C. Assisted living arrangements have become increasingly common alternative to nursing homes

A nurse plans activities each month at an assisted living facility. Which activity is most cognitively stimulating for clients with mild cognitive impairment? A. Stretching B. Movie night C. Book club discussions D. Reminiscence therapy

C. Book club discussions

A 55-year old client recently diagnosed with Type 2 Diabetes completed a diabetes education class. The client does water aerobics three times a week. The client's blood sugar ranges from 126 mg/dl to 143 mg/dL, the client's hemoglobin A1c decreased from 10.5 to 8.1, and the client lost 20 lbs (9.07 kg). Which statement best describes this client's actions? A. Activity theory B. Age stratification theory C. Functional consequences theory D. Life-course development theory

C. Functional consequences theory

A nurse performs a reflective cultural self-assessment. Which outcome should the nurse expect? A. Identification of the flaws and weaknesses of the nurse's own culture. B. An accurate ranking of different cultures according to their specific merits. C. Progressive from judgmental views of other cultures to recognition of positive attributes. D. The ability to assess clients according to their cultural affiliation rather than their individual characteristics.

C. Progressive from judgmental views of other cultures to recognition of positive attributes.

A nurse prepares to administer scheduled medications to a new resident with mild non-Alzheimer-type dementia. Which type of medication should the nurse administer without concern of worsening delirium? A. A benzodiapepine B. An anticholinergic C. An atypical antipsychotic D. A cholinesterase inhibitor

D. A cholinesterase inhibitor

Which is the priority nursing intervention for the management of delirium? A. Reducing noise and placing familiar objects in the client's environment. B. Providing psychological support through cognitive and social stimulation. C. Giving the client a clock, a watch and calendars to provide the client with temporal orientation. D. Giving the client low dose oxygenation and maintain his or her fluid and electrolyte balance.

D. Giving the client low dose oxygenation and maintain his or her fluid and electrolyte balance.

An older adult client, saddened by a recent diagnosis of Type 2 Diabetes, is concerned about the future. Which action demonstrates a problem-focused approach to this stressor? A. Seeking out a second opinion from another physician B. Eliciting support and sympathy from a sibling and neighbor C. Deciding to make no lifestyle changes despite the new diagnosis D. Obtaining diabetic cookbooks and learning to changes cooking habits

D. Obtaining diabetic cookbooks and learning to changes cooking habits

A nurse assesses an older adult using a Min-Mental State Examination. The client is very slow to respond to the questions. Which conditions may be present and will require follow-up by the nurse? Select all that apply. A. Dementia B. Depression C. Confabulation D. Lack of education E. Concrete thinking

a, b

A nurse works to protect vulnerable populations and reduce health disparities. Which nursing actions work toward that goal? Select all that apply. A. The nurse teaches each client about preventive care. B. The nurse incorporates clients' belief systems into the plan of care. C. The nurse communicates a nonjudgmental attitude toward health belief systems. D. The nurse asks the client how the care system can incorporate the clients" health beliefs. E. The nurse acknowledges that the clients in subgroups will not change beliefs or actions.

a, b, c, d

An older adult admitted to a geriatric unit in the hospital is oriented to person only. Which actions should the admitting nurse perform? Select all that apply. A. Reassess orientation status. B. Repeat orientation as needed. C. Post a calendar with dates crossed off D. Orient the client to the room, unit, and plan of care. E. Have a conversation with the client about challenges to cognitive function.

a, b, c, d

A nurse assesses an older adult client who has smoked for 43 years. Which are negative functional consequences of smoking for this client? Select all that apply. A. Pulmonary disease B. Abnormal breath sounds C. The ability to run a 5 kilometer race D. Low oxygen-carrying capacity E. Exposing children to secondhand smoke

a, b, d

A nurse reviews the medication list of an older adult. Which biologic processes will affect drug clearance? Select all that apply. A. "Are you a smoker?" B. "Do you drink alcohol?" C. "What is your typical diet?" D. "What over-the-counter drugs to you use?" E. "Do you use any herbs or dietary supplements?"

a, b, d, e

A nurse is teaching a colleague about the difference between age-related changes and risk factors. Of the following examples, which should the nurse use when discussing age-related changes? Select all that apply. A. An older adult with muscle weakness B. An older adult with obstructive lung disease C. An older adult with decreased bowel motility D. An older adult with cognitive changes from medications

a, c

A nurse reviews the medication list of an older adult. Which biologic processes will affect drug clearance? Select all that apply. A. Decrease in hepatic blood flow B. Increase in glomerular filtration rate C. Likely slower elimination half-life D. Decrease in sensitivity to bioactive substances

a, c, d

A nurse in an assisted living facility develops interventions that focus on improving cognitive abilities in the residents. Which should the nurse include in the plan of care? Select all that apply. A. Book club B. Calisthenics C. Shopping trip D. Letter writing E. Christmas caroling F. Reminiscence therapy

a, d

A nurse determines risk factors for an older adult client's plan of care. Which characteristics of the client would the nurse consider risk factors? Select all that apply. A. Chronic bronchitis B. Loss of bone density C. Decreased vital lung capacity D. Delayed gastric emptying E. Digoxin toxicity

a, e

A nurse assesses the eating habits of an older adult client who takes iron supplements. Which statements indicate client understanding? Select all that apply. A. "I prefer coffee to take my pills." B. "I drink orange juice with my iron." C. "I take my iron in between my meals." D. "I take all my pills with a glass of warm water." E. I may have light green, hard stools when I have a bowel movement."

b, c, d

A nurse assesses older adults in their own homes. Which questions are appropriate to include in this assessment of the bathroom? Select all that apply. A. "Is there a lock for the bathroom door?" B. "Is the height of the toilet seat appropriate?" C. "Can the person enter and exit the tub safely?" D. "Does the tub have skid-proof strips or a rubber mat in the bathroom?" E. "Does the color of the toilet seat contrast with surrounding colors?"

b, c, d, e

A nurse assesses an older adult client in a long-term care facility admitted for rehab following injuries received in a fall. The client develops new onset confusion and combativeness. Which factors must the nurse investigate as a source of these changes? Select all that apply. A. Social separation B. Hyponatremia C. Medication interactions D. Positional pain E. Urinary tract infection

b, c, e