GNUR 290 Exam 1 Questions

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." Quiz 5 Module 5

B. "The staff is well trained to foster wellness in persons who have dementia." Nurses can use phrases such as "a person with dementia" or a "person with a dementing illness" to accurately refer to the medical syndrome of impaired cognitive function while avoiding pejorative connotations associated with describing older adults as "demented." The terms "senile" and "organic brain syndrome" are no longer in use.

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?" Quiz 3 Module 3

B. "How do you organize your medications?" This is a good questions because it is open-ended and sounds less judgemental. A person with macular degeneration has vision impairments so a question on how they choose to organize their medications provide good insight on how well their are following their medication regime.

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 Quiz 5 Module 5

B. Delusions Delusions are fixed false beliefs that have little or no basis in reality and cannot be corrected by appealing to reason. Hallucinations are sensory experiences that have no basis in an external stimulus. Delusions are not known to be a manifestation of unresolved anger. Illusions are misperceptions of an external stimulus

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?" Quiz 3 Module 3

A. "Are you a smoker?" B. "Do you drink alcohol?" D. "What over-the-counter drugs to you use?" E. "Do you use any herbs or dietary supplements?"

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 been 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." Quiz 1 Module 1

A. "You have to remember that there's a huge economic disparity among older adults." An important consideration with regard to economic conditions of older adults is the tremendous range in financial status, which varies significantly according to race, gender, and living arrangements. The number of adults living below the poverty line, however, has decreased in recent years. The disparities that separate disadvantaged groups from more economically secure older adults are predicted to persist. Minorities are more likely, not less likely, to be living with their relatives.

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. Quiz 2 Module 2

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

A nurse assesses 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 Quiz 1 Module 1

A. An 83-year-old single woman Women and those over the age of 75 are more likely to live in poverty. Couples and those 65 to 74 are less likely. Five percent of older white men live in poverty.

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 Quiz 2 Module 2

A. An older adult with muscle weakness C. An older adult with decreased bowel motility An older adult with obstructive lung disease and/or cognitive changes from medication are NOT necessarily age-related. This can occur to someone of any age.

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 Quiz 2 Module 2

A. Chronic bronchitis E. Digoxin toxicity Risk factors include things like diseases and adverse medication effects. Loss of bone density, decreased vital lung capacity, and delayed gastric emptying are neither of those two and can be better understood as age-related changes.

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 Quiz 3 Module 3

A. Decrease in hepatic blood flow C. Likely slower elimination half-life D. Decrease in sensitivity to bioactive substances

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 Quiz 5 Module 5

A. Dementia B. Depression The nurse assesses the amount of time and effort expended in answering questions. This is particularly important when trying to differentiate between dementia and depression. Lack of education and concrete thinking would not slow the client in responding to assessment tools such as the mini-mental. Confabulation is when the client creates information

The child of an older adult client asks the nurse about vitamins, antioxidants, and age-related macular degeneration. Which theory of aging is the mostappropriate to this topic? A. Free radical theory B. Immunosenescence theory C. Program theory D. Wear-and-tear theory Quiz 2 Module 2

A. Free radical theory

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. Quiz 5 Module 5

A. Observe the client walking into or out of the room. In the context of a psychosocial assessment, motor function includes such assessment parameters as posture, movement, and body language. It is not an assessment of reflexes, strength, or range of motion

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 Quiz 2 Module 2

A. Pulmonary disease B. Abnormal breath sounds D. Low oxygen-carrying capacity B can be eliminated because this would be a positive consequence. Exposing children to secondhand smoke is also wrong because it does not fit the definition of a negative functional consequence (negative when they interfere with a person's level of function or quality of life or increase someone's dependence).

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. Quiz 5 Module 5

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. The nurse understands that the older adult may take time to orient to new surroundings and may need to be given cues to assist them. Temporary memory impairment because of acute medical problems may impact the orientation questions. Asking the client about his or her subjective cognitive challenges may yield meaningful information, but this does not necessarily gauge orientation.

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 client's health beliefs. E. The nurse acknowledges that the clients in subgroups will not change beliefs or actions. Quiz 1 Module 1

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 client's health beliefs.

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." Quiz 1 Module 1

B. "Healthy maturity is characterized by wisdom." The other responses are not therapeutic.

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." Quiz 3 Module 3

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."

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?" Quiz 3 Module 3

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?" All of these pertain to patient safety.

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 Quiz 2 Module 2

B. Age-related changes Slower reaction time and vision problems are age-related changes. Risk factors would not fit because they are neither diseases or adverse medication effects. This is NOT positive so C is incorrect. And a wellness outcome does not fit either.

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 Quiz 1 Module 1

B. Consciously incompetent

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 Quiz 3 Module 3

B. Hyponatremia C. Medication interactions E. Urinary tract infection

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 Quiz 2 Module 2

B. Immunity theory Immunity theory or immunosenescne refers to age-related diminished function of the immune system that incrases the susceptibility of older people to diseases. Evidence of this is an increases susceptibility to autoimmune diseases such as lupus or rheumatoid arthritis.

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 Quiz 3 Module 3

B. Mental status

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. Quiz 1 Module 1 (Ch. 2)

B. Obtain a professional interpreter. Whenever possible, obtain a professional interpreter. Avoid using visitors or staff and even family members. Talk directly to the older adult, not the 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 Quiz 1 Module 1 (Ch2)

B. Scientific paradigm This is based on the idea that life is controlled by a serious of physical and biochemical processess that can be studied and controlled by humans. The holistic paradigm is about the balance and harmony of human nature; the whole person is viewed in the context of the total environment. Magico-relgious paradigm is about the supernatural forces that dominate the fate of the world; illness and health comes from a supernatural force. Analytic Paradigm is not a thing.

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. Quiz 3 Module 3

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

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 Quiz 5 Module 5

B. Vascular dementia While the four major types of dementia are not discrete or mutually exclusive, vascular dementia is characterized by pathophysiologic processes including infarctions from occlusion of blood vessels. This pathophysiology is not characteristic of Alzheimer disease, Lewy body dementia, or frontotemporal lobe dementia

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 feel financially secure?" C. "Are you able to engage in activities of daily living, including social activities?" D. "Do you have a reliable support network?" Quiz 1 Module 1

C. "Are you able to engage in activities of daily living, including social activities?" 3 main components to healthy aging are: (1) engagement with life (2) high cognitive and physical function (3) low probability of disease and disability

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?" Quiz 5 Module 5

C. "Can you tell me the reason that your doctor admitted you to the hospital?" Appraising an individual's understanding of why he or she is receiving treatment can help assess insight. Questions about hypothetical responses to situations also assess executive function, but not insight specifically

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." Quiz 2 Module 2

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." Quiz 2 Module 2

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

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. Quiz 3 Module 3

C. Assess the client for hypoglycemia and hypotension. Alcohol can cause adverse reaction to medication, causing them to work too much or too little.

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 an increasingly common alternative to nursing homes. D. Most older Americans reside in some form of institutional arrangement. Quiz 1 Module 1

C. Assisted living arrangements have become an increasingly common alternative to nursing homes. A, B, D are are wrong.

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 Quiz 2 Module 2

C. Functional consequences theory These modifications are directed toward alleviating and modifying the negative functional consequences of risk factors, a componenent of functional consequences theory.

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. Quiz 5 Module 5

C. Identify genetic or lifestyle factors that may have contributed to the client's dementia. A major goal of ongoing assessment of clients with dementia is to identify factors that interfere with the person's level of functioning or quality of life so that interventions can be initiated to alleviate these contributing factors. Medical diagnosis is not a nursing action and causative factors are not a priority after diagnosis. Dementia is not curable.

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. Quiz 1 Module 1

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

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 Quiz 3 Module 3

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

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 Quiz 5 Module 5

D. A cholinesterase inhibitor Cholinesterase inhibitors are standard treatment for mild-to-moderate Alzheimer disease. Anticholinergics, including benzodiazepines, as well as atypical antipsychotics can all lead to delirium

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. Quiz 5 Module 5

D. Giving the client low dose oxygenation and maintain his or her fluid and electrolyte balance. Priority questions address physiologic integrity. The client needs to be stabilized before the other interventions can be implemented