N128 Week 3 - Lewis Adaptive Quizzing #1

Which questions will the nurse ask a nursing home resident to evaluate the effectiveness of ca re? Select all that apply. |:| "Have your energy levels improved?" El "What was your latest blood sugar level?'I I: "Are you feeling happier and better than before?" |:| "Can you name the nursing stafifyou are not happy with?" D "Are you able to move around more easily with an assistive device?"

"Have your energy levels improved?" "Are you feeling happier and better than before?" "Are you able to move around more easily with an assistive device?"

Which response by the nurse is appropriate for a patient who is insured by Medicare and who requires dental care? 0 "Medicare does not cover dental care." 0 "Medicare Part D will cover the dental care." 0 "Let me assist you in making a dental appointment." 0 "Medicare will cover the cost of some ofyour dental care.'l

"Medicare does not cover dental care."

Which percentage of community-dwelling older adults in the United States suffer from elder mistreatment? Q 1% to 5% Q 6% to 8% Q 2% to 10% Q 10% to 15%

2% to 10%

The term "old-old" refers to adults in which age range? 0 65 to 74 years 0 75 to 84 years 0 85 to 94 years 0 85 years and older

85 years and older

Which part of Medicare would cover the 6-day hospitalization of a 67-year-old patient with acute chest pain who is diagnosed with coronary artery disease? 0 A Q B Q C O D

A

Medicare regulations require which intervention when a patient is being moved from one care setting to another? 0 A nursing care plan 0 A care transition plan 0 Quality review of care 0 Review of the patient's chart

A care transition plan

Which patient has a higher risk for malnutrition? O A young adult 0 A frail older adult 0 A patient with aphasia O A patient with irritable bowel syndrome

A frail older adult

Which scenario is the best way to develop safe and effective care transitions? 0 A registered nurse collaborating with the patient to coordinate care 0 A social worker collaborating with the patient and family to coordinate care 0 A registered nurse collaborating with the patient and family to coordinate care 0 A social worker and registered nurse collaborating with the patient and family to coordinate care

A social worker and registered nurse collaborating with the patient and family to coordinate care

When working with an older adult, which ethical issue influences nursing practice? 0 Family support 0 Ability to make decisions 0 Transition to assisted living 0 Diagnosis of chronic illness

Ability to make decisions

Which common concerns do the patient and family members face when transferring the patient to a long-term care facility? Select all that apply. |:| Availability of a bed in the facility |:| Visiting hours in the nursing facility |:| Acceptance of the decision by the patient |:| Transportation of the older adult to the facility |:| Level of care given to the patient by the nursing staff

Acceptance of the decision by the patient Level of care given to the patient by the nursing staff

Which agency must be notified of suspected elder mistreatment (EM)? 0 Adult Protective Services 0 Hospital security department 0 Local domestic abuse shelter 0 US. Food and Drug Administration

Adult Protective Services

Medicare provides health insurance for patients with which qualifications? Select all that apply. [:l Eligible Iow income [:l Age 65 years or older [:l Under age 65 with certain disabilities [:l End—stage renal disease requiring dialysis [:l End—stage renal disease requiring a renal transplant

Age 65 years or older Under age 65 with certain disabilities End—stage renal disease requiring dialysis End—stage renal disease requiring a renal transplant

Psychologic abuse may present with which clinical manifestations in an older adult patient? Select all that apply. |:| Agitation |:| Depression |:| Oversedation El Vaginal bleeding E] Withdrawn behavior

Agitation Depression Withdrawn behavior

Which factor puts an older adult at risk for elder mistreatment (EM)? 0 Retirement 0 Alcohol abuse 0 Immigration status 0 Financial independence

Alcohol abuse

Which factors put an older adult at risk for elder mistreatment (EM)? Select all that apply. |:| Smoking |:| Alcohol use |:| Physical limitations |:| Ethnic background |:| Cognitive limitations |:| inability to perform activities of daily living (ADLs)

Alcohol use Physical limitations Cognitive limitations Inability to perform activities of daily living (ADLs)

Which patient is referred to as an old-old adult? 0 An 85-year-old patient who lives alone 0 A 66—year-old patient with heart failure 0 A 73—year-old patient with a hip prosthesis O A 75—year-old patient with mental dysfunction

An 85-year-old patient who lives alone

Which interventions will the nurse include to ensure safety when caring for an older patient who is taking medications for multiple health issues? Select all that apply. |:| Assess for alcohol use. El Evaluate cognitive function. El Advocate for low—income prescription support services. |:| Instruct the patient to acquire medications from multiple pharmacies. |:| Instruct the patient to avoid using an electronic medication—reminder system.

Assess for alcohol use. Evaluate cognitive function. Advocate for low—income prescription support services.

Before developing a plan of care, which intervention will the nurse complete when caring for a group of elderly adults in a predominantly Jewish area of the community in order to provide culturally competent care? 0 Ensuring that all interventions align with the Jewish faith 0 Assessing each older adult's ethnic and cultural orientation 0 Observing the practices and activities of daily living of the population 0 Speaking with local faith leaders to obtain background on the elderly population

Assessing each older adult's ethnic and cultural orientation

Which intervention is important to promote culturally competent care for an elderly group of citizens at a senior center in an underserved area of the city? 0 Ensuring access to local stores that can support the needs of elderly individuals 0 Assessing the availability of religious institutions to support social ethnic activities 0 Determining the need for ancillary health care services, such as home health aides 0 Providing resources to support common needs of the elderly, including mobility and activities of daily living

Assessing the availability of religious institutions to support social ethnic activities

Which devices can be used as memory aids to help the older adult who is very forgetful to perform daily activities? Select all that apply. [:| Cane [:| Clock [:| Wheelchair [:| Sticky notes [:| Hearing aids

Clock Sticky notes

Elder mistreatment may occur in which settings? Select all that apply. Community hospital Rehabilitation facility Senior citizen center Long—term care facility Home of the elderly patient

Community hospital Rehabilitation facility Long—term care facility Home of the elderly patient

Why is the promotion of mobility important during recovery from surgery? O Continued activity prevents deconditioning. O Pharmacokinetics are improved by patient mobility. 0 Lack of stimulation contributes to the development of cognitive deficits in older adults. 0 Regularly scheduled physical rehabilitation provides an important sense of purpose for older patients.

Continued activity prevents deconditioning.

Which factors place the older adult at a higher risk for elder mistreatment (EM)? Select all that apply. |:| Dementia |:| Depression |:| Active lifestyle |:| Caregiver respite |:| Decreased social support

Dementia Depression Decreased social support

What factors place older adults at greater risk for elder mistreatment (EM)? O Increased social support 0 Dementia and depression 0 Pneumonia and heart failure 0 Increased ability to perform activities of daily living (ADLs)

Dementia and depression

Which services does the Medicare and Medicaid service titled "Programs for All-Inclusive Care for the Elderly" (PACE) provide? Select all that apply. |:| Dental care |:| Wound care |:| Primary care |:| Transportation |:| Nutritional assistance |:| Prescription medications

Dental care Wound care Primary care Prescription medications

Which patient condition may increase the risk of frailty? O Aphasia O Influenza 0 Depression 0 Acute gastroenteritis

Depression

Which steps will a nurse take upon discovering that a nursing home patient is a victim of physical and verbal abuse? Select all that apply. |:| Call a lawyer for the patient. |:| Confront the family and caregiver. |:| Document the patient's statement. |:| Collect evidence, such as blood-stained clothes and Sheets. |:| Take pictures ofinjured body areas after obtaining the patient's consent.

Document the patient's statement. Collect evidence, such as blood-stained clothes and Sheets. Take pictures ofinjured body areas after obtaining the patient's consent.

An older adult patient who is admitted for injuries caused by abuse from the person with whom he or she resides may be suffering from which type of abuse? 0 Family 0 Domestic 0 Community 0 Institutional

Domestic

Which qualification determines elder mistreatment (EM)? 0 An attorney must be involved to classify an act as EM. 0 At least two incidents must occur to be termed EM. 0 EM is an unintentional act that causes harm to the elderly. 0 EM is an intentional act that causes a risk for harm to the elderly.

EM is an intentional act that causes a risk for harm to the elderly.

Which term describes intentional acts of omission or commission by a caregiver or "trusted other" that cause harm or the risk for harm to a vulnerable older adult? 0 Ageism O Self-neglect O Ethnogeriatrics 0 Elder mistreatment

Elder mistreatment

Underuse of medication in the older adult who is hospitalized is considered which type of action? 0 Domestic violence 0 Nursing judgment O Routine plan of care 0 Elder mistreatment (EM)

Elder mistreatment (EM)

Which component of the interdisciplinary team can help provide guidance in the decision-making process and assist when differences of opinion occur in health care decisions? 0 Chaplain 0 Primary nurse 0 Ethics committee 0 Health care provider

Ethics committee

Which group of people is responsible for the majority of reported elder mistreatment cases? 0 Hospital staff 0 Adult day care 0 Family members 0 Home health aides

Family members

Which declines in cognitive functioning may occur with aging? Select all that apply. E] Fluid intelligence E] Crystallized intelligence E] Long-term recall memory E] Short-term recall memory E] Mental performance speed

Fluid intelligence Short-term recall memory Mental performance speed

Which geriatric condition may present with significant weight loss, weakness, and low energy and activity levels? 0 Frailty O Ageism O Homelessness O Memory impairment

Frailty

Which body changes are expected with aging? Select all that apply. |:| Increased metabolism |:| Increased adipose tissue El Decreased hepatic blood flow |:| Decreased glomerular filtration rate |:| Increased active transport mechanism

Increased adipose tissue Decreased hepatic blood flow Decreased glomerular filtration rate

Which action will the nurse take when assessing an older adult patient who insists the nurse involves the patient's son? 0 Involve the caregiver in the assessment. 0 Politely tell the patient that it is not legal. 0 Tell the son to leave the hospital immediately. 0 Report this to the health care provider immediately.

Involve the caregiver in the assessment.

Which interventions help decrease a patient's risk of developing relocation stress syndrome? Select all that apply. |:| Involve the patient in the decision to move. |:| Encourage staff members to greet the patient and provide orientation. |:| Encourage personnel at the new institution to send a welcome message to the patient. |:| Keep the new location a surprise until the day of the move to prevent anxiety about the move. |:| Describe the new location, but discourage sharing a video about the facility with the patient.

Involve the patient in the decision to move. |:| Encourage staff members to greet the patient and provide orientation. |:| Encourage personnel at the new institution to send a welcome message to the patient.

Which factors contribute to underreporting of abuse or mistreatment by the victim? Select all that apply. |:| Isolation El Cultural norms El Fear of reprisal I: Shame, guilt, or self-blame |:| Impaired cognitive or physical function |:| Desire for placement in a long-term care facility

Isolation Cultural norms Fear of reprisal Shame, guilt, or self-blame Impaired cognitive or physical function

Aging may have which effects on drug metabolism? Select all that apply. [:l Plasma protein levels rise. [:l Renal elimination increases. [:l Hepatic enzyme activity increases. [:l Levels ofdrugs in the circulatory system rise. [:l Gastrointestinal absorption ofdrugs increases. [:l A small quantity of central nervous system (CNS) drugs produces a large effect.

Levels ofdrugs in the circulatory system rise. A small quantity of central nervous system (CNS) drugs produces a large effect.

Which factors increase the risk of dehydration and malnutrition for a frail older adult? Select all that apply. |:| Ethnicity |:| Living alone |:| Cultural practices I: Low socioeconomic status |:| Decline in cognitive status

Living alone Low socioeconomic status Decline in cognitive status

Which care setting is appropriate for an older adult patient who requires assistance with activities of daily living (ADLs) but is not bedridden or homebound and does not have a support system or caregiver? 0 Adult day care 0 Long-term care 0 Home health care 0 Adult day health care

Long-term care

Which cognitive function remains constant with aging? O Crystallized intelligence 0 Long-term recall memory 0 Mental performance speed 0 Synthesis of new information

Long-term recall memory

Which factors are associated with homelessness in older adults? Select all that apply. |:| Low income |:| Living alone |:| Reduced cognitive ability |:| Increased availability of meal—site services |:| Living in a community that lacks affordable housing

Low income Living alone Reduced cognitive ability Living in a community that lacks affordable housing

The comprehensive geriatric assessment includes which elements? Select all that apply. |:] Medical history [:1 Social resources [:l Medication review El Functional assessment C] Family medical history |:| Cognitive and mood evaluation

Medical history Social resources Medication review Functional assessment Cognitive and mood evaluation

Which factors are common causes of medication errors in older adults? Select all that apply. [:1 Addiction [:l Memory loss [:l Decreased vision El Low or no income El Inadequate knowledge

Memory loss Decreased vision Low or no income Inadequate knowledge

Which does aging primarily affect? O Excretion of drugs 0 Absorption of drugs 0 Metabolism of drugs 0 Distribution of drugs

Metabolism of drugs

An older adult patient who is a victim of elder mistreatment has an increased risk for which condition? 0 Cancer 0 Diabetes 0 Arthritis 0 Mortality

Mortality

Which assessment findings may indicate physical abuse? O Weight loss and malnutrition O Multiple injuries at various stages of healing O Depression, agitation, and withdrawn behavior O Bruised breasts and unexplained vaginal or anal bleeding

Multiple injuries at various stages of healing

Which definition describes ageism? O Denial of negative stereotypes regarding aging 0 Positive attitudes toward the elderly based on age 0 Negative attitudes toward the elderly based on age 0 Negative attitudes toward the elderly based on chronic illnesses

Negative attitudes toward the elderly based on age

Which factors lead to a higher risk of accidents or injuries in older adults? Select all that apply. [:1 Decreased weight [:l Neurologic impairment [:l Decreased visual acuity El Increased muscle strength El Changes in gait and balance

Neurologic impairment [:l Decreased visual acuity El Changes in gait and balance

Which interventions may help reduce the risk offalls in the home? Select all that apply. |:] Night—lights |:] Toilet grab bars E] The use of a cane |:] Colored step strips |:] Railings on the stairway

Night—lights |:] Toilet grab bars |:] Colored step strips |:] Railings on the stairway

Which ethical decisions may provide challenges when a nurse is providing end-of—life care for an older adult? Select all that apply. [:l Health promotion [:l Nutritional support [:l Treatment of infection [:l Relocation stress syndrome [:l Transfer to more intensive treatment units

Nutritional support Treatment of infection Relocation stress syndrome

If elder mistreatment is suspected, the nurse will take which action prior to photographing any wounds? 0 Obtaining consent 0 Bathing the patient 0 Treating the patient 0 Notifying Adult Protective Services

Obtaining consent

A patient with repeated injuries on the ankles and wrists that are at various stages of healing may be experiencing which type of abuse? 0 Sexual 0 Physical 0 Financial 0 Psychologic

Physical

Performing range-of—motion exercises provides which health benefit for the older adult patient? 0 Reduces anxiety 0 Prevents immobility O Increases fluid intelligence 0 Improves long—term memory

Prevents immobility

An older adult who is being isolated and verbally berated by the caregiver is suffering from which type of abuse? 0 Sexual 0 Physical 0 Financial 0 Psychologic

Psychologic

Which nursing interventions help patients, family, and other health care workers understand ethical issues related to end-of—life care? Select all that apply. |:| Remain current on moral issues. El Advocate for the family's wishes. I: Advocate for an institutional ethics committee. |:| Acknowledge when a moral dilemma is present. |:| Provide mediation for emotionally difficult decisions.

Remain current on moral issues. Advocate for an institutional ethics committee. Acknowledge when a moral dilemma is present.

Which interventions will the nurse include during the assessment of an elderly patient admitted from home with an infected pressure sore? 0 Screening for mistreatment 0 Development of a safety plan 0 Notifying the health care provider 0 Asking the caregiver what happened

Screening for mistreatment

Which factors negatively affect the reporting rate of elder mistreatment (EM)? Select all that apply. [:| Rural home [:| Chronic illness [:| Sexual orientation |:| Immigration status [:| Ethnic background |:| Fear of long—term care

Sexual orientation |:| Immigration status [:| Ethnic background |:| Fear of long—term care

An older adult suffering from sexual abuse may present with which assessment finding? O Sexually transmitted infection 0 Anal bleeding from hemorrhoids O Use of lubricant during intercourse O Vaginal bleeding after a Papanicolaou smear

Sexually transmitted infection

An older adult who lives in a rural community may experience which barriers to health care access? Select all that apply. D Social isolation El Telehealth devices I: Financial limitations |:| Lack of transportation |:| Lack of quality health care

Social isolation Financial limitations Lack of transportation Lack of quality health care

Which health care professional develops the transition plan for a trail elderly patient who has been acutely hospitalized and is being discharged to a rehabilitation facility? 0 Hospital safety officer 0 Social worker on the inpatient unit 0 Director of the rehabilitation facility 0 The patient's health care provider

Social worker on the inpatient unit

Which change in elderly patients affects drug metabolism? 0 The half-life of the drug is decreased. 0 The hepatic blood flow increases with age. 0 The enzymes responsible for drug metabolism increase. 0 There is a 50% decline in the renal clearance of the drugs.

There is a 50% decline in the renal clearance of the drugs.

Medicare provides coverage for which need of the older adult? 0 Dental care 0 A hearing aid 0 Long-term care 0 Treatment for heart failure

Treatment for heart failure

Which intervention may help decrease the disparity of health care for older adults living in rural areas? O Extension of clinic hours 0 Increased nursing staff for the clinic 0 Use of community centers for health screenings 0 Increased use of unlicensed assistive personnel (UAPS) in the clinic

Use of community centers for health screenings

Which intervention may help an older adult patient who has been admitted to the long-term care setting to feel more comfortable? 0 Use of large-print clocks O Visually confusing wall designs 0 Answering patient questions vaguely O Glaring lighting in the patient's room

Use of large-print clocks

An older adult whose family members refuse to allow the older adult privacy during assessments and who have recently forced the older adult to move from his or her home may be experiencing which type of elder mistreatment (EM)? 0 Neglect 0 Financial abuse 0 Psychologic abuse 0 Violation of personal rights

Violation of personal rights

Which devices are considered assistive devices to enhance functional mobility? Select all that apply. |:| inhaler D Walker |:| Wheelchair E] Medication El Coronary stent

Walker Wheelchair