Older Adult Exam I
A older man is transferred to a hospice facility with end-stage disease. Which is a suitable nursing intervention for this older adult and his family according to the goals of long-term care? Select one: a. Decrease the analgesic dose to prevent sedation. b. Inform family members about strict visiting hours. c. Provide a basin and towels for morning self-care. d. Facilitate family rituals related to death and dying.
The correct answer is: Facilitate family rituals related to death and dying.
An older man who paints houses for a living has had a myocardial infarction (MI). Which intervention should the nurse implement to prevent adverse health effects from his occupational history? Select one: a. Promote coughing and deep breathing. b. Analyze the electrocardiogram's rhythm. c. Avoid substances that are hepatotoxic. d. Provide low-cholesterol diet meals.
The correct answer is: Promote coughing and deep breathing.
Acute illness is to chronic illness as to which of the following comparisons? Select one: a. An emergency department is to a nursing home b. A hospital staff nurse is to a nurse practitioner c. Inpatient surgical care is to outpatient medical care d. Health insurance is to Medicare for older adults
a. An emergency department is to a nursing home
Compared with acute pain, which of the following statements is true of persistent pain? Select one: a. Can bring about long term changes in lifestyle. b. Is usually described as a burning pain. c. Leads to significantly altered vital signs. d. Is generally gone within 4 months.
a. Can bring about long term changes in lifestyle.
The nurse administers an opioid analgesic to an older male postoperative patient in the surgical unit. Which is the most important intervention for the nurse to implement before leaving the patient's room? Select one: a. Instruct him to ask for help before getting up. b. Offer toileting and a sip of water. c. Place side rails up x 4. d. Position the patient comfortably.
a. Instruct him to ask for help before getting up
The older adult is at a higher risk for acute psychological pain than a younger adult because older adults: Select one: a. Have many illnesses. b. Experience more loss. c. Live with impairments. d. Possess fewer assets.
b. Experience more loss.
An older woman had hip replacement surgery 1 day ago, and the nurse thinks that the woman also has dementia. Which patient assessment does the nurse use to determine whether this woman is experiencing pain? Select one: a. Moves during sleep b. Has stable vital signs. c. Holds abdomen tightly. d. Is not verbalizing
c. Holds abdomen tightly.
An older female patient is diagnosed with a chronic illness. Which of the following principles should the nurse apply when answering her questions? Select one: a. Usually, chronic disease has a negligible impact on the family. b. The most prevalent form of disease in the United States is acute illness c. Older adults successfully cope with chronic disease by learning about the disease. d. Chronic illness is unending, and coping can be influenced by the perception of uncertainty
d. Chronic illness is unending, and coping can be influenced by the perception of uncertainty
Which of the following statements is true about analgesic medications for older adults? Select one: a. Opioids are less effective in older patients than in younger patients. b. The dose limit for acetaminophen is difficult to reach for older adults. c. Over-the-counter NSAIDs are generally harmless. d. Stool softeners and laxatives should be used with opioids
d. Stool softeners and laxatives should be used with opioids.
Which of the following statements by a new graduate nurse should be corrected by an experienced nurse? Select one: a. "Older adults are many times still interested in sexual relations." b. "Patients over age 65 are still lifelong learners." c. "Most older patients are ill and disabled. That's why we care for so many of them in the hospital." d. "Many older adult patients remain independent enough to live alone."
The correct answer is: "Most older patients are ill and disabled. That's why we care for so many of them in the hospital."
An older patient who was just diagnosed with a terminal disease states, "All my life I attended church, but I am still worried about what will happen after death." The nurse's best response is which of the following? Select one: a. "The unknown may be frightening. Do you want to talk about this?" b. "You must feel good about attending church most of your life." c. "Religious people know that God is a good God." d. "People that have had near death experiences say it is peaceful."
The correct answer is: "The unknown may be frightening. Do you want to talk about this?"
Which statement is true about residential living for older adults? Select one: a. A residential care facility is the new term for a nursing home. b. A "granny flat" is an apartment in a high-rise building reserved for seniors. c. An assisted living facility (ALF) must have a registered nurse (RN) on staff. d. Administrators are realizing that their duty is to care for the residents as people.
The correct answer is: Administrators are realizing that their duty is to care for the residents as people.
Which is characteristic of relocation stress syndrome in a resident of a long-term care facility? Select one: a. Caring family b. Agitation c. Hallucinations d. Apprehension
The correct answer is: Apprehension
The nurse understands that stress incontinence occurs: Select one: a. Because of emotional strain b. With a urinary tract infection (UTI) c. As a result of increased intraabdominal pressure d. With a specific amount of urine in the bladder
The correct answer is: As a result of increased intraabdominal pressure
The nurse scans an older man's identification band in preparation for medication administration. Which step should the nurse implement next? Select one: a. Ask the patient to state his name b. Document the medication as given. c. Administer the patient's medication d. Check for allergies to the medication.
The correct answer is: Ask the patient to state his name
Which nursing intervention is a holistic approach to an older adult? Select one: a. Assigns female nurses to older women who are Islamic. b. Performs glucose testing during the weekly worship service. c. Allows older adults in a nursing home to eat meals alone. d. Wheels ambulatory adults to exercise when running late.
The correct answer is: Assigns female nurses to older women who are Islamic.
Which intervention should the nurse use to decrease the risk of burns during mealtime in patients with mental and physical impairments? Select one: a. Use plastic mugs instead of ceramic. b. Assist patients with warm drinks. c. Serve only cold beverages to patients at risk. d. Wait until the drink has cooled.
The correct answer is: Assist patients with warm drinks.
The nurse is aware that cultural competence means having the skills to put cultural knowledge to use in all of the following except: Select one: a. Assessment b. Communication c. Collaboration d. Intervention
The correct answer is: Collaboration
n older adult who is on bed rest after surgery is prescribed morphine for pain. Which of the following is the nurse's priority for preventive care? Select one: a. Poor liquid intake b. Constipation c. Diarrhea d. Poor solid food intake
The correct answer is: Constipation
In which areas have advanced practice nurses demonstrated their skill in improving? (Select all that apply.) Health outcomes Length of stay Cost effectiveness Reimbursement measures Interprofessional communication
The correct answer is: Cost effectiveness, Health outcomes
Which is a common age-related physical change that may affect digestion and food intake? Select one: a. Loss of smell b. Decreased cholecystokinin secretion c. Decreased motility in the esophagus d. Loss of the majority of taste buds
The correct answer is: Decreased motility in the esophagus
Which option is not a primary reason that documentation is important? Select one: a. Documentation helps defend the nurse in the event of a possible lawsuit. b. Documentation enables a patient to receive consistent care from one shift to the next. c. Documentation is the basis for reimbursement to the facility d. Documentation enables the team to provide care to meet a resident's individual needs.
The correct answer is: Documentation helps defend the nurse in the event of a possible lawsuit.
Which of the following is most likely to be true about caring for an older African-American patient? Select one: a. The patient may follow hot-cold beliefs. b. During a physical assessment, an examination of the interior of the patient's mouth with adequate light is important. c. African Americans may avoid eye contact when interacting with others. d. The patient can expect to find support from his church after discharge.
The correct answer is: During a physical assessment, an examination of the interior of the patient's mouth with adequate light is important.
The nurse must inform an older adult who does not speak English about patient rights. In addition, the nurse must have the adult sign the document about information access. Which intervention should the nurse use to maintain the confidentiality of this older adult? Select one: a. Have an English-speaking family member explain the document to the patient. b. Instruct an interpreter to read the information access document to the resident privately. c. Present the patient with a Spanish version of the information access document. d. Explain the document to the patient using an interpreter to ensure understanding.
The correct answer is: Explain the document to the patient using an interpreter to ensure understanding.
An older woman tells the nurse that she has experienced increasing fatigue and shortness of breath over the last 2 days. Which goal is the nurse's priority? Select one: a. Explore the woman's complaints. b. Balance exercise and rest periods. c. Balance exercise and rest periods. d. Promote safety to prevent injury.
The correct answer is: Explore the woman's complaints.
As the aging population in the United States increases, the nurse knows that the Select one: a. Baby boomer generation accounts for a very small percentage of this group. b. Extension of the average life span has also increased c. Population segment over age 85 is decreasing. d. Diversity of this age group will certainly decrease.
The correct answer is: Extension of the average life span has also increased
According to researchers, which characteristic will most centenarians share in the future? Select one: a. Demented b. Female c. Malnourished d. Wheelchair bound
The correct answer is: Female
Which age-related change contributes to anorexia and weight loss in the older adult? Select one: a. Fewer taste buds b. Wearing dentures c. Softened tooth enamel d. Excessive saliva
The correct answer is: Fewer taste buds
The latest trends in medicine encourage health care providers to prescribe nutrient-dense foods and exercise to prevent or delay the shortening of telomeres. On which biological theory of aging are these practices based? Select one: a. Caloric restriction b. Cross-link theory c. Genetic research d. Pacemaker theory
The correct answer is: Genetic research
In which context are members of a cohort described when using the age-stratification theory to explain the effect of similar events, conditions, and circumstances? Select one: a. Sociological b. Historical c. Biological d. Chronological
The correct answer is: Historical
Which of the following is a true statement about differing health belief systems? Select one: a. Personalistic or magicoreligious beliefs have been superseded in Western minds by biomedical principles b. The belief that health depends on maintaining a balance among opposite qualities is characteristic of a magicoreligious belief system c. Ayurvedic medicine is another name for traditional Chinese medicine. d. In most cultures, older adults are likely to treat themselves using traditional methods before turning to biomedical professionals
The correct answer is: In most cultures, older adults are likely to treat themselves using traditional methods before turning to biomedical professionals
Which of the following is a true statement about skin care for older adults? Select one: a. A licensed practical nurse is qualified to care for the feet of a patient with diabetes. b. Maintaining oral hydration may reduce the incidence of xerosis. c. Onychomycosis is quickly eradicated with antifungal creams or powders. d. A ram's-horn nail should be cut to give a smooth, rounded edge.
The correct answer is: Maintaining oral hydration may reduce the incidence of xerosis.
A nurse completing a hospital discharge to home understands that which of the following interventions is most important before discharge. Select one: a. Medication reconciliation b. Contacting a durable medical equipment facility c. Educating the client on appropriate range-of-motion exercises d. Providing a list of community resources
The correct answer is: Medication reconciliation
Exercises are prescribed for older adults as therapy to improve which one of the following qualities? Select one: a. Body sculpting b. Muscle strength c. Relative intensity d. Muscle retraining
The correct answer is: Muscle strength
Which of the following statements is true about social and emotional health of older adults? Select one: a. Computers and the Internet have little to contribute to older adults in their need for social support. b. Contemporary society has strong norms for the behavior of adults older than 80 years. c. The transition to old age entails a declining level of contribution to others as one becomes increasingly dependent on them. d. Nurses are often significant sources of social and emotional support for older
The correct answer is: Nurses are often significant sources of social and emotional support for older adults.
Which of the following is a true statement about documentation? Select one: a. Nurses should keep records of patients' wishes. b. The nurse is responsible for completing all of the Minimum Data Set (MDS). c. The Outcomes and Assessment Information Set (OASIS) is a complete record of the health status of a patient. d. Patients do not have access to their own medical records
The correct answer is: Nurses should keep records of patients' wishes.
A man is terminally ill with end-stage prostate cancer. Which is the best statement about this man's wellness? Select one: a. Wellness is the same thing as faith healing, and if the client would be more receptive, then he could be back at work in a few weeks. b. Wellness is possible in the management of his medical care. c. Nursing interventions can help empower a client to achieve a higher level of wellness d. Wellness is unfortunately not a real option for this client.
The correct answer is: Nursing interventions can help empower a client to achieve a higher level of wellness
The children in an African-American family attended college because their mother worked two jobs as they were growing up. She never finished high school, the children are grown, and she lives alone in retirement. Which noted weakness of sociological theories on aging explains why the social exchange theory is not applicable to this older adult? Select one: a. Gender b. Opportunity c. Ethnicity d. Culture
The correct answer is: Opportunity
A family that has three small children prepares to move an older female parent into their home knowing that she stays up all night. The nurse helps the family prepare for the change. Which part of planning should the nurse indicate is the family's priority? Select one: a. Sharing household responsibilities b. Preparing the house for her arrival c. Helping her use her skills and talents d. Setting limits on nighttime activities
The correct answer is: Preparing the house for her arrival`
The nurse prepares to transfer an older adult to a long-term care facility and calls the facility to give a report. Which nursing actions are the responsibilities of the transferring nurse and the receiving nurse? Select one: a. Ensuring the patient is stable for transfer b. Incorporating patient goals into the plan c. Providing continuity of care during the transfer d. Supplying patient documents for planning
The correct answer is: Providing continuity of care during the transfer
Identify the best statement about gerontological nursing. Select one: a. Nurses have only recently become involved in the care of the older adult. b. Purposes of gerontological nursing include the promotion of health and support for maximal independence. c. ANA certification is available only for gerontological nurses in research positions. d. Gerontological care was the second specialty in which the American Nurses Association (ANA) offered a certification program.
The correct answer is: Purposes of gerontological nursing include the promotion of health and support for maximal independence.
What is a SOAP note? Select one: a. Form of bar code b. Record of supplies used in patient hygiene c. Record of an event during a patient's stay, formatted according to the Simple Object Access Protocol (SOAP), enabling it to be easily transmitted between computers d. Record of patient data listing the patient's subjective complaint, objective data recorded by the nurse, the nurse's assessment of the situation, and the nurse's plan of action
The correct answer is: Record of patient data listing the patient's subjective complaint, objective data recorded by the nurse, the nurse's assessment of the situation, and the nurse's plan of action
Which change in the skin is abnormal in an older person? Select one: a. Thinner and more fragile skin b. Loss of hair on the extremities c. Greater number of freckles d. Red, swollen 3-day-old wound
The correct answer is: Red, swollen 3-day-old wound
An older female resident in the residential facility keeps a large collection of personal items and photographs of her late husband on her bedside table, but the nursing assistant and resident frequently argue about this. Why should the nurse intervene between the resident and the nursing assistant? Select one: a. Resident is attempting to maintain her sense of personal space. b. Resident's argumentative nature can indicate early dementia. c. Clutter from all the personal items is a safety and liability risk. d. Resident needs to accept the reality of her spouse's death.
The correct answer is: Resident is attempting to maintain her sense of personal space.
Which of the following is an important consideration about the skin of an older adult person? Select one: a. Skin becomes darker in unexposed areas. b. Sweat gland activity increases. c. Skin becomes more vulnerable to damage. d. Generous amounts of soap should be used for cleansing.
The correct answer is: Skin becomes more vulnerable to damage.
Which of the following is a true statement about sleeping in older adults? Select one: a. Older adults tend to fall asleep quickly but are awakened throughout the night. b. Selective serotonin-reuptake inhibitors (SSRIs) can alleviate sleep disturbances caused by depression. c. Sleep disturbances in the older adult can be caused by cardiovascular disease, arthritis, or diabetes. d. Benzodiazepine agents are the medications of choice for sleep disorders.
The correct answer is: Sleep disturbances in the older adult can be caused by cardiovascular disease, arthritis, or diabetes.
Which action should the nurse take when addressing older adults? Select one: a. Speak in an exaggerated pitch. b. Use a lower quality of speech. c. Use endearing terms such as "Honey." d. Speak clearly.
The correct answer is: Speak clearly.
Which role is most likely to have a significant effect on the type of aging process experienced by the older adult? Select one: a. Parent b. Friend c. Spouse d. Grandparent
The correct answer is: Spouse
Several organizations collaborated in 2001 to publish Scope and Standards of Gerontological Nursing Practice by the ANA. What is the significance of the collaborative effort to gerontological nurses? Select one: a. Ensures minimum gerontological competencies for all graduating students b. Standardizes gerontological nursing practice among various organizations c. Changes the health care delivery to increasing numbers of older adults d. Mandates gerontological certification for nurses who care for older adults
The correct answer is: Standardizes gerontological nursing practice among various organizations
Which of the following considerations is most likely to be true when working with an interpreter? Select one: a. The nurse should face the patient rather than the interpreter. b. An interpreter is never needed if the nurse speaks the same language as the patient. c. A patient's young granddaughter who speaks fluent English would make the best interpreter because she is familiar with and loves the patient. d. When working with interpreters, the nurse can use technical terms or metaphors.
The correct answer is: The nurse should face the patient rather than the interpreter.
Decreased functioning of which physical structure is likely to result in decreased metabolism in older adults? Select one: a. Kidney b. Thyroid gland c. Brain d. Skeleton
The correct answer is: Thyroid gland
Which action should be included in all bladder-retraining programs? Select one: a. Providing 1000 ml of fluids daily b. Toileting at bedtime c. Toileting every hour d. Using adult incontinence pads
The correct answer is: Toileting at bedtime
Which of the following is a true statement about nutrition for older adults? Select one: a. No government programs promote congregate dining among older adults. b. The older person should be encouraged to practice strict controls on cholesterol intake to ensure protection against heart disease. c. Transportation can be a critical factor in nutritional insufficiency in older adults. d. Soul food is a concern primarily for the African-American culture.
The correct answer is: Transportation can be a critical factor in nutritional insufficiency in older adults.
The nurse prepares for the arrival of older adults evacuated from a hurricane to a shelter for short-term care. Which of the following is the priority nursing intervention? Select one: a. Use individual medical records to develop a medication plan. b. Help older adults display family photographs and memorabilia. c. Help older adults teach one another a new skill in the shelter. d. Demonstrate that the staff is prepared to meet their needs.
The correct answer is: Use individual medical records to develop a medication plan.
Which is an accurate statement regarding gerontological nursing education? Select one: a. Undergraduate nursing programs extensively cover gerontological nursing in dedicated courses, comparable with the coverage of psychiatric nursing. b. Accreditation of a nursing program guarantees that appropriate amounts of gerontological nursing content are included in the curriculum. c. When content is integrated throughout a curriculum, less than 25% is devoted to geriatric care. d. Gerontological nursing content has long been integrated into the curriculum of the typical school of nursing.
The correct answer is: When content is integrated throughout a curriculum, less than 25% is devoted to geriatric care.
The nurse best addresses the possible intrinsic factors that contribute to falls experienced by older adult clients in an acute care setting by: Select one: a. encouraging the client to wear his glasses b. regularly assessing the room for clutter on the floor. c. keeping a low-level light on in the room after the client retires for the night d. instructing team members to keep the client's bed low to the floor.
The correct answer is: encouraging the client to wear his glasses
The nurse in an acute care facility is caring for a 79-year-old client recovering from a cerebral vascular accident that has resulted in mild loss of muscle function in his right arm and leg. The nurse is best addressing the client's need via the functional model of care when: Select one: a. placing the telephone where it can be reached with his left hand. b. instructing the client's family on how to properly assist the client in walking. c. assessing the client's right-sided muscle strength daily. d. reaffirming to the client that physical therapy will improve his muscle strength.
The correct answer is: placing the telephone where it can be reached with his left hand.
Which of the following is a true statement about Medicare for older adults? Select one: a. Medicare covers care for those who have trouble with activities of daily living. b. Complementary and alternative medicines (CAM) are not covered by Medicare. c. Eighty percent of Medicare's annual expenditures are for individuals with chronic illnesses. d. Medicare enrollees spend under $1500 annually for out-of-pocket expenses related to chronic illnesses.
c. Eighty percent of Medicare's annual expenditures are for individuals with chronic illnesses.
Which of the following statements is true about rehabilitation and restorative care for older adults? Select one: a. The purpose of rehabilitation and restorative care is to regain specific abilities lost because of a condition. b. The patient's capabilities are recognized at the time of admission. c. Rehabilitation consists primarily of regular physical therapy sessions. d. A person can learn skills and gain abilities that enable functioning
d. A person can learn skills and gain abilities that enable functioning
Which of the following statements is the most suitable for establishing goals when teaching an older adult with a chronic illness about potential changes in the health maintenance regimen? Select one: a. The patient will be able to make needed changes in his or her life if the nurse provides accurate, written instructions. b. Psychological functioning is usually impaired only to a small extent in a patient with a chronic illness. c. The patient's values, culture, and beliefs will have little to do with the types of changes he or she will be able to make. d. Management of the patient's chronic disease rests on the patient and the caregiver; therefore the goals should be collaboratively set.
d. Management of the patient's chronic disease rests on the patient and the caregiver; therefore the goals should be collaboratively set.
