Care Final
When discussing sarcopenia with an older adult, the nurse shares that it: A. Is responsible for fragility in women more often than in males. B. Includes systemic manifestations as well as bilateral joint deformities C. Is diagnosed by a positive pannus blood test D. Results from a vitamin D deficiency
A
When preparing an educational program on minimizing the effects of aging to a seniors group the nurses discussion on exercise is based upon the fact that: A. Losses experienced with age related mobility are associated with physical inactivity B. Mobility is affected by aging but the effects can be lessened with lifestyle changes C. A positive attitude about aging is a factor in the minimizing of age related changes D. Aging results in some degree of loss in strength and flexibility
A
An 88 year old being admitted to rule out lung cancer is assessed using the short form of the geriatric depression scale tool. When it is determined that the earned score is 9, the nurse initially: A. Asks if they have any thoughts of committing suicide B. Recognizes that this score is not indicative of depression C. Knows it is not unusual for clients this age to earn such a score D. Notifies the clients healthcare provider immediately
A
An important trait seen in a nurse who is effective in caring for the terminally ill is emotional maturity. Which statement by a nurse shows this maturity? A. I cry for a client when I'm alone but never when I'm with them B. My job is to create a good death for my clients C. This is a stressful job and it isn't something just any nurse can do D. My clients are the best part of this emotionally draining job
A
An older adult is concerned that if her spouse, who recently suffered a stroke, is placed in a nursing home, "they will take everything in order to pay for his care." What response will the nurse make? A. "A spouse is allowed to keep a percentage of the family income and cash as well as the family home, car, and personal property." B. "You should consider transferring the assets to your son so that your husband will qualify for Medicaid." C. "Have you considered caring for your husband at home since Medicare will cover custodial care at home?" D. "Are you aware that your children have a legal obligation to provide financial support towards the care of disabled parents?"
A
An older client with a history of hypertension and osteoarthritis who has recently fallen and fractured two ribs is prescribed extra strength Tylenol for the pain. What stating by the client requires further evaluation by the nurse? A. Two extra strength Tylenol tablets (500 mg/tablet) every 4 hours around the clock and my pain is gone. B. I make sure that I take my Tylenol with breakfast when I first get up. C. I find that when I drink herb tea and then take my Tylenol at bedtime I sleep through the whole night D. I heard that meditation may help me deal with the pain without taking the Tylenol
A
An older patient who was recently admitted to the subacute setting after having a knee replacement is very anxious and refuses to get out of bed stating that it is too painful. Which intervention will the nurse implement? A. Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed B. Allow the patient to remain in bed but share that getting up will be required at least twice a day starting the next morning C. Use the Boyer lift to get her out of bed so that the knee will not experience much movement and so there will be little pain D. Share with the patient that it's important to get out of bed and that there is pain medication available if it does hurt
A
State Death with Dignity Laws require that the terminally ill client be: A. educated regarding treatment alternatives B. over the age of 55 C. be supported in their decision by immediate family members D. eligible for federal support services
A
The nurse suspects that the spouse of a terminally ill client is experiencing anticipatory grief when they: A. dramatically reduce the time they spend attending to the client. B. refuse to leave the clients beside regardless of the reason C. sob inconsolably whenever they visit D. Spend hours recalling details of their life together
A
What is true about instruments to assess for depression in older adults? A. The shortened geriatric depression scale does not contain a question to evaluate suicide potential B. The geriatric depression scale is administered by a health care provider in an interview with the older adult C. Older adults tend to score inaccurately low (indicating less depression) than younger adults on the Zung self rating depression scale D. The beck depression inventory is designed for gerontological patients
A
When the daughter of a client diagnosed with moderate Alzheimer's disease asks about the possible benefits of enrolling her mother in art classes, the nurse's best response is based on the knowledge that: A. creative activities are not limited to cognitively intact elders; even individuals with dementia can benefit from creative activities B. individuals with dementia who have rational language skills can benefit from creative activities C. cognitively impaired elders cannot benefit from creative activities due to altered brain processes D. cognitively impaired elders are usually too agitated to participate in creative arts.
A
Which activity assures the nurse that the client's wish to, "leave a living legacy" has been accomplished? A. Donating their body to the local teaching hospital for research purposes B. discussing their experiences as a World War II veteran in Europe to a reporter C. keeping a journal to be passed on to their great grandchildren D. making a pilgrimage to a location with personal religious significance
A
Which client statement indicated an understanding of a primary benefit to be derived from moderately intense aerobic exercise? A. "Exercise will help keep my heart strong." B. "I will certainly sleep better" C. "When I go to yoga class j feel more focused" D. "I can already see a difference in my alertness"
A
Which description would be most characteristic of a self-actualized individual? A. An economically disadvantaged older black man who regularly checks out books from the library to read to neighborhood children. B. A wealthy white older woman who is constantly searching for a better laxative C. A middle class white man who was forced into an early retirement and is living in fear of being evicted from his apartment D. The older wife of a famous celebrity who travels the world but starves herself and seeks plastic surgery in her quest to fight the physical signs of aging
A
Which intervention best demonstrates that the nurse understands the spiritual needs of a terminally ill client? A. Arranging care so that the client's prayer time is not interrupted B. Assuming the responsibility of notifying the hospital chaplain of the client's admission C. Providing the client with the schedule of religious services offered in the chapel D. Suggesting that the family attend worship services with the client whenever possible
A
Which nursing intervention will best initially help an older client who is about to move to a new apartment feel safe living alone for the first time? A. Arrange with the local police to have a home security assessment done and then follow through with their suggestions B. Consider having a dog as a pet since even a small dog can provide protection and as a bonus companionship C. Have a peep hole installed in the apartment door and never open the door to strangers D. Join and actively participate in the local community watch organization
A
Which statement best demonstrates an older adults success at achieving self actualization? A. My father was an alcoholic but he did love us B. I always feel safe when my son is visiting C. My heart problems are better since I had the surgery D. I've been elected president of my service organization
A
The nurse documents that an older adult client is living independently in a safe environment. Which assessment data supports this evaluation? SELECT ALL THAT APPLY. A. the nurse observes the client wearing a safety alarm bracelet B. The client demonstrates the homes security alarm system C. Various safety features were installed when the bathroom was remodeled D. The client has access to a financially generous retirement benefit E. The clients home is within walking distance of a grocery store.
A, B, C
Which assessment finding is a contributor to an older clients risk for falls? SELECT ALL THAT APPLY A. Clients type 2 diabetes is poorly controlled with diet and exercise alone B. Client is awaiting cataract surgery on right eye C. Client reports a fall in the last year D. Client was adopted at age 5 when parents were killed in a fire E. Client has a history of contact dermatitis and psoriasis
A, B, C
A nurse shows an understanding of the appropriate administration of a mini-cog assessment tool when: SELECT ALL THAT APPLY. A. Informing the client that "I'm going to say three words: cat, coffee, and smile" B. Asking the client "can you repeat the words we talked about a little while ago?" C. Asking the client "do you have trouble remembering names and addresses?" D. Asking the client to "tell me what time this clock is showing" E. Explaining to the client that "I'd like you to draw a clock for me on this paper"
A, B, D
The nurse in a clinic setting that provides care for an ethnically diverse population of older clients shows an understanding of the LEARN model to direct the assessment process when: SELECT ALL THAT APPLY A. Recognizing that the clients hands are clenched as she answers assessment questions. B. Explaining to the client that herbal remedies may not be sufficient treatment for his chest congestion C. Suggesting to the client that it would be beneficial if she would trust her health care provider to prescribe the correct treatment D. Asking the client to describe what he thinks will help him feel better E. Acknowledging that the client has a different view of the appropriate treatment
A, B, D, E
When educating an older adult about Medicare Part D which information will be included? Select all that apply. A. It is an elective prescription drug plan with associated out-of-pocket premiums B. All persons with either Medicare Part A or B can voluntarily purchase a Medicare Part D prescription drug plan. C. The plan covers all costs of drugs after a deductible is paid D. The plan is not voluntary for individuals who are receive both Medicaid and Medicare E. This prescription drug plan requires client co-payments
A, B, D, E
An older adult is seen in the emergency room after falling and sustaining substantial soft tissue bruising. The assessment interview notes a history of arthritic pain in several joints. The client is prescribed acetaminophen 650 mg four times per day and Motrin 800 mg four times per day for control of the persistent arthritic pain. When providing discharge teaching the nurse includes information regarding the signs and symptoms of: SELECT ALL THAT APPLY. A. Gastrointestinal bleeding B. Renal impairment C. Increased anxiety D. Confusion E. Medication interactions
A, B, E
The nurse is managing the care of an older client experiencing the symptoms of heat fatigue. Which intervention will the nurse implement I help resolve the condition? SELECT ALL THAT APPLY. A. Monitoring the clients intake of electrolyte replacement fluids B. Withholding the clients prescribed anti diuretic medications C. Keeping the environmental humidity low and temperature cool D. Documenting that the clients skin remains pale, moist, and cool E. Helping the client assume a comfortable resting position.
A, B, E
Which precaution would be beneficial in minimizing an older adults risk of being a victim of fraud? SELECT ALL THAT APPLY. A. never provide personal information to telephone sales solicitors B. Do not allow uninvited sales persons into your home C. Keep your bank account and credit card numbers with you at all times D. Rely on the advice of people who only friends have recommended E. Contact the local Medicare or Medicaid service office for info when needed
A, B, E
A 77-year-old client recently lost her husband to a chronic progressive neurological disease. She has a history of osteoarthritis and hypertension and was newly diagnosed with metastatic gastric cancer. She sold her home and moved to another state to be closer to her children, but she misses her many close friends. What makes her at risk for spiritual distress? Select all that apply. A. Metastatic Cancer B. Age 77 C. moving far away from family and friends d. loss of a spouse E. chronic conditions; hypertension and arthritis
A, C, D
Which intervention is an example of countercoping for a client who has recently received a terminal diagnosis of cancer? Select all that apply. A. answering the clients questions regarding the trajectory of their illness B. Offering to pray with the client C. Scheduling a meeting with the client and family to identify alternative end of life plans D. Assessing the client frequently for depression and risk of self harm E. Being available to just listen to the client talk about dying
A, C, D, E
When individualizing pain management for a client hospitalized after major surgery, the nurse will: SELECT ALL THAT APPLY A. Implement non pharmacological interventions whenever possible B. Reassure the client that pain medication is available whenever they express a need for it C. Tut rate the prescribed analgesic medication to provide effective pain management D. Anticipate the clients need for pain medications E. Assess the client for cultural beliefs that affect individual expression of pain
A, C, D,E
The client is diagnosed with dyslipidemia. The diagnosis is supported when the clients lipid panel indicates a: SELECT ALL THAT APPLY. A. High density lipids level of 70 mg/dl B. Glucose level of 230 mg/dl C. Total cholesterol level of 260 mg/dl D. Low density lipids level of 120 mg/dl E. Triglyceride levels of >2000 mg/dl
A, C, E
An older aphasic patient has severe osteoarthritis, bilateral contractures of the lower extremities, and a stage IV pressure ulcer. The nurse practitioner prescribed analgesic medications to be administered around the clock which as needed doses to be administered as appropriate. What observation by the nurse would indicate that the pain regimen is effective. SELECT ALL THAT APPLY. A. Patient slept throughout the night. B. Patient winces only when turned and repositioned C. Patient compliant with attempts to provide AM care D. Patient slept during dressing change E. Patient ate 80% of breakfast, 70% of lunch and 100% of dinner
A, C,D,E
The nurse is treating a frail, older client for possible hypothermia. Which assessment data suggests the condition is resolving? SELECT ALL THAT APPLY. A. Clients temperature is 97.4 B. The clients feet are tingling C. Client is shivering D. Clients hands are warm and pink E. Client is in a fetal position.
A, D
When a client asks "What could be causing my triglycerides to be so low; I'm really careful about my diet?" The nurse responds by asking the client: SELECT ALL THAT APPLY. A. "Have you ever been diagnosed with malnutrition?" B. "Do you have a history of pancreatitis?" C. "Is your type 2 diabetes well managed?" D. "Have you ever been diagnosed with renal failure?" E. "Are you on medication for hyperthyroidism?"
A, D
The nurse managers of the geriatric and pediatric units arrange an intergenerational holiday party. The rationale for arranging such a partnering is based on which principle? Select all that apply. A. intergenerational activities can help all participants establish new relationships B. intergenerational activities are required by state and local geriatric regulatory agencies C. intergenerational activities provide the unites with an opportunity to improve inter-agency cooperation D. Intergenerational activities are beneficial for older adults because they can decrease isolation and foster a sense of meaning and purpse E. intergenerational activities provide youngsters with an opportunity to interact with older adults
A, D, E
When a cognitively impaired, wealthy, white client is noted to have burns on her upper back, her son states that the patient burned herself when attempting to shower. Which statement by a member of the team reflects a need for further education on elder abuse? Select all that apply. A. "She is wealthy; abuse does not happen in people of financial means." B. Even if we are not sure, we are legally bound to report our suspicions." C. "We need to consider that most abusers are either adult children or spouses." D. Her cognitive deficiencies put her at risk for elder abuse." E. The client is white and race places an important role in who is likely to be abused."
A, E
A 78 year old patient who is dying of colon cancer with metastases to the liver is refusing to eat or drink. He is alert and oriented and states that he has no desire to eat, which is causing the family great distress. In order to best address the client and the family, the nurse: A. explain the family's concern to the patient B. Educate the family that this is normal behavior in this situation C. contact the physician for an order for enteral feeding D. contact the dietitian for feeding supplements
B
A woman is terminally ill. Although it has never been discussed in the family nor stated outright by her physician, she suspects that she will die because of her illness. Upon which concept will the nurse base therapeutic intervention on? A. closed awareness B. suspected awareness C. mutual pretense D. open awareness
B
An older adult is being treated for severe pain resulting from a history of osteoarthritis. In her discharge teaching, which information is most important to the successful management of the pain? A. Check for incompatibilities before taking any new medications B. To take the analgesic around the clock as prescribed C. Arrange to take a dose of analgesic prior to physical activity D. Be alert for the signs of overdose toxicity
B
An older adult is currently prescribed both adoring and ibuprofen daily. What instructions are most important for the nurse to provide to assure the expected outcomes for this client? A. The medications should be taken together to ensure the effectiveness of both medications B. Take ibuprofen 30 minutes after the aspirin so as not to interfere with its effectiveness. C. The medications should be taken at least 4 hours apart to minimize the risk of gastric irritation D. The aspirin will negatively affect the analgesic effect of the ibuprofen
B
An older client in a long term care facility is receiving an annual physical and is ordered lab tests that include a CBC, serum electrolytes, and thyroid tests. When the clients son questions why these tests are being ordered by saying "dad is 85 and supposed to be sleepy" the nurses response is based in an understanding that: A. The CBC and serum electrolytes are useful screening tests, but the usefulness of the thyroid test should be questioned B. When conducted annually all of the tests are helpful in promoting maximum health for older adults in the long term care setting C. The tests are useful, but only if clinically indicated D. The healthcare provider ordering the tests needs to explain the rationale to the son
B
An older woman with breast cancer has completed a course of external radiation and is receiving chemo. After her recent chemo treatment she complains of severe weakness, dizziness, and lethargy and is admitted to the hospital. Her platelet count is 45,000. Based on this scenario what nursing intervention is of the highest priority? A. Maintaining skin integrity B. Preventing falls C. Preventing infection D. Replacing fluids
B
The cost of nursing home care is significant. The primary payer for nursing home care is: A. Medicare B. Medicaid and private pay C. long term care insurance D. Medi-Gap insurance
B
The nurse is providing care to a client diagnosed with dementia. What option is an example of the appropriate use of implied consent by the nurse? A. Preparing to draw blood from a clients arm after asking "can I see your arm" B. Changing a clients dressing when the client asks "will you change this bandage now?" C. Using the clients monthly allowance to buy a watch when he continuously asks for the time D. Arranging for a benign mole to be removed after the client states "I don't like this here"
B
The nurse is recommending that a client diagnosed with moderate stage Alzheimer's disease attend a support group when he becomes defensive about not driving his automobile and the effects it will have on "being stuck at home" which is the priority outcome expected for this client when attending the group sessions? A. Facilitates socialization thus minimizing the effects of social isolation B. Helps with minimizing the loss as a factor in causing depression C. Allows for the opportunity for a mental health professional to assess the client D. Provides caregivers with respite while assuring the client is well attended to
B
The nurse is reviewing the post surgical lab values of an older adult client. The clients erythrocyte sedimentation rate is 20 mm/hr. The nurse initially responds to this data by: A. Requesting that the lab re run the test B. Recognizing that the value is normal for older adults C. Asking the client if they have been diagnosed with any chronic inflammatory diseases D. Notifying the clients health care provider immediately
B
The original intent of social security was to: A. Provide a hospital insurance plan B. Minimize the dependency of older members on younger members of society C. Provide the blind, older adult, or disabled with adequate financial support D. Penalize women financially for numerous zero wage years while raising children
B
What is the role of the nurse in assisting older adults with travel interests? A. suggesting that they travel with a seniors group B. Addressing with arrangements to have medical care if needed during their travels C. Providing information regarding pet care services for their beloved dog D. Reassuring the client that their concerns about safety are unfounded
B
What research finding is the basis for care planning of the client receiving palliative care? A. palliative care is most useful when implemented in the last six months of life B. Pain management is inadequately addressed among the terminally ill population. C. Palliative care is only offered to patients whose deaths are imminent. D. Resuscitation in the case of a cardiac or respiratory arrest is not implemented
B
When a clients thyroid panel shows an elevated TSH, the nurse reviews the clients medication history for a current prescription for A. Heparin B. Lithium C. Phenytoin (dilantin) D. Aspirin
B
When a terminally ill client expresses a need for something more to help me cope with the pain the nurse bases the recommendation of meditation on which principle concerning this alternative therapy? A. it is efficient and usually takes less than 5 minutes to implement B. It has been shown to decrease anxiety and depression C. It improves cognitive abilities D. It has been known to eliminate emotional distress
B
When answering an older clients questions about diet, exercise, and bone integrity which exercise would the nurse identify as ineffective at meeting the need for moderately intense aerobic activity? A. Jumping rope for 15 minutes daily B. Yoga for 45 minutes twice a week C. Biking 2 miles daily D. Swimming laps for 30 minutes twice a week
B
When educating a client on the use of an adjuvant medication, which statement best demonstrates the nurses understanding of this therapy? A. These medications are used instead of opioids to decrease the likelihood of addiction B. These drugs are used in combo with analgesics to increase the effects of the analgesics C. Adjuvant medications are prescribed because they seldom cause any significant side effects D. These types of medications are used to eliminate the side effects of opioid medications
B
When working with a bereaved individual, the goal of nursing interventions is to: A. assist the individual to go through the stages of grief work in the optimal order B.assist the individual to attain a healthy adjustment to the loss experience C. encourage the individual to talk about his or her feelings about the deceased individual. D. offer support and advice about how to successfully achieve grief work.
B
Which statement best demonstrates the primary benefit of intergenerational partnering and the activities that it creates? A. These types of activities can help establish new relationships. B. Intergenerational activities can foster a sense of meaning and purpose. C. Such partnering can increase the self-esteem of the younger people. D. These activities can decrease social isolation in the older people.
B
What information should be included in an informational program to be presented on burn prevention to a senior citizens group? SELECT ALL THAT APPLY. A. Have the contact information for the local fire department easily accessible B. Do not smoke in bed or when sleepy C. Establish a plan for exiting each room of your home in the case of a fire D. Have a fire extinguisher readily available in the kitchen E. Wear well fitted clothing when cooking or when grilling outdoors.
B, D, E
Ethnocentrism is defined as: A. An understanding of anothers cultural beliefts and practices B. A belief that ones ethnic group is superior to that of another C. A conflict that occurs when an individual interacts with another whose beliefs differ from his iwn D. Application of limited knowledge about one person with characteristics specific to another person
B.
It has been projected that the cultural group presenting the greatest growth rate among the older adult population will be the: A. African Americans B. Hispanic Americans C. Asian/Pacific Island Americans D. Native Americans
B.
Regarding health care disparities, it is true that older adults of color have: A. Equal risk factors for vulnerability as do the young adults of color B. Increased risk factors for vulnerability if they are female C. An increase in risk factors for vulnerability if care is provided by public facilities D. Equal risk factors for vulnerability as do all older adults
B.
The initial step to effect the safe management of mild to moderate acute pain that has not been controlled with OTC medication is to: A. Begin acetaminophen every 4 hours for 24 hours B. Titrate dosage of a short acting opioid upward of over 24 hours to achieve relief C. Administer a single low dose of short acting opioid and monitor for relief D. Supplement with non pharmacological interventions
C
A 69 year d patient in the geriatric clinic has an annual physical exam and a CBC and serum electrolytes drawn. While the physical exam was uneventful the lab results show an elevated blood urea nitrogen. The nurse will then: A. Ask that the test be rerun since the client showed no physical signs of renal failure B. Instruct the client on collecting a 24 hour urine specimen for a more detailed analysis C. Review the clients med list since BUN can be affected by many meds D. Assure the client that an elevated BUN is normal in older adults
C
A 78 year d client resides independently in the community. The visiting home health nurse finds that despite its being 90 degrees outside, the windows are closed and the client is wearing s seater. The nurse initially recognizes that this behavior may be related to: A. Age related motor deficiencies that result in self neglect B. Cognitive changes that diminish the individuals awareness of temperature changes C. Age related neurosensoy changes that diminish awareness of temperature changes. D. Delirium related to an acute illness that is affecting body heat production
C
A frail, elderly widow is admitted to the hospital after sustaining a fall. The client lives alone and has no living relatives. After cognitive testing revealed mild cognitive impairment, the interdisciplinary team on the Acute Care for the Elderly Unit recommends long-term care placement, and that a durable power of attorney for health care (DPOA) be established . When the client seems confused over what a DPOA-HC's 's responsibilities are, the nurse responds that: A. "A DPOA-HC is a person you name to make health care decisions for you when you can't make them for yourself B. "A DPOA-HC is a person you trust to make financial decisions for you and to manage your money." C. "A DPOA-HC is a person appointed by the court to have sure you get good care and to manage your affairs. D. "A DPOA-HC is a person who is appointed by the court to make nursing home placement decisions for your care
C
A home care nurse in an areas of the country that is prone to tornadoes routinely discusses disaster preparedness with older adult clients. What is the primary rationale for this intervention? A. The older adult is more likely to live in a communal environment which provides assistance in times of natural disasters B. Federal and private assistance agencies generally provide older adults with priority attention in time of natural disasters C. Older adults are less likely to seek formal and informal help when affected by natural disasters D. Most older adults have insurance to help them recover from material losses due to a natural disaster
C
A home care nurse is conducting a home fire safety assessment for an older client who lives alone. Which observation is a particular worrisome for the nurse? A. The client recites "stop, drop, and roll" mantra when asked what to do if her clothes caught fire while cooking B. The bedroom and bathroom both have solid wood doors installed C. The home has 3 fire alarms positioned above windows in the kitchen, bedroom, and living room D. The client shows the nurse a copy of the apartment complex's fire evacuation plan
C
A limitation of the Katz index of activities of daily living is that: A. It puts a heavier weight on the cognitive abilities necessary to perform ADLs B. Completion of the tool requires the joint efforts of the interdisciplinary team C. All ADLs are weighted equally and the cutoff score is arbitrarily determined D. It is completed as a self report by the patient
C
A nurse suspects that her next door neighbor an older woman is a victim of elder abuse by her daughter. What is the appropriate action for the nurse to do in this situation? A. Since the neighbor is not a patient the nurse should not get involved B. Visit the neighbor frequently to confirm the suspicions C. Complete a confidential report with the adult protective services in the area D. Ask the neighbor herself if she is being abused
C
A paper on culture and illness would be likely to include the statement that: A. Ethnic groups always share common geographic origin and religion B. Culture is the same as ethnicity C. Ethnicity involves recognized traditions, symbols, and literature D. Most members of an ethnic group exhibit identical cultural traits
C
An elder is experiencing chronic pain resulting from a terminal illness. which intervention by the nurse would be most appropriate they verbalize a desire to find some sort of meaning to all this? A. introduce a sensory distraction such as television B. Reassure them that this is a normal phase that everyone experiences. C. Listen and help them express their feelings about life and death D. Ask the doctor to order a psychiatric consult for possible depression
C
In planning discharge teaching for a client with diabetes, which precaution related to fall prevention is particularly important for the nurse to include? A. Practicing stress management techniques B. Removing newspapers and other clutter from the floor C. Rising slowly from the table after meals D. Consuming recommended daily amounts of vitamin D
C
The FANCAPES assessment tool focuses on the older adult's: A. Ability to perform instrumental activities of daily living B. Cognitive abilities C. Ability to meet personal needs to identify the amount of assistance needed D. Level of dementia present
C
The nurse is admitting a client to a long term care facility. What information will the nurse provide the clients when they express a concern about needing to spend all their monthly income on the cost of their care? A. "Your sister can provide you will some spending money. I'll ask the next time she visits" B. "The facility will provide you with what you need; just let me know if you need something C. You will receive some money each month that you can use to buy whatever you want D. Most people here have very few outside needs; I'm sure you will feel he same way
C
The nurse is preparing educational material concerning fire safety in the home. What research data will be included in the material? A. Older women are more likely to die in fires than older men. B. Most fires occur outside the home. C. Fire mortality is highest in adults older than 65 years of age D. Most people who die in fires are killed by the flames
C
When an older adult is considering long term care insurance what is important for the nurse to encourage the client to consider? A. The older one is when applying the lower the rates will be B. It is financially better to avoid purchasing LTCI through a group policy C. It is wise to scrutinize all exclusions before enrolling D. All policies cover care at home as well as in a long term care facility
C
When comparing the older Americans resources and services (OARS) with the Katz index of ADLs, what is true? A. The Katz index and the OARS both measure only ADL performance B. The OARS is not valid for use in older adults who are cognitively impaired, whereas the Katz index is C. The OARS is a comprehensive assessment tool that measures ability in 5 areas; the Katz index measures only ADL performance D. The OARS is used only for older adults in the long term care setting; the Katz index is used in all settings.
C
When using the Fulmer SPICES assessment tool the nurse expects to ask: A. Do you think that you slept well? B. Are you ever incontinent of urine? C. Who helps you when you can't do something by yourself? D. When was the last time you fell?
C
Which factor is the greatest barrier to an older adult living independently? A. Limited financiers that prevent upkeep and maintenance of a residence B. Depression that occurs after the death of a spouse or significant other occurs C. Deficits in vision and or hearing resulting in safety issues D. The manifestation of cognitive impairment resulting from dementia or Alzheimer's
C
Which nursing assessment will best identify he older adult individual who is at greatest risk for a muscle weakness related fall? A. Assessing for a history of falls within the last month B. Asking the client to stand on one foot C. Determining if the client is taking thyroid medication D. Assessing hand grip strength
C
Which principle is the basis for the nurses plan of care regarding exercise for an older adult who is non ambulatory? A. Non ambulatory clients are usually resistant to engaging in any form of exercise B. Caregivers are usually unaware of the benefits of exercise for these individuals C. Appropriate exercise will positively affect the individuals quality of life. D. Passive range of motion exercise is best suited for the needs of such a client
C
Which principle regarding grief crisis intervention is the basis for intervention planning? A. the acute phase is the most intense period in the grieving process B. The intensity of the grief is in proportion to the expected death trajectory C. Grief work is most effective when addressed during the acute phase of grief D. Anticipatory grief is an expected barrier to grief work
C
Which truism will the nurse base spousal grief counseling upon? A. Men are less likely to grieve the loss of a spouse B. Women carry deeper attachments to their spouses than men do. C. Women are generally more likely to outlive their spouses D. The male response to grief has been thoroughly studied and documented
C
A 78 year old man is being evaluated in the geriatric clinic. His daughter reports that he has been very forgetful lately, and she is concerned that he might be senile. The advanced practice nurse administers the clock drawing test and the patient draws a distorted circular shape and places the numbers all on one side of the shape. Based on his performance, the nurse concludes that the pt: A. Needs a functional status assessment B. Probably has Alzheimer's disease C. Probably has delirium D. Needs further evaluation
D
A Navy war veteran is seeking advice about getting treatment for a chronic respiratory problem at the local veterans hospital. The nurse's initial response is to ask: A. "Why aren't you considering the local general hospital for the care that you need?" B. Are you willing to travel to a veterans hospital that offers respiratory diagnostic services?" C. Have you ever been treated at a veterans hospital before?" D. "Is the problem related to something that occurred while you were in the Navy?"
D
A nurse in the geriatric outpatient clinic frequently receives questions from clients about exercise. The nurse answers their questions based on the knowledge that regular exercise: A. Performed in excess as a young adult will lead to osteoporosis B. Must be avoided by older adults with rheumatoid arthritis because it strains the joints C. Is likely to lead to increased falls and possibly fractures D. Prevents muscle atrophy and improves mobility thus reducing the risk of falls
D
A nurse is working in a community health center that is sponsoring a program that offers both digital rectal exams and free prostate specific antigen blood tests to all men over the age of 60. A man approaches and asks "what is this all about?" The nurse responds: A. "The PSA test is a definitive way to diagnose prostate cancer" B. "A PSA test is indicative when a man has other symptoms of prostate cancer" C. "The PSA test is unreliable unless a digital rectal exam immediately precedes it" D. "A PSA test is one of the primary screening tests for prostate cancer"
D
An 88 year old woman is admitted to the hospital with a diagnosis of pneumonia. She has a history of hypertension and CHF, and is on a total of 5 different medications. The nurse caring for the woman develops a care plan that includes the diagnosis risk for falls. A priority nursing intervention for this client is to: A. Place the client on bedrest so that she does not fall B. Keep all of the side rails up on the clients bed at nighttime C. Assess the clients dietary intake for calcium adequacy D. Perform a fall assessment
D
An older adult is admitted to the hospital after a serious fall when noting that the client has been prescribed meperidine (Demerol) for muscle pain the nurse: A. Administers the medication so as to prevent the client for developing a fear of the pain B. Questions the client and family concerning any allergies to analgesic medications C. Conducts a pain assessment and determines the clients need for an analgesic medication D. Calls the physician to question the appropriateness of this medication order
D
An older adult is admitted to the hospital with complications resulting from lung cancer with metastasis to bone. A long acting opioid administered around the clock is prescribed. When explaining this intervention to the family the nurse bases the explanation on the principle that this technique: A. Prevents the development of an addiction to opioids B. Prevents many side effects of traditionally administered opioids C. Provides relief with lesser amounts of opioids D. Provides more stable therapeutic plasma levels of the drug
D
An older adult patient with a history of osteoporosis is hospitalized for wrist surgery. Which medication that is currently being prescribed would be most likely to interfere with bone integrity? A. Premarin B. Calcitonin C. Tums D. Heparin
D
An older adult with gastric cancer with bone metastasis is being discharged from the hospital after beginning a regimen of opioid analgesics to control the metastatic pain. What should be included in the discharge teach plan? A. Preventing pressure ulcers B. Benefits of grief counseling C. Increasing calories in diet D. The development of a plan to prevent constipation
D
An older resident of a long term care facility diagnosed with dementia has in the last 48 hours become more confused than usual and while usually requiring help with toileting has been incontinent of iron. The clients healthcare provider orders a CBC and serum electrolytes. When the lab tests are all within normal limits the nurse initially: A. Suggests that the resident be placed in broad spectrum antibiotics to prevent infection B. Changes the plan of care to include bladder training and implement a 24 hour calorie count C. Attributes the changes in the residents functioning to advancing dementia D. Speaks with the healthcare provider regarding the changes in the clients function and the possibility of obtaining a urine culture
D
Compared with acute pain, persistent pain requires the nurse to: A. Document the character of the pain as burning B. Monitor vital signs more frequently C. Administer analgesics at least every 4 hours D educate the client to the benefit of specific lifestyle changes
D
Select the true statement regarding cohort effect: A. All generations share a similar perspective on life events B. Each individual within a cohort experiences events in a similar manner C. Cohort effects would likely cause brothers to share the same expectation for treatment D. Birth cohort is important in understanding how one experiences a world event
D
The nurse sits at the beside of a comatose, terminally ill older client reading the wishes expressed in the numerous cards the client has received. Which concept of grief work is the nurse addressing with this intervention? A. Everyone needs social interaction B. The nurse needs to "attend to the patient" C. Hearing is believed to be the last sense to be lost D. The individual is living until they are dead
D
When a chronically ill 80-year-old client is admitted to your acute care facility in an unconscious state, the nurse's priority is to determine: A. the client's wishes concerning a 'good death' B. where the client's living will can be found C. if the client has expressed a wish to be a "do not resuscitate" (DNR). D. who is the client's durable power of attorney for health care (DPAHC).
D
When asked by an older adult client, "what is the difference between my normal lab values and the ones for a 55 year old?" The nurse responds based in the understanding that there are: A. Age adjusted ranges for older adults for all of the common lab findings, similar to those for infants and children B. Age adjusted ranges only for the over 85 age group; there are no expected changes in the 65-84 year old age group C. Age adjusted ranges only for the hematological tests which are due mostly to changes in the bone marrow D. No age adjusted ranges for older adults due to the large variations within the age group and the increasing number of factors that influence the results.
D
When performing a pain assessment on a client who is aphasic, the nurse should consider: A. That older adults do not tolerate opioid analgesics well and so exhibit side effects B. That the patients precious stroke interrupted pain pathways so she does not feel pain C. That the patient is lying quietly in bed so not likely experiencing pain D. Reports from the family or staff at the nursing home about changes in functional status
D
Which attempt by the family to prevent an older, frail adult from falling causes the home health nurse concern? A. Encouraging the client to use a cane when ambulating B. Installing wooden railings on the stairway to the bathroom C. Keeping several low wattage night lights on in the evening D. Keeping the side rails up on the clients bed at night
D
Which behavior is characteristic of grief by a disenfranchised adult child in response to a parent's death following a lengthy, painful illness? A. Crying out loudly while invoking "God's help in going on with life." B. Announcing to family members that, "I've already grieved the loss." C. Having difficulty even deciding what to wear to the funeral D. Going on a drinking binge instead of attending the funeral.
D
Which option is an example of which type of elder exploitation? A. A home bound client is left alone for days at a time by the caregiver B. An older client is smacked if they don't eat all of their food C. A client diagnosed used with Alzheimer's disease is bathed only twice a month D. A home bound client can only get groceries by agreeing to pay for her neighbors groceries as well
D
