Final Exam Review (Geriatric Nursing Pre-Test)

When the gerontological nurse in a clinic asks a 70-year-old man about his sexual activity, he begins to cry and says, "I feel so bad for my wife; she is only 60, and I can't seem to satisfy her as often as I used to." Which is the nurse's most appropriate response?

"Certain body functions, such as erections, slow down with age. Could you tell me more about your sexual relations? For instance, how often do you have intercourse?"

Members of a family are caring for their father at home. Which statement by a family member indicates a need for teaching and caregiver instruction

"Dad has gotten lazy about his bathroom habits. He blames his arthritis medication for his toileting accidents."

A gerontological nurse at a nursing home conducts a reminiscence therapy group for residents with confusion. A member of the group stands up and says, "I just heard my cow. I have to go and milk her now." The nurse's most therapeutic response is:

"Please tell us about your cow."

A gerontological nurse is creating a staff development program for a unit. To assess the staff's learning needs, the nurse's best approach is to ask staff members:

"What do you need to know to do your job better?"

For an individual with age-related hearing loss, which sound is most difficult to hear?

A young child talking in a cafeteria line

The holiday season is approaching and a woman is admitted to a psychiatric unit. She reports that her husband of 45 years passed away four weeks ago. She frequently cries, eats poorly, periodically complains of back and stomach aches, and has begun isolating herself. What type of grief is this woman exhibiting?

Acute

A 73-year-old patient is admitted to a rehabilitation facility after sustaining a mild stroke. After three nights in the facility, the patient begins to sleep only four to five hours a night and to awaken frequently during the night. The patient then complains of not feeling rested and begins to nap during the day. Which is the most appropriate nursing action?

Completing an assessment of the patient's sleep-wake cycle to determine necessary interventions

Which symptom in older adults is most indicative of a urinary tract infection?

Confusion

Which condition might be indicated by an increase in hemoglobin values?

Dehydration

A gerontological nurse in a daycare program for older adults observes that the participants have long toenails, corns, calluses, and other problems indicating a need for better foot care. What is the nurse's best action?

Developing an educational program on foot health and arranging for podiatry services at the site

A 78-year-old patient calls a telephone triage nurse and reports several falls after taking over-the-counter medication for a recent cold. Which medication contributed to the falls?

Diphenhydramine (Benadryl)

Which type of fracture has the highest morbidity and mortality in the older adult?

Hip

Age-related changes in which two organs most affect an older adult's reaction to medication?

Liver and kidneys

Which is an accurate statement about Medicare?

Medicare is a health insurance program with carefully described benefits that may restrict the length of hospital stays.

Which profession first developed standards of gerontological care and provided a certification mechanism to ensure expertise?

Nursing

Which assessment tool measures economic resources, mental health, and activities of daily living?

Older Americans Resources and Services Assessment

An accrediting body evaluates a nursing home by monitoring the number of residents who developed pressure ulcers and urinary tract infections. What type of audit is being conducted?

Outcomes

Which is a risk factor for vaginitis in older adult women?

Prolonged antibiotic therapy

Which signs are characteristic of deep vein thrombosis?

Rapid onset of unilateral leg swelling with dependent edema

An alert and oriented 82-year-old woman, who lives with her daughter, has been admitted to the hospital with bruises about the face and head. The daughter reports that her mother fell. Which behavior by the daughter raises the greatest suspicion of elder abuse?

Refusing to leave her mother alone to answer questions

In discussing the biological theories of aging, the nurse would include information on which of the following theories?

The "wear and tear" theory

A gerontological charge nurse delegates the administration of a nasogastric tube feeding to a licensed practical nurse (LPN). Which statement about this situation is most accurate?

The charge nurse is responsible for delegated care.

A nursing home conducts a survey to evaluate nursing care. However, some residents did not express their concerns due to fear of reprisal by the staff. Which aspect of the evaluation is most affected?

Validity

A common side effect of angiotensin-converting enzyme inhibitors that frequently results in discontinuation of therapy is:

a dry, persistent cough.

A 65-year-old man with a 45-year history of smoking complains of a change in his cough pattern, a nonproductive cough, and an ache in his chest. The man's chest x-ray reveals an infiltrate. The gerontological nurse suspects:

a lung tumor.

Heat stroke is a serious form of hyperthermia that is characterized by

absence of sweating

The primary function of an ombudsman is to:

act as a clearinghouse for complaints and problems.

An 83-year-old female patient underwent a total hip replacement three days ago. She should not cross her legs because:

adduction of the hip can cause dislocation of the prosthesis.

A 72-year-old man with asthma, chronic obstructive pulmonary disease, and chronic anxiety is admitted to a nursing home. Care plan objectives for this man include:

adherence to his medication regimen, inhalation therapy, and instruction about methods of conserving energy.

A 63-year-old patient is returning home after being hospitalized for injuries received during a robbery and home invasion. Although neighborhood robberies are rampant, the patient has lived in the same house for 50 years and does not want to move. The patient receives a monthly social security check. The gerontological nurse's most appropriate step is to:

advise the patient to arrange for someone to visit regularly or move into the home.

An 80-year-old patient is in the terminal stage of Alzheimer disease. The treatment team meets with the patient's family, who are angry and complain about a recent incident in which their parent's dentures were misplaced. The team members realize that:

anger at staff is a symptom of grief and needs to be addressed.

Unusual symptoms of pneumonia often found in long-term care residents include:

anorexia and new behavioral problems.

The most common cause of chronic pain in older adults is:

arthritis.

In teaching an older adult client, the gerontological nurse's most appropriate initial strategy is to:

assess the client and individualize the teaching methods.

The main reason that older adults with a chronic illness tolerate functional impairments is that they:

associate their symptoms with aging rather than an illness

The most appropriate environment for a person with chronic dementia is one that

contains familiar objects.

A physician has just informed an older adult patient that test results indicate that the patient has cancer and will require extensive surgery. The patient says, "I know the tests are wrong. I feel fine." The gerontological nurse's most appropriate response is to:

convey availability to talk to the patient.

A factor that contributes to hypothermia in older adults is:

decreased activity

A stage III pressure ulcer is characterized by:

deep craters with or without undermining and full-thickness skin loss involving subcutaneous tissue

A gerontological nurse is teaching dressing techniques to a patient with right hemiplegia and a severe speech impairment. An appropriate first step in the nurse's teaching would be to:

demonstrate the proper way to put on a shirt.

A 75-year-old patient who sustained a stroke has residual left-sided weakness. From the first day of hospitalization, the patient has been combative and demanding, and has refused to swallow any medication. The most constructive nursing action is to:

determine the patient's premorbid personality.

An early sign of alcohol withdrawal is:

diaphoresis.

All care plans for older adult patients include:

discharge planning.

A patient with Stage 2 Alzheimer disease visits the mental health clinic. During the interview, the patient becomes hostile and refuses to answer further questions. The gerontological nurse's best action is to:

discontinue the interview.

The adult children of an aging couple ask a gerontological nurse about alternative therapies or nontraditional services to improve their parents' health. The nurse's most appropriate response is to:

discuss the benefits, risks, and limitations of various therapies.

The progression of intermittent claudication is measured by the:

distance walked before leg pain starts.

Persons who are taking anticholinergic drugs are at high risk for:

dry mouth.

The gerontological nurse facilitates the benefits of life review by:

encouraging reminiscence, oral histories, and storytelling.

A 76-year-old patient with osteoarthritis complains of pain, stiffness, and deformities of the fingers. The gerontological nurse recommends

exercise

An 80-year-old resident of a retirement center states that something is wrong with the lighting in the room because colored rings appear around the light bulbs. The resident most likely has:

glaucoma.

A 92-year old patient, who recently underwent a below-the-knee leg amputation, is resisting attempts at rehabilitation. The most likely reason for the resistance is that the patient:

has goals that differ from the rehabilitation care plan.

Sildenafil citrate (Viagra) is hazardous for patients with:

heart failure and borderline hypotension.

Older adults who take the herbal supplement cascara sagrada are monitored for the presence of:

hypokalemia.

When hospital quality assurance indicators are assigned, the nursing staff strives to

identify high-risk, high-volume, or problem-prone areas

The primary risk factor for the development of pressure ulcers in older adult patients is:

immobility.

In assessing the lighting for a patient with glaucoma, the gerontological nurse knows that:

lower levels of light are needed.

A 78-year-old male resident at a long-term care facility, who is a former business executive, has been smoking and extinguishing cigarettes in a paper cup in areas where smoking is prohibited. He has been informed repeatedly of the designated smoking areas. The resident's behavior indicates an attempt to:

maintain autonomy by exercising control

A 68-year-old man calls his daughter every night to talk about his beloved wife who died four weeks ago. During the day, he is sad and goes out frequently to get away from the empty house. The man's most probable state is:

mourning

The gerontological nurses in a teaching nursing home are informed of a research project to obtain voiding cystometrograms on all residents. The gerontological nurses' responsibility is to ensure that the:

non-English speaking residents receive a complete explanation of the study in their native languages

In preparing a presentation for older adults, a gerontological nurse keeps in mind that:

older adult learners are heterogeneous due to diverse educational experiences and learning strategies.

When relocating from a family home to a continuing care community, the most crucial factor in an older person's adjustment is his or her

perceived control of the move.

A comprehensive staff development program in a long-term care facility is based on the:

philosophy, goals, and objectives of the organization.

The primary reason for establishing quality improvement committees at long-term care facilities is to:

provide quality care based on measurable data.

The occurrence of tuberculosis in the older adult is significantly increased among individuals who:

reside in institutions.

Nursing facilities that receive federal funds must complete for all residents a:

resident assessment instrument within 14 days and a care plan within 21 days

An older adult patient, who is recovering from surgery, has a sodium level of 128 mEq/L and is confused. Their provider diagnoses syndrome of inappropriate secretion of antidiuretic hormone. The gerontological nurse's primary goal for this patient is to:

restore the patient's fluid and electrolyte balance.

Reminiscence therapy promotes an older adult's sense of security by:

reviewing comforting memories.

Older adults with Parkinson disease exhibit:

rigidity and tremor at rest.

A gerontological nurse is caring for an older adult who has been confined to home for the last 10 weeks due to illness. The patient is anxious, has multiple somatic complaints, and has become unable to follow instructions. The nurse knows that this phenomenon commonly occurs with:

sensory deprivation

A 90-year-old patient with multiple medical problems is admitted to the hospital's geriatric care unit. The nursing assessment reveals lethargy, poor capillary perfusion, and urinary incontinence. These findings alert the gerontological nurse to the potential for:

skin breakdown.

To prevent injury, a gerontological nurse advises an older adult who is taking tricyclic antidepressants to:

stand up slowly from sitting or lying positions.

Pain of gastrointestinal origin is best differentiated from pain of cardiac origin by the presence of:

substernal chest discomfort

An 87-year-old man, who has been living independently, is entering a nursing home. To help him adjust, the most effective action is to

suggest that he bring his favorite things from home to make his room seem familiar.

A healthy 80-year-old female patient complains that her skin feels dry and sometimes itchy. The gerontological nurse advises her to:

take fewer baths, use soap sparingly, and apply skin cream afterward

An 80-year-old patient complains of sleeping less despite spending more time in bed. The patient does not use alcohol, caffeine, or any medications other than acetaminophen for arthritis pain. The patient goes to bed at 11:00 pm, falls asleep in 15 minutes, awakens several times during the night, and promptly goes back to sleep. The patient feels refreshed in the morning and works five days a week as a volunteer. Thegerontological nurse's most appropriate response is to:

tell the patient that the sleeping pattern is a normal age-related change.