g t 7

A nurse is caring for an 85-year-old male client with diabetes in a community setting. The nurse promotes functional wellness by which of the following activities?

Encouraging the client to maintain current levels of physical activity

The nurse's first response when told by a client during an assessment interview that he "can't take furosemide (Lasix)" is to ask:

"Can you describe what happened when you took Lasix?"

Which of the following are examples of elderspeak? (Select all that apply.)

A nursing assistant refers to one of her patients as "grandma." A nurse attempts to medicate a patient and states, "Now come on and be a good girl." A nursing assistant tells a patient, "It is time for our bath now."

Best practice recommendations for nursing education in relation to gerontology include which of the following?

Provision of a "stand-alone" course in gerontological nursing Integration of gerontological content throughout the curriculum Recruitment of nurses with Masters and Doctoral degrees and a specialty in gerontology to faculty roles

Which technique is most effective when communicating with a client who is positioned in bed?

Sitting in a chair at the bedside facing the client

The nurse shows an understanding of how telomeres relate to aging and longevity when stating:

"Cigarette smoking affects longevity by accelerating telomere shortening." "Telomere shortening due to obesity can reduce life expectancy by more than 8 years." "Excessive emotional stress reduces antioxidant levels resulting in shorter telomeres which reduces longevity." "Shorter telomeres increase vulnerability to early-onset of age-related health problems."

A client with asthma asks the nurse about taking Echinacea for a cold. The nurse responds:

"Echinacea may be dangerous for people with asthma."

A home care nurse is caring for an older patient from a different culture who is bed-bound and high risk for development of a pressure ulcer. The nurse discusses the plan of care with the patient's daughter, emphasizing the importance of turning every 2 hours and posts a turning clock on the wall. When the nurse returns later in the week, the turning clock has been removed, and the patient's daughter reports that she turns her mother occasionally. She states, "I am taking very just don't understand; our ways do not involve doing things on schedules." The best response by the nurse is:

"How can we best work together to provide the best care for your mother?"

Which nursing statement shows a true appreciation for an older client's willingness to tell his personal stories about "the war"?

"I learn so much about clients when they share their life story with me."

The nurse admitting a client to a same day surgery unit makes the decision to notify the surgical team to cancel the procedure based on the client's statement that:

"I took my garlic pill this morning to make sure my blood pressure stays normal."

When a client asks, "What could be causing my triglycerides to be so high; I'm really careful about my diet?" the nurse responds by asking the client: (Select all that apply.)

"Is your type 2 diabetes well managed?" "Have you ever been diagnosed with renal failure?" "Do you have a history of pancreatitis?"

A nurse demonstrates understanding of the continuity theory when the nurse provides which of the following advice to an older adult?

"It is important to think about the activities that have been most satisfying for you nurse demonstrates understanding of the continuity theory when the nurse provides which throughout your adult life and make a plan to continue them." "Since you enjoyed teaching young children so much, perhaps you would enjoy volunteering in the day care center."

Which statement by the nurse is the strongest example of ageism by professional nurses?

"It is so difficult to find nurses who are truly effective geriatric nurses."

The daughter of an older hospitalized patient tells a nurse: "I am worried about my father. His memory is sharper when he is at home. He is forgetful, but is functional. Since he has been hospitalized his memory problems are much worse." The best response by the nurse is:

"Memory changes are is in an unfamiliar or stressful situation."

The son of a nursing home resident asks a nurse: "What is the significance of being certified in gerontology? I see that you are, but not all of the nurses are." The best response by the nurse is which of the following?

"National certification as a gerontological nurse is a way to demonstrate special knowledge in caring for older adults."

An older client prescribed a transdermal morphine patch for severe chronic pain is being educated on the appropriate administration of the medication. The nurse shows an understanding of essential information regarding this route of drug administration when stating: (Select all that apply.)

"This is an effective route for delivering small doses of medication over long periods of time." "Since you have problems with digestion, this is a good way to take your medication." "Please show me how you would apply your patch." "Be sure to avoid placing the patch on injured skin."

A 78-year-old female patient was recently diagnosed with atrial fibrillation and started on Coumadin (warfarin) for stroke prophylaxis. A nurse provides extensive education on warfarin including the need for routine blood testing. The woman states the following to a nurse: "I understand all that you have taught me, but I do not know what a good number for the INR test is." The nurse bases her response on the knowledge that the recommended INR is:

2.0-3.0.

An 81-year-old patient is being discharged from the hospital to home. She is on seven different medications, which are to be taken at four different times during the day. What would be most useful in helping this patient manage her medications?

A pillbox with compartments for each day and each of the doses

A nurse manager is providing a novice geriatric nurse with guidelines when encouraging an older client to reminisce about his or her life and past experiences. Which suggestions will be included? (Select all that apply.)

Don't correct the client even when you suspect the memory is incorrect. When the focus remains on sad topics, assess the client for possible depression. Expect and respect a degree of repetition

A nurse is assessing a patient's activities of daily living. The nurse will assess which of the following? (Select all that apply.)

Eating Continence Toileting Bathing

A nurse is planning an education program on wellness in a local senior citizen center. The nurse plans to provide education on the importance of immunizations, annual physical examinations, screening for diabetes, and vision and hearing screening. It is important for the nurse to understand which of the following?

Less than 50% of older adults (ages 65 and older) utilize available preventive services.

An older resident in a senior community tells a nurse: "I am really worried. I joined an exercise class, and I just learned everyone's name yesterday, and I cannot remember them all today. Am I developing Alzheimer's disease?" The best response by the nurse is:

Let's monitor your recall abilities to see if the problem persists."

A 66-year-old retired professional basketball player is admitted to the hospital for a total knee replacement due to osteoarthritis. In discussing discharge planning for this patient, the nurse includes which theory of aging to help him understand the importance of early and ongoing exercise postoperatively?

Activity theory

An older patient learns that he has metastatic cancer. The patient states: "I must have angered God." This is an example of which type of belief?

Magico-religious

A nurse in the ambulatory care setting is preparing to do an interview with a non- English-speaking client. The nurse secures an interpreter. In order to have the most effective interview, the nurse should do which of the following?

Allow more time for the interview. Watch the client's nonverbal communication. Have the interpreter check whether the client understands the communication.

Based on the census reports of 2015, the typical profile of a centenarian includes which of the following characteristics?

An American woman with no signs of dementia

Primary prevention strategies for older adults include which of the following?

An annual influenza immunization clinic A smoking cessation program

A nurse interviews for a job in a hospital that advertises that it is "elderly friendly." The nurse would expect to see which of the following in place?

An elder-assistance program to help patients remember their appointments and navigate the hospital services. Rooms furnished with foldout beds for family members/caregivers. An initiative to provide gerontological education for all nurses.

When caring for an ill adult client, the nurse is particularly concerned that the client communicates well since: (Select all that apply.)

assessment, planning of care, and even the therapeutic relationship is based on effective communication. it is the social connection that all individuals base interpersonal relationships upon. the need to communicate is a basic need of all individuals.

A nurse is developing an educational session for a group of older adults at a senior center. Which of the following would the nurse include in the education?

Attention span, language, and communication skills typically remain stable with increasing age. Older brains slow down and take longer to process constantly increasing amounts of information. In order to preserve brain function, it is important to engage in challenging cognitive activities.

When performing the initial assessment on a new client in a geriatric outpatients practice, the most effective method the nurse can implement to elicit an accurate medication assessment is to ask that the client:

bring in all of the medications that she is currently taking.

Gerotranscendence theory posits that:

older adults withdraw from society in order to give the individual an opportunity for self-reflection and self-exploration. time and superficial relationships become less important. material possessions have less meaning.

Serious and well-controlled research studies on aging have been available:

only in the past 60 years.

A married couple retired to a life care community after the husband had heart surgery. The wife has always been physically and socially active and joined an aerobic class, knitting groups, and a book club shortly after moving to the community. She walks on a daily basis and swims twice a week. Her husband spends his days reading and watching television. He was never a social person and enjoys being by himself. Which of the sociological theories of aging best describes the couple?

Continuity theory

When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse best ensures an understanding of oral hypoglycemic medications when providing:

oral explanations and sending the client home with a written copy.

Current initiatives to enhance the specialty of gerontological nursing include which of the following?

Development of the Nurse Competence in Aging project Promotion of geriatric nursing to excellence to the nursing community Offering scholarships for study and research in geriatric nursing

An antihypertensive medication has been prescribed for an older patient with hypertension. The patient tells a clinic nurse that he would like to take an herbal substance to help lower his blood pressure instead of the prescription medication. Which of the following should the nurse do? (Select all that apply.)

Encourage the patient to discuss the use of an herbal substance with his primary care provider. Explore with the patient which herbal substance he is planning on taking. Educate the patient on possible interactions of the herbal substance with his other medications.

Which intervention is therapeutic when facilitating communication with a cognitively impaired older client? (Select all that apply.)

Explain a task using simple, concise phrasing and one step at a time. Allow for additional time for the client to respond to questions or directions. Use nonverbal as well as verbal cues to help get your message across to the client.

A nurse organizes a symposium for health care professionals in the field of geriatrics. Which of the following topics align with Healthy People 2020s emerging issues relevant to healthy aging?

Fair pay and compensation standards for informal caregivers Emerging chronic conditions among baby boomers Minimum competency levels for health care professionals Health disparities in LGBT older adults

A nursing student is preparing a presentation on the wellness-based model for healthy aging. Which of the following concepts should the student include in the presentation?

Healthy aging is individually defined and can change over time. There are many strategies to promote healthy aging that are believed to be helpful but do not have empirical evidence to support them. Healthy aging cannot be achieved by only focusing on later life. It is a lifelong process.

The major goal of the NICHE (Nurses Improving Care for Health System Elders) program includes which of the following?

Improve outcomes for hospitalized older adults.

Which of the following factors contribute to poor outcomes for older adults during transitions of care?

Inability to read and understand discharge instructions Inadequate financial resources to purchase medications

What factor is an important contribution to polypharmacy in older adults?

Inadequate communication among medical care providers

An older patient is prescribed warfarin for stroke prevention. A nurse is providing patient education. Which of the following foods should the patient be taught to avoid?

Kale Spinach

Changes in certified nursing facilities in recent years include which of the following?

Increase in the number of subacute beds Decrease in nursing facility length of stay Increase in level of acuity of the residents

An older female resident of an assisted living facility says the following to a nurse: "I am very frightened about getting dementia. I have read a lot about brain exercises, but I am not sure what I should be doing." The nurse formulates a response based on knowledge of which of the following?

Individuals should engage in some type of brain exercising activity a couple of times a week for at least 25 minutes. Brain exercising activities may include computer-based games, memory training, board games, reading, and engaging in conversation. Individuals should choose brain exercise activities that are unfamiliar, challenging, and fun.

A community health nurse provides an annual flu prevention workshop at a local senior center. The activities include a lecture on preventing infections, which includes hand washing and limiting exposure to individuals who are ill, as well as an influenza immunization clinic. The nurse is basing her activities on what component of aging?

Inflamm-aging

A nurse hears a colleague state the following: "Can you believe that Mr. Jones' daughter just bought him a tablet computer? He is 90 years old. It is ridiculous to think that he can learn to use it." The nurse formulates a response based on research that shows:

Internet use is less prevalent in individuals over age 75 than those ages 65-74. older adults comprise the fastest growing population using computers and the Internet. technology has the potential to improve quality of life for older adults.

A nurse is planning a fall prevention education refresher session for the residents of a long-term care facility. The individuals are all cognitively intact and range in age from 80 to 100. The previous education on fall prevention was presented 2 months ago. What special considerations should the nurse take in relation to teaching this group of older adults? (Select all that apply.)

Make sure that all pamphlets are in large readable font (14-16 points) and include upper and lower case lettering. Ensure that there is adequate lighting in the room and that the temperature is comfortable. Provide ongoing positive feedback during the session.

Baby boomers born before 1960 were subject to which of the following health challenges during their childhood?

Measles Scarlet fever Rubella

A nurse is planning care for a group of super-centenarians in an assisted living facility. The nurse considers which of the following?

Most super-centenarians are functionally independent or require minimal assistance with activities

A nurse identifies a need to assess a patient's cognitive status. The nurse chooses to use the clock-drawing test. The nurse knows that the patient must have which of the following abilities? (Select all that apply.)

Number fluency Familiarity with analog clocks Ability to hear and see

An older woman with breast cancer has completed a course of external radiation and is receiving chemotherapy. After her recent chemotherapy treatment, she complains of severe weakness, dizziness, and lethargy and is admitted to the hospital. Her platelet count is 19,000. Based on this scenario, what nursing intervention is of the highest priority?

Preventing falls

The impact of the Hospital Readmission Reduction Program (HRRP) on avoidable readmissions includes which of the following?

Readmission rates for the selected conditions have dropped nationwide. Many hospitals have instituted system-wide interventions to prevent readmissions.

Which age-related change affects absorption?

Reduced saliva

A resident of a long-term care facility is assessed by a nurse upon admission to the facility. The assessment includes a comprehensive health, social, and functional profile. The tool that the nurse utilizes is:

Resident Assessment Instrument (RAI).

A nurse plans programs for older adults in a senior center. She asks a retired teacher to lead an art class and a retired nurse to assist with a health fair. The nurse is utilizing which theory of aging?

Role theory

A limitation of the Katz Index of activities of daily living (ADLs) is that:

all ADLs are weighted equally.

When comparing the Older American's Resources and Services (OARS) with the Katz Index of ADLs, what is true?

The OARS is a comprehensive assessment tool that measures ability in five areas; the Katz Index measures only ADL performance.

Which of the following are true statements about the current health care workforce?

The professions of social work, physical therapy, and psychiatry are demonstrating the same trends as nursing. Europe and the developing countries are experiencing similar shortages in health care workers with geriatric expertise as in the United States. It is anticipated that there will be a need for approximately 3.5 million additional direct care and professional health care workers by the year 2030.

An elderly man is brought to the geriatrics clinic by his wife because of his increasing confusion. As part of his medical workup, the nurse practitioner orders which of the following laboratory tests? (Select all that apply.)

Urine analysis Vitamin D level Thyroid stimulating panel Vitamin B12

The nurse is aware inflamm-aging most likely explains why the older population is at risk for autoimmune disorder. What common strategy has been found to have deleterious effects on immunity?

Use of supplemental antioxidants

Ethnocentrism is defined as:

a belief that one's ethnic of another.

The FANCAPES assessment tool focuses on the older adult's:

ability to meet personal needs to identify the amount of assistance needed.

An older female patient tells a nurse the following: "In my culture, women are the silent partner in the family. Men make all of the decisions. However, when we came to the United States, all that changed. I became an American. I am in charge of my family just like my husband." This is an example of:

acculturation.

When discussing pharmacological considerations, a 68-year-old client asks, "Why do medications seem to act differently than they did when I was younger?" The nurse bases the response on the concept that:

age-related changes affect the way drugs are metabolized by older adults.

A nurse utilizes the SPICES tool (Sleep disorders, Problems with eating, Incontinence, Confusion, Evidence of falls, and Skin breakdown) to assess an older female patient in the hospital. The nurse notes that the patient has new onset urinary incontinence. The first action by the nurse is to:

conduct a more in-depth focused assessment of the urinary incontinence.

A female nurse is caring for an older woman from the Hasidic Jewish community. The woman's son is at the patient's bedside. The nurse notes that when she communicates with the patient and her son, the son does not maintain eye contact with her and also notes that he withdraws when she attempts to shake his hand. The best response by the nurse is to:

continue conversing with both the patient and the son.

The nurse implements the concepts of the activity theory of aging when instructing the older client with osteoarthritis to:

continue her daily walking routine.

A nurse completes a cultural assessment of an older adult who is being admitted to an assisted living facility. Reasons for completing a cultural assessment include:

culture guides decision-making about health, illness, and preventive care. culture provides direction for individuals on how to interact during health care encounters. culture impacts attitudes toward aging.

When a nursing interview identifies that a client is daily taking doses of herbal supplements, the nurse's priority is to:

discuss the client's knowledge regarding the herbal supplements' side effects.

The area in which nurses have the greatest effect on the safe, effective medication therapy of an older client is:

educating the client to all aspects of the medication.

A paper on culture and illness would be likely to include the statement that:

ethnicity involves recognized traditions, symbols, and literature.

During an admission interview, a patient tells the nurse about taking Ginkgo biloba daily. The nurse responds to this information by inquiring whether the client:

experiences gastrointestinal (GI) upset.

The family member of a patient asks if vitamin C will prevent aging. In formulating an appropriate response, the nurse considers the:

free radical theory.

The nurse is conducting a presurgical interview when it is noted that the older adult patient's medication list includes Tylenol 650 mg four times a day for arthritic pain, gingko 80 mg twice a day, and glucosamine chondroitin 500 mg three times per day. The nurse proceeds to share with the client that in order to minimize the risk for postsurgical complications, there is the need to refrain from taking:

ginkgo for 2 weeks due to the potential for increased bleeding.

Factors that affect the pharmacokinetics of lipophilic medications in older adults include:

greater adipose tissue ratio to body mass.

When asked by new parents what the life expectancy is for their African American newborn, the nurse replies that, "2015 statistics indicate that your son:

has a good chance of celebrating his 75th birthday."

The Beers Criteria is an effective tool for health care professionals prescribing and/or managing the medication therapy of older adults since it identifies medications that for this population:

have a higher than usual risk for injury.

Regarding health care disparities, it is true that older African Americans have:

increased risk factors for vulnerability if they are female.

A nurse completes a functional status assessment of an older person using the Lawton IADL instrument, a self-reported instrument. The nurse knows that limitations of self-reported measures include that: (Select all that apply.)

individuals tend to overestimate their functional ability. self-reports often differ from that of proxy reports.

A 77-year-old Hispanic Catholic nun (retired) who immigrated to the United States 15 years ago lives alone but in an apartment complex where her biological sister lives as well. She is being discharged home after a hospitalization for congestive heart failure with prescriptions for eight different medications. She is considered at risk for medication misuse due to contributing factors that include: (Select all that apply.)

language barrier. living alone. large number of medications.

An older adult client is being seen for the first time at the outpatient geriatric clinic. As a component of the nursing admission history, the nurse inquires about the use of herbs and other supplements. The basis for this inquiry is that such herbal therapy:

may interact with prescription medications.

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 patient:

needs further evaluation.

When asked by an older adult client, "What is the difference between my normal laboratory values and the ones for a 55 year old?" The nurse responds based on the understanding that there are:

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.

he major focus regarding older adult regarding the use of herbal supplements is the:

possibility of dangerous interactions between herbals and the client's prescription medications.

Factors that complicate assessment of older adults include: (Select all that apply.)

presence of multiple comorbid conditions. atypical presentation of illness difficulty in differentiating symptoms of disease from normal age-related changes. increase in iatrogenic illness.

Significant factors contributing to the growth of community-based care include:

rapidly escalating health care costs. older adults' preferenece.

An older woman asks a nurse in the cardiology practice, "What is the ideal number that my cholesterol levels should be? I am confused by all of the different numbers." The nurse formulates her response on the knowledge that:

recent guidelines from the American Heart Association state that there is no "one size fits all" recommendation and that recommendations must be individualized to each patient.

The nurse is reviewing the postsurgical laboratory values of an older adult client. The client's erythrocyte sedimentation rate (ESR) is slightly elevated. The nurse initially responds to this data by:

recognizing that slight elevation is normal for many older adults.

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:

recognizing that the client's hands are clenched as she answers the assessment questions. asking the client to describe what he thinks will help him feel better. explaining to the client that herbal remedies may not be sufficient treatment for his chest congestion. acknowledging that the client has a different view of the appropriate treatment.

A 69-year-old patient in the geriatric clinic has an annual physical examination and a complete blood count and serum electrolytes are drawn. While the physical examination was uneventful, the laboratory results show an elevated blood urea nitrogen (BUN). The nurse will then:

review the client's medication list since renal health can be affected by many specific medications.

When conducting an admissions interview with an older client, the nurse observes that the client pauses for a period of time before responding to the questions. The nurse responds to this client based on the

sorting through his or her vast life experiences in order to answer appropriately.

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 urine. The client's health care provider orders a complete blood count and serum electrolytes. When the laboratory tests are all within normal limits, the nurse initially:

speaks with the health care provider regarding the changes in the client's function and the possibility of obtaining a urine culture

Health literacy is defined as:

the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions.

The nurse suspects that a client is experiencing tardive dyskinesia when observing that:

the client's facial muscles are twisting involuntarily.

One reason why many "baby boomers" have multiple chronic conditions such as heart disease, diabetes, and arthritis is that:

there was a lack of importance placed on healthy living as they were growing up.

The nurse preparing wellness information for older adult clients is promoting interventions consistent with healthy biological aging when suggesting that they: (Select all that apply.)

use moisturizers daily to minimize dry skin. practice stress reduction techniques on a regular basis. consider getting a yearly influenza vaccination.

An older client in a long-term care facility is receiving an annual physical examination and is ordered laboratory tests that include a complete blood count, serum electrolytes, and thyroid tests. When the clients son questions why these tests are being ordered by saying, "Dad is 85 why are you bothering him?" the nurse's response is based on an understanding that:

when conducted annually, all of the tests are helpful in promoting maximum health for older adults in the long-term care setting.

The nurse preparing an educational program focused on herbal supplement targets as a likely interested group:

white females who own their own successful businesses.