Geriatric Nursing Test #2

The nurse suspects that an older person is experiencing a side effect from a prescribed anticholinergic medication. What did the nurse assess to make this clinical determination? A. Productive cough B. Constricted pupils C. Pale skin color D. Elevated temperature

D

A 75-year-old client, hospitalized with a cerebral vascular accident (stroke), becomes disoriented at times and tries to get out of bed, but is unable to ambulate without help. What is the most appropriate safety measure? A. Restrain the client in bed. B. Ask a family member to stay with the client. C. Check the client every 15 minutes. D. Use a bed exit safety monitoring device

D

A nurse suspects her patient may be suffering from delirium. What signs does the nurse observe to support this diagnosis? A) Slurred speech and one sided weakness B) Mask-like face and tremors C) Gradual onset of forgetfulness reported by family members D) Confusion and visual hallucinations

D

An older adult diagnosed with dementia lives with family and attends daycare. After observing poor hygiene, the nurse at the center talks with the patient's adult child. This caregiver becomes defensive and says, "It takes all my time and energy to care for my mother. She's awake all night. I never get any sleep." Which nursing intervention has priority? a. Teach the caregiver more about the effects of dementia. b. Secure additional resources for the mother's evening and night care. c. Support the caregiver to grieve the loss of the mother's ability to function. d. Teach the family how to give physical care more effectively and efficiently.

b

An 80-year old patient is being seen at the primary care clinic for routine care. The nurse performs a physical assessment on the patient. Based on the potential changes in the cardiac system associated with aging, which instructions would the nurse most likely give to this patient? A. Tell the patient to change positions slowly. B. Remind the patient to avoid environmental irritants. C. Explain that the patient should drink 8-10 glasses of water per day. D. Tell the patient that she must cover her mouth when sneezing.

A

An older adult diagnosed with Alzheimer disease lives with family. During the week, the person attends a day care center while the family is at work. In the evenings, members of the family provide care. Which factor makes this patient most vulnerable to abuse? A. Dementia B. Living in a rural area C. Being part of a busy family D. Being home only in the evening

A

An older person has difficulty remembering activities completed the day before yet can relate in detail people who attended a birthday party several decades ago. What should this finding indicate to the nurse? A. Normal changes B. Untreated delirium C. Symptom of a stroke D. Early dementia

A

An older person states that activities that used to be joyful are now viewed as a nuisance and is experiencing persistent feelings of sadness for several weeks. Which medication should the nurse suspect as the cause of this person's symptoms? A. Ranitidine B. Gabapentin C. Furosemide D. Acetaminophen

A

An older person with a low glomerular filtration rate is experiencing gout. Which medication should the nurse anticipate being prescribed for this person? A. Allopurinol B. Probenecid C. Sulfinpyrazone D. Colchicine

A

The charge nurse is concerned that nursing-assistive personnel (NAP) in a skilled facility are prone to neglecting the needs of the residents. What statement did the nurse hear one of the NAP make to come to this conclusion? A. "Maybe I'll bring you some water, if you behave." B. "I'll be back in a few minutes to take you to the dining room." C. "Your daughter will be here at 10 am. How about a shower now to get ready?" D. "Everyone's in the rec room watching the movie! Don't you want to see it too?"

A

The home health nurse assesses a hazard for a patient in the home setting. Which of the following assessments is considered a safety hazard? A. Throw rugs present in all rooms B. Stairways with handrails C. Grab bars in the bathroom D. Non-skid tape in the bathtub

A

The manager of a skilled facility is concerned that residents are not receiving required care and are experiencing neglect. Which information caused the manager to make this assumption? A. Resident sitting in urine-saturated clothing for hours B. Pressure ulcer healing rate at 10% C. All residents prescribed the annual influenza vaccination D. Family members visiting more frequently

A

The nurse arrives for a home visit and suspects that the older person is experiencing financial exploitation. Which observation caused the nurse to make this clinical decision? A. No electricity in the home B. Dry cracked lips C. Streaks of stool down the person's legs D. Rat droppings on the kitchen floor

A

The nurse documents that the family caregiver of an older person should be assessed for stress during every home visit. What caused the nurse to make this notation in the older person's medical record? A. Family caregiver complaining about the volume of laundry B. Unread newspapers stacked on the kitchen table C. The sink is full of dirty dishes D. Person sitting quietly watching television

A

The nurse has been caring for a patient over the past several years in an outpatient clinical. The nurse notices the patient has been much more withdrawn at visits and reports her children refuse to take her to church any more, an activity the patient has done for years and enjoys. The patient's daughter is also very demeaning to the patient at the visit. The nurse knows these can be signs of: a. psychological or emotional abuse b. neglect c. physical abuse d. financial abuse

A

The nurse notes that an older person's thigh muscles are atrophied; however, the muscles of the upper arms are tight and have definition. Which recommendation should the nurse make to this person to improve muscle function? A. Increase the amount and distance of walking B. Eliminate smoking and alcoholic beverages C. Increase the amount of housework done each day D. Decrease the intake of protein at meals

A

The nurse observes an older person stumble when getting up from sitting in a chair. Which recommendation should the nurse make to this person? A. Perform balance exercises when washing the dishes B. Hire a personal trainer to develop an exercise plan C. Encourage to practice scooting on the floor in a seated position D. Practice crawling on the floor in the prone position

A

The nurse suspects that an older patient is experiencing an altered drug response. Which reason does the nurse identify that this response is being caused by the aging process? A. Increased concentration of water-soluble drugs B. Increased availability of highly protein-bound drugs C. Increased excretion of drugs because of decreased renal function D. Increased effect of drugs metabolized by the liver

A

The nurse suspects that an older person is experiencing an increase in stress. Which finding caused the nurse to make this clinical determination? A. Increased blood pressure B. Mild lower-extremity edema C. Urinary frequency during the night D. Weight loss of 2 kg over 1 month

A

Identify methods to specifically prevent osteoporosis in postmenopausal women (Select all that apply)? A. Eating more beef. B. Eating 8 oz. of yogurt daily. C. performing weight bearing exercises. D. Spending 15 minutes in the sun each day. E. Taking postmenopausal estrogen replacement

B, C, D, E

The nurse is evaluating a patient who is in soft wrist restraints. Which of the following activities does the nurse perform? (Select all that apply.) a. Check the patient's peripheral pulse in the restrained extremity b. Evaluate the patient's need for toileting c. Offer the patient fluids if appropriate d. Release both limbs at the same time to perform range of motion (ROM) e. Inspect the skin under each restraint

A, B, C, E

Which clinical manifestation of osteoarthritis (OA) should the nurse include when teaching about osteoarthritis? (Select all that apply.) A. Joint pain with activity B. Pain and stiffness at night C. Abrupt onset D. Mild fever E. Crepitus with movement of joint

A, B, E

The nurse is providing education to a middle-aged female about her changing health needs. The nurse should be sure to include information on which age-related changes? (Select all that apply.) A. Loss of bone mass B. Decrease in height C. Increased circulation D. Decreased muscle mass E. Increased mineral exchange

A, B., D

How can the nurse facilitate communication with an older adult? Select all that apply: A. Assess for hearing deficit at the beginning of the interaction. B. Speak more loudly than normal, and at a slightly higher pitch. C. Pay special attention to cues from body language. D. Speak slowly, allowing time for the patient to word his answers.

A, C, D

Which age-related changes predispose the elderly patient to drug toxicity and extended duration of action of drugs? (Select all that apply.) A. Decreased body water B. Increased ratio of muscle to fat C. Low serum albumin D. Reduced blood flow to liver

A, C, D

The nurse, at change-of-shift report, learns that one of the clients in his care has bilateral soft wrist restraints. The client is confused, is trying to get out of bed, and had pulled out the IV line, which was subsequently reinserted. Which action(s) by the nurse is appropriate? Select all that apply. A. Document the behavior(s) that require continued use of the restraints. B. Ensure that the restraints are tied to the side rails. C. Provide range-of-motion exercises when the restraints are removed. D. Orient the client. E. Assess the tightness of the restraints.

A, C, D, E

Mr. Lim who is diagnosed of moderate dementia has frequent catastrophic reactions during shower time. Which of the following interventions should be implemented in the plan of care? Select all that apply. A. Assign consistent staff members to assist the client. B. Accomplish the task quickly, with multiple staff members assisting C. Schedule the client's shower at the same time of day D. Sedate the client 30 minutes prior to showering E. Tell the client to remain calm while showering F. Use a calm, supportive, quiet manner when assisting the client

A, C, F

The nurse performs a skin assessment of an older adult. Which finding is abnormal and needs to be reported? A. Increased patches of dark pigmentation on exposed skin. B. A dark, elevated patch that bleeds when touching C. Deep wrinkles and frown lines around the mouth and eyes D. Numerous brown or flesh-colored skin tags around the neck

B

A patient has moderate macular degeneration. To decrease the possibility of falls at night, you would do what? A. Keep a very bright light burning in her room B. Ask her to call for assistance to the bathroom C. Keep her cane within reach of the bed D. Have an attendant stay with her at night

B

An older person is concerned about the cost of prescribed medications. What should the nurse suggest? A. Take a full dose of the medication every other day B. Ask the health care provider for samples C. Take half of the prescribed dose D. Consider purchasing the medication from another country

B

An older person is prescribed escitalopram to help with feelings of depression. What information in the person's medical history supports the selection of this medication? A. Osteoarthritis B. Benign prostatic hypertrophy C. Diverticulitis D. Orthostatic lymphedema

B

An older person's daughter is getting divorced and plans to move herself and two toddlers in with the older person. What should the nurse suggest when the older person expresses anxiety over this change in living situation? A. Recommend an alternative living arrangement for the daughter B. Suggest stress-reduction techniques and exercise C. Encourage to charge the daughter rent D. Ask if the older person has considered moving to an adult-living community

B

One reason for medication problems in the elderly is that A. Regular use of laxatives increases absorption of medications B. Decreased renal function slows excretion of drugs C. Enhanced sense of taste of medications D. Increased perception of pain from injections

B

The administrator is preparing for a site visit of the skilled-nursing facility. Which action indicates that the organization is prepared to address any issues of elder mistreatment to the proper authorities? A. Contact name and telephone number for the local and state Center for Aging B. Policy and process to report elder mistreatment placed in a folder posted in the nurse's station C. Documentation when the most recent staff inservice on fire safety occurred D. Names and numbers of all organization administrators placed near the unit telephones

B

The client is to begin taking atorvastatin (Lipitor) and the nurse is providing education about the drug. Which symptom related to this drug should be reported to the health care provider? A. Constipation B. Increasing muscle or joint pain C. Hemorrhoids D. Flushing or "hot flash"

B

The elder with a sensory impairment as a result of the aging process may: A. Experience an abrupt awareness of the sensory loss B. Be subject to safety problems C. Increase socialization patterns D. Easily adapt to new environments

B

The majority of adults over 65 live in either assisted living or long-term care facilities. A. True B. False

B

The nurse has received shift report and enter the room to assess an older adult client. Upon entering the room, the nurse notes that the client will not make eye contact and is unwilling to engage in a discussion. The client states, "I never sleep well, but I'm tired now, so will you let me sleep tonight?" The nurse recognize this as which common problem experienced by a client of this age? A. Sleep deprivation B. Depression C. Dementia D. Stroke

B

The nurse suspects that an older person is at risk for elder mistreatment. Which finding supports the nurse's conclusion? A. Volunteers at the library B. The person is female C. Retired school teacher D. Lives with adult children

B

Which ability should Nurse Rebecca expect from a client in the mild stage of dementia of the Alzheimer's type? A. Remembering the daily schedule B. Recalling past events C. Coping with anxiety D.Solving problems of daily living

B

Which goal is a priority for a client with a DSM-IV TR diagnosis of delirium and the nursing diagnosis Acute confusion related to recent surgery secondary to traumatic hip fracture? A. The client will complete ADLs B. The client will maintain safety C. The client will remain oriented D. The client will understand communication

B

Which of the following responses by an older-adult client is most reflective of a need for further education by the nurse regarding the physiological changes associated with the older adult? A. "I call a cab if I want to go out after dark." B. "I can't help worrying about becoming forgetful." C. "I have my eyes checked regularly. Can't afford to fall." D. "I really enjoy eating good vanilla ice cream, but I have cut way down."

B

Which older adult is experiencing normal aging changes of the urinary system? A. A man who has difficulty voiding, especially when starting his stream B. A woman who wakes up to void once during the night C. A woman who is experiencing incontinence D. A man who says he has burning when he urinates

B

Which statement is true regarding falls in the elderly? A. Most falls occur in the garage B. Hip fractures resulting from falls are a leading cause of placement in long-term care facilities C. Fall risk decreases with addition of medications D. Sedatives reduce the risk of falls

B

You are performing a physical examination of the spine on an older adult. Which of the following findings is common with aging? A. Lordosis B. kyphosis C. Ankylosis D. Scoliosis

B

Your patient assigned to you has pneumonia. You are reviewing the age-related changed involved with the older adult. Select all age-related changes of the respiratory system that apply. A. Decreased in residual lung volume (can't exhale as hard, so hold onto more air) B. Decreased gas exchange C. Decreased cough efficiency D. Increased gas exchange

B, C

A nurse reviewing the medication list for an elderly patient notices several drugs that would increase the risk of falls because of Orthostatic hypotension, which are: ( select all that apply) A. Anticoagulants B. Diuretics C. Stool softeners D. Anti hypertensive E. Antihistamine

B, D, E

Which female patients are at risk for developing osteoporosis? Select all that apply. A. 60 year old white aerobic instructor. B. 55 year old Asian American cigarette smoker. C. 62 year old African American on estrogen therapy. D. 68 year old white who is underweight and inactive E. 58 year old Native American who started menopause prematurely.

B, D, E

An older person plays Scrabble with family members several times a week. What should the nurse expect when assessing this person? A. Adequate coping skills B. Tolerance for physical changes C. Intact cognitive functioning D. Improvement in short-term memory

C

80-year-old Mr. Stevens is accompanied to the clinic by his son, who tells the nurse that the client's constant confusion, incontinence, and tendency to wander are intolerable. The client was diagnosed with chronic cognitive impairment disorder. Which nursing diagnosis is most appropriate for the client's son? A. Risk for other-directed violence B. Disturbed sleep pattern C. Caregiver role strain D. Social isolation

C

A 70-year-old patient has not been taking his medications for hypertension and coronary artery disease. The nurse discovers the patient's son who has control of the finances has not been purchasing the medications and the patient's bank account only has a few dollars available. This is an example of which: a. self-neglect. b. abandonment. c. financial or material exploitation. d. psychological abuse.

C

A 91 year old female comes into the emergency room with symptoms of delirium. Which of the following would NOT be a possible cause of her condition? A. Urinary tract infection B. Dehydration C. Alzheimer's disease D. Recent anesthesia

C

An 84-year-old female patient is displaying signs of a delirium episode. To prevent the patient from injury, the most appropriate action by the nurse is to: A. Ask the provider about ordering an antipsychotic medication. B. Have the patient's guardian stay with the patient and give reassurance. C. Assign a staff member to remain with patient and provide frequent reorientation. D. Use a soft chest restraint to secure the patient in bed.

C

An 87-year-old man is admitted to the hospital for cellulitis of the left arm. He ambulates with a walker and takes a diuretic medication to control symptoms of fluid retention. Which intervention is most important to protect him from injury? A. Leave the bathroom light on. B. Withhold the client's diuretic medication. C. Provide a bedside commode. D. Keep the side rails up.

C

An older person with osteoarthritis asks what can be done to prevent further development of the disorder. Which response should the nurse provide? A. "Avoid beverages containing alcohol and caffeine." B. "Increase the intake of calcium and vitamin D." C. "Maintain a normal body weight." D. "Limit weight lifting and walking exercises."

C

An older persont babysits toddler grandchildren several times a week. What should the nurse suggest to ensure for safety when the children are in the person's home? A. Order a 30-day supply of the medication instead of a 90-day supply B. Place medications in a purse when the children are present C. Request the medication have childproof caps D. Place unused medications in the trash

C

During a home visit the nurse notes that an older person, who lives alone, is being visited by an adult son who is asking their parent for money. After the son leaves, what should the nurse do to ensure for this person's safety? A. Discuss identifying a guardian with an attorney B. Recommend that the person be admitted to a care facility immediately C. Devise a safety plan with the person D. Provide a list of caregiver-support groups

C

During an assessment an older person explains the onset of a health problem in relationship to the date in which the spouse passed away. What should the nurse conclude about this person's response? A. The person is grieving the death of a spouse B. The health problem was caused by the spouse's death C. The person is using a calendar date as a memory cue D. The spouse had the same health problem

C

The nurse assesses a patient who takes ibuprofen [Advil] on a regular basis. Which finding in the patient would prompt the nurse to contact the healthcare provider immediately? A. jaundice B. drowsiness C. hematemesis D. dysmenorrhea

C

The nurse has administered a presurgical anticholinergic drug about 30 mins ago. Which of the following responses would be of concern and should be reported immediately? A. "Nurse, my throat is dry" B. "I'm feeling a bit anxious. When will the surgeon be here?" C. "I need to leave. I have important business to do!" D. "My nose is suddenly stuffy. I wonder if I have a cold."

C

The nurse instructs a group of senior citizens with osteoporosis on nonpharmacologic measures to prevent further bone deterioration. Which statement indicates that teaching has been effective? A. "I should use antacids with aluminum." B. "I should take a 30-minute walk 3 times a week." C. "I should take my calcium pills first thing in the morning." D. "I should not smoke and have an alcoholic beverage together."

C

The nurse instructs an older person on ways to prevent esophageal irritation when taking medication. Which statement indicates that teaching has been effective? A. "I should lie down after taking medication." B. "Most medication causes chest or shoulder pain." C. "I should take each medication separately with 8-ounces of water." D. "An enteric-coated aspirin is less effective than one without the coating."

C

The nurse notes several older persons with family caregivers are waiting to see the healthcare provider for a scheduled appointment. For which person will the nurse make completing the Elder Assessment Instrument a priority? A. Person talking with family caregiver about a magazine article B. Person asking the family caregiver if they can go to the store after the appointment C. Person sitting with head down, hair uncombed, shoes untied D. Person watching the television while the family caregiver makes a telephone call

C

The nurse notes that an older person is prescribed a dose of digoxin that is lower than the recommended amount. Which age-related change explains the reason for this lower dosage? A. Increase in body fat B. Dry mouth and secretions C. Changes in sensitivity of certain drug receptors D. Decreased gastric acidity

C

The nurse notes that an older person is prescribed a total-protein level. Which physical assessment finding would support this laboratory test being used as an indication of elder mistreatment? A. Inability to remember recent events B. Weak hand grasps C. Body wounds and bruises at various stages of healing D. Shortness of breath with ambulation and mild exertion

C

The nurse notes that an older person, who lives alone, demonstrates a flat affect and sadness during the winter months. What should the nurse consider to help this person with symptoms of depression? A. Attend a support group B. Work on a hobby C. Engage in light therapy D. Antidepressant medication

C

The spouse of an older person is concerned because of an acute change in ability to remember how to get dressed in the morning. What should the nurse consider as causing the change in cognitive functioning? A. Sleep deprivation B. Insufficient nutritional intake C. Worsening Alzheimer's disease D. Undiagnosed infection

C

There are factors that influence the musculoskeletal system associated with aging. The nurse recognizes that with age: A. Men have the greatest incidence of osteoporosis B. Muscle fibers increase in size and become tighter C. Weight-bearing exercise reduces the loss of bone mass D. Muscle strength does not diminish as much as muscle mass

C

Which of the following would be an abnormal assessment finding for an older adult that the nurse would document and report to the primary care provider? Decreased: A. Reaction time B. Short-term memory C. Intellectual ability D. Cognitive processing speed

C

The administrator of an assisted-living facility cancels a scheduled outing for residents because of an increased risk of falls. What occurred that caused the outing to be cancelled? A. Access bus had a flat tire B. Drug representative arrived with donuts to talk about medications C. Unexpected snow storm D. Blood-pressure clinic was scheduled for the same time

C.

A student nurse was asked which of the following best describes dementia. Which of the following best describes the condition? A. Memory loss occurring as part of the natural consequence of aging. B. Difficulty coping with physical and psychological change. C. Severe cognitive impairment that occurs rapidly D. Loss of cognitive abilities, impairing ability to perform ADLs

D

An older person experiences a variety of adverse effects from prescribed medications. Which intervention should the nurse use to help this person achieve a restful sleep? A. Schedule small frequent meals B. Remove cheese from the meal tray C. Coach in guided imagery D. Provide a cup of warm milk

D

An older person is observed walking slowly down the street. Which age-related change should the nurse consider as most likely contributing to this person's ability? A. Lack of balance B. Fatigue C. Poor nutrition D. Change in cartilage

D

An older person reports taking a non-steroidal antiinflammatory (NSAID) medication several times a day to help with the pain caused by rheumatoid arthritis. Which response should the nurse make after learning this information? A. "Increase the dose if the medication becomes less effective." B. "They are the treatment of choice for your health problem." C. "Have you considered using acetaminophen instead?" D. "Do you take anything to protect your stomach?"

D

An older person seeks medical attention for a facial laceration that reportedly occurred by hitting the face on the door of an open kitchen cabinet. Which information in the person's medical record will hinder the nurse's ability to discern if the injury is caused by elder mistreatment? A. Cares for an aging spouse with chronic health problems B. Pays for a home-health aide who performs household chores C. Lives with adult daughter and three grandchildren D. Mild cognitive changes associated with Alzheimer's disease

D

An older person takes garlic to keep blood pressure under control. For which prescribed medication should the nurse assess for adverse effects because of the herbal supplement? A. Cyclosporine B. Alprazolam C. St. John's wort D. Warfarin

D

An older person with osteoporosis is prescribed alendronate. Which information should the nurse emphasize when teaching about this medication? A. Take 30 minutes after consuming a full meal B. Take first thing in the morning with breakfast C. Remain upright for 60 minutes after taking D. Remain upright for 30 minutes after taking

D

An older-adult patient in no acute distress reports being less able to taste and smell. What is the nurse's best response to this information? A. Notify the health care provider immediately to rule out cranial nerve damage B. Schedule the patient for an appointment at a smell and taste disorders clinic C. Perform testing on the vestibulocochlear nerve and a hearing test D. Explain to the patient that diminished senses are normal findings

D

As a mandatory reporter of elder abuse, which of the following must be present before a nurse notifies the authorities? A. Statements from the victim B. Statements from witnesses C. Proof of abuse and/or neglect D. Suspicion of elder abuse and/or neglect

D

During a home visit the nurse notes that an older person is not taking a medication as prescribed. Which medication factor may be causing this failure to adhere to the prescribed medication regime? A. Lack of perceived benefit of medications B. Lack of confidence in the health care provider C. Lower cognitive function D. Inability to get the tablet out of the packaging

D

During a home visit the older person reminds the nurse to lock the door and keep the blinds closed because the neighbors are outside talking about the older person. What should the nurse include when assessing this person? A. Heart rhythm B. Blood glucose level C. Blood pressure D. Hearing function

D

During a home visit, the nurse notes that an elderly woman is caring for her bedridden husband. The woman states that this is her duty and that she does the best she can and her children come to help when they are in town. Her husband is unable to care for himself, and she appears thin, weak, and exhausted. The nurse notices that several of his prescription medication bottles are empty. This situation is best described by the term: A. physical abuse. B. financial neglect. C. psychological abuse. D. unintentional neglect.

D

The 50-year-old son of an elderly widow brings his mother to the clinic for an examination. He states that she is becoming confused and is falling in the home. When left to be examined by the nurse, the female widow appears fearful, lucid, and says that she has never fallen down in her own home. What type of situation might this elderly widow be experiencing? a. Psychological abuse. b. Financial abuse. c. Social abuse. d. Physical abuse.

D

The nurse believes that an antipsychotic medication prescribed for an older person should be discontinued. Which extrapyramidal symptom did the nurse assess to make this clinical decision? A. Sudden onset of muscle rigidity B. Tongue thrusting C. Elevated body temperature D. Fidgeting and rocking

D

What should the nurse explain when discussing expected changes in the female reproductive system to an older adult? A. Increased pubic hair is expected B. Uterine enlargement is normal C. Vaginal tissues become more vascular D. Production of vaginal secretions decreases

D

Which of the following outcome criteria is appropriate for the client with dementia? A. The client will return to adequate self-functioning B. The client will learn new coping to handle anxiety C. The client will seek out resources in the community for support D. The client will follow an established schedule for ADLs

D

Which of the following will Nurse Dory use when communicating with a client who has cognitive impairment? A. Complete explanations with multiple details B. Pictures or gestures instead of words C. Stimulating words and phrases to capture client's attention D. Short words and simple sentences

D

While observing people walking in the community, the nurse is concerned that an older person is at risk for falling. What did the nurse observe to make this decision? A. Pushing the walker ahead before taking a step B. Talking with others while walking C. Stopping periodically to sit on a park bench D. Wearing shoes that are loose or untied

D