gerontology final
what type of information do we remember the longest?
Information we have a use for
Which of the following characteristics of rheumatoid arthritis (RA) are unlike those of osteoarthritis (OA)?
RA is systemic and symmetrical, OA is not
the suicide rate for older adults is increasing especially among older men. Which of the following is the most common means of suicide for older men?
firearms *are going to come to the doctor with a physical complaint. they are not going to come in saying their depressed/emotional
Every culture has it's own definition of when a person is considered old. The statement, "Bob must be old, he is unable to do his job" is an example of which definition of old?
functional
major difference between medicare and medicaid
funding because Medicare is federally funded while medicaid is funded by both the state and federal government
The nurse suspects that a patient's spouse is experiencing caregiver burden, the best way for the nurse to assess for this condition is by?
gathering assessment data from the caregiver and the patient
An older male patient is planning to marry a woman in her 30s and wonders if he can still father a child. The nurse informs the patient that
it is still possible at this time of life to father a child
which of the following communication activities are learned first and taught the least?
listening
anticoagulation therapy is the standard treatment for atrial fibrillation. Patient education for anti-coagulation therapy must include
increased risk for GI bleed
The number of older adults is (blank) worldwide -because we're living longer and were helping
increasing
which is the most prevalent risk factor for impaired hearing
exposure to loud noises
a nurse is caring for an older patient in the hospital who reports: "I am worried because simple tasks such as balancing my checkbook seem to take me a little longer. Is there something wrong with me?" The best response by the nurse is
As you age, normal changes in the brain make central processing such as balancing a check book, take a little longer
As a new nurse working in an independent living facility for older adults. you have been shocked at the number of residents who struggle with alcoholism. Which of the following is a risk factors for this disease that you should keep in mind as you serve this population?
Alcohol may be used as a coping mechanism
What is an example of ageism?
All older people become cognitively dysfunctional
which information will the nurse include when discussing the major differentiation between delirium and dementia with novice nurses? select all
Dementia results in a slow steady decline in cognitive ability Delirium is characterized by fluctuations in alertness Individuals with dementia learn to make up answers to hide their confusion in the early/mild stage
Every culture has it's own definition of when a person is considered old. The statement, "Bob must be old, he is retied" is an example of which definition of old?
social
The nurse is planning to assess an older patient's functional health patterns for cardiovascular disease. Which question will the nurse use to access the patient's nutrition pattern?
Do you weigh yourself everyday?
According to Erickson's stage theory of development, which of the following is the developmental crisis of late adulthood?
Ego integrity vs. despair
which of the following approaches to hygienic care is beneficial for a pt with dementia?
Explain each step as you go, and keep the pt covered as much as possible
the best test to ascertain the effectiveness of a diabetic medication is
Hgb A1c
which of these statements if made by an older adult, would be most likely to be an indicator of depression?
I am just too tired to do anything
A nurse is a medical clinic is providing teaching to an older adult client who has osteoarthritis that is affecting her knees. Which of the following client statements indicated an understanding of the teaching?
I can use either heat or ice to relieve the discomfort
which of the following statements is true regarding silent messages or not talking?
It sends a message to the receiver that may be misinterpreted
An older woman with moderate Alzheimer's exhibits behavior changes which including crying and repeatedly verbalizing the same phrase over and over. Her behaviors have increased over the last 2 hours. What intervention should the nurse implement?
Look for stressors that might be present
An older woman retires after a long career as an elementary school principal and begins to volunteer in the local library reading to children. The older woman is very pleased with her volunteer activities. This is consistent with which theory of aging?
Role theory
caregiver burnout is common in those who provide care for the chronically ill and dying, including nurses. In assessing their own caregiver burnout, what questions should nurses ask themselves periodically?
What have I done for myself today
A nurse enters the room of a recently admitted elderly client in a longterm care facility and overhears a CNA calling the client "Granny". Which of the following would be the most appropriate action on the part of the nurse?
While in the clients room w/CNA. the nurse address the client by her formal name. The nurse then asks the patient how she would like to be addressed
The nurse observes older women learning advanced knitting techniques the nurse concludes that this learning activity is suitable for these women because it accomplishes which of the following?
adds to existing knowledge
Religion is best defined as
an organized system of beliefs, practices and rituals
An 80-year old woman, who cares for her husband at home without assistance, requires minor surgery. Lacking any family members residing in the area, the wife expresses concern about her husband's care while she is recovering. The nurse's best recommendation is
arrange inpatient respite care for the husband
When assessing a patient with new onset Parkinson's disease, the nurse expects to see
asymmetrical hand or arm tremors
which age-related disorder of the cardiovascular system is characterize by a hardening of the arteries due to building up of plaque in the blood vessels?
atherosclerosis
the nurse is preparing an elderly patient for surgery in the morning. According to the hx and physical the patient has presented with post-surgical dementia in the pat The nurse performs which of the following assessments prior to surgery?
baseline cognitive assessment
the pt presents with copious amounts of sputum, pale skin and cough the nurse suspects
bronchitis
differences b/w pallative care and hospice, pallative care can
can coexist with life-prolonging treatment
The patient has been diagnosed with bilateral dry macular de-generation. Her main complaint is
central vision loss
Every culture has it's own definition of when a person is considered old. The statement, "Bob must be old, he is 65" is an example of which definition of old?
chronological
which intervention to manage wandering in clients in a long-term care facility should be implemented? select all
close observation to identify persons individual wandering patterns provide an enclosed pathway for safe walking attempting to engage the person in social interactions
More than half of all ppl over the age 65 have cataracts. What are their most common complaints?
cloudy and blurred vision
The home care nurse visits an older patient whose spouse died 2 years ago. The nurse notices his clothes remain hung in the closet and she sets a place for him at the table during mealtime. The nurse suspects she is suffering from which type of grief?
complicated
older adults are most likely to enter an ED with which of the following symptoms of pneumonia?
confusion
An older patient has a bp reading 158/88. The patient reports no other symptoms or medical hx of illness but reports this is his third high reading. What should the nurse instruct the patient to do?
contact primary care provider for further evaluation and treatment
Normal changes in the anatomical structure of the chest and altered muscle strength can affect an older persons ability to (blank) which can effect their recovery
cough forcefully
what are some of the classic signs of osteoarthritis select all
crepitus joint pain more intense in the morning joint instability
A public health nurse is assessing an older adult client who lives with a family member. The nurse identifies several bruises in various healing stages. The client and family member explain that the bruises are a result of clumsiness. However, based on the distribution of the bruises, the nurse suspects abuse. Which of the following actions should the nurse take first?
document the location of the bruises in the clients chart
which of the following is a reliable s/s of dehydration in older adult? select all
dry mucous membrane dark urine sunken eyes
the document names someone to act on individuals behalf if they cannot speak for them-self. It included preferences about selection of medical provider, healthcare and end of life decisions
durable power of attorney
An older nursing home resident reports that her hearing loss is getting worse. What is the 1st action of the nurse?
examine the resident's ears for cerumen accumulation
The son of an older adult couple ends his life suddenly. After 1 year the wife remains in seclusion and is hospitalized for dehydration. What must occur 1st if the nurse hopes to improve the patients mental health and wellness?
good rapport and a trusting, caring relationship must be established
hospice care is recommended to the family of an old client who appears to be nearing the end of her life and who requires a great deal of physical care in her son's home. The son is opposed to hospice care. He tells the nurse, "I won't be responsible for killing my mother". Which of the following would be the nurse's best reponse?
hospice care emphasizes client comfort and quality of life and does not hasten death.
caregiver assessments should be part of routine delivery of health and long term care services. The purpose of a caregiver assessment is to?
identify the caregivers ability to provide care determine how the healthcare team can help the caregiver ascertain the needs and preferences of the caregiver and care recipient
what is the definition of exploitation as a form of abuse?
illegal taking, misuse, or concealment of funds, property, or assets
A 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. (could be Tb etc) The nurse is basing her activities on which theory of aging?
immunologic theory
which of the following is the hallmark infection sign in older ppl?
increased baseline temperature
an elderly patient has experienced angina (chest pain) in the past and is concerned a myocardial infarction may occur next. The nurse explains the patient to be alert for
mild pain in the back or abdomen
an older patient being treated for hypertension becomes lightheaded when getting up in the middle of the night to void and when making sudden movements. How should the nurse best instruct this patient
move slowly from lying to sitting position an then slowly from sitting to standing
an older woman is complaining of mild, localized back pain and some nausea and heartburn. Your immediate concern is that she is experiencing
myocardial infarction
a home health nurse is teaching an older adult client who just had cataract surgery. Which of the following instructions should the nurse include
no bending at the waist
an older woman was seen in her physician's office and it is determined that she has a positive urine culture. She is started on antibiotic therapy for UTI. The patient is surprised at the diagnosis. The woman did not think that she had a UTI because her temp was only 98 degrees F. One reason why the patient may not have developed a higher temp is?
normal age-related changes to the immune system function affect an older person's response to illness
During an interview the nurse notes that an older pt. occasionally has trouble thinking of a name of a medication they have been taking for over a year. The pt is alert, oriented to time, person situation and place, and lives independently. The nurse would describe the patient's cognitive assessment as which of the following?
normal signs of aging
A effective way to provide nourishment to a patient with advanced dementia who wanders is?
offer finger foods
The unintentional inability of a family caregiver to identify and provide the needs for an older adults is classified as which type of elder mistreatment?
passive neglect
Poor health literacy can be a barrier to good healthcare compliance health care literacy effects
patient satisfaction
A suicidal male older adult is most likely to present to their primary care physician with what type of complaint?
physical
The nurses treatment focus for a pt with Alzheimers disease is
preserving self-care abilities
What is the best long-term goal when planning nursing care for an older patient with diabetes mellitus
prevent disease progression
Inflicting mental anguish on an older adult by a caregiver is classified as which type of mistreatment?
psychological abuse
an older patient is reading a large-print magazine and states that reading is difficult for her in the evening. Which intervention should the nurse implement first?
put a high-intensity lamp at the head of the bed (gilmore light)
which are modifiable risk factors for hypotension? select all
quit smoking weight loss, if needed reduce stress level
the nurse encourages the pt to complete a life review. The patient asks, "why bother"? The nurse explains that the main purpose of a life review is to
reexamine and resolve past issues
the nurse can place an older adult with diminished vision into 1 of 4 patient rooms. Which is the most suitable room for an older adult?
room is contsrating wall colors and good lighting
A parent who choses not to provide themselves with basic hygienic care may be exhibiting which form of elder mistreatment?
self neglect
an older patient is dx w/ heart failure. During the health hx what will the nurse assess for the 1st symptom of the disorder?
short of breath
cause of COPD
smoking
The nurse completes her morning assessment on a new postoperative patient and notes a change in cognitive status from the previous day. The nurse recognizes which of the following as a precipitating factor for delirium?
surgery change in medication hearing difficulty
during a home visit the nurse learns that an older patient with hypertension takes prescribed medications only when feeling tense. What instructions should the nurse provide the pt?
take your blood pressure medication as prescribed regardless of when feeling tense
a nurse is observing a aide perform denture care for a resident in nursing home. the nurse recommends that the aide receive additional education on denture care when the nurse observes which of the following?
the aide uses toothpaste
your patient has been told by the doctor, "he is a good canadite for heart failure" and asks the nurse "how does that affect my heart?
the hearts ability to pump because weaker than normal
At the completion of a physical assessment the nurse determines that an older patient is at risk for the development of osteoporosis. which one of the following would lead the nurse to this conclusion?
the postmenopausal female
an older pt is admitted to the hospital for treatment of pneumonia. The pt has a court-appointed conservator who manages her finances. The nurse understands that
the presence of a conservator does not mean the pt cant give informed consent
An older adult, who is terminally ill is followed by hospice. Which situation best illustrates the principles of hospice care are being met?
the pt and family report good pain and symptom control
during a nursing assessment, an older adult tells the nurse her grandson swears she is shrinking. Which patient teaching should the nurse implement to address musculoskeletal reasons for height change?
the thinning of the disks in your spine along with gravity cause you to shorten
An older person with a terminal disease states: "All my life I attended church, but I am still worried about what will happen after death." The nurse's best response is which of the following?
the unknown may be frightening. Do you want to talk about this?
hyperglycemia is harder to detect in older adults because of which of the following?
there is a higher tolerance for elevated levels of circulating glucose in older adults
a home health nurse is assessing an older adult client in the home who has decreased vision due to a history of glaucoma. Which of the following findings should the nurse identify as a safety risk?
throw rugs are present in the kitchen
the patient tells you that she has started hearing a faint buzzing sound lately. You listen closely but do not hear it. Which of the following hearing disorders does the nurse suspect?
tinnitus
which of the following will help a person become a better listener?
try not to think how you will respond to the sender while they are talking
signs and symptoms of age-related macular degeneration evident on an Amsler grid includes
wavey lines
A nurse suspects that a family caregiver is neglecting an older adult client. Which of the following statements by the caregiver should the nurse identify as the priority to address?
we only buy the prescriptions we can afford
a 62-year-old former pro football player is in the hospital for a total knee replacement due to osteoarthritis. Which theory of aging would help explain this patient's current health problems?
wear and tear
which of the following patient teachings should the nurse provide to a pt newly diagnosed with osteoporosis
weight bearing exercises have been helpful
As nurse working in an independent living facility for older adults, you work with a resident whom you suspect of being alcoholic. Which of the following physical effects that you have observed in this pt would lead to your suspicion?
weight loss
physical changes of aging in the skin occur as a result of intrinsic and extrinsic factors. Which of the following are extrinsic factors that contribute to the skin aging?
wind sun air pollution
an older person who is cognitively intact and has decision making capacity makes a decision to stop chemotherapy for breast cancer. The patient's daughter is upset at her mother's decision and approaches the nurse, stating: 'I don't agree with my mother's decision to stop treatments." The best response by the nurse is
you mother is able to make her own decisions. I suggest you talk to her