Gero Exam 2

While conducting a home visit the nurse learns that the older patient has developed cataracts. Which statement should the nurse make about this patient's ability to drive? A) "You might want to consider planning to avoid nighttime driving." B) "This is likely a good time for you to consider giving up your license." C) "The myth of older drivers being more dangerous is exactly that: a myth." D) "It's probably best to consider asking your children to drive you around from now on."

A "You might want to consider planning to avoid nighttime driving."

The nurse is preparing a list of patients who will need the annual influenza inoculation. Which older adult will most likely refuse this vaccination? A) A 71-year-old Christian Scientist B) A 68-year-old man who attends a Unitarian church C) A 68-year-old female patient who identifies herself on admission as a Jehovah's Witness D) A 78-year-old who says that she is a member of the Church of Jesus Christ of Latter Day Saints

A A 71-year-old Christian Scientist

Which of the following older adults is likely at the highest risk for developing esophageal cancer? A) A 74-year-old with alcoholism who has chewed tobacco for many decades. B) A 66-year-old who has experienced significant dysphagia since her CVA 3 years prior. C) An 80-year-old who has a history of sepsis that was attributed to periodontal disease. D) An obese, 72-year-old who has a history of a hiatal hernia.

A A 74-year-old with alcoholism who has chewed tobacco for many decades.

A nurse recommends to an older patient's family to place a seat alongside the bathtub to enable the older adult bather to rest while drying off. What is the best explanation for the nurse's recommendation? A) A drop in blood pressure may follow bathing. B) Nonslip surfaces are essential for tubs and shower floors. C) The elderly use the bathroom often and can benefit from the rest. D) Most elderly have an age-related problem discriminating hazards.

A A drop in blood pressure may follow bathing.

During a home visit the nurse learns that an older patient with macular degeneration restricts the intake of fluids after 6 pm. What would the nurse suspect as a reason for the patient to limit fluids after this time? A) A fear of falling at night B) A lack of thirst perception C) Lack of non-skid footwear D) Problems differentiating shades of the same color

A A fear of falling at night

The nurse wants to ensure that assigned patients are comfortable. What will the nurse use as a measurement of comfort? A) A state of physical, emotional, and spiritual well-being B) An absence of reports, signs, or symptoms of physical pain C) A transcendent emotional and spiritual state that exists regardless of the presence or absence of pain D) A condition of maintaining a patient's self-report of pain being below a self-reported threshold of 1 out of 10

A A state of physical, emotional, and spiritual well-being

An older patient tells the nurse that he meditates to seek enlightenment. Because of this, the nurse might inquire if he wishes to have which item eliminated from his daily dietary intake? A) Beef B) Cereal C) Refined sugar D) Leavened bread

A Beef

A dentist examines an 80-year-old man with a history of pipe smoking. The dentist notes white patches in the patient's mouth. What action should be the dentist's priority? A) Biopsy the lesion B) Refer the patient for periodontal care C) Refer or treat the patient for moniliasis D) Discuss with the man the reasons why he should quit smoking

A Biopsy the lesion

An older patient is complaining of not being able to sleep because of leg pain. What is the first thing that the nurse should identify when relieving the patient's pain? A) Cause of the pain B) Psychological factors C) Sleeping position at night D) Medications that could interfere with sleep

A Cause of the pain

A patient experiencing chronic pain asks the nurse if there is "anything else" that can be done to help with the pain. Which response should the nurse make to address complementary therapies with the patient? A) Complementary therapies provide added options for treating pain. B) Complementary therapies can be explored when medication has failed to relieve pain. C) Complementary therapies are preferable to medications in light of their more holistic nature. D) Complementary therapies often have unproven effectiveness but bring emotional comfort to patients.

A Complementary therapies provide added options for treating pain.

A patient with cancer asks the nurse to pray with him but the nurse does not feel comfortable with prayer. What should the nurse do? A) Decline politely and ask a coworker to pray with the patient B) Arrange transportation so that the patient can attend prayer meetings at his church C) Pray with the patient after making sure he understands that the nurse would prefer not to D) Pray with the patient realizing that the patient's needs are more important than the nurse's beliefs

A Decline politely and ask a coworker to pray with the patient

An 80-year-old patient who has just spent 2 days at the beach with his family is demonstrating confusion, dry skin, a dry brown tongue, sunken cheeks, and concentrated urine. What health problem do the patient's symptoms most likely indicate? A) Dehydration B) Renal failure C) Hyperthermia D) Food poisoning

A Dehydration

A 77-year-old post-surgical patient has been complaining of abdominal pain throughout the nurse's shift. In addition, the patient has a temperature of 101.5°F (38.5°C) and has had small, frequent, loose bowel movements four times since the morning. Which of the following health problems would the nurse suspect? A) Fecal impaction B) Colon cancer C) Appendicitis D) Biliary tract disease

A Fecal impaction

The nurse is preparing to document that an older patient is experiencing nocturnal myoclonus. What assessment finding is consistent with this documentation? A) Five leg jerks or movements per hour of sleep B) Any number of leg jerks related to the use of antidepressants C) Five leg jerks brought on by an epileptic seizure during a night's sleep D) Leg jerks in combination with episodes of breathing cessation during sleep

A Five leg jerks or movements per hour of sleep

An older patient recovering from a stomach virus is experiencing pain and nausea. Since the patient does not have any other complicating illnesses, which herb could the nurse suggest for the symptoms? A) Ginger B) Valerian C) Devil's claw D) White willow

A Ginger

The nurse in the office advises a client with ongoing issues with constipation to keep a food journal. During a typical 24-hour period, the client has a bagel and coffee for breakfast, macaroni and cheese for lunch, and soup and salad for supper. What dietary changes should the nurse recommend to this client? A) Gradually increase the amount of fiber in the daily diet B) Eat several small meals each day C) Immediately increase the amount of fiber in the diet to 7 to 10 servings per day D) Increase the amount of soups and cheeses in the menu

A Gradually increase the amount of fiber in the daily diet

An older patient suffering from chronic exhaustion has an EEG that shows little time is spent in REM sleep. After reviewing the patient's history, what does the nurse suspect might be contributing to the patient's sleep problem? A) Has two or three glasses of wine near bedtime B) Obese and diagnosed with type 2 diabetes 6 years ago C) Takes low-dose aspirin for the prevention of heart disease D) Stressed due to the spouse's new diagnosis of Alzheimer disease

A Has two or three glasses of wine near bedtime

The nurse is admitting an older patient to the care area. What is the first step the nurse should take when evaluating the patient's circulation in the extremities? A) Health history and then inspect the legs B) Exercise history for periods of immobility C) Identify medications for side effects of hypotension D) Vital signs to verify that blood pressure is within an acceptable range

A Health history and then inspect the legs

The nurse is planning interventions for an older patient who is prone to developing constipation. Which intervention would be appropriate for the nurse to implement with this patient? A) Increase fluids and encourage activity B) Scheduled administration of oil-based laxatives C) Provide normal saline enemas every 2 to 3 days D) Reduce activity and provide senna each day before bed

A Increase fluids and encourage activity

A group of residents in a skilled nursing facility are sitting outside in the garden enjoying a hot summer day. What primary concern does the nurse recognize for these residents? A) Lack of thirst perception B) Lack of energy and related depression C) Lack of motivation to get out of the sun D) Effects of certain medications on body temperature

A Lack of thirst perception

An 81-year-old client has developed a fecal impaction while convalescing at home after hip surgery. Which of the following corrective actions should the nurse undertake? A) Manually remove the feces with a gloved finger. B) Assist the client to sit on the commode to facilitate stool passage. C) Break up the impaction with external abdominal massage. D) Insert a flatus bag to prevent entrance of air into the rectum

A Manually remove the feces with a gloved finger.

Which self-care activity should the nurse instruct an older patient with a history of congestive heart failure, type 2 diabetes, and hypertension? A) Monitoring of radial heart rate and lung sounds B) Starting a course of antibiotics with temperature increases C) Accurate measurement of total daily fluid intake and output D) Adjustment of blood pressure medication dosage based on home blood pressure readings

A Monitoring of radial heart rate and lung sounds

What should the nurse keep in mind when determining the relationship between pain and sleep in an older patient? A) Nonpharmacologic measures to control pain and enhance sleep are preferable to analgesics. B) Analgesic drugs should be administered to older adults to prevent potential episodes of pain. C) Older adults are more sensitive to pain than younger adults, and more at risk of having pain interfere with sleep. D) The availability of alternative forms of pain control such as massage and diversion means that pharmacologic pain medications are inappropriate and unnecessary.

A Nonpharmacologic measures to control pain and enhance sleep are preferable to analgesics.

The nursing home staff is working on a renovation project for the special care unit. What should be a key element of the plan? A) Paint the bedrooms green B) Paint the dining room violet C) Use wavy-patterned rugs in the hallways D) Use contrasting colors for the doors of the storage closets

A Paint the bedrooms green

An older female patient will only eat oatmeal and has bad breath. A dental exam reveals that the patient has a few of her own teeth and uses a partial appliance. She also has red, swollen, painful gums, and some teeth are loose at the gumline. The nurse realizes the patient is experiencing which health problem? A) Periodontal disease B) Endodontic disease C) Gastrointestinal disease D) Lack of adequate nutrition

A Periodontal disease

Which of the following lighting schemes should the nurse manager integrate into the plan for a new long-term care facility? A) Placement of multiple diffuse lighting sources B) The use of large banks of windows to maximize direct sunlight C) Placement of large fluorescent lighting panels centered in each room D) Low levels of lighting to reduce glare and accommodate residents with light sensitivity

A Placement of multiple diffuse lighting sources

The nurse visiting a patient living in the daughter's home finds the patient in an old hospital bed that has bilateral full-length side rails. What should the nurse do? A) Present alternatives to the family B) Recommend frequent repositioning C) Discuss additional preventive measures D) Commend the family on the use of this type of bed

A Present alternatives to the family

An older patient who lives at home has had several admissions to the hospital for infections and drug reactions over the last 18 months. Which nursing diagnosis would the nurse identify as being appropriate for this patient? A) Risk for Injury B) Risk for Infection C) Risk for Impaired Mobility D) Risk for Violence: Self-Directed

A Risk for Injury

After complaining about severe depression following the death of a daughter, a 77-year-old client is prescribed an antidepressant. Recently, the client was diagnosed with an oral fungal infection. What should the nurse suggest to the client? A) Sip water to promote saliva B) Stop taking the antidepressant C) Explore complementary therapies D) Eat yogurt to combat the risk of fungus

A Sip water to promote saliva

A patient is observed sitting on the side of the bed crying. When approached the patient does not say anything but continues to cry and hold the nurse's hand. What should the nurse do to communicate being present with the patient? A) Sit down next to the patient B) Leave the patient alone to cry C) Encourage the patient to stop crying D) Ask the patient to use the call bell if he or she wants to talk

A Sit down next to the patient

An adult male patient who works full time complains of being tired all day even after getting 8 hours of sleep each night. Which condition is most likely the cause of this patient's complaint? A) Sleep apnea B) Alcohol abuse C) Nocturnal myoclonus D) Age-related changes to sleep

A Sleep apnea

An older patient with a diagnosis of osteoarthritis complains of stiffness in the joints, tenderness, and pain. Which type of pain is this patient most likely experiencing? A) Somatic pain B) Visceral pain C) Nociceptive pain D) Neuropathic pain

A Somatic pain

At the conclusion of a health history the nurse conducts a spiritual assessment with the patient. Why is this assessment important? A) Strong spiritual beliefs facilitate health and healing B) A spiritual crisis can trigger a psychosomatic disease C) It is the nurse's job to facilitate communication between the patient and the clergy D) The nurse needs to be careful that therapeutic regimens do not violate a patient's religious beliefs

A Strong spiritual beliefs facilitate health and healing

Which approach should the nurse use when considering pain management of an older patient recovering from injuries from a motor vehicle crash? A) Try non-opioids and adjuvant drugs before providing opioid analgesia. B) Implement opioids if complementary therapies have proven to be ineffective. C) Begin with a moderate dose of opioid analgesia and taper down to the lowest effective dose. D) Restrict analgesia options to NSAIDs and adjuvant medications due to the risk of unwanted effects.

A Try non-opioids and adjuvant drugs before providing opioid analgesia.

An older patient who recently retired from working as a waitress for 40 years complains of leg cramps that interfere with sleeping. The patient also experiences dizziness when getting out of bed first thing in the morning. What problem should the nurse suspect is occurring with this patient? A) Varicose veins B) Arteriosclerosis C) Thrombophlebitis D) Peripheral aneurysms

A Varicose veins

An older patient with a history of renal failure is admitted with dehydration and hyponatremia. The nurse identifies which assessment findings as being consistent with the diagnosis of dehydration? (Select all that apply.) A) Confusion B) Shortness of breath C) Decreased skin elasticity D) Increased blood urea nitrogen (BUN) E) Adventitious lung sounds on

A, C, D

The nurse determines that a patient is experiencing spiritual distress. What did the nurse assess in this patient? (Select all that apply.) A) Anger B) Smiling C) Complaining D) Poor appetite E) Refusing to make plans

A, C, D, E

The nurse identifies the diagnosis of risk for injury as being appropriate for an older patient. What health problems would increase this patient's risk for injury? (Select all that apply.) A) Hard of hearing B) Weak gag reflex C) Chronic renal failure D) Fatigue and weakness E) Macular degeneration

A, C, D, E

The nurse is visiting the home of an older patient with changes in peripheral vision and depth perception. What should the nurse instruct the family to ensure safety for the patient? (Select all that apply.) A) Use contrasting colors on the stairs B) Avoid the use of bright colors on walls C) Arrange furniture so that it is in full view D) Ensure good lighting throughout the home E) Approach the patient directly and not from the side

A, C, D, E

The nurse was considering melatonin supplements for an older patient with a sleep disturbance but realized this action would be contraindicated because of the patient's medications. Which medications interact with melatonin? (Select all that apply.) A) Warfarin B) Salicylates C) Antipsychotics D) Antidepressants E) Immunosuppressants

A, C, D, E

After an assessment the nurse is concerned that an older patient is at risk for the development of an abdominal aortic aneurysm. What did the nurse assess in this patient? (Select all that apply.) A) Diagnosis of angina B) History of hypertension C) History of arteriosclerosis D) Treatment for diabetes mellitus E) Experienced a myocardial infarction

A, C, E

An older patient consistently rates pain as being a 6 on a scale from 0 to 10 even after receiving pain medication every 6 hours. What should the nurse realize the patient is at risk for developing? (Select all that apply.) A) Depression B) Heart disease C) Hopelessness D) Kidney stones E) Spiritual distress

A, C, E

The gerontological nurse enrolls in a program to learn healing touch. How does this technique differ from therapeutic touch? (Select all that apply.) A) Seals energy leaks B) Manipulates soft tissues C) Rebalances energy fields D) Applies pressure to body areas E) Incorporates opening energy blockages

A, C, E

The home care nurse is conducting a home environment assessment for an older patient with peripheral vascular disease and foot wounds. Which findings should the nurse identify as safety issues for the patient? (Select all that apply.) A) Hot water temperature 124°F B) Fire extinguisher present in the hall closet C) Functioning smoke detector in the kitchen D) Refrigerator stocked with food that is not outdated E) Medication labels absent from prescription containers

A, E

For patients from which of the religious groups would an opportunity to fast in the weeks before Easter be most important? A) Jewish B) Eastern Orthodox C) Seventh-Day Adventist D) Episcopalian (Anglican)

B Eastern Orthodox

An older patient with hypertension has been admitted to a nursing home to recover from minor orthopedic surgery. What should the nurse include in this patient's nursing care plan to improve tissue perfusion? A) Educating the patient about the importance of diet B) Encouraging the patient to ambulate several times each day C) Inspecting the patient's extremities daily for signs of altered tissue circulation D) Maintaining an adequate blood pressure level by monitoring vital signs and medications

B Encouraging the patient to ambulate several times each day

An older patient being treated for intermittent pain is complaining of increased pain despite being started on a new pain management plan. What should the nurse do to help this patient? A) Discussing alternative methods of pain management B) Identifying underlying factors that could be interfering with the current plan C) Reevaluating and setting realistic, specific goals for the pain management plan D) Discussing with the pain management team about increasing the dosage of the medication

B Identifying underlying factors that could be interfering with the current plan

A health-conscious resident of an assisted living facility is promoting the value of fiber to a fellow resident. Which statement made by the resident about the benefits of fiber is accurate? A) Improved bowel activity and increased metabolic rate B) Improved bowel activity and decreased serum cholesterol C) Improved gastric emptying and prevention of colon cancer D) Increased nutrient absorption and decreased glucose tolerance

B Improved bowel activity and decreased serum cholesterol

In planning the budget for next year, the nurse manager in a special care unit includes line items for a toaster, flowering plants, and a birdfeeder. How should the manager justify these costs to administration? A) Personal items for patients B) Items for residents' sensory stimulation C) Suggested requirements to meet labor contract D) Important tools for maintaining staff satisfaction

B Items for residents' sensory stimulation

An older female patient in the resident care facility insists that her hair be kept covered at all times. Of which branch of the Jewish faith is she most likely a member? A) Reform B) Orthodox C) Rabbinical D) Conservative

B Orthodox

Which characteristic of a resident's room in a nursing home demonstrates Maslow's need of security? A) Large airy windows B) Personal drawers and closets C) Consistent placement of the furniture D) Comfortable couches and rocking chairs

B Personal drawers and closets

An older patient is recovering from hip replacement surgery. Which risk factor would most likely affect tissue perfusion in this older patient? A) History of hypotension B) Prolonged immobility after surgery C) The effects of anesthesia after a surgical procedure D) A history of anemia affected by additional blood loss from the surgery

B Prolonged immobility after surgery

The nurse notes excessive swelling of the ankles and legs in a patient with a history of congestive heart failure. What would be a recommended change to this patient's care plan? A) Reduce oxygen B) Reduce ambulation C) Encourage deep breathing D) Implement dietary changes

B Reduce ambulation

An older patient who enjoys good health is experiencing a decline in stamina despite being physically active over the years. The nurse recognizes which age-related change as likely affecting the patient's stamina? A) Increased resting heart rate and blood pressure B) Reduced heart contractility and a prolonged cardiac cycle C) Stenosis of the aorta and decreased muscle tissue perfusion D) Hypotension with consequent inadequate peripheral blood supply

B Reduced heart contractility and a prolonged cardiac cycle

An older female patient tells the nurse that even though she believes in a higher power she is not interested in information on the hospital's chaplaincy services since she has never been religious. What does the nurse recognize as the relationship between religion and spirituality? A) Some people are religious, while others are spiritual. B) Religion is a particular, structured way of expressing spirituality. C) Religion is the essence of our being that connects us with the Divine. D) All human beings have an innate desire for religious structure and spiritual fulfillment.

B Religion is a particular, structured way of expressing spirituality.

An older female patient tells the nurse that through periods of trial and tribulation, the Bible has been the source of ongoing strength and support. Which statement supports this patient's beliefs by researched evidence? A) Patients from low socioeconomic levels tend to be more religious. B) Religious commitment has a positive effect on health care outcomes. C) Patients holding strong religious convictions experience great emotional stress during illness. D) Among the elderly, high levels of religiosity correlate with greater levels of physical disability.

B Religious commitment has a positive effect on health care outcomes.

During an interview process as a staff nurse for a geriatric patient care area, the nurse is asked about her philosophy of spirituality. Why is this important when caring for older patients? A) Spirituality becomes more unconditional as people age B) Spirituality often becomes more important to people as they age C) An individual's spirituality remains stable from youth through old age D) As people age, their spirituality becomes more quantitative than qualitative

B Spirituality often becomes more important to people as they age

As part of the treatment regimen for the diagnosis of colon cancer, a 73-year-old client has recently received a colostomy. What should the nurse prioritize during discussions in the early stages of patient teaching? A) Modifications in food and fluid intake that the device necessitates B) The lifestyle adjustments and effect on self-concept that often accompany colostomies C) Further treatment options that exist for colon cancer D) The importance of monitoring for signs of infection at the colostomy site

B The lifestyle adjustments and effect on self-concept that often accompany colostomies

A healthy older patient is experiencing sleep problems. What should the nurse instruct the patient about the influence of aging as it relates to sleep? A) As people age, most of them require fewer hours of sleep. B) The normal aging process has minimal effect on the quantity of sleep. C) Older adults are no longer bothered by noise and lights during the night. D) Older people sleep more soundly but awaken more often during the night.

B The normal aging process has minimal effect on the quantity of sleep.

Which statement should the nurse use to plan interventions to address the behavior of an older patient sitting quietly alone in a room? A) Spending a lot of time alone is a sign that an elder is lonely or grieving. B) Uninterrupted periods of solitude and inactivity are therapeutic for the elderly. C) Solitude should be discouraged among elders because it leads to social isolation. D) Occupational therapy should be arranged for an elder often observed doing nothing.

B Uninterrupted periods of solitude and inactivity are therapeutic for the elderly.

After measuring an 80-year-old patient's blood pressure, the nurse realizes that it is within acceptable range. Which is an acceptable blood pressure range for this patient? A) Usually under 130 mm Hg systolic and 90 mm Hg diastolic B) Usually under 140 mm Hg systolic and 90 mm Hg diastolic C) Usually under 140 mm Hg systolic and 80 mm Hg diastolic D) Usually under 130 mm Hg systolic and 80 mm Hg diastolic

B Usually under 140 mm Hg systolic and 90 mm Hg diastolic

An older patient is telling the nurse about life stresses, including a chronically ill spouse and problems with grandchildren. What is the most appropriate information for the nurse to provide to the patient? A) Pharmacological options B) Ways to prevent chronic stress C) The benefits of natural remedies D) The name and phone number of a geriatric therapist

B Ways to prevent chronic stress

An older male patient is upset by having to be admitted to a skilled nursing facility for extended care and renal dialysis treatments. What can the staff do to minimize this patient's anger? (Select all that apply.) A) Recommend counseling for anger issues B) Respect the patient's private possessions C) Offer to assist with basic needs and desires D) Ask the patient to explain preferences for activities E) Provide the patient with areas for privacy or solitude

B, C, D, E

An older patient takes over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) for self-treatment of arthritis. For which nutritional health problems will the nurse include when assessing this patient? (Select all that apply.) A) Thirst B) Nausea C) Diarrhea D) Vomiting E) Constipation

B, C, D, E

The staff nurses are discussing ways to reduce safety risks for patients with Alzheimer's disease. Which impairments could cause safety risks for these patients? (Select all that apply.) A) Diabetes B) Dementia C) Depression D) Disorientation E) Memory deficits

B, C, D, E

A patient with cardiovascular disease wants to know why magnesium supplements are prescribed. What should the nurse respond to this patient? (Select all that apply.) A) Lowers blood pressure B) Lowers total cholesterol C) Decreases homocysteine levels D) Dilates arteries and facilitates circulation E) Raises high-density lipoprotein cholesterol

B, D, E

The home care nurse is concerned that an older patient is at risk for a kitchen fire. What actions can the nurse recommend to reduce the risk of this occurring? (Select all that apply.) A) Avoid placing electrical items near a water source B) Instruct the patient to stay in the kitchen while cooking C) Encourage the use of meal delivery services to reduce cooking D) Recommend the use of a timer to check the food on the stove E) Suggest a microwave be used to heat liquids and not the stove

B, D, E

The nurse is planning care for several older patients in a long-term care facility. At which points in time will the nurse assess the patients for pain? (Select all that apply.) A) After helping with morning care B) When the patients complain of pain C) Prior to providing a patient with a meal D) When assessing the patients' vital signs E) When a patient asks for pain medication

B, D, E

The nurse, planning care for older patients on a geriatric unit, realizes which of the following health problems as occurring more frequently among older adults than in younger adults? (Select all that apply.) A) Cellulitis B) Pneumonia C) HIV/AIDS D) Diverticulitis E) Endocarditis

B, D, E

The nurse determines that an older patient is in stage II of sleep. What did the nurse observe in this patient? (Select all that apply.) A) Relaxed muscles B) Easily awakened C) Rapid respirations D) Difficult to awaken E) Minor eye movement seen

B, E

The nurse assesses a client with abdominal and rectal discomfort, diarrhea, and fever. What initial data source should the nurse use to determine a possible cause of his symptoms? A) Medical history, for prostatic hypertrophy B) Nutritional record, for the amount of dietary fiber C) Defecation record, for frequency and character of bowel movements D) Medication record, for use of anticholinergic medications

C Defecation record, for frequency and character of bowel movements

The nurse assists the aging client to create a menu. Which of the following foods, if requested by the client will require further teaching as it should not be included on this list? A) 2% milk B) Canned tuna C) Fried chicken D) Squash

C Fried chicken

The spouse of a patient with dementia remains upbeat and is appreciative of having good health and a loving family. The nurse realizes that the spouse is demonstrating which component of spirituality? A) Hope B) Fatalism C) Gratitude D) Transcendence

C Gratitude

An older patient is demonstrating signs of dehydration. Which action should the nurse initiate first? A) Minimize food intake and maximize fluid intake B) Advocate for the initiation of intravenous rehydration C) Initiate monitoring and recording of fluid intake and output D) Ask that the physician order blood work to confirm or rule out dehydration

C Initiate monitoring and recording of fluid intake and output

The daughter of an older patient believes that fresh air kills germs and keeps her father's bedroom window open at night. Because her father wears pajamas, she insists that he is comfortable. What recommendation should the nurse make? A) The patient should wear flannel pajamas. B) Place one quilt and two blankets on the patient's bed C) Keep the temperature in the patient's room not lower than 75°F D) Ensure that the window in the patient's room has permanent screening

C Keep the temperature in the patient's room not lower than 75°F

The nurse prepares to give a presentation on the pathology of caries to a group of seniors. Which of the following rationales is correct when understanding why today's elders had a greater risk of caries when they were young than today's children and young adults? A) Poor diet B) Age-related changes C) Lack of fluoride in the water D) Lack of knowledge regarding oral hygiene

C Lack of fluoride in the water

An older patient reports a significant amount of cheese, milk, and calcium-fortified orange juice in her diet. She also takes a 750 mg calcium supplement at breakfast. What should the nurse instruct the patient about her calcium intake? A) Keep the intake of calcium to 30% of kilocalories or less B) Take calcium supplement doses totaling not more than 5,000 mg C) Limit the intake of calcium to a total of 2,000 mg or less from all sources D) Follow the RDA listed on the milk products' nutrition labels for calcium intake

C Limit the intake of calcium to a total of 2,000 mg or less from all sources

The nurse plans the care of the older adult with dysphagia. Which of the following is the priority initial nursing intervention? A) Thicken the liquids B) Weigh the patient daily C) Observe the patient's food intake D) Offer the patient verbal cues when eating

C Observe the patient's food intake

The nurse notes that two obese male residents snore loudly throughout the night. The nurse recognizes that snoring usually accompanies which health problem? A) Central sleep apnea B) Nocturnal sleep apnea C) Obstructive sleep apnea D) A combination of central and obstructive sleep apneas

C Obstructive sleep apnea

When reviewing the medical record the nurse notes that a newly admitted older patient has a history of angina. Which assumption can the nurse make about this patient? A) The patient will take anticoagulants and have calf and foot edema B) The patient will be obese and have a history of venous insufficiency C) The patient will have an order for nitroglycerine as needed and will be intolerant of vigorous activity D) The patient will be prone to dizziness when changing positions quickly and will be prescribed ACE inhibitors

C The patient will have an order for nitroglycerine as needed and will be intolerant of vigorous activity

A 75-year-old patient and his 40-year-old daughter both have an intestinal virus with complaints of vomiting and diarrhea. Why is the nurse concerned about the patient being at risk for dehydration? A) The patient is on a fixed income B) The virus will make changes to the patient's gastrointestinal system C) The vomiting and diarrhea will cause a reduction in intracellular fluids D) The patient does not want to bother a health care professional for a common virus

C The vomiting and diarrhea will cause a reduction in intracellular fluids

An older male patient recovering from a myocardial infarction (MI) asks the nurse if future sexual activity is now contraindicated. Which statement should the nurse use to respond to the patient? A) Sexual activity after MI is usually contraindicated. B) Medications can be used to enhance sexual function. C) There are positions that produce the least strain on the heart during sexual activity. D) Current research suggests that sexual activity does not require modification following MI.

C There are positions that produce the least strain on the heart during sexual activity.

An older male patient taking medication for hypertension asks what else can be done to reduce the blood pressure. What measures should the nurse recommend to the patient? A) A low-fat, low-cholesterol diet B) Deep breathing and Buerger-Allen exercises C) Weight loss and a reduction in sodium intake D) Daily low-dose aspirin and one alcoholic drink daily

C Weight loss and a reduction in sodium intake

An older patient wants to use complementary therapies to help treat hypertension that has not responded to medication therapy. Which recommendation is the most appropriate for the nurse to make? A) Ginseng and ginger B) Acupuncture and ginger C) Yoga and hawthorn berry D) Vitamins A and D supplements

C Yoga and hawthorn berry

An older patient has a triglyceride level of 300 mg/dL. Which dietary changes would be indicated for this patient? (Select all that apply.) A) Restrict the intake of soluble fiber B) Substitute vegetable oil for olive oil C) Increase the intake of fish and chicken D) Use skim milk and nonfat cottage cheese E) Add fresh fruit and vegetables to meals each day

C, D, E

An older patient is experiencing nociceptive pain in the shoulder. For which potential consequences of debilitating pain should the nurse assess in the patient? (Select all that apply.)A) Anemia B) Dementia C) Depression D) Decreased oral intake E) Immobility resulting in skin breakdown

C, D, E

The nurse develops a plan of care for a 75-year-old male patient who has had a myocardial infarction (MI). Which of following characteristics of the man's history and present conditions predispose him to constipation? (Select all that apply.) A) The man has a history of GERD. B) The man takes a -blocker for the treatment of hypertension. C) The man's activity level is significantly reduced as a result of his MI. D) The man has received several doses of morphine since admission. E) The man's fluid intake has been minimal since admission.

C, D, E

After receiving new dentures the nurse provides instruction to an older patient on the use and their care. Which patient statement indicates that teaching about the dentures has been effective? A) "I do not have to brush and floss my teeth every day." B) "I suppose that I'll have to get these resized and adjusted from time to time." C) "I'll have to change my diet to include only soft and pureed foods now I suppose." D) "I've had to go to the dentist so often over the last few years and it's a relief not to have to anymore."

B "I suppose that I'll have to get these resized and adjusted from time to time."

The nurse discusses gallbladder disease with a client diagnosed with cholelithiasis. The client indicates understanding of the pathological process when the client states: A) "I never had any GI infections before this one." B) "I will be undergoing laparoscopic surgery to remove the stones." C) "I hear that the gallbladder gets weak with old age." D) "I'm glad that this issue can be dealt with medication."

B "I will be undergoing laparoscopic surgery to remove the stones."

An older male patient admits to doing many things in life that he is not proud of and is having a difficult time getting them out of his mind. How should the nurse respond to the patient's statement? A) "Remember that no one has lived a perfect life." B) "Is there anyone that you might want to ask forgiveness from?" C) "Is there anything I can do to help you focus on more positive things?" D) "Do you think that you were really any worse than most other people?"

B "Is there anyone that you might want to ask forgiveness from?"

An older patient just learning of having a terminal illness begins to cry. Which statement or question should the nurse make to facilitate the patient's spiritual health? A) "Remember that everything in life, even the bad things, happens for a reason." B) "Is there anything in your spiritual beliefs or practices that might bring you comfort at this time?" C) "It's not appropriate for me to pray with you, but would you like me to arrange a visit from the chaplain?" D) "It's likely best for you to try to focus on what is going right in your life, even though that's likely hard right now."

B "Is there anything in your spiritual beliefs or practices that might bring you comfort at this time?"

The nurse teaches a group of older adults about diet. Which of following recommendations made by the nurse is most likely to result in the promotion of gastrointestinal (GI) health? A) "If possible, eat organic, whole foods." B) "It's important to emphasize fiber and fluid intake." C) "Try to maximize the amount of unsaturated fats you eat every day." D) "You should try to limit your food and fluid intake."

B "It's important to emphasize fiber and fluid intake."

A 76-year-old client has been diagnosed with an axial hiatal hernia following several months of belching and heartburn. What should the nurse teach the client about the management of this health problem? A) "Even though you would expect them to help, it's important to avoid over-the-counter antacids as much as possible." B) "Losing weight and trying a bland diet might help alleviate some of the symptoms you're experiencing." C) "This problem can be easily corrected with day surgery, which your physician will likely suggest." D) "Try to limit yourself to two larger meals daily in order to minimize the amount of time in a day that food is in your stomach."

B "Losing weight and trying a bland diet might help alleviate some of the symptoms you're experiencing."

The nurse is on a task force to reduce the incidence of falls among residents of a long-term care facility. Which measure should the nurse recommend to prevent the most falls? A) The use of diffuse, natural lighting on the unit B) A fall history and fall risk assessment of each patient on admission C) Psychosocial interventions aimed at reducing individuals' fear of falling D) Use of physical restraints on new patients who have delirium or dementia.

B A fall history and fall risk assessment of each patient on admission

An 84-year-old man who resides in a long-term care facility has recently become incontinent of bowel, a situation that is without precedent. What is the nurse's priority for assessment? A) Review of the man's medication regimen B) Assessment for the presence of fecal impaction C) Assessment for changes to the man's cognitive status D) Examination of the man's stool for frank and occult blood

B Assessment for the presence of fecal impaction

A patient tells the nurse that she has practiced meditation for years since it has helped her with mental clarity. Which type of meditation should the nurse document that the patient practices? A) Mindfulness B) Concentrative C) Transcendental D) Trans-mutational

B Concentrative

An older resident of a long-term care facility has recently been prescribed a non-barbiturate sedative. For which effect should the nurse assess in this patient? A) Anticholinergic effects B) Daytime sedation and confusion C) Respiratory depression and sleep apnea D) Changes in blood pressure and heart rate

B Daytime sedation and confusion

An older patient is receiving oxycodone for cancer pain. For which side effect should the nurse assess the patient? A) Thirst B) Delirium C) Addiction D) Muscle weakness

B Delirium

A patient is demonstrating signs of spiritual distress but refuses to be visited by clergy or to participate in religious services. What should the nurse do to help the patient? A) Arrange for a volunteer to read inspirational essays to the patient B) Do not challenge the patient's decision or attempt to change his mind C) Pray that the patient will come to recognize his need for spiritual support D) Talk with the hospital chaplain about looking in on the patient without talking about religion

B Do not challenge the patient's decision or attempt to change his mind

Two nurses are discussing the relationship between spirituality and religion. Which statement explains this relationship? A) They are the same. Both connect individuals to the Divine and to other living things. B) They are directly related. The more spiritual the individual, the greater his or her commitment to religion. C) They interact inversely. Heavy involvement in organized religion diminishes spirituality and vice versa. D) They are different. Spirituality is a sense of connection to the Divine; religion is a structure of beliefs, rituals, and rules.

D They are different. Spirituality is a sense of connection to the Divine; religion is a structure of beliefs, rituals, and rules.

An older patient is prescribed a thiazide diuretic as treatment for mild right heart failure. Which herbal supplements should the nurse instruct the patient to avoid while taking this medication? (Select all that apply.) A) Green tea B) Kava-kava C) White willow D) Cascara sagrada E) Aloe barbadensis

D, E

A confused but physically healthy older patient eats a diet very high in cereals and breads, with fruit only once per week and little protein. How does the patient's diet impact her current condition? A) A lack of vitamin A can affect her night vision. B) A high-calcium diet can lead to problems with kidney stones. C) The lack of fruit in her diet can contribute to complaints of constipation. D) A high-carbohydrate diet can stimulate abnormally high release of insulin, which can add to her confusion.

D A high-carbohydrate diet can stimulate abnormally high release of insulin, which can add to her confusion.

Which patient on a geriatric medicine unit would the nurse recognize as being most prone to sleep problems? A) An obese female patient receiving IV antibiotics for the treatment of a urinary tract infection B) A 74-year-old female receiving transfusions of packed red blood cells for an upper GI bleed C) A 78-year-old male recovering from an ischemic stroke and has skin breakdown on the coccyx D) A male patient admitted for exacerbation of chronic obstructive pulmonary disease (COPD) with a history of angina

D A male patient admitted for exacerbation of chronic obstructive pulmonary disease (COPD) with a history of angina

An older patient has dentures and tells the nurse that she has not seen the dentist for years. What is the best advice the nurse should provide the patient? A) Visit the dentist periodically to replace the dental appliance B) Visit the dentist regularly if she wears his dentures everyday C) Make an emergency dental visit if she notices a problem with the gums D) Schedule regular visits with the dentist to monitor for lesions and fit of the dental appliance

D Schedule regular visits with the dentist to monitor for lesions and fit of the dental appliance

A 70-year-old patient with lung cancer is receiving transdermal doses of a narcotic analgesic. Which of the following nursing interventions can minimize any gastrointestinal (GI) issues? A) Monitor the patient's respirations B) Monitor the drug's sedative effects C) Start at the lowest dosage of medication D) Start the patient on a bowel regimen

D Start the patient on a bowel regimen

An older patient is demonstrating signs of dress. How does the nurse explain the body's immediate reaction to stress? A) Formation of ulcers B) Elevation of blood pressure C) Development of heart disease D) Stimulation of the sympathetic nervous system

D Stimulation of the sympathetic nervous system

The family of an older patient with dysphagia comes to the skilled nursing facility at mealtimes to feed the patient. Which of the family's feeding practices should the nurse follow up with teaching or correction? A) The family makes sure that the patient does not talk while eating B) The family checks for pocketing of food prior to introducing another bite C) The family places the patient in high Fowler position during and after feeding D) The family introduces large pieces of food to prevent accidental inhalation of small food particles

D The family introduces large pieces of food to prevent accidental inhalation of small food particles

Which aspect of the microenvironment is a 79-year-old widow most likely to focus on first? A) The decor of the house is several decades out of date. B) The home was recently burglarized and the television stolen. C) The front steps of the house are decaying and pose a safety risk. D) The home is unbearably hot in the summer and has cockroaches.

D The home is unbearably hot in the summer and has cockroaches.

During a morning assessment the nurse notes that the oral temperature of an older patient is 96°F (35.6°C). What guide will the nurse use to make decisions about this assessment finding? A) Older adults are at increased risk for hyperthermia B) Low temperature constitutes a risk to cardiac health C) Older adults often lose body heat in response to infection D) The normal body temperature of older adults is often lower than that of younger people

D The normal body temperature of older adults is often lower than that of younger people

The nurse is caring for an older patient with a fractured hip. Which pain control goal would be the most realistic for the patient? A) The patient will experience relief from pain. B) The patient will state that being in a state of comfort. C) Scheduled and breakthrough analgesia will be administered as needed. D) The patient's self-report of pain will remain below 5 out of 10 while hospitalized.

D The patient's self-report of pain will remain below 5 out of 10 while hospitalized.

The daughter of an older patient is concerned because the patient continues to experience lower back pain even though all exams, labs, and radiology studies have been negative. What should the nurse discuss with the patient's daughter? A) Pain is a normal part of being old. B) The pain is phantom pain, and nothing else can be done. C) The patient's complaint does not fall into the true definition of pain. D) The patient's team needs to explore all possible valid reasons for her mother's pain, including physical causes.

D The patient's team needs to explore all possible valid reasons for her mother's pain, including physical causes.

Which of the following statements most accurately captures an aspect of dental health among older adults? A) Clients who wear dentures do not normally require visits to the dentist. B) The incidence of dental caries increases significantly with age. C) Periodontal disease is less common in older adults than in younger clients. D) The presence of dental problems can be indicative of a variety of other diseases.

D The presence of dental problems can be indicative of a variety of other diseases.

What should the nurse use to help guide interventions to meet the spiritual needs of a patient? A) The client's prognosis for recovery B) The nurse's own religious tradition C) The denominational affiliation of the chaplain D) The presence of icons and religious books at the bedside

D The presence of icons and religious books at the bedside

An older patient has been diagnosed with a venous thromboembolism. Which age-related change most likely contributed to this diagnosis? A) Decreased coronary blood flow B) Less efficient cardiac oxygen usage C) Decreased elasticity of blood vessels D) Increased resistance of peripheral vessels

C Decreased elasticity of blood vessels

An older patient has identified stress as being the cause for not receiving adequate sleep and wants to "do something" to relax. Which activities should the nurse suggest to the patient? (Select all that apply.) A) Read B) Take a walk C) Needlework D) Listen to music E) Visit with friends

A, C, D

The nurse manager of a geriatric medicine unit learns that spiritual care services are underutilized by patients and their families. Which phenomenon explains this finding? A) While spiritual needs are a universal part of the human condition, many people do not acknowledge these needs. B) The high-stress environment of a hospital is incompatible with the solace and quiet necessary for addressing spiritual needs. C) Spiritual needs are less apparent during times of immediate and tangible need, such as acute illness requiring hospital treatment. D) Many older adults who have experienced a lifetime of self-sufficiency and practical resourcefulness do not have spiritual needs.

A While spiritual needs are a universal part of the human condition, many people do not acknowledge these needs.

An older male patient with end-stage renal disease is sad and believes that he will die within a few days. Which interventions should the nurse use to promote hope in the patient? (Select all that apply.) A) Using humor at the bedside B) Facilitating a life review for the client C) Helping the client to find pleasure during current life activities D) Encouraging the client to focus on a time of life that was more pleasant E) Introducing the client to an individual who has a much poorer prognosis and/or health status

A, B, C

An older patient with heart disease asks the nurse what foods can be eaten to help reduce any further problems with the disease. What should the nurse instruct this patient? (Select all that apply.) A) Use cold-pressed olive oil B) Increase the intake of fiber C) Reduce the intake of fried foods D) Avoid fish rich in omega-3 fatty acids E) Avoid all caffeine and other stimulants

A, B, C

An older patient is being admitted to a long-term care facility. What information will the nurse include when conducting a sleep history with this patient? (Select all that apply.) A) Usual bedtime routine B) Characteristics of sleep C) Amount of daytime drowsiness D) Food and fluids consumed before sleep E) Number of hours doing housework each day

A, B, C, D

Which interventions would be appropriate for the nurse to use to improve the tissue perfusion of an older patient? (Select all that apply.) A) Reminding about frequent position changes B) Ensuring an adequate body temperature C) Encouraging physical activity when possible D) Assessing for and preventing sources of pressure on the body E) Limiting exercise and ensuring adequate rest between periods of exertion

A, B, C, D

The nurse is concerned that an older patient with renal failure is developing malnutrition. What did the nurse assess in this patient? (Select all that apply.) A) Hematocrit level 30% B) Hemoglobin level 7 g/dL C) Serum albumin level 2.5 g/100 mL D) Blood glucose level 110 mg/dL E) Weight loss of 6% over the last month

A, B, C, E

While providing care the nurse suspects an older patient recovering from a stroke is experiencing pain. What did the nurse assess in the patient? (Select all that apply.) A) Agitation B) Perspiration C) Poor appetite D) Increased focus E) Increased blood pressure

A, B, C, E

An older patient with cardiovascular disease is losing weight because of a poor appetite. Which interventions should the nurse use to help support this patient's nutritional needs? (Select all that apply.) A) Provide foods that are high in glucose B) Serve favorite foods in an attractive manner C) Explain that ethnic foods should be never eaten D) Provide several small meals throughout the day E) Explain that occasional foods can be eaten weekly

A, B, D

During an assessment an older male patient states that he has not been happy in life because he does not deserve to be loved. The nurse realizes that this patient believes love has been withheld because of which criteria? (Select all that apply.) A) Productivity B) Social position C) Education level D) Physical condition E) Material possessions

A, B, D, E

During an assessment the nurse learns that an older patient uses flavonoids to help reduce joint inflammation caused by osteoarthritis. Which dietary items should the nurse ensure the patient receives to maintain this patient's practice? (Select all that apply.) A) Green tea B) Chocolate C) Grapefruit D) Blueberries E) Raspberries

A, B, D, E

The nurse is planning care to address a patient's spiritual distress. Which interventions would be appropriate to include in this plan of care? (Select all that apply.) A) Pray with the patient upon request as needed and desired B) Find a volunteer to read the Bible to the patient upon request C) Remind the patient that spiritual needs are often addressed last D) Contact the patient's church to have the clergy visit the patient E) Help the patient identify factors contributing to spiritual distress

A, B, D, E

The nurse observes an older patient crying, tensed, and lying rigidly in bed. What action should the nurse take first? A) Reposition the patient in bed B) Perform a systematic pain assessment C) Ask the patient if she is experiencing a problem D) Prepare a dose of breakthrough medication for the patient.

C Ask the patient if she is experiencing a problem

The staff on a unit that provides care to patients with dementia wants to make changes to the patients' environment. What would be the recommended change to lighting? A) Remove all incidental lamps from the rooms B) Keep a bedside light on in the rooms all night C) Avoid using the fluorescent light over the beds at night D) Close the curtains during the day to minimize the effect of sunlight

C Avoid using the fluorescent light over the beds at night

An older resident with dementia has been pacing and holding his right arm up against his chest. What should the nurse do first to help this patient? A) Notify the physician and get an order for an x-ray B) Document the behavior and report it to the next shift C) Check the resident's record for the history of this resident's behavior D) Medicate the resident with acetaminophen that is available PRN in his record

C Check the resident's record for the history of this resident's behavior

An older patient who has been treated for diabetes mellitus for 10 years continues to have difficulty controlling the blood glucose level. Which potential complication of diabetes should the diabetes educator include when instructing this patient? A) Signs of congestive heart failure B) Signs of a myocardial infarction C) Complications of arteriosclerosis D) Complications of cardiac arrhythmias

C Complications of arteriosclerosis

An older patient who spends most of the time in bed because of impaired mobility is complaining about not getting enough sleep. What would cause the nurse concern if this patient were prescribed sleep sedatives? A) Promotion of incontinence B) Depression of some vital body functions C) Decreased body movements during sleep D) Decreased susceptibility to adverse reactions

C Decreased body movements during sleep

The nurse discusses dental health with an 81-year-old client. Which of the following statements, when made by the client is identified as true? A) "Everyone loses their teeth, it's natural." B) "I can't get any cavities any more, only young people get them." C) "Fluoride treatments might help strengthen the enamel on my teeth." D) "There is no treatment for my bad teeth and poor appetite."

C "Fluoride treatments might help strengthen the enamel on my teeth."

A design firm is contracted to remodel a care facility. Which bathroom design component is most conducive to safety and quality of life for the older adult residents who will use them? A) Throw rugs will be placed on the tile floors B) Bathrooms will include bathtubs rather than showers C) A small independent light to remain lit in the bathroom at all times D) A single, rotating faucet installed at the sink to control water flow and temperature

C A small independent light to remain lit in the bathroom at all times

Because many residents in a long-term care facility are experiencing sleep problems, which routine should the nurse reevaluate? A) Offering a light snack at bedtime B) Bathing residents in the evening rather than first thing in the morning C) Activities are concentrated in the morning to ensure evenings are free D) Encouraging residents to refrain from going to bed when they first feel drowsy in the evening

C Activities are concentrated in the morning to ensure evenings are free

Nonpharmacologic pain relief measures have been ineffective to reduce an older patient's pain to promote sleep. What should the nurse do next? A) Provide a trial of opioids B) Give the strongest dosage of analgesic and gradually decrease as necessary C) Administer the lowest dosage of analgesic and gradually increase as necessary D) Offer the lowest dosage of analgesic and give only when requested by the patient

C Administer the lowest dosage of analgesic and gradually increase as necessary

The nurse is identifying the different sleep patterns of assigned patients on a geriatric care unit. Which patient is demonstrating the typical sleep pattern of a patient who is older? A) Age 82 patient sleeps a total of more than 12 hours out of 24 B) Age 90 patient describes the quality of sleep as "better than it ever was" C) Age 80 patient falls asleep early in the evening but wakes up before dawn D) Age 79 patient sleeps in until 9 o'clock each morning despite a lifetime of early rising

C Age 80 patient falls asleep early in the evening but wakes up before dawn

An older individual is touring an assisted living facility with his family in order to find a place to live after the death of his spouse and issues with mobility. Which characteristic of the facility is most in need of modification? A) The temperature of common areas is kept between 75°F and 77°F B) Aromatherapy is used in the facility to provide a pleasant scent environment C) Area rugs are placed in front of each sink in residents' washrooms to ensure warmth D) There is more tile than carpet throughout the facility and carpets are glued to the floor

C Area rugs are placed in front of each sink in residents' washrooms to ensure warmth

The nurse is caring for older patients in a long-term care facility. When ensuring for these patients' dignity, which statement reflects the role of dignity as it relates to the spiritual needs of the older adult? A) Older adults who have lived a life of integrity and service have earned dignity. B) An acknowledgment of spiritual needs is necessary for the presence of dignity. C) Older adults may lack many of the attributes that are valued in society, but they can derive a sense of dignity from spirituality. D) Older adults who have moved successfully through Erikson's stages of development can experience dignity in spite of disability.

C Older adults may lack many of the attributes that are valued in society, but they can derive a sense of dignity from spirituality.

An older patient has been treated with acetaminophen for chronic pain, and it is no longer effective. What would be the next drug of choice for this patient? A) Codeine B) Ibuprofen C) Oxycodone D) Morphine patch

C Oxycodone

An older female patient, experiencing cancer pain and nausea and vomiting from chemotherapy, asks the nurse to pray for her during this difficult time. How should the nurse respond to the patient's request? A) Facilitate a visit from a chaplain to the client at the bedside. B) First determine whether the client shares a similar religious tradition as the nurse. C) Pray for the client, asking a higher power to intervene and provide peace and relief. D) Explain that praying is beyond the nurse's scope of practice and explore alternative interventions.

C Pray for the client, asking a higher power to intervene and provide peace and relief.

An older patient hospitalized for pneumonia is having difficulty sleeping and is frustrated with the noises at night. What should the nurse do about this situation? A) Obtain an order for a benzodiazepine to be taken at bedtime B) Change the temperature of the client's room to be more conducive to sleep C) Provide a form of white noise and plan to minimize noise during caregiving activities D) Teach the client about the normal changes in sleep quality and quantity that accompany aging

C Provide a form of white noise and plan to minimize noise during caregiving activities

A patient who is cognitively impaired is demonstrating signs of being in pain. How should the nurse assess this patient's pain level? A) Ask the patient to numerically rate the pain B) Observe the patient often over the next several hours C) Provide the patient with a visual analog scale to gauge pain D) Go through the McGill Pain Questionnaire with the patient

C Provide the patient with a visual analog scale to gauge pain

An older patient who resides in an assisted living facility is experiencing chronic pain. The physical exam reveals joint swelling and a medical history of osteoarthritis. Which approach should be used to ensure effective pain management? A) Observation of gait B) Radiological studies to pinpoint pain C) Qualitative and quantitative assessment of symptoms D) Documentation of the body language indicative of pain

C Qualitative and quantitative assessment of symptoms

An older patient who resides in an assisted living facility experiences dizziness and lightheadedness when getting out of bed in the morning and when standing up quickly from a chair. Which intervention would be appropriate at this time? A) Assess the patient's dietary and activity habits B) Plan a weight-loss and exercise regimen together with the patient C) Review the medication regimen and teach appropriate safety measures D) Recommend the use of garlic and hawthorn berries to address hypotension

C Review the medication regimen and teach appropriate safety measures

The nurse is planning to assess the pain level of an older patient who is hearing impaired. Which assessment technique would be the most appropriate for the nurse to use? A) Withhold analgesia until the patient requests it. B) Ask the patient to rate pain on a scale of 1 to 10. C) Show the patient a scale with 0 being a smile and 6 being a crying grimace. D) Show the patient a picture of the body with a pain intensity scale, and use keywords to ask about her pain.

C Show the patient a scale with 0 being a smile and 6 being a crying grimace.

The nurse finds a patient sitting in bed, crying. What should the nurse do when the patient says that nothing is wrong? A) Ignore the problem because the patient obviously does not wish to talk. B) Document the patient crying and go back to see the patient later in the shift. C) Sit in the chair beside the patient's bed, and maintaining eye contact, ask a few questions about the day. D) Fill the patient's water pitcher and move around the room, doing some small things to make the patient more comfortable.

C Sit in the chair beside the patient's bed, and maintaining eye contact, ask a few questions about the day.

The client is a healthy, active 85-year-old with constipation. Which of the following age-related changes may contribute to this complaint? A) Inactivity B) Reduced food and fluid intake C) Slower peristalsis D) Decreased sensory perception

C Slower peristalsis

A patient with a diagnosis of lung cancer has recently developed metastases to the bone which is causing severe pain. The nurse would characterize this patient's pain as being which type? A) Chronic B) Neuropathic C) Somatic nociceptive D) Visceral nociceptive

C Somatic nociceptive

An older patient asks for natural methods, instead of medications, to help with falling asleep. What can the nurse suggest to this patient? A) Avoid protein, take a walk every day, and drink a non-caffeinated herbal tea at bedtime B) Avoid carbohydrates, take a walk every day, and drink non-caffeinated herbal tea at bedtime C) Take a walk every day, get exposure to the sun daily, and drink non-caffeinated herbal tea at bedtime D) Minimize the amount of exercise, get exposure to the sun daily, and drink non-caffeinated herbal tea at bedtime

C Take a walk every day, get exposure to the sun daily, and drink non-caffeinated herbal tea at bedtime

An older patient asks the nurse for medication to promote sleep. What is the best alternative to sleep sedatives that the nurse can suggest? A) Watch television before going to bed B) Drink some wine before going to bed C) Take a warm bath before going to bed D) Avoid eating carbohydrates before going to bed

C Take a warm bath before going to bed

The nurse is identifying interventions to help older patients with insomnia. What action should the nurse perform first? A) Educate older patients about how foods and beverages affect sleep B) Identify insomnia as a short-term problem associated with physical or mental illness C) Suggest natural methods to the older patient fall asleep sooner and sleep more soundly D) Recognize insomnia as a symptom and assess for factors that contribute to disrupted sleep

D Recognize insomnia as a symptom and assess for factors that contribute to disrupted sleep

An older patient with multiple health problems asks the nurse for advice about recurrent insomnia. Which statement made by the nurse is most accurate? A) "Caffeine obviously makes it hard for you to sleep, while a moderate amount of alcohol at bedtime is useful." B) "You should try over-the-counter sleep aides for several weeks before you move on to prescription options." C) "It's very normal for the quality of sleep to decrease with age, so this is usually a problem that requires accommodation rather than treatment." D) "A lot of medications have the potential to interfere with sleep, so it would be useful to review your medications with your physician or a pharmacist."

D "A lot of medications have the potential to interfere with sleep, so it would be useful to review your medications with your physician or a pharmacist."

An older patient asks the nurse practitioner what measures can be taken to maintain a healthy heart. Which regimen should the nurse recommend to the patient? A) "A low-salt diet and an aspirin tablet with each meal can promote a healthy heart." B) "Abstaining from alcohol and limiting your use of painkillers have a protective effect on your heart." C) "One Tylenol tablet and a glass of red wine each day have been shown to help prevent heart attacks." D) "A low-dose aspirin each day and moderate use of alcohol can help prevent cardiovascular disease."

D "A low-dose aspirin each day and moderate use of alcohol can help prevent cardiovascular disease."

The nurse is providing a seminar for a group of seniors on changing nutritional needs. What should the nurse instruct the participants about the reduced need for calories? A) "You should consume at least three servings of fruits and vegetables daily." B) "You should limit your fat intake to less than 50% of total calories consumed." C) "The consumption of a high-carbohydrate diet prevents the release of glucose." D) "As you age, your basal metabolic rate declines, contributing to weight gain even when you consume the same amount of calories as when you were younger."

D "As you age, your basal metabolic rate declines, contributing to weight gain even when you consume the same amount of calories as when you were younger."

What dietary advice should the nurse provide to an older patient who is experiencing pain and inflammation due to rheumatoid arthritis? A) "Eating fewer calories will minimize inflammation in your joints." B) "A high protein, low-carbohydrate diet has been shown to benefit many arthritis sufferers." C) "A low-cholesterol diet and drinking lots of fluids might help with the pain you're experiencing." D) "Cutting back on your consumption of meat, fatty dairy products and oils might have a positive effect on your pain."

D "Cutting back on your consumption of meat, fatty dairy products and oils might have a positive effect on your pain."

Which of the following statements by older adult clients should the nurse interpret as a potential pathological process rather than a normal age-related change? A) "Food just doesn't seem to have as much taste as it did when I was younger." B) "I feel like it takes so much longer to digest my meals than it used to." C) "Even when I have a bowel movement it often doesn't feel like it's complete." D) "I tend to regurgitate a lot of my food after a meal these days."

D "I tend to regurgitate a lot of my food after a meal these days."

The family of an older patient is concerned because the patient at times complains of pain but at other times does not. The family does not know what to believe. What can the nurse explain to the family about aging and pain perception? A) "Older adults become progressively more sensitive to pain." B) "The only pain to be concerned about is pain that lasts longer than 3 months." C) "Older people have been shown to be less sensitive to pain than younger people." D) "It's actually not clear in the research what happens to people's perception of pain as they age."

D "It's actually not clear in the research what happens to people's perception of pain as they age."

An older patient is experiencing restless legs that are interfering with sleep. What should the nurse respond to this patient's problem? A) "Some people find that daily exercise helps with this problem." B) "Most often restless legs can be traced to a deficiency in dietary calcium." C) "There are prescription drugs that nearly always provide relief from this problem." D) "There are a number of different medications that can cause this problem or make it worse."

D "There are a number of different medications that can cause this problem or make it worse."

At a health promotion class at a senior's center, a 67-year-old client asks the nurse, "What can be done to help manage my spouse's diverticular disease?" What is the nurse's most appropriate response to this client's query? A) "Try to encourage your spouse to drink at least 8 glasses of water each day." B) "You and your spouse might want to try eating 4 or 5 small meals rather than 3 larger ones each day." C) "I'd encourage you and your spouse to integrate more exercise into your daily routine." D) "Try to increase the amount of fiber that you include in the meals you cook."

D "Try to increase the amount of fiber that you include in the meals you cook."

During a home visit, the nurse is asked by an older couple if vitamin and nutritional supplements can compensate for poor food intake. What should the nurse respond to this question? A) "Supplements can be useful but avoid those that contain calcium." B) "The risks of excess dosages mean that supplements are best avoided entirely." C) "Supplements should be thought of as supplements, not replacements, so it's best not use them." D) "Vitamin and nutrient supplements can be a useful short-term nutritional measure, but only if they don't interact with prescribed medications."

D "Vitamin and nutrient supplements can be a useful short-term nutritional measure, but only if they don't interact with prescribed medications."

An older woman asks what she can do to reduce the risk of developing osteoporosis. What should the nurse respond to this patient? A) "The key to preventing osteoporosis is to remain physically active on a regular basis." B) "For women who have complete menopause, vitamin D supplements are the best form of prevention." C) "The best thing that you can do is to maximize your calcium intake by including dairy at most meals and taking supplements as well." D) "You need to make sure you are getting the recommended daily dose of calcium, which may involve taking supplements at each meal."

D "You need to make sure you are getting the recommended daily dose of calcium, which may involve taking supplements at each meal."

The nurse teaches the client who recently had hiatal hernia diagnosed. To keep the patient free from pain, what should the nurse recommend? A) Increased fiber intake B) Taking a nap after each meal C) Ensuring not to skip meals D) Remain upright for 1 hour after eating

D Remain upright for 1 hour after eating

The nurse is aware of the spiritual dimension in Erikson's conceptualization of the older adult's growth and development. When applying Erikson's theory to the care of older patients, what does the nurse realize as being a spiritual component of Erikson's final development task? A) Awareness that one is loved by others and has provided unconditional love. B) A confidently held hope that a transcendent and positive afterlife awaits one following death. C) A sense of contribution that one's relationships and endeavors have benefited society and one's family. D) A sense of wholeness rooted in the knowledge that life experiences make sense and have served a purpose.

D A sense of wholeness rooted in the knowledge that life experiences make sense and have served a purpose.

The nurse teaches a 65-year-old client with a chronic constipation problem. In reviewing her dietary habits, the nurse finds that the client's diet is low in fiber. Which of the following points should the nurse prioritize when teaching about increasing fiber intake? A) Add 20 g of fiber to other foods (such as wheat bran to ground beef or muffins). B) Attempt a bowel movement following breakfast. C) Use a suppository to stimulate elimination. D) Add fiber gradually to minimize symptoms of gas or bloating.

D Add fiber gradually to minimize symptoms of gas or bloating.

Which statement should be incorporated into the restraint policy for residents of a long-term care facility? A) Restraints should never be used. B) Physical restraints should only be used with verifiably agitated patients. C) Restraints should only be used when one-to-one staff supervision is not possible. D) Alternatives should be explored before chemical and physical restraints are utilized.

D Alternatives should be explored before chemical and physical restraints are utilized.

An older patient recovering from surgery is experiencing left calf edema and the area is red and painful to touch. Which actions should the nurse anticipate to be prescribed for this patient? A) Bed rest and administration of nitroglycerine as ordered B) Massaging the affected leg and providing analgesia as ordered C) Mobilizing the client and providing an ice pack for the affected leg D) Application of elastic stockings and administration of anticoagulants as ordered

D Application of elastic stockings and administration of anticoagulants as ordered

The nurse is planning care for an older patient with class 3 congestive heart failure (CHF) being admitted to a skilled nursing facility. Which action would be appropriate for this patient during the first week of hospitalization? A) Bed rest B) Digitalis as needed C) Passive range-of-motion exercises every shift D) Assist to a chair on day 1 and progressively increase ambulation each day

D Assist to a chair on day 1 and progressively increase ambulation each day

During a home visit the nurse notes that an older patient has a tray of many types of vitamins, minerals, and herbal supplements on the kitchen counter. The patient was recently discharged from the hospital after having an acute myocardial infarction. What should the nurse instruct the patient about these supplements? A) Continue taking the supplements but only with meals B) Stop taking the vitamins and other supplements until further notice C) Take the vitamins but do not exceed the recommended daily allowances for older adults D) Check with the health care provider to identify any supplements that may produce adverse interactions with prescribed medication

D Check with the health care provider to identify any supplements that may produce adverse interactions with prescribed medication

The nurse is caring for an older patient who is nearing death and realizes that no professional clergy needs to be contacted. This patient is most likely a member of which faith? A) Pentecostal B) Unitarianism C) Seventh-Day Adventists D) Church of Jesus Christ of Latter Day Saints

D Church of Jesus Christ of Latter Day Saints

A newly admitted older patient has severe edema in the lower extremities and no hair on the legs. What do these manifestations most likely indicate to the nurse? A) A diet low in protein B) Exposure to the cold from a lack of heat C) Frequent falls and injuries because of unsteady gain D) Circulatory problems related to age and a chronic illness

D Circulatory problems related to age and a chronic illness

During a physical exam, the nurse notes that the patient has a smooth red tongue. Which of the following diagnostic tests is an expected follow-up? A) Biopsy any lesions. B) Scrape the tongue for syphilis. C) Screen for lead poisoning. D) Complete a nutrition screening.

D Complete a nutrition screening.

A 60-year-old patient who participates in outdoor activities is diagnosed with angina. Which activity should the nurse instruct the patient to avoid to decrease the risk of anginal syndrome? A) Golfing B) Gardening C) Sitting in a spa D) Cross-country skiing

D Cross-country skiing

An older patient with a history of anginal syndrome and congestive heart failure is admitted to the Cardiac Care Unit with a myocardial infarction. Which assessment finding should the nurse report to the health care provider? A) Early morning fatigue B) Increase in respiratory rate C) Dyspnea when getting out of bed to sit in a chair D) Decrease in blood pressure and increase in temperature

D Decrease in blood pressure and increase in temperature

The nurse discusses nutritional health with an 89-year-old client whose total protein level is 5 (abnormally low). Which of the following physiological changes should the nurse interpret as a potential pathological process rather than a normal age-related change? A) Decreased amounts of pepsinogen released in the stomach B) Decreased peristalsis of the esophagus and stomach C) Decreased taste sensations, decreasing food intake D) Decreased teeth and chewing ability

D Decreased teeth and chewing ability

The history of a 70-year-old female indicates that she has been taking laxatives daily for years. Which of her following complaints may be a result of this laxative abuse? A) Nausea B) Peptic ulcers C) Anorexia D) Dehydration

D Dehydration

An older patient asks the nurse what he can about nausea that occurs after eating because of delayed gastric emptying. What advice should the nurse provide to the patient? A) Changing to a vegetarian, organic diet B) Limiting food intake and taking antacids regularly C) Increasing the amount of soluble and insoluble fiber in his diet D) Eating several small meals throughout the day rather than three larger ones

D Eating several small meals throughout the day rather than three larger ones

Even though a nursing assistant notices that an older patient's oral intake has been poor since being admitted to the care area, the assistant is not concerned since "older people don't need to eat much anyway". How should the nurse respond to this comment? A) That's a myth actually; older adults have increased caloric and nutritional needs B) Actually, older adults who are sick require more calories than younger people do during recovery" C) You're right, but it's still important that we provide vitamin supplements especially when a patient is recovering from an illness D) Even though it is true that older people don't need quite as many calories as younger people, they need as many nutrients as you or I

D Even though it is true that older people don't need quite as many calories as younger people, they need as many nutrients as you or I

The daughter of an older patient with diabetes and peripheral vascular disease wants to soak the patient's feet. What teaching should the nurse provide to the daughter regarding soaking the patient's feet? A) Foot soaking can lead to fungal infections B) Foot soaking is noted to improve circulation C) Foot soaking offers a viable alternative to tub bathing D) Foot soaking is likely to increase the patient's foot problems

D Foot soaking is likely to increase the patient's foot problems

Maslow's hierarchy of six basic human needs includes love. Which characteristic of an older person's home environment demonstrates that the need for love has been fulfilled? A) Large airy windows B) New, stylish furniture C) Adjustable track lighting D) Furniture acquired as a newlywed

D Furniture acquired as a newlywed

After a nutritional assessment the nurse learns that a 70-year-old female patient routinely ingests a diet high in fat. The nurse realizes the patient is at an increased risk for developing which health problem? A) Cancer B) Arthritis C) Osteoporosis D) Heart disease

D Heart disease

An older patient complains of aching and swelling in the right leg. The nurse notes cyanosis of the extremity and suspects a possible venous thromboembolism. What is the most likely site of the patient's thromboembolism? A) Aorta B) Inferior vena cava C) Superior vena cava D) Iliofemoral segment

D Iliofemoral segment

The nurse teaches an 87-year-old inactive client about avoiding constipation. Which of the following fluid and diet choices should the nurse include in the teaching? A) Avoid beverages with caffeine B) Drink iced liquids C) Encourage low-residue foods D) Increase intake of fruit juices

D Increase intake of fruit juices

Which foods should the nurse recommend to a patient who appears to be deficient in the B-complex vitamins? A) Limes B) Prunes C) Yellow vegetables D) Leafy green vegetables

D Leafy green vegetables

The nurse is instructing a nursing assistant on how to feed all patients with dysphagia. What information should the nurse include in this instruction? A) Thicken liquids and cut solids into very small pieces B) Use a spoon to transport even solid food to the patient's mouth C) Listen for bowel sounds to make sure the food has reached the stomach D) Make sure the patient is sitting upright whenever consuming food or fluid

D Make sure the patient is sitting upright whenever consuming food or fluid

A female patient is anxious after having a mastectomy for breast cancer. As part of her pain management program, what alternative therapy should the nurse recommend as the most beneficial? A) Naturopathy B) Biofeedback C) Nutritional therapy D) Meditation and prayer

D Meditation and prayer

Which assessment finding indicates that an older patient is experiencing congestive heart failure? A) Sharp chest pain with exertion B) Tortuous calf veins and a history of venous ulcers C) History of myocardial infarction and peripheral edema D) Moist lung crackles are audible on auscultation with shortness of breath on exertion

D Moist lung crackles are audible on auscultation with shortness of breath on exertion

An older patient with type 2 diabetes mellitus is complaining of burning feet. The nurse determines that the patient is most likely experiencing which type of pain? A) Somatic pain B) Visceral pain C) Nociceptive pain D) Neuropathic pain

D Neuropathic pain

An older patient complains of overwhelming daytime fatigue, which the spouse attributes to loud snoring and erratic breathing patterns during the night. Which health problem should the nurse suspect as causing this patient's fatigue? A) Insomnia B) Central sleep apnea C) Nocturnal myoclonus D) Obstructive sleep apnea

D Obstructive sleep apnea

An older patient is relocating to the home of her daughter who wants to modify the home environment to suit her mother's needs. What information should the nurse provide to the daughter to address the patient's age-related sleeping needs? A) Older people are less active during the day and require less sleep at night. B) Older people are not affected by age-related changes but may have some individual needs. C) Older people stay awake very late into the night and as a result usually sleep late in the morning. D) Older people sleep less soundly and may awaken to noises that would not cause the same reaction in younger adults.

D Older people sleep less soundly and may awaken to noises that would not cause the same reaction in younger adults.

An 80-year-old patient is admitted to the hospital for dehydration related to flu symptoms and receives intravenous fluids. What is a major risk factor for the patient during this hospitalization? A) Fluid restriction can lead to infection and constipation. B) Fluid restriction can lead to serious electrolyte imbalance. C) Dehydration can lead to decreased ability of the bladder to distend. D) Overhydration can lead to problems when receiving intravenous fluids.

D Overhydration can lead to problems when receiving intravenous fluids.

The nurse discusses dental health with an aging client. Which of the following physiological changes should the nurse interpret as a potential pathological process rather than a normal age-related change? A) Retraction of the gum's pulp B) Diminished saliva C) Hardened brittle tooth enamel D) Periodontal disease causing tooth loss

D Periodontal disease causing tooth loss

The nurse observes the skin of an older patient and then asks the patient questions about his nutritional status. How did inspection of the patient's skin guide the nurse to complete a nutritional assessment? A) Purpura may indicate hyperglycemia B) Fungus infections may indicate zinc deficiency C) Poor skin turgor may be an indicator of overhydration D) Persistent "goose bumps" may indicate a vitamin deficiency

D Persistent "goose bumps" may indicate a vitamin deficiency