Nursing for the Older Adult - Test 1
A nurse identifies those who are at risk for familial stress. Which of the following persons exemplifies the sandwich generation? A) A 50-year-old who balances the care of an 82-year-old parent and a 20-year-old child B) A 58-year-old whose elderly parents have been forced to live in separate care facilities C) A 72-year-old who deals with own health problems with the care of a grandchild D) An 83-year-old who is the sole caregiver for the 79-year-old spouse
a
nurse cares for an older adult at risk for a venous stasis ulcer. Which interventions should the nurse include in the teaching with this older adult? (Select all that apply.) A) Health promotion interventions B) Functional consequences C) Wellness outcomes D) Environmental modifications
ad
A 93-year-old asks the nurse, "I sure would like to live to get that 100 year birthday card from the president." Which of the following responses by the nurse is best? A) "Keeping fit and dealing with stress in a positive way helps your chances of living to be 100." B) "Surviving to 100 is strongly impacted by eating meat, fruits and grains." C) "Those people in your socioeconomic situation have higher chance of living to 100." D)"You have had a cancer and a stroke, so that decreases your chance of surviving to 100."
a
A diabetes nurse is providing care for a 73-year-old man who is a regular client of the hospital's outpatient diabetes clinic. What assessment question most clearly addresses this client's potential for optimal function? A) "What are some goals that you have for maximizing your level of wellness?" B) "How can we help you to take ownership of your own health?" C) "Is there anything that you're doing that might be exacerbating your diabetes?" D) "How long do you think that you'll be able to live independently?"
a
A group of nurses is involved in the planning and implementation of a health promotion campaign that is aimed at older adults. Which of the following questions is the best guide to such a campaign? A) "How can we help older adults maintain wellness as they age?" B) "What can we do to increase life expectancy in our region?" C) "How can we help older adults avoid age-related changes? D) "What is stopping older adults from living longer lives?"
a
A nurse assesses the risk of the members of the community. Which of the following are most likely to be living at or below the poverty line? A) An 83-year-old single woman B) A couple who are both 72 years old C) A white 73-year-old man D) A Hispanic couple in their 60s
a
A rural community nurse sets up a monthly disease screening service. Local news coverage chooses not to cover this event. Which of the following justifications best supports the screenings? A) Health promotion is essential for older adults because they have complex health care needs. B) Older adults are less responsive to health promotion interventions. C) Older adults as a group receive fewer prevention and screening services than other populations. D) Preventive services are less effective after the onset of chronic illness.
a
An 85-year-old client takes meals on wheels around the community. The client states, "All those old people really need me, you know how older people are. They can't get out, and are a burden to their family, and I just want to help." Most of the people on the client's delivery route are in their 60s. Which of the following characterizes this scenario? A) Ageism B) Aging anxiety C) Aging attribution D) Antiaging
a
An older adult reflects, "Why should I go to the gym, I'm going to get fat anyway." Which response by the nurse is most appropriate? A) "Age-related changes are inevitable; however, most problems affecting older adults are related to risk factors, so it's important to do what you can to maintain a high level of functioning." B) "Older adults experience positive or negative functional consequences because of age-related changes." C) "Risk factors do impact consequences, but you can override them." D) "Many problems affecting older adults are based on genetics."
a
The Functional Consequences Theory accounts for the important role that each of the domains of nursing play in the wellness of older adults. Which of the following situations best demonstrates the effect of environment on the older adult? A) A resident of a care facility experiences a fall because there are not grab bars outside his bathtub. B) A hospital patient develops Clostridium difficile-related diarrhea because a care provider did not perform adequate hand-washing. C) A man cannot afford a wheeled walker and suffers a fall while trying to mobilize using his cane. D) A woman develops emphysema as a result of her 70 pack-year history of cigarette smoking.
a
The nurse hears a colleague make the statement, "Most older adults have nothing to worry about financially." Which of the following statements reflects an accurate response to this? A) "You have to remember that there's a huge economic disparity among older adults." B) "Actually, the number of older people living below the poverty line has been increasing, not decreasing." C) "This isn't really true now, but it is true that the gaps that disadvantaged groups live with are expected to shrink." D) "This is true for some groups, but not for minorities who are less likely to be living with their relatives."
a
The nurse is differentiating between an 81-year-old patient's age-related changes and his risk factors for disease. Which of the following characteristics of the patient would the nurse consider as a risk factor? A) Chronic bronchitis B) Loss of bone density C) Decreased vital lung capacity D) Delayed gastric emptying
a
Which of the following interventions most closely aligns with the practices of health promotion? A) Leading a flexibility and mobility class among older adults B) Providing presurgical teaching to an older adult prior to hip replacement C) Administering an anti-inflammatory and analgesics to an older adult with osteoarthritis D) Teaching an older adult how to administer her inhaled bronchodilators independently
a
Which of the following statements best explains the relevance of psychological theories for gerontological nursing? A) Human needs theory allows the nurse to determine priorities of nursing care for older adults. B) Life-span development theories support the belief that it may be difficult to initiate behavioral changes in older adults. C) Psychological theories explain why nurses should focus their discussion more on the present than on the past when talking with older adults. D) Psychological theories explain why reminiscence groups may not be beneficial for older adults.
a
notable demographic trend that is expected to become more pronounced involves the sandwich generation. Which of the following individuals exemplifies the demands and challenges experienced by the sandwich generation? A) A 50-year-old woman who balances the care of her 82-year-old father and her 20-year-old son B) A 58-year-old man whose elderly parents have been forced to live in separate care facilities C) An 83-year-old man who is the sole caregiver for his 79-year-old wife. D) A 70-year-old woman who must accommodate her own health problem
a
A nurse is identifying positive functional consequences as part of the development of an older client's care plan. Which of the following outcomes exemplifies the concept of positive functional consequences for an older adult? (Select all that apply.) A) The older adult with arthritis can walk 1 mile without pain. B) The older adult who is overweight develops a plan to lose 2 lb a month. C) The older adult has constipation from pain medication. D) The older adult schedules cataract surgery.
abd
A nurse determines risk factors for an 81-year-old client's plan of care. Which of the following characteristics of the client would the nurse consider as a risk factor? (Select all that apply.) A) Chronic bronchitis B) Loss of bone density C) Decreased vital lung capacity D) Delayed gastric emptying E) Digoxin (Lanoxin) toxicity
ae
A 79-year-old man is dismayed that his driver's license will not be renewed, an action that his primary care provider states is a result of his loss of visual acuity and increased reaction time. This man is experiencing the consequences of A)risk factors. B)age-related changes. C)positive functional consequences. D)wellness outcomes.
b
A graduate nurse expresses an interest in focusing future study to healthy aging. Toward which of the following fields should the experienced nurse steer the graduate nurse? A) Palliative care B) Gerontological nursing C) Nursing home administration D) Social work
b
A home health nurse performs an admission on a 90-year-old client who has a small dog. The client states that the most important problem is urinary incontinence. The client's blood pressure is 135/90 mm Hg, with last bowel movement 3 days ago. Which of the following areas addresses the person's goals? A)Safety B)Incontinence C)Blood pressure D)Constipation
b
A nurse assesses a 66-year-old woman who strained a muscle. The client attends the gym daily, and states, "I injured my muscle grouting the floor tile getting ready for the bridge class I teach." Which of the following categorizes this client's aging? A) Healthy B) Active C) Productive D) Successful
b
A nurse assesses a community of older adults. Which of the following persons is at highest risk for a shortened life expectancy? A) A college professor born in 1956 B) A homemaker born in 1957 C) A nuclear engineer born in 1958 D) A nurse born in 1959
b
A nurse helps older adults increase healthy behaviors by restructuring. Which of the following communication techniques should the nurse use to help the older adult overcome barriers? A) "Could you walk with your friend for a half-hour after you both come back from the lunch program at the senior center?" B) "I know it's hard to get outside in the winter, so let's try to identify some ways of getting more exercise indoors during your usual activities." C) "Let's talk about the benefits of exercise. When you walk regularly you reduce constipation and muscle pain." D) "Your activity has been decreasing during the last 3 years and it is at the point that you are at an increased risk for heart disease."
b
A nurse who provides care for older adults in a long-term care setting is aware of the importance of maintaining residents' connectedness to society. How can this aspect of quality of life be best achieved? A) Ensuring that there are multiple television sets available to residents of the facility B) Arranging regular visits by school children to the facility C) Conducting reminiscence therapy D) Allowing residents to have input into the meal planning at the facilit
b
Despite the fact that older adults are proportionately the highest users of health care services, many nurses harbor misconceptions and deficits in practice related to gerontological nursing. What is the most likely solution to this problem? A) A shift from the treatment of older adults in institutional settings to home care B) Increased nursing education and clinical experience specific to working with older adults C) A focus on early discharge planning for older adults in hospital settings D) Increased use of aggressive pharmacological interventions in the treatment of acute illnesses in older adults
b
The Functional Consequences Theory can be applied to promote wellness in older adults in diverse settings. Which of the following examples demonstrates this application? A) Organizing an interdisciplinary meeting to discuss the available treatment options for an older adult with an acute illness B) Facilitating early mobilization to prevent muscle wasting and loss of function in an older hospital patient C) Deferring the final decision regarding an older man's choice of assisted living facility to the man's son and daughter D) Placing a 76-year-old woman on the waitlist for a kidney transplant
b
The nurse is discussing an older adult's recent diagnosis of rheumatoid arthritis with a colleague. Which of the nurse's statements reflects an accurate view of the relationship between aging and wellness? A) "It's important that the individual knows this is an expected part of growing older." B)"We need to teach the older adult how he can keep living a fruitful life in spite of his diagnosis." C)"We need to make sure our teaching is not too detailed for someone of his age." D)"We need to ensure his expectations of continuing to live alone are realistic."
b
The nurse is teaching nursing students about the importance of health promotion among older adults. Which of the following statements by the students indicates a need for further teaching? A) "Teaching older adults how to live with diabetes would be a useful health promotion initiative." B) "I can see why we would want to promote timely discharge back to the community following hospitalization." C) "I think that attending to spiritual growth could likely be a part of health promotion." D) "If we could promote healthy, simple diets, then some diseases could likely be prevented."
b
The nurse is working with a 79-year-old female patient with a diagnosis of osteoporosis. Which of the following interactions best exemplifies the nurse's understanding of the relationship between age-related changes and risk factors? A) The nurse performs strength and mobility training appropriate to the patient's age and diagnosis. B) The nurse teaches the patient about bone density in older women and the role of vitamin D and calcium intake. C) The nurse plans interventions in light of the body-mind-spirit interconnectedness of the patient. D) The nurse teaches the patient about how her risk factors are a consequence of age.
b
n older adult is sore from "doing too much in the yard yesterday." Which statement by the nurse best promotes healthy aging? A) "It's time to start exercising and eating right." B) "Let's look at how we can improve your health so you can do more." C) "Of course you can't do as much as you did before, you need to pace yourself." D) "You need to act your age, and let others do that work."
b
nurse interviews a centenarian gathering data for a large study. In the interview, the centenarian defines aging as not growing older, but growing wiser. Which of the following is the best response to this definition by the nurse? A) "Aging might make you wiser, but it does lead to eventual death." B) "Healthy maturity is characterized by wisdom." C)"How did you get to live to this old?" D) "I will never make it to be 100 like you."
b
r. Say is an 81-year-old man whose current hospital admission has been prompted by an exacerbation of his chronic renal failure. The nurse who is caring for Mr. Say is aware of the importance of fostering his wellness, a goal that can be achieved by emphasizing which of the following? A) Comparing Mr. Say's health to other patients who are more ill B) Exploring Mr. Say's abilities and strengths C) Advocating that Mr. Say's code status be changed to "do not resuscitate" D) Teaching Mr. Say that his health problems do not have to affect his daily routines
b
A nurse assesses a 71-year-old person who has smoked for 43 years. Which of the following is a negative functional consequence of smoking for this person? (Select all that apply.) A) Children are exposed to secondhand smoke B) Low oxygen-carrying capacity C) Abnormal breath sounds D) The ability to run a 5-K race E) Pulmonary disease
bcd
A 55-year-old adult female patient recently learned she has type 2 diabetes. She does water aerobics three times a week, has completed a diabetes education class, and does blood glucose monitoring herself. Her blood sugar and hemoglobin A1c have improved and she has lost weight. Which of the following statements best describes this patient's actions? A) Age stratification theory B) Life-course development C) Compression of morbidity D) Longevity and senescence theory
c
A 55-year-old client was recently diagnosed with type 2 diabetes. The client completed a diabetes education class and does water aerobics three times a week. The blood sugar and hemoglobin A1c have improved since losing 20 lb. Which of the following statements best describes this client's actions? A) Activity theory B) Age stratification theory C) Functional consequences theory D) Life-course development theory
c
A 77-year-old man was put on broad-spectrum antibiotics when he was hospitalized for sepsis. He has a history of rheumatoid arthritis and a recurring problem with pneumonia. Which of the following theories best explains why he has had these concerns? A) Apoptosis theory B) Neuroendocrine theory C) Immunity theory D) Genetic theory
c
A client, who retired from work this year, asks the nurse the secret to successful aging. Which of the following responses by the nurse is most helpful? A) "Later life can be a time of engagement, contribution and well-being, you must work to make it so." B) "Life is a bowl of cherries, if you are in the pits, crawl out." C) "Studies show that volunteering and helping others improve satisfaction with life." D) "The body is senescent and you will find you slow down each year."
c
A graduate nurse expresses an interest in focusing future study to healthy aging. Toward which of the following resources should the experienced nurse steer the graduate nurse? A) American Heart Association B) Healthy Brain Initiative C) Healthy People 2020 D) Springer Publishing Company
c
A group of community health nurses is using the transtheoretical model (TTM) as the foundation of a new health promotion campaign for older adults. What goal for the participants are the nurses likely to promote when working with older adults in the program? A) A recognition of the importance of screening for common health problems B) Increased participation in exercise programs and an awareness of the relationship between exercise and wellness C) The replacement of participants' unhealthy behaviors with healthy behaviors D) An awareness of the differences between life expectancy and active life expectancy
c
A healthy 65-year-old says, "I don't think I will live much past 70." The studies however show that this client should live to 84 years of age. Which of the following statements, by the nurse, summarizes the compression of morbidity for this client? A) "Let's work on extending your life expectancy." B) "The goal is to live better, not longer." C) "We should work on postponing chronic illnesses." D) "You are lucky that you are healthy."
c
A nurse at the aging center organizes exercise classes including tai chi. Which of the following principles is the nurse incorporating? A) Disease prevention B) Environmental modification C) Health promotion D) Spiritual awakening
c
A nurse is aware that many health care providers prioritize the role of biology in the aging process. What is a weakness of biologic theories of aging? A) Biologic theories do not account for the differences in life expectancy between males and females. B) Biologic theories are unable to explain the role of cell division in life expectancy and the aging process. C) Biologic theories of aging do not adequately address issues of wellness and quality of life. D) Biologic theories of aging are unable to explain the significant increases in life expectancy that occurred in the 20th century.
c
A nurse is teaching an older person about the concept of successful aging. Which of the nurse's questions addresses an important contributor to successful aging? A)"Are you largely free of acute or chronic illnesses?" B)"Do you feel financially secure?" C)"Do you feel like you actively engage with life?" D)"Do you have a reliable support network?"
c
A nurse who works with older adults is teaching a colleague about the similarities and differences between gerontology and geriatrics. Which of the following questions best conveys the focus of gerontology? A) "How can we secure more funding for research and development of drugs specifically for older adults?" B) "How can we teach older adults about the relationship between their lifestyle and their health?" C) "How can we help older adults maintain wellness as they age?" D) "How can we reduce the incidence of falls among older adults who live in care facilities?"
c
An older adult has recently begun to display unprecedented lapses in short-term memory. The nurse overhears a colleague reassuring the person by saying, "Try not to worry; it's just a part of growing older." The nurse recognizes that this is an example of what phenomenon? A) Multiple jeopardy B) Gerontophobia C) Age attribution D) Implicit ageism
c
Mr. Dey is a 69-year-old man who has been a cigarette smoker since his late teens. In recent weeks, he has asked the nurse who helps manage his diabetes numerous questions about the potential benefits of quitting smoking, a subject that he has normally avoided in past interactions. The nurse has now explicitly asked Mr. Dey if he would like to quit smoking, to which he has replied that he will "give it some serious thought." Mr. Dey is demonstrating what stage of the transtheoretical model (TTM)? A) Precontemplation B) Preparation C) Contemplation D) Action
c
The nurse is conducting a study on the needs and living situations of older adults in the community. Which of the following statements should the nurse take into account? A) A majority of older Americans will live in a nursing home at some point. B) More older men live alone than older women. C) Assisted-living arrangements have become increasingly common. D) Most older Americans reside in some form of institutional arrangement.
c
The nurse is explaining to a new colleague the similarities and differences between gerontology and geriatrics. Which of the following situations would most likely be addressed by a geriatrician rather than a gerontologist? A) Teaching older adults techniques to identify and deal with age-related changes B) Organizing and leading exercise classes to facilitate mobility C) Identifying and treating a patient's vascular dementia D) Rearranging an older adult's apartment to minimize the risk of falls
c
The nurse is teaching an older person about the concept of successful aging. Which of the nurse's questions addresses an important contributor to successful aging? A) "Are you largely free of acute or chronic illnesses?" B) "Do you feel financially secure?" C) "Do you feel like you actively engage with life?" D) "Do you have a reliable support network?"
c
The nurse is using the Functional Consequences Theory as a lens for planning patient care in a health care facility. The nurse recognizes that which of the following is an element of this nursing theory? A) Most problems affecting older adults may be attributed to age-related changes. B) Most functional consequences cannot be addressed through nursing interventions. C) Wellness is a concept that is broader than just physiologic functioning. D) The Functional Consequences Theory is a more comprehensive alternative to holistic nursing care.
c
You are asked by the son of an 81-year-old patient about vitamins, antioxidants, and age-related macular degeneration. Which of the following theories of aging will help you most when responding to him? A) Immunity theory B) Wear-and-tear theory C) Free radicals theory D) Nonstochastic theory
c
Which of the following statements, made by a new nurse, are myths and need correcting? (Select all that apply.) A) "Ageism is highly influenced by stereotypes and cultural values." B) "Ageism is more common in industrialized societies." C) "In the United States, 20% of the older adults who need care are in a nursing home." D) "People consider themselves old when they are old enough to apply for Medicare." E) "With increased age, people become more diverse and people become less like their age peers."
cd
A 74-year-old woman has recently begun integrating more fresh fruit and vitamin supplements into her diet in an effort to increase the levels of antioxidants in her body. This woman's actions indicate an understanding of what theory of aging? A) Cross-linkage theory B) Program theory of aging C) Immunosenescence D) Free radical theor
d
A gerontological nurse is aware that quality of life is an important consideration when assessing the functioning of older adults. What measure should the nurse use when appraising older adults' quality of life? A) Gerotranscendence B) Life expectancy C) Senescence D) Active life expectancy
d
A gerontological nurse who works in a public health setting has limited funding for initiatives. Which of the following prevention and health promotion initiatives is most likely to result in significant benefits for the older adults who participate? A) A awareness program that promotes screening sigmoidoscopy B) Teaching older adults about falls prevention in the home C) A program of bone density screening for older adults D) An exercise program for older adults who live in the community
d
A nurse administrator is involved in strategic planning for a large long-term care facility that has locations in numerous regions of the country. The nurse should anticipate what trend when planning for the future care of older adults? A) A gradual decline in overall life expectancy B) A decrease in the proportion of older adults who are members of minority groups C) Average longevity of males exceeding that of females D) Increased use of assisted living facilities by older adults
d
A nurse in a community setting plans wellness outcomes with a 68-year-old female client who desires to participate in a half-marathon run. Which of the following outcomes should the nurse document? A) The client will remain free of disease. B) The client will participate in daily aerobic activity class without falls. C) The client will increase activity until able to run 30 minutes. D) The client will participate in the half marathon that is scheduled in 6 months.
d
A nurse interviews a centenarian gathering data for a large study. In the interview, the centenarian says, "You're only as old as you feel, some days I feel like 'I'm 50.'" To which definition of aging does this response correspond? A) Chronologic aging B) Functional aging C) Perceived aging D) Subjective aging
d
A nurse who provides care to many older adults recognizes the importance of implementing a wellness approach to care. What principle underlies this approach to the health care of older adults? A) Older adults have decreasing expectations for wellness as they move through the aging process. B) Health problems are a Western cultural construct that has no objective, physiological basis. C) Older adults must come to accept a decline in wellness as they age. D) A holistic approach to caring for older adults can foster their well-being at every stage of life.
d
The nurse is identifying positive functional consequences as part of the development of an older patient's care plan. Which of the following statements best captures the concept of positive functional consequences? A) They are synonymous with functional assessment. B) They are the result of conscious intent. C) They are not outcomes of age-related changes. D) They result from automatic actions or purposeful interventions.
d
The nurse is teaching a colleague about the difference between age-related changes and risk factors. Which of the following examples best demonstrates an age-related change? A) An older adult with a diagnosis of diabetes mellitus B) An older adult who is obese C) An older adult with obstructive lung disease D) An older adult with decreased bowel motility
d
The nurse works with a program that performs interviews, blood work, and digital rectal exams aimed at identifying older men with benign prostatic hyperplasia (BPH). The program also facilitates bathroom alterations in older adults' homes to ensure men with BPH have easy access to a toilet. Which of the following components of health promotion has yet to be implemented in the program? A) Screening B) Risk assessment C) Environmental modification D) Risk reduction interventions
d
The subculture theory of aging has been proposed to explain some of the sociocultural aspects of the aging process. Which of the following characteristics of older adults is explained by the subculture theory? A) Older adults have little control over the biological effects of the aging process. B) Older adults have a decreased need for social interaction and peer support as they become older. C) Older adults may see their status with their peers in terms of economic achievement. D) Older adults may interact much more with other older adults than with members of other age groups.
d
Until recently, a 77-year-old woman lived alone in her own home. Her younger sister assisted her with grocery shopping, and they would occasionally have lunch together. Recently, the woman fell on some ice and fractured her ankle. Her orthopedic surgeon and her case manager have obtained for her a short-term placement in a long-term care facility for rehabilitation physical therapy. After the patient's physical therapy is finished and her ankle is healed, the patient tells her nurse that she wants to stay at the facility; she is very happy living there and likes the social interaction that she experiences there. Which of the following theories of aging best describes the status of this patient? A) Activity theory B) Person-environment fit theory C) Life-course theory D) Theory of thriving
d
Which of the following circumstances would be most likely to render a screening program unnecessary? A) Treatment of the disease is available at low cost. B) The disease follows a predictable course. C) The disease is more common among older adults than among younger and middle-aged adults. D) The symptoms of the disease appear at the same time that it is detectable by screening.
d
nurse is aware that addressing issues related to connectedness and quality of life is central to the Functional Consequences Theory. Which of the following actions is most likely to enhance the older adult's connectedness? A) Teaching a patient who has had a below-the-knee amputation how to care for his stump B) Organizing a client's intravenous antibiotic therapy on an outpatient basis C) Performing a focused respiratory assessment on a client who has a diagnosis of lung cancer D) Changing a policy so that a husband and wife can remain in the same room of a care facility
d