3403- Final Exam

2. The cause of the spouse's death was suicide.

According to research, which factor increases the probability that the surviving spouse will have a pathological or morbid grief response? 1. The couple had an ambivalent relationship. 2. The cause of the spouse's death was suicide. 3. The relationship between the spouses was satisfying. 4. There was anticipatory grief before the spouse's death.

d. Elder mistreatment

The infliction of actual harm or a risk for harm to vulnerable older persons through action or behavior of others defines which term below? a. Elder abuse b. Elder neglect c. Self-neglect d. Elder mistreatment

Demanding, emotional extremes, live alone, socialize little, hx of mental illness, may have guilt

What are characteristics of those who ineffectively cope with loss?

4. Employ electronic devices that provide alerts.

Which action would the nurse take when caring for an older adult with a history of recent memory loss? 1. Instruct the client to move slowly when changing positions. 2. Remind the client to look where he or she places the feet while walking. 3. Adjust the daily schedule to accommodate sleep pattern. 4. Employ electronic devices that provide alerts.

2. Identify the stressors that precipitate the client's behavior

Which initial action would the nurse take for a nursing home resident with moderate Alzheimer disease who begins to engage in numerous acting-out behaviors? 1. Assess the client's level of consciousness 2. Identify the stressors that precipitate the client's behavior 3. Observe the client's performance of activities of daily living 4. Monitor the side effects associated with the client's medications

2. Wife weeps, moans, and calls out his name

Immediately after a man dies, which behavior is most likely to be a cultural manifestation of the survivors' grief response? 1. Youngest daughter holds the children 2. Wife weeps, moans, and calls out his name 3. Oldest son takes charge of notifying others 4. Oldest daughter looks stunned and shocked

a. rapidly establishing rapport.

Nursing interventions designed to assist older adults or family members in attaining a healthy adjustment to a loss would include all the following EXCEPT a. rapidly establishing rapport. b. observing for functional disruption. c. assisting in the search for meaning. d. helping with the reorganization of the structure of life.

c. people who are eligible for Medicare and Medicaid.

PACE provides community services to: a. people ages 65 and older only. b. people who prefer to live in an assisted living facility (ALF). c. people who are eligible for Medicare and Medicaid. d. people on disability.

b. disease treatment.

Palliative care can be described as all of the following EXCEPT that which focuses on a. comfort. b. disease treatment. c. symptoms. d. quality of life.

A. preparation for death with comfort are the goals of care.

The gerontological nurse's decision is based on the knowledge that hospice care is indicated when... A. preparation for death with comfort are the goals of care. B. clients and families are having difficulty coping with grief reactions. C. clients have unmanageable pain and suffering as a result of a physical condition. D. family members can no longer care for dying loved ones at home.

Medication management, patient and family education, comprehensive and collaborative discharge planning, excellent communication

What are nursing interventions for improving transitional care?

Enhanced self-esteem, personal growth and satisfaction, finding or making meaning through caregiving

What are positive impacts of caregiving?

c. Omnibus Budget Reconciliation Act (OBRA).

Your family member who is a resident in a nursing home has become dehydrated, and her blood pressure and pulse have dropped significantly enough to require hospitalization. You realize that there has been a lapse in her care and know that you can share the incidence with: a. Medicare. b. Quality Assurance Performance Improvement (QAPI). c. Omnibus Budget Reconciliation Act (OBRA). d. Center for Medicare and Medicaid Services (CMS).

Medication discrepancies

What is the main reason people readmit to the hospital?

A. Subacute care unit The best option is post-acute care in a skilled nursing facility. The expectation is that the patient will be discharged home or to a less intensive setting. The length of stay is usually no more than 1 to 3 months. Rehabilitation services are an essential component of post-acute units.

A nurse begins discharge planning for an older adult after a total hip replacement. The patient requires continued nursing care and physical therapy before returning home. Which environment best suits the patient's needs? A. Subacute care unit B. Assisted living facility C. Residential care facility D. At home, with adult day care

d. develop a personal understanding of your own feelings about grief and death.

As a first-year nursing student, you are assigned to care for a dying patient. To best prepare you for this assignment, you will want to: a. complete a course on death and dying. b. control your emotions about death and dying. c. compare this experience to the death of a family member. d. develop a personal understanding of your own feelings about grief and death.

c. their own homes.

As a gerontological nurse, you will know that more older adults live in: a. nursing homes. b. rehabilitation centers. c. their own homes. d. hospitals.

2. "I would keep the teaching sessions short." 3. "I would involve the client in any discussion or activity."

The registered nurse (RN) is teaching a nursing student about how to educate clients based on their developmental capacity. Which statements made by the nursing student are applicable for older adults? (Select all that apply) 1. "I would encourage independent learning." 2. "I would keep the teaching sessions short." 3. "I would involve the client in any discussion or activity." 4. "I would encourage learning through pictures and short stories." 5. "I would teach the client psychomotor skills to maintain his or her health."

Increased levels of depression/anxiety, poorer self reported physical health, compromised immune system, increased mortality rates, higher rates of insomnia, increased alcohol use

What are negative impacts of caregiving?

Lighting, big print, face patient

What are physical needs of teaching older adults?

Support people that they have in life

What are psychosocial needs of teaching older adults?

Follows through entire continuum of care, makes referrals to community resources, monitor quality of arranged services, be a resource for patient (advice, counseling), reduce stress of transitioning, follow up after referrals

What are roles of a nurse in case management

Coolness, increased sleep, disoriented, noisy breath, restlessness, decrease intake/output, withdrawal, vision like experiences.

What are signs/symptoms of approaching death?

It's ok to go, thank you, I'm sorry for, we will be ok

What are some things that end of life patients may need to hear from loved ones before they go?

d. Continuing care retirement community (CCRC)

Your clients are interested in a facility that will allow them full care and services for the rest of their lives. Which one of the following would you suggest? a. Assisted living facility (ALF) b. Adult day services (ADS) c. Residential care facility (RCF) d. Continuing care retirement community (CCRC)

1. Minimizing sedating medications 2. Modifying the home environment 4. Manage foot and footwear problems

An older adult experiencing delirium suffers from a leg fracture caused by a fall. Which interventions would the nurse follow to prevent future falls? (Select all that apply.) 1. Minimizing sedating medications 2. Modifying the home environment 3. Teaching clients about the safe use of the Internet 4. Manage foot and footwear problems 5. Providing information about the effects of using alcohol

1. Enhancing interest and recruitment 3. Being a positive role model 4. Demonstrating a deep commitment in caring for the older adult 6. Preparing for geriatric nursing in a school setting

As a nurse caring for clients, how do you see yourself advancing the care of older adults, which is so essential now and in the future? (Select all that apply.) 1. Enhancing interest and recruitment 2. Combating the consistent sense of apathy concerning the significance of nursing role models of care for older adults 3. Being a positive role model 4. Demonstrating a deep commitment in caring for the older adult 5. Promoting ageism 6. Preparing for geriatric nursing in a school setting

a. geriatric nurse generalist.

As a nurse contemplating a future in gerontological nursing, you might plan on achieving a master's degree and becoming one of the following EXCEPT a. geriatric nurse generalist. b. gerontological nurse practitioner (GNP). c. advanced practice registered nurse (APRN) with gerontological certification. d. gerontological clinical nurse specialist (GCNS).

A. Improve her quality of life. D. Focus on reducing the severity of disease symptoms.

An 80-year-old patient is receiving palliative care for heart failure. What are the primary purposes of her receiving palliative care (select all that apply)? A. Improve her quality of life. B. Assess her ability to recover from the disease. C. Have time to teach patient and family about disease. D. Focus on reducing the severity of disease symptoms. E. Provide care that the family is unwilling or unable to give.

4. "You may experience dizziness when moving from sitting to standing."

Carbidopa-levodopa is prescribed for a client with Parkinson's disease. Which instruction will the nurse include when teaching the client about this medication? 1. "Take this medication between meals." 2. "Blood levels of the medication should be monitored weekly." 3. "It can cause happy feelings followed by feelings of depression." 4. "You may experience dizziness when moving from sitting to standing."

-Relevant information -Related to what the older person already knows -Literacy levels -Don't talk down, not necessary -Understand pt. prior to teaching -Emphasis on CONCRETE/PRACTICAL information

Learning late in life is made easier in which ways?

Coordinates cares in acute setting, follows up after discharge, and rehab. Does not provide direct cares

Explain how a case manager is involved with patients

May need to learn to: drive, cook, manage money, shop, do laundry

Spousal caregiving may lead to changes in roles, what are those changes?

1. Assess the wife for caregiver burden. 4. Assess the husband for signs of physical abuse. 5. Identify social support within the community.

The home health care nurse visits an older adult couple living independently. The wife cares for the husband, who has dementia. Which interventions would the nurse implement for them? (Select all that apply.) 1. Assess the wife for caregiver burden. 2. Arrange hospice care for the husband. 3. Make health care decisions for the couple. 4. Assess the husband for signs of physical abuse. 5. Identify social support within the community.

4. Replacement of a neurotransmitter in the brain Rationale: Carbidopa-levodopa is used because levodopa is the precursor of dopamine. It is converted to dopamine in the brain cells, where it is stored until needed by axon terminals; it functions as a neurotransmitter.

The nurse administers carbidopa-levodopa to a client with Parkinson's disease. Which activity describes the mechanism of action of this medication? 1. Increase in acetylcholine production 2. Regeneration of injured thalamic cells 3. Improvement in myelination of neurons 4. Replacement of a neurotransmitter in the brain

Well rested, see what they know, key points

What are cognitive needs of teaching older adults?

Following a healthy diet, participating in physical and stimulating activities, being social, cards/puzzles

How can nurses educate people to enhance cognitive health and brain plasticity?

1 in 5

How many older patients are readmitted to the hospital within 30 days of discharge?

D. Most assist living facilities employ an RN or LPN, but they aren't there 24-hours

A family wants their older adult loved one to go to an assisted living facility with around the clock nursing care. The nurse explains which of the following about nursing care in assisted living facilities to the family A. An assisted living is a good choice since there is 24-hour nursing care provided B. An assisted living will have 18-hours of nursing care, which is sufficient C. Most assisted livings facilities only employ Patient Care Attendants D. Most assist living facilities employ an RN or LPN, but they aren't there 24-hours

A. Extremities cool to the touch C. Patient reports seeing dead relatives D. Periods of apnea E. Confusion

A nurse is caring for a patient who is on hospice and nearing end of life. What signs alerted the nurse to the nearing of death? (select all that apply) A. Extremities cool to the touch B. Increased appetite C. Patient reports seeing dead relatives D. Periods of apnea E. Confusion

4. "Which family member do you prefer to receive information?" Rationale: Studies have shown that people from China, Greece, and Ethiopia view honesty about diagnosis and prognosis as heartless, unnecessary, and even harmful to the client. Usually family members from these cultures decide what is most important to share with the client.

A recent immigrant from China is critically ill and dying. Which question would the nurse ask when collecting information to meet this client's emotional needs? 1. "Do you like living in this country?" 2. "How long have you been in this country?" 3. "Is there a family member who can translate for you?" 4. "Which family member do you prefer to receive information?"

3. Lack of sleep and loss of appetite Rationale: Insomnia, depressed mood, anxiety, and anorexia are common responses associated with loss, especially the death of a spouse

Which behavior is most likely to indicate that a client is experiencing grief associated with the loss of the husband? 1. Inability to express her emotions 2. Reluctance to go to social functions 3. Lack of sleep and loss of appetite 4. Subjective report of not feeling right

4. It involves a decrease in bone substance.

Which definition would the nurse use to explain osteoporosis? 1. It is avascular necrosis. 2. It is caused by pathological fractures. 3. It is hyperplasia of osteoblasts. 4. It involves a decrease in bone substance.

2. Urinary tract infection

Which genitourinary factor contributes to urinary incontinence in older adult clients and needs to be considered by the nurse when planning the care for these clients? 1. Sensory deprivation 2. Urinary tract infection 3. Frequent use of diuretics 4. Inaccessibility of a bathroom

1. Collecting recent data concerning the falls to clearly identify the problem

Which step of the problem-solving process would be most important for the nurse to consider when addressing a recent increase in client falls on the unit? 1. Collecting recent data concerning the falls to clearly identify the problem 2. Analyzing data collected to identify solutions to address issues contributing to falls 3. Identifying risks and consequences of possible solutions to decrease falls on the unit 4. Considering how one's own beliefs concerning causes of the recent increase may affect solutions 5. Establishing criteria to determine if implementation of a fall safety training program is effective

3. Attainment of a sense of worth as a person

Which would the nurse assess to determine whether a 75-year-old individual is meeting the developmental tasks associated with aging? 1. Achievement of a personal philosophy 2. Adaptation to the children leaving home 3. Attainment of a sense of worth as a person 4. Adjustment to life in an assisted-living facility

4. Decreased activity of sebaceous glands

While assessing the skin of an older adult, the nurse observes that the skin has a dry and uneven color. Which change is responsible for this condition? 1. Decreased subcutaneous fat 2. Decreased extracellular water 3. Decreased proliferation capacity 4. Decreased activity of sebaceous glands

-re-hospitalization -infections -new diagnoses -relapses

Why does transitional care occur?

D. Program for All-Inclusive Care for the Elderly (PACE)

A nurse is discharging a patient from the hospital after a stroke. The patient prefers a community-based service, and is eligible for Medicare and Medicaid. What would the nurse recommend? A. Hospice services in the home B. The patient lives with a relative C. An assisted living facility D. Program for All-Inclusive Care for the Elderly (PACE)

D. There will be more intensive rehab in subacute care.

A nurse is helping an older adult determine the best living situation after surgery. She is wondering what subacute care is and why she would told that would be a good choice. What is the best response by the nurse? A. A nursing home stay is often shorter than a subacute care stay. B. There will be fewer nursing staff in subacute care. C. Subacute care is always reimbursed by Medicaid. D. There will be more intensive rehab in subacute care.

A. An adult child moves away from her family and friends to care for a parent with severe dementia.

A nurse is teaching assisted living staff about caregiver abuse. In which scenario would the identify as a client at higher risk for caregiver abuse? A. An adult child moves away from her family and friends to care for a parent with severe dementia. B. An elderly woman with COPD lives at home and is visited frequently by her adult child. C. An elderly parent with difficult performing bathing lives alone and receives help from several adult children. D. An elderly man who cares for his husband who is in early stages of Alzheimer's disease and has a network of available supportive family members

4. Presbyopia Rationale: Presbyopia is the decreased accommodative ability of the lens that occurs with aging

An 82-year-old retired schoolteacher is admitted to a nursing home. During the physical assessment, the nurse would identify which ocular problem common to persons at this client's developmental level? 1. Tropia 2. Myopia 3. Hyperopia 4. Presbyopia

2. Diminished sensation of pain 4. Impaired hearing of high frequency sounds

An 85-year-old client has just been admitted to a nursing home. When designing a plan of care for this older adult, the nurse recalls which expected sensory losses associated with aging? (Select all that apply) 1. Difficulty in swallowing 2. Diminished sensation of pain 3. Heightened response to stimuli 4. Impaired hearing of high frequency sounds 5. Increased ability to tolerate environmental heat

3. Generativity versus stagnation

An 85-year-old client is alert and able to participate in care. According to Erikson, which developmental stage will the client need to adjust to? 1. Industry versus inferiority 2. Identity versus role confusion 3. Generativity versus stagnation 4. Autonomy versus shame/doubt

4. Right to information about their health but not about their medications 6. Right to visitation from others except legal advisors, who must obtain permission from the nursing facility before visiting the older adult

The Bill of Rights for long-term residents was created to protect the rights of the residents in nursing homes. Which of the following examples do not protect these rights? (Select all that apply.) 1. Right to voice grievances 2. Right to be free from abuse 3. Right to have a say in their care and treatment 4. Right to information about their health but not about their medications 5. Right to be free from restraints 6. Right to visitation from others except legal advisors, who must obtain permission from the nursing facility before visiting the older adult

Human development, personal relationships, nature of loss, coping strategies, socioeconomic status, culture/ethnicity, spiritual/religious beliefs, hope

What are factors the influence loss and grief?

d. Caregiving

Which of the following describes a time of transition that requires a restructuring of one's goals, behaviors, and responsibilities and is a source of both joy and stress? a. Caregiver stress b. Caregiver burden c. Caregiver role strain d. Caregiving

d. The use of paid, formal caregivers for older adults with disabilities has been increasing.

Which of the following statements is FALSE regarding caregivers of older adults? a. Family members provide for the majority of care for older adults. b. A daughter is usually the caregiver of her mother. c. Caregiving is considered a major public health issue. d. The use of paid, formal caregivers for older adults with disabilities has been increasing.

d. Closed awareness is the need to remain in a collaborative role.

Which one of the following does NOT describe a need of the dying? a. Composure enables the person to modulate emotional extremes. b. Closure is an opportunity for reconciliation and transcendence. c. Expert management of symptoms and support are a part of care. d. Closed awareness is the need to remain in a collaborative role. e. Needed information is communicated.

4. "My son was diagnosed with terminal cancer 2 months ago and they can't stop my son from dying."

Which parent is expressing anticipatory grief? 1. "My daughter died 4 years ago and I'm still crying and walking around like I'm in a dream." 2. "My 4-year-old was diagnosed with diabetes mellitus, but I'm sure she'll outgrow it." 3. "My son's treatments are painful. I'm so angry. Most days I just want to take him and run away." 4. "My son was diagnosed with terminal cancer 2 months ago and they can't stop my son from dying."

Website that provides details on nursing homes across country including: inspections, staffing levels, etc.

What is nursing home compare?

Resilience

What is something that can make the grieving processes "easier"?

$225 per day, $82,125 per year

What is the average cost of a nursing home per day and year for a semiprivate room?

Residential care and assisted living

What is the least restrictive care facility for older adults besides aging in place?

Meal preparation

What is the most commonly provided service in assisted living?

70%

What % of people who have dementia live @ home?

6 c's approach: care, control, composure, communication, continuity, closure

6 c's in the approach method?

3. Allow the client a longer period of time to complete the meal.

A 93-year-old client in a nursing home has been eating less food during mealtimes. Which is the correct nursing intervention? 1. Substitute a supplemental drink for the meal. 2. Spoon-feed the client until the food is completely eaten. 3. Allow the client a longer period of time to complete the meal. 4. Arrange a consultation for the placement of a gastrostomy tube.

4. "You should share your feelings with him while you can."

A client is dying. Hesitatingly, his wife says to the nurse, "I'd like to tell him how much I love him, but I don't want to upset him." Which is the correct response by the nurse? 1. "You must keep up a strong appearance for him." 2. "I think he'd have difficulty dealing with that now." 3. "Don't you think he knows that without you telling him?" 4. "You should share your feelings with him while you can."

4. "Older adults have lost the tissue that helps puff out the skin."

A family member who visits an 80-year-old client in a nursing home remarks how thin and wrinkled the client looks. Which response by the nurse will help the family member understand the normal aging process? 1. "Most people at that age should be careful about weight gain." 2. "This is typical of older adults; they really don't eat well." 3. "It looks as though sun exposure has taken its toll." 4. "Older adults have lost the tissue that helps puff out the skin."

C. Intense grieving for 6 months or more with little to no indication of grief resolution

A nurse caring for a grieving family is aware that complicated grief may occur. A manifestation of complicated grief is: A. Not seeking support after a loss due to feelings of shame, guilt, or lack of recognition of the loss B. Hiding grief from others as opposed to allowing support from friends and family C. Intense grieving for 6 months or more with little to no indication of grief resolution D. More pronounced feelings of anger and depression due to resentment over the unacknowledged loss

b. Hartford Institute for Geriatric Nursing (HIGN)

As a nursing student who is interested in furthering his or her education in gerontological nursing, which of the following would be beneficial? a. Advancing Care Excellence for Seniors (ACES) b. Hartford Institute for Geriatric Nursing (HIGN) c. Geriatric Nursing Education Consortium (GNEC) d. Hartford Geriatric Nursing Initiative (HGNI)

-staff and residents comply with schedules/routines -focus on tasks needed to be done -rotation of staff among units -little involvement in decision making among residents -hospital like environment -structured activities

Describe institution-centered culture

-emphasis on relationships between residents and staff -individualized care plans -staff know residents and their preferences -decision making as close to resident as possible -homelike environment -pets -sense of community and belonging

Describe person-centered culture

2. Intrinsically motivated

During a home visit, the nurse finds that a healthy older adult person is actively practicing laughing therapy to maintain good health without pressure or insistence from family members. Which inference about the client would the nurse make from these findings? 1. Not motivated 2. Intrinsically motivated 3. Extrinsically motivated with self-determination 4. Extrinsically motivated without self-determination

1. Include age-appropriate exercise daily

During a routine clinic visit, an older adult complains about being unable to sleep well at night and then feeling sleepy throughout the next day. Which sleep promotion technique would the nurse advise? 1. Include age-appropriate exercise daily 2. Read in bed before sleeping 3. Avoid naps during the daytime 4. Have a hot cup of tea at bedtime

Changed from medical model to a home model of nurturing, support, and empowerment of formal caregivers

How has the culture of nursing home care changed?

c. Scope and Standards of Gerontological Nursing Practice

What book or journal provides a comprehensive overview of the scope of gerontological nursing for today's geriatric nurse? a. Nursing Research b. American Journal of Nursing c. Scope and Standards of Gerontological Nursing Practice d. Newton and Anderson's first textbook on nursing care of older adults

a. custodial care.

Medicare is a big issue for the adults who depend on this medical insurance to pay for their hospital bills, medications, and rehabilitation. When talking to your older client about what Medicare will pay for and what it will not, you tell her or him that Medicare will not cover the cost of a. custodial care. b. skilled care. c. hospice care. d. a semiprivate room.

c. An adult female child caring for an older female parent

What describes the most common care-giving scenario? a. A middle-aged man caring for an older male parent b. A teenage girl caring for her grandmother c. An adult female child caring for an older female parent d. An older adult caring for an adult child

Clarification, control, collaboration, directed relief (encouragement to express feelings), cooling off

What are strategies of countercoping?

1. closed 2. mutual preference 3. suspected 4. open awareness

What are the 4 stages of awareness?

-Ensure they are ready to learn -Watch for signs of fatigue -Use plain language, readable font -Use teach back methods to enhance understanding

What are tips for best practice when guiding older adult learners?

Living will, durable power of attorney, medical power of attorney

What does an advanced directive include?

Teach then how to evaluate the reliability and validity of the health information on the internet

What is important to teach older adults when using computers to seek health information?

d. Gathering assessment data from the caregiver and the patient.

The home health care nurse suspects that a patient's spouse is experiencing caregiver burden. The nurse assesses for this condition by: a. Referring the family to a social services agency. b. Waiting for the caregiver to talk about the stress. c. Obtaining feedback from the patient about the caregiver. d. Gathering assessment data from the caregiver and the patient.

3. Change in mental status Rationale: Older adults are sensitive to changes in fluid and electrolyte levels, especially sodium, potassium, and chloride. These changes will manifest as a change in mental status and confusion.

The nurse assesses an older adult client with a diagnosis of dehydration. Which finding is an early sign of dehydration? 1. Sunken eyes 2. Dry, flaky skin 3. Change in mental status 4. Decreased bowel sounds

4. Offer a cup of prune juice.

The nurse is caring for an older adult client who has constipation. Which independent nursing intervention helps reestablish a normal bowel pattern? 1. Administer a mineral oil enema. 2. Offer 1 cup of fluid every hour. 3. Manually remove fecal impactions. 4. Offer a cup of prune juice.

c. Encourage the client to use a compartmentalized pill storage container for his daily medications

The nurse is planning client education for an older adult being prepared for discharge home after hospitalization for a cardiac problem. Which nursing action addresses the most commonly determined need for this age-group? a. Suggest that he purchase an emergency in-home alert system b. Arrange for the client to receive meals delivered to his home daily c. Encourage the client to use a compartmentalized pill storage container for his daily medications d. Provide only written document describing the medications the client is currently prescribed

d. Develop large-print handouts that reflect the verbal information presented.

The nurse is setting up an education session with an 85-year-old patient who will be going home on anticoagulant therapy. Which strategy would reflect consideration of aging changes that may exist with this patient? a. Show a colorful video about anticoagulation therapy. b. Present all the information in one session just before discharge. c. Give the patient pamphlets about the medications to read at home. d. Develop large-print handouts that reflect the verbal information presented.

d. Are capable of taking charge of their own lives

The nurse, preparing to discharge an 81-year-old client from the hospital, recognizes that the majority of older adults: a. Require institutional care b. Have no social or family support c. Are unable to afford any medical treatment d. Are capable of taking charge of their own lives

1. Involve the significant other's support system.

The significant other of a client who is dying of acquired immunodeficiency syndrome (AIDS) tells the nurse, "Life is not worth living without my partner." Which intervention would the nurse implement to help the significant other cope with the impending death? 1. Involve the significant other's support system. 2. Explore the significant other's psychotic thoughts. 3. Suggest a bereavement group to the significant other. 4. Reinforce the current self-image of the significant other.

c. caregiver stress.

The spouse of a patient with Alzheimer's disease tells the nurse, "I am exhausted. He is up all hours, always wandering around. He needs constant care, and I can't afford a nursing home. I can't do this much longer." The spouse is most likely experiencing: a. anxiety. b. social isolation. c. caregiver stress. d. situational low-self esteem.

True

True/False: Caregivers of people with dementia more often report negative aspects of caregiving than do caregivers of people without dementia.

Maintain composure, use good judgement, are optimistic without denying a loss

What are characteristics of those who effectively cope with loss?

d. Informal care-giving saves the health care system enormous sums of money.

What makes nursing support of caregivers so important for health care in the United States? a. Family members providing care in the home are always the best caregivers. b. Forty percent of caregiving takes place in the home of older adults. c. The health care system reimburses families for caregiving from Medicare. d. Informal care-giving saves the health care system enormous sums of money.

b. Eldercare

What type of care is projected to be the fastest growing employment sector in the health care industry? a. Childcare b. Eldercare c. Adulthood d. Adolescent care

3. Slower reaction times

When teaching about aging, the nurse explains that older adults usually have which characteristic? 1. Inflexible attitudes 2. Periods of confusion 3. Slower reaction times 4. Some senile dementia

4. "I should apply powders or talc on a perineum wound."

When teaching an older adult client about skincare to prevent pressure ulcers, which client statement indicates a misunderstanding? 1. "I should gently pat my skin." 2. "I should use mild, heavily fatted soap." 3. "I should wash my skin with tepid, rather than hot water." 4. "I should apply powders or talc on a perineum wound."

4. Assign the nursing assistant to stay with the client while the nurse calls the health care provider.

Which action would the nurse take for an older adult client who is agitated, confused, and actively attempting to get out of bed? 1. Ask family members to leave the room so the client can rest. 2. Place a vest restraint on the client to prevent falling out of bed. 3. Explain to the family that it is common for older clients to get confused in the hospital. 4. Assign the nursing assistant to stay with the client while the nurse calls the health care provider.

3. Increased sensitivity to glare 4. Diminished sensation of pain

Which age-related change would the nurse consider when formulating a plan of care for an older adult? (Select all that apply.) 1. Difficulty in swallowing 2. Increased sensitivity to heat 3. Increased sensitivity to glare 4. Diminished sensation of pain 5. Heightened response to stimuli

2. Decreased subcutaneous fat

Which age-related skin change occurs in older adult clients and increases their potential for developing pressure ulcers? 1. Atrophy of the sweat glands 2. Decreased subcutaneous fat 3. Stiffening of the collagen fibers 4. Degeneration of the elastic fibers

3. Environmental hazards 4. Inappropriate footwear 5. Improper use of assistive devices

Which are extrinsic factors responsible for falls in older adults? (Select all that apply.) 1. Impaired vision 2. Cognitive impairment 3. Environmental hazards 4. Inappropriate footwear 5. Improper use of assistive devices

2. Use past experiences while teaching. 4. Keep the environmental distractions to a minimum. 5. Use audio, visual, and tactile cues to enhance learning.

Which principles would promote learning in older adults? (Select all that apply.) 1. Emphasize abstract material. 2. Use past experiences while teaching. 3. Teach by presenting multiple examples at a time. 4. Keep the environmental distractions to a minimum. 5. Use audio, visual, and tactile cues to enhance learning.

3. Ability to perform tasks without becoming frustrated

Which priority factor would the nurse consider when planning care for a nursing home client who demonstrates numerous disorganized behaviors related to disorientation and cognitive impairment? 1. Level of interest in unit activities 2. Orientation to time, place, and person 3. Ability to perform tasks without becoming frustrated 4. Cognitive impairment, which will increase until adjustment to the home is accomplished

4. Earlier experiences with grief Rationale: How a person has handled grief in the past provides clues to how she or he will cope with grief in the present. Although family interactions, social support system, and emotional relationships are all important, they are less predictive for a client's reaction to grief

Which factor is most important in predicting a person's reaction to imminent loss and grief? 1. Family interactions 2. Social support system 3. Emotional relationships 4. Earlier experiences with grief

c. unavailable family members.

With the increase in nuclear families, 15% of the caregivers are long-distance. Issues that need to be identified when initiating long-distance caregiving include all EXCEPT: a. reliable individuals or services. b. acceptable facilities. c. unavailable family members. d. legal issues.

d. maturational loss.

You are caring for a patient who is depressed because the only child has gone away to college. The nurse will assess this type of depression as: a. actual loss. b. perceived loss. c. situational loss. d. maturational loss.

2. Regularly offer the client a urinal.

Which intervention would the nurse implement first when providing care for an older adult male client who is immobile and incontinent of urine? 1. Restrict the client's fluid intake. 2. Regularly offer the client a urinal. 3. Apply incontinence pants. 4. Insert an indwelling urinary catheter

3. Provide instructions relative to diet and exercise.

Which intervention would the nurse provide to an older adult client with a low body mass index (BMI) with osteoporosis? 1. Encourage continuous, steady weight gain. 2. Monitor for decreased urine calcium. 3. Provide instructions relative to diet and exercise. 4. Teach about safety factors in the use of opioids and nonsteroidal anti-inflammatory drugs.

1. Offer choices consistent with the resident's heritage.

Which intervention would the nurse use to provide emotional support for a resident in a nursing home who recently immigrated from another country? 1. Offer choices consistent with the resident's heritage. 2. Assist the resident to adjust to the nursing home culture. 3. Ensure that the resident is treated like the other residents. 4. Correct the resident's misconceptions about appropriate health practices.

3. Provide client and family reassurance. 5. Perform symptom management for the client.

Which interventions would the nurse perform while caring for an actively dying client? (Select all that apply.) 1. Admit the client in hospice care. 2. Perform aggressive laboratory tests. 3. Provide client and family reassurance. 4. Keep the client undisturbed for a long time. 5. Perform symptom management for the client.

3. Reinforcing the client's strengths and promoting reminiscing

Which is the most important nursing intervention when working with an older adult client? 1. Encouraging frequent naps 2. Strengthening the concept of ageism 3. Reinforcing the client's strengths and promoting reminiscing 4. Teaching the client to increase calories and focusing on a high-carbohydrate diet

C. Offering a monthly parenting class for these new parents

Which nursing intervention best addresses the need for social support demonstrated by an young adult couple who will be assuming responsibility for the raising of two nephews? A. Facilitating a support group for children being raised by parents other than their own B. Helping the new parents express their feeling regarding this unexpected role change C. Offering a monthly parenting class for these new parents D. Suggesting couple's therapy to assist in managing any new stress on their marriage

1. Frequently repositioning the client 2. Maintaining oral hygiene in the client 5. Applying body lotion to the client's skin daily

Which nursing interventions enhance comfort in a dying client in the hospital? (Select all that apply.) 1. Frequently repositioning the client 2. Maintaining oral hygiene in the client 3. Limiting frequent visits of the family members 4. Measuring the vital signs of client frequently 5. Applying body lotion to the client's skin daily

3. Decreased bone density

Which physiological change occurs in older adults and warrants the nurse teaching the client about safety tips to prevent falls? 1. Slowed movement 2. Cartilage degeneration 3. Decreased bone density 4. Decreased range of motion (ROM)

D. More nurses are needed who have knowledge in older adult care.

Which statement identifies a predictive trend regarding the health care needs of older adults in society? A. Most nurses will not be caring for older adults. B. Fewer providers in all disciplines are needed. C. Older adults can expect to receive fewer health care services. D. More nurses are needed who have knowledge in older adult care.

d. Providers are under obligation to provide the same information.

Which statement is not true about the Patient Self-Determination Act (PSDA)? a. Hospitals are responsible for providing written information about a client's self-determination rights. b. Health maintenance organizations (HMOs) are required to provide written information about self-determination rights. c. Hospices are obliged to inform clients of their self-determination rights. d. Providers are under obligation to provide the same information.

Identify specific problems, strengths, resources, abilities, needs, and how much they need the health care team to be involved

Why is a caregiver assessment so important to conduct?

a. An unusual amount of anxiety b. Missed doctor's appointments d. Some unexplained bruising and two lacerations e. A lack of grooming

You are visiting your elderly client in his son's home. You note that he has lost 10 lbs since your visit last month. Your client assures you he is eating three meals per day. Concerned about neglect or abuse, you quietly perform a history and physical assessment. Which of the following observations supports your concern? a. An unusual amount of anxiety b. Missed doctor's appointments c. The elder answers your questions freely even with the caregiver present d. Some unexplained bruising and two lacerations e. A lack of grooming f. The client is dressed appropriately

a. Grief that is often exacerbated on special dates

Your older adult client lost his wife of 65 years and is approaching their 66th wedding anniversary. You anticipate that he will go through "shadow grief," which can be defined as which one of the following? a. Grief that is often exacerbated on special dates b. A crisis c. Grief that cannot be publically acknowledged d. An effective coper