COOA- SAS 1-12

What are the two parts to communication? A) There only needs to be one part, when someone says something B) When someone says something, and the other person has understood C) When someone says something, and the other person has replied D) When someone says something while using non-verbal communication

B) When someone says something, and the other person has understood

Which of the following is NOT a barrier to the optimum use of palliative care at the end of life? A)Reimbursement policies B)Easily determined prognoses C)Lack of well-trained healthcare professionals D)Attitudes of patients, families, and clinicians

B)Easily determined prognoses

Which of the following can be a barrier to communication? A) A nurse talking while the patient is talking B) A nurse using slang C) A hot room D) All of the above

D) All of the above

When assessing for drug effects in the older adult, which phase of pharmacokinetics is the greatest concern? A. Absorption B. Distribution C. Metabolism D. Excretion

D. Excretion

Person-centered communication strategies with older people might involve: a) Avoiding assumptions about their capacity to communicate effectively b) Giving too much information at once c c) Speaking too quickly c d) Prioritizing staff safety, comfort and well-being

a) Avoiding assumptions about their capacity to communicate effectively

The nurse is examining a 76-year-old female with the complaints of fatigue, ankle swelling, and mild shortness of breath over a three-week period. An appropriate nursing diagnosis might include: a. Decreased cardiac output related to altered contractility and elasticity of cardiac muscle b. Activity tolerances due to compensation of oxygen supply c. Increased cardiac output related to an aging heart muscle d. Decreased urinary output due to poor kidney perfusion

a. Decreased cardiac output related to altered contractility and elasticity of cardiac muscle

Which best describes what guides the appropriate nursing care of an aging adult? a. Evidence-based practice developed with ongoing research into the needs and outcomes of older adults b. General nursing care previously practices c. Facility policies and procedures d. Physician orders for patient complaints

a. Evidence-based practice developed with ongoing research into the needs and outcomes of older adults

Which is most closely aligned with ethics? a. Morals b. Laws c. Statutes d. Client rights

a. Morals

The family member of a patient asks if vitamin C will prevent aging. In formulating an appropriate response, the nurse considers what theory? a. free radical theory. b. autoimmune theory. c. wear-and-tear theory. d. continuity theory.

a. free radical theory.

A primary care provider's order indicate that a consent form needs to be signed. Since the nurse was not present when the primary care provider discussed the procedure, which statement best illustrates the nurse fulfilled the client advocate role? a. "The doctor has asked that you sign this consent form." b. "Do you have any questions about the procedure?" c. "What were you told about the procedure you are going to have?" d. "Remember that you can change your mind and cancel the procedure."

b. "Do you have any questions about the procedure?

Nurse Beth explains medical and nursing procedures to Mr. Dela Cruz's family members. What role did Nurse Beth play in this situation? a. Manager b. Advocate c. Teacher d. Provider of Care

b. Advocate

The nurse noted that an older patient complains of always feeling cold. Which age- related change to the skin could be causing this in the patient? a. Fewer protein stores b. Decreased subcutaneous tissue c. Reduced levels of immune cells d. Slower blood flow to the skin layers

b. Decreased subcutaneous tissue

A 70-year-old presents to the clinic stating that his family thinks he is losing his mind and they want to put him in a home. What would be the initial role of the gerontological nurse? a. Begin the process of finding a qualified nursing home b. Do a complete history,physical, and assessment c. Speak with the family about their concerns d. Make light of the subject until the nurse can evaluate the situation

b. Do a complete history,physical, and assessment

What is the single most cost-effective discovery made in the past 30 years that has influenced the prevention and treatment of cardiovascular events? a. The development of oral hypoglycemic drugs b. Recognizing the need to lower blood pressure in older adults c. Antismoking campaigns d. Zero tolerance for drug and alcohol abuse in older adults

b. Recognizing the need to lower blood pressure in older adults

What is the single most cost-effective discovery made in the past 30 years that has influenced the prevention and treatment of cardiovascular events? a. The development of oral hypoglycemic drugs b. Recognizing the need to lower blood pressure in older adults c. Antismoking campaigns d. Zero tolerance for drug and alcohol abuse in older adults

b. Recognizing the need to lower blood pressure in older adults

An older patient asks why a wound is taking so long to heal. What explanation should the nurse provide to this patient? a. "There is less protein in the skin with aging" b. "The tissue between the skin cells is weaker." c. "The amount of blood flow to the skin is slower with aging." d. "The number of immune cells in the skin reduces with aging."

c. "The amount of blood flow to the skin is slower with aging."

The family of a client with a terminal illness hesitates to agree to palliative care because of not wanting to give up on a possible cure. How should the nurse respond while also including a principle of palliative care? a. "Most people don't realize that palliative care means there is no cure." b. "There will not be another opportunity if palliative care is refused now." c. "The client can continue to receive treatment intended to cure the disease." d. "Palliative care and curative treatments cannot be provided at the same time."

c. "The client can continue to receive treatment intended to cure the disease."

Which of the following is an age-related physiologic change that may affect the absorption of drugs? a. Xerostomia b. Faster stomach emptying c. Altered pH of the stomach contents d. Increased gastrointestinal tract motility

c. Altered pH of the stomach contents

Which theory suggests that older people who have low levels of social activity have a high degree of life satisfaction? a. Activity b. Age stratification c. Disengagement d. Exchange

c. Disengagement

According to the best available evidence, which one of the following lifestyle interventions for reducing primary hypertension is not likely to be effective? a. Dietary salt restriction b. Fish oil supplementation c. Magnesium supplementation d. Physical activity and Weight loss

c. Magnesium supplementation

A client is experiencing tachycardia. The nurse's understanding of the physiological basis for this symptom is explained by which of the following statements? a. The demand for oxygen is decreased because of pleural involvement b. The inflammatory process causes the body to demand more oxygen to meet its needs. c. The heart has to pump faster to meet the demand for oxygen when there is lowered arterial oxygen tension. d. Respirations are labored.

c. The heart has to pump faster to meet the demand for oxygen when there is lowered arterial oxygen tension

A client is experiencing tachycardia. The nurse's understanding of the physiological basis for this symptom is explained by which of the following statements? a. The demand for oxygen is decreased because of pleural involvement b. The inflammatory process causes the body to demand more oxygen to meet its needs. c. The heart has to pump faster to meet the demand for oxygen when there is lowered arterial oxygen tension. d. Respirations are labored.

c. The heart has to pump faster to meet the demand for oxygen when there is lowered arterial oxygen tension.

Which choice best explains the practice setting for the gerontological nurse? a) In the home of the client b) Only in acute care settings c) Clinics and long-term care facilities d) Home of the client, acute care facilities, long-term care settings, and clinics or anywhere clients over the age of 65 seek health care and health education

d) Home of the client, acute care facilities, long-term care settings, and clinics or anywhere clients over the age of 65 seek health care and health education

An example of an environmental barrier to effective communication is: a) Inflexible appointment systems b) Medical jargon c) Staff shortages d) Noisy clinical settings

d) Noisy clinical settings

Which is the most effective method of managing polypharmacy? a. Review of medications at each office visit, to ensure an accurate med list. b. Limit your patients' medication list to no more than 4 medicines. c. Regularly assess patient adherence to the medication regimen. d. (a) and (c)

d. (a) and (c)

A nurse who reads research articles and incorporates research findings into nursing practice would demonstrate which of the following roles? a. Collaborator b. Primary Investigator c. Producer d. Consumer

d. Consumer

In an older population we can expect that drugs will be: a. Absorbed more quickly b. Metabolized more quickly c. Excreted more rapidly by the kidneys d. Excreted less readily

d. Excreted less readily

This provides the "best guess" of the future size of the frail older population, does not assume any particular trend in disability rates. a. High disability scenario b. Low disability scenario c. Middle disability scenario d. Intermediate disability projection

d. Intermediate disability projection

Problems that the potential burden on aging society contribute on the care-giving system and public finances are the following except , a. Challenge of assuring sufficient resources b. Effectivity of service system c. Quality of Long-term care d. More health care workers

d. More health care workers

Oral drugs may be absorbed less quickly in older people because: a. Of increased number of receptors in the heart b. Of increased liver metabolism c. Of increased kidney function d. Of decreased gastrointestinal motility

d. Of decreased gastrointestinal motility

The nurse is evaluating a 64-year-old male for coronary artery disease (CAD). Understanding that CAD is the leading cause of mortality, which risk factor would not be related to CAD? a. Hypertension b. Dyslipidemia c. Diabetes d. Sexual orientation

d. Sexual orientation

Nurse Bianca is aware that the theory of aging most likely to explain why the older population is at risk for autoimmune disorder is known as: a. cross-link theory. b. free radical theory. c. error theory. d. autoimmune theory.

d. autoimmune theory.

The nurse is engaging the patient in social conversation. What is the benefit of social conversation in the health care setting? A) It lets the patient know that he or she is considered to be a person, not just a patient. B) It encourages sharing of intimate details. C) It establishes the nurse's role as a health care provider. D) It blocks more meaningful therapeutic communication.

A) It lets the patient know that he or she is considered to be a person, not just a patient.

When using an interpreter to speak with an 84-year-old Chinese patient, on what should the nurse focus? A) The patient, not the interpreter B) Encouraging the interpreter to paraphrase C) Limiting questions from the patient D) Listening to the words, not emotional tone

A) The patient, not the interpreter

During a nurse-client interaction, which nursing statement may belittle the client's feelings and concerns? A. "Don't worry. Everything will be alright." B. "You appear uptight." C. "I notice you have bitten your nails to the quick." D. "You are jumping to conclusions."

A. "Don't worry. Everything will be alright."

Which statement made by the graduate nurse working in the hospice unit with a patient near the end of life requires intervention by the preceptor nurse? A. "The patient has eaten only small amounts the past 48 hours; will the physician consider placing a feeding tube?" B. "The family seems comfortable with the long periods of silence." C. "The physician ordered an increase in the dosage of morphine; I will administer the new dose right away." D. "The blood pressure is lower this afternoon than it was this morning; I will communicate the changes to the family."

A. "The patient has eaten only small amounts the past 48 hours; will the physician consider placing a feeding tube?"

A student nurse is learning about the appropriate use of touch when communicating with clients diagnosed with psychiatric disorders. Which statement by the instructor best provides information about this aspect of therapeutic communication? A. "Touch carries a different meaning for different individuals." B. "Touch is often used when deescalating volatile client situations." C. "Touch is used to convey interest and warmth." D. "Touch is best combined with empathy when dealing with anxious clients."

A. "Touch carries a different meaning for different individuals."

When working with an older adult who is hearing-impaired, the use of which techniques would improve communication? (Select all that apply.) A. Check for needed adaptive equipment. B. Exaggerate lip movements to help the patient lip read. C. Give the patient time to respond to questions. D. Keep communication short and to the point. E. Communicate only through written information.

A. Check for needed adaptive equipment. C. Give the patient time to respond to questions. D. Keep communication short and to the point.

The caregiver children of an elderly patient whose death is imminent have not left the bedside for the past 36 hours. In your assessment of the family, which of the following findings indicates the potential for an abnormal grief reaction by family members (select all that apply)? A. Family members cannot express their feelings to one another. B. The dying patient is becoming more restless and agitated. C. A family member is going through a difficult divorce. D. The family talks with and reassures the patient at frequent intervals. E. Siblings who were estranged from each other have now reunited.

A. Family members cannot express their feelings to one another. C. A family member is going through a difficult divorce.

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 coping ability with 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.

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

A new nurse complains to her preceptor that she has no time for therapeutic communication with her patients. Which of the following is the best strategy to help the nurse find more time for this communication? A. Include communication while performing tasks such as changing dressings and checking vital signs. B. Ask the patient if you can talk during the last few minutes of visiting hours. C. Ask Pastoral care to come back a little later in the day. D. Remind the nurse to complete all her tasks and then set up remaining time for communication.

A. Include communication while performing tasks such as changing dressings and checking vital signs.

A hospice nurse is visiting with a dying patient. During the interaction, the patient is silent for some time. What is the best response? A. Recognize the patient's need for silence, and sit quietly at the bedside. B. Try distraction with the patient. C. Change the subject, and try to stimulate conversation. D. Leave the patient alone for a period.

A. Recognize the patient's need for silence, and sit quietly at the bedside.

Which of the following is NOT a priority for patients with a life-limiting illness receiving palliative care? A)Relieving burden B)Prolonging life at all costs C)Obtaining a sense of control D)Strengthening relationships with loved ones

B)Prolonging life at all costs

Which of the following statements, made by the daughter of an older adult client concerning bringing her mother home to live with her family, presents the greatest concern for the nurse? A. "If this doesn't work out, she can always go to live with my sister." B. "I don't think she will react very well to me making decisions for her." C. "I'm afraid that mom will be depressed and miss her home." D. "My children will just have to adjust to having their grandmother with us."

B. "I don't think she will react very well to me making decisions for her."

After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, "You are incompetent!" Which is the nurse's best response? A. "Do you believe that I was the cause of your blood test being canceled?" B. "I see that you are upset, but I feel uncomfortable when you swear at me." C. "Have you ever thought about ways to express anger appropriately?" D. "I'll give you some space. Let me know if you need anything."

B. "I see that you are upset, but I feel uncomfortable when you swear at me."

The home health nurse visits a 40-year-old breast cancer patient with metastatic breast cancer who is receiving palliative care. The patient is experiencing pain at a level of 7 (on a 10-point scale). In prioritizing activities for the visit, you would do which of the following first? A. Auscultate for breath sounds. B. Administer prn pain medication. C. Check pressure points for skin breakdown. D. Ask family members about patient's dietary intake.

B. Administer prn pain medication.

7-year-old woman was recently diagnosed with inoperable pancreatic cancer. Before the diagnosis, she was very active in her neighborhood association. Her husband is concerned because his wife is staying at home and missing her usual community activities. Which common end-of-life (EOL) psychologic manifestation is she most likely demonstrating? A. Peacefulness B. Decreased socialization C. Decreased decision-making D. Anxiety about unfinished business

B. Decreased socialization

Which information obtained by the home health nurse when making a visit to an 88-year-old with mild forgetfulness is of the most concern? A. The patient's son uses a marked pillbox to set up the patient's medications weekly. B. The patient has lost 10 pounds (4.5 kg) during the last month. C. The patient is cared for by a daughter during the day and stays with a son at night. D. The patient tells the nurse that a close friend recently died.

B. The patient has lost 10 pounds (4.5 kg) during the last month.

A long-term care facility sponsors a discussion group on the administration of medications. The participants have a number of questions concerning their medications. The nurse responds most appropriately by saying: A. "Don't worry about the medication's name if you can identify it by its color and shape." B. "Unless you have severe side affects, don't worry about the minor changes in the way you feel." C. "Feel free to ask your physician why you are receiving the medications that are prescribed for you." D. "Remember that the hepatic system is primarily responsible for the pharmacotherapeutics of your medications."

C. "Feel free to ask your physician why you are receiving the medications that are prescribed for you."

An assisted living facility has provided its clients with an educational program on safe administration of prescribed medications. Which statement made by an older-adult client reflects the best understanding of safe self-administration of medications? A. "I don't seem to have problems with side effects, but I'll let my doctor know if something happens." B. "I'm lucky since my daughter is really good about keeping up with my medications." C. "I'll be sure to read the inserts and ask the pharmacist if I don't understand something." D. "It shouldn't be too hard to keep it straight since I don't have any really serious health issues."

C. "I'll be sure to read the inserts and ask the pharmacist if I don't understand something."

When interviewing a client, which nonverbal behavior should a nurse employ? A. Maintaining indirect eye contact with the client B. Providing space by leaning back away from the client C. Sitting squarely, facing the client D. Maintaining open posture with arms and legs crossed

C. Sitting squarely, facing the client

A home health nurse is assisting a client to transfer from the bed to a wheelchair. Which of the following is not true regarding this process? A. Stand in front of the client as he or she stands up to go to the wheelchair B. If needed, when the client stands to go to the wheelchair, grasp the gait belt from underneath at each side C. Take large steps to a position so that the client's knee caps are touching the front of the wheelchair D. On the count of three, assist the client to stand up to walk to the wheelchair

C. Take large steps to a position so that the client's knee caps are touching the front of the wheelchair

The nurse asks a newly admitted client, "What can we do to help you?" What is the purpose of this therapeutic communication technique? A. To reframe the client's thoughts about mental health treatment B. To put the client at ease C. To explore a subject, idea, experience, or relationship D. To communicate that the nurse is listening to the conversation

C. To explore a subject, idea, experience, or relationship

Mr. Gonzales, 72 years old, is admitted to the emergency room with a diagnosis of acute myocardial infarction. The client tells the nurse, "I'm scared. I think I'm going to die." Which of the following responses by the nurse would be MOST appropriate? A) "Everything is going to be fine. We'll take good care of you." B) "I know what you mean. I thought I was having a heart attack once." C) "I'll call your doctor so you can discuss it with him." D) "It's normal to feel frightened. We're doing everything we can for you."

D) "It's normal to feel frightened. We're doing everything we can for you."

Why is it important for the nurse to be cautious when using medical jargon with an older adult patient? A) It could become an opportunity to instruct the patient. B) It could become an effective abbreviated communication shortcut. C) It could become an indicator of formal communication. D) It could become a communication barrier.

D) It could become a communication barrier.

Nurse Clara asked Mrs. Ramirez about how her day went. Mrs. Ramirez crossed her arms and rolled her eyes but did not say anything. Nurse Clara nodded her head up and left the room. Have they communicated? A) No, at this stage it is one-way communication B) No, when they answer you they will have communicated back, completing two-way communication C) No, but they are being rude D) Yes, they have used non-verbal communication

D) Yes, they have used non-verbal communication

A client states, "You won't believe what my husband said to me during visiting hours. He has no right treating me that way." Which nursing response would best assess the situation that occurred? A. "Does your husband treat you like this very often?" B. "What do you think is your role in this relationship?" C. "Why do you think he behaved like that?" D. "Describe what happened during your time with your husband."

D. "Describe what happened during your time with your husband."

Which nursing statement is a good example of the therapeutic communication technique of focusing? A. "Describe one of the best things that happened to you this week." B. "I'm having a difficult time understanding what you mean." C. "Your counseling session is in 30 minutes. I'll stay with you until then." D. "You mentioned your relationship with your father. Let's discuss that further."

D. "You mentioned your relationship with your father. Let's discuss that further."

Which of the following statements accurately reflects data that the nurse should use in planning care to meet the needs of the older adult? A. 50% of older adults have two chronic health problems. B. Cancer is the most common cause of death among older adults. C. Nutritional needs for both younger and older adults are essentially the same. D. Adults older than 65 years of age are the greatest users of prescription medications.

D. Adults older than 65 years of age are the greatest users of prescription medications.

The nurse is aware that the majority of older adults: A. Live alone B. Live in institutional settings C. Are unable to care for themselves D. Are actively involved in their community

D. Are actively involved in their community

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

A home health aide is dressing a client. Which of the following is not true regarding this care? A. Encourage the client to choose his or her own clothes B. Overextend the extremities if necessary when undressing and dressing C. Assist the client to don pants, shirt with sleeves, and socks D. Never the force the extremities when undressing and dressing

D. Never the force the extremities when undressing and dressing

Of the following options, which is the greatest barrier to providing quality health care to the older-adult client? A. Poor client compliance resulting from generalized diminished capacity B. Inadequate health insurance coverage for the group as a whole C. Insufficient research to provide a basis for effective geriatric health care D. Preconceived assumptions regarding the lifestyles and attitudes of this group

D. Preconceived assumptions regarding the lifestyles and attitudes of this group

The nurse is caring for a group of older adult patients who are all receiving multiple medications. The nurse understands that it is essential to individualize each patient's therapy. Which is the best rationale for this practice? A. The percentage of drug absorbed often is decreased in older adults. B. Most older adults have decreased body fat and increased lean mass. C. Hepatic metabolism tends to increase in older adults, resulting in decreased drug levels. D. Renal function declines with age, leading to decreased drug excretion.

D. Renal function declines with age, leading to decreased drug excretion.

A client wants to wear a pair of sunglasses in the facility at night time. Which of the following is the appropriate action of the home health nurse? A. None of the other options B. Allow the client to wear the sunglasses since it is his or her right to do so C. Let the client wear the sunglasses in the hopes that he or she will run into something due to impaired vision D. The sunglasses will impair the vision; so the home health aide should not allow the client to wear the sunglasses

D. The sunglasses will impair the vision; so the home health aide should not allow the client to wear the sunglasses

You are visiting with the wife of a patient who is having difficulty making the transition to palliative care for her dying husband. What is the most desirable outcome for the couple? A. They express hope for a cure. B. They comply with treatment options. C. They set additional goals for the future. D. They acknowledge the symptoms and prognosis.

D. They acknowledge the symptoms and prognosis.

An unhelpful approach to communication with an older person may involve: a) Always speaking slowly b) Assessing them as an individual c) Adapting to their individual needs d) Seeing them as partners in their care

a) Always speaking slowly

Members of a family are caring for their father at home. Which statement by a family member indicates a need for teaching and caregiver instruction? a. "Dad has gotten lazy about his bathroom habits. He blames his arthritis medication for his toileting accidents." b. "Dad's room is close to the bathroom and we keep a light on for him at night." c. "It's inconvenient, but we stop other activities to remind Dad to go to the bathroom on a regular schedule." d. "We try to avoid coffee and tea at night, but Dad really likes a cup of coffee for breakfast."

a. "Dad has gotten lazy about his bathroom habits. He blames his arthritis medication for his toileting accidents."

An 80-year-old female who enjoys good health explains to her primary provider that she attributed her health status to her regular intake of berries, fruit, green tea, which she states "help cleanse the damaging molecules out of my body."Which of the following theories of aging underlies the client's health behaviors? a. Free radical theory b. Biogerontology c. Disposable soma theory d. Cross-linking theory

a. Free radical theory

The patient in the clinic tells the nurse she can "feel her biologic clock ticking." The nurse knows the patient views aging based on which theory? a. Gene theory b. Programmed theory c. Rate of living theory d. Somatic mutation theory

a. Gene theory

All of the following are impacts of polypharmacy EXCEPT: a. Increased communication between care teams b. Adverse drug events c. Increased healthcare costs d. Medication non-adherence

a. Increased communication between care teams not sure

What role involves gerontological nurses being aware of current research literature, continuing to read and put into practice the results of reliable and valid studies? a. Research Consumer b. Advocate c. Teacher d. Provider of Care

a. Research Consumer

While bathing an elderly client who has limited abilities for self-care, the nurse notices several patches of dry skin on the client's heels, elbows, and coccyx. The nurse cleans and dries all the areas well and applies a moisturizing lotion. The most appropriate immediate follow-up by the nurse to ensure appropriate nursing care for this clients skin is to: a. Revise the client's care plan to show the need for the application of moisturizing lotion b. Assume personal responsibility to apply the moisturizing lotion daily to the client's skin c. Encourage the client to tell whomever bathes her to apply the moisturizing lotion to her areas of dry skin d. Inform the staff that the client's skin is showing signs of breakdown and moisturizing lotion needs to be applied daily

a. Revise the client's care plan to show the need for the application of moisturizing lotion

What is the most appropriate nursing diagnosis for an older adult who is bedridden because of progressed Parkinson disease? a. Risk for impaired skin integrity related to immobility b. Immobility related to Parkinson disease c. Impaired skin integrity related to incontinence d. Ischemia related to disuse syndrome

a. Risk for impaired skin integrity related to immobility

One of the roles of the registered nurse in terms of informed consent is to: a. Serve as the witness to the client's signature on an informed consent. b. Get and witness the client's signature on an informed consent. c. Get and witness the durable power of attorney for health care decisions' signature on an informed consent. d. None of the above

a. Serve as the witness to the client's signature on an informed consent.

The nurse would recognize successful aging according to Jung's theory when a long-term care facility resident demonstrates which of the following behaviors? a. The resident takes special care to dress for dinner in a manner that pleases his tablemates. b. The resident asks permission to sit on the patio with other residents. c. The resident asks persons in his hall if his television is bothering them. d. The resident wears a large cowboy hat at all times because he likes it.

a. The resident takes special care to dress for dinner in a manner that pleases his tablemates.

1. You are caring for a client at the end of life. The client tells you that they are grateful for having considered and decided upon some end of life decisions and the appointments of those who they wish to make decisions for them when they are no longer able to do so. During this discussion with the client and the client's wife, the client states that "my wife and I are legally married so I am so glad that she can automatically make all healthcare decisions on my behalf without a legal durable power of attorney when I am no longer able to do so myself" and the wife responds to this statement with, "that is not completely true. I can only make decisions for you and on your behalf when these decisions are not already documented on your advance directive." How should you, as the nurse, respond to and address this conversation between the husband and wife and the end of life? a. You should respond to the couple by stating that only unanticipated treatments and procedures that are not included in the advance directive can be made by the legally appointed durable power of attorney for healthcare decisions. b. You should be aware of the fact that the wife of the client has a knowledge deficit relating to advance directives and durable powers of attorney for healthcare decisions and plan an educational activity to meet this learning need. c. You should be aware of the fact that the client has a knowledge deficit relating to advance directives and durable powers of attorney for healthcare decisions and plan an educational activity to meet this learning need. d. You should reinforce the wife's belief that legally married spouses automatically serve for the other spouse's durable power of attorney for health care decisions and that others than the spouse cannot be legally appointed while people are married

a. You should respond to the couple by stating that only unanticipated treatments and procedures that are not included in the advance directive can be made by the legally appointed durable power of attorney for healthcare decisions.

Nurse Maria implements the concepts of the activity theory of aging when instructing the older client with osteoarthritis to: a. continue her daily walking routine. b. curtail further increases in physical activity. c. document preferred end-of-life interventions. d. avoid exposing herself to crowds.

a. continue her daily walking routine.

When teaching an independent older adult patient how to self-administer insulin, the most productive approach is to: a. facilitate involvement in a small group where the skill is being taught. b. gather information about the patient's family health history. c. provide frequent, competitive skills testing to enhance learning. d. use repeated return demonstrations to promote the patient's retention of the involved tasks.

a. facilitate involvement in a small group where the skill is being taught.

An 80-year-old patient, who lives at home with a spouse, is instructed to follow a 2 g sodium diet. The patient states, "I've always eaten the same way all my life, and I'm not going to change now." To promote optimal dietary adherence, the gerontological nurse's initial approach is to: a. inform the patient about the need to follow the diet. b. inquire about the patient's current food preferences and eating habits. c. list the variety of foods that are allowed on the diet. d. provide dietary instruction to the patient's spouse, who prepares the meals.

a. inform the patient about the need to follow the diet.

Your client is in the special care area of your hospital with multiple trauma and severe bodily burns. This 75 year old male client has an advance directive that states that the client wants all life saving measures including cardiopulmonary resuscitation and advance cardiac life support, including mechanical ventilation. As you are caring for the client, the client has a complete cardiac and respiratory arrest. This client has little of no chance for survival and they are facing imminent death according to your professional judgement, knowledge of pathophysiology and your critical thinking. You believe that all life saving measures for this client would be futile. What is the first thing that you, as the nurse, should do? a. Call the doctor and advise them that the client's physical status has significantly changed and that they have just had a cardiopulmonary arrest. b. Begin cardiopulmonary resuscitation other emergency life saving measures. c. Notify the family of the client's condition and ask them what they should be done for the client. d. Ensure that the client is without any distressing signs and symptoms at the end of life.

b. Begin cardiopulmonary resuscitation other emergency life saving measures.

Based on the free theory of aging, what would be an appropriate behavior that might increase one's life expectancy? a. Exercise for 45 minutes at least three times a week. b. Eat food rich in antioxidants. c. Eat a low-calorie, high protein diet. d. Do nothing. Life expectancy is determined through genetic programming.

b. Eat food rich in antioxidants

Which of the following improves attitudes toward aging and older adults? a. Staying away from older adults b. Education about older adults c. Travelling to older communities d. Watching the portrayals of older adults in movies and on TV

b. Education about older adults

The family of a client receiving palliative care for a terminal illness hesitate to call for the nurse since all staff seem to be too busy to address the client's needs. Which action should the nurse take to improve the connection with the family? a. Vary the number and type of caregivers who respond to the client's needs b. Enter the room and stand or sit at the bedside to talk with the client and family c. Provide the family with reading material that explains the role of palliative care d. Attend to infusions and environmental issues while talking with the client and family

b. Enter the room and stand or sit at the bedside to talk with the client and family

The 45-year-old patient reports to the nurse he feels he is going through a "mid-life crisis." The nurse recognizes this phenomenon refers to the theory developed by which psychologist? a. Jung b. Erikson c. Newman d. Havighurst

b. Erikson

The nurse in the long term care facility who cares for primarily order adults knows these adults are in which stage of Erikson's developmental tasks? a. Trust vs mistrust b. Integrity vs Despair c. Industry vs Inferiority d. Generativity vs stagnation

b. Integrity vs Despair

What is the leading cause of catastrophic out-of-pocket costs for families and involves substantial government spending, primarily through Medicaid and Medicare? a. Palliative-care b. Long-term care c. Hospice Care d. Home Care

b. Long-term care

The nurse clarifies to a group of clients that the field of nursing interest that specializes in disease prevention, increasing autonomy and self care, and maintenance of function for older adults is a. gerontology. b. geriatrics. c. developmental psychology. d. public health.

b. geriatrics.

As a student nurse, you understand that it is important to study Gerontological Nursing because: a. it is fixed and unchanging. b. it provides a way to understand the aging process and provide quality care to older adults c. it can help predict the responses that the body can do in during aging. d. it gives positive outlook to older adults.

b. it provides a way to understand the aging process and provide quality care to older adults

The American Nurses Association's Gerontological Nursing: Scope and Standards of Practice emphasizes: a. that abnormal responses to the aging process determine the appropriate nursing diagnoses. b. that the health status data of older adult patients be documented in a retrievable form. c. the role of the older adult patient as the sole decision maker in planning his or her care. d. the unchanging nature of the goals and plans of care for older adult patients.

b. that the health status data of older adult patients be documented in a retrievable form.

The single most important thing we can do as healthcare providers to prevent polypharmacy is: a. Encourage our patients to carry a list of home medications in their wallet b. Tell our patient to appoint a lead doctor c. Educate our patients on each of their new medications d. Tell our patients to Google all of their medications

c. Educate our patients on each of their new medications

What best describes nurses as a care provider? a. Determine client's need b. Provide direct nursing care c. Help client recognize and cope with stressful psychological situation d. Works in combined effort with all those involved in patient's care

c. Help client recognize and cope with stressful psychological situation not sure

The RN student has been studying ethics in health care. Based on what she has learned, how would she explain the bioethical principle of autonomy? a. It states that the physician knows what is best for the patient. b. It does not apply to informed consent. c. It refers to patient self-determination. d. It states that every patient has a right to health care.

c. It refers to patient self-determination.

The following are the different disability projection scenarios except: a. High disability scenario b. Low disability scenario c. Middle disability scenario d. Intermediate disability projection

c. Middle disability scenario

You are asked by your supervisor to take photographs of the residents and their family members who are attending a holiday dinner and celebration at your long term care facility. What should you do? a. Take the photographs because these photographs are part of the holiday tradition at this facility b. Take the photographs because all of the residents are properly attired and in a dignified condition c. Refuse to take the photographs unless you have the consent of all to do so d. Refuse to take the photographs because this is not part of the nurse's role

c. Refuse to take the photographs unless you have the consent of all to do so

Which of the following is not a solution to add funding for future care services? a. Efforts to promote private long-term care insurance b. Medicaid and Medicare expansions c. Retaining long-term care workers d. More attention from policymakers

c. Retaining long-term care workers

Which of the following is most closely aligned with the principles and concepts of informed consent? a. Justice b. Fidelity c. Self determination d. Nonmalficence

c. Self determination

As a nurse manager, Nurse Beth knows that she needs to develop the following skills except; a. Time management b. Assertiveness c. Staff insubordination d. Communication

c. Staff insubordination

Nurse Beth told Mr. Dela Cruz about ways to decrease the risk of heart disease. What role of a gerontologic nurse did Nurse Beth portray? a. Manager b. Advocate c. Teacher d. Provider of Care

c. Teacher

The primary reason an older adult client is more likely to develop a pressure ulcer on the elbow as compared to a middle-age adult is: a. A reduced skin elasticity is common in the older adult b. The attachment between the epidermis and dermis is weaker c. The older client has less subcutaneous padding on the elbows d. Older adults have a poor diet that increases risk for pressure ulcers

c. The older client has less subcutaneous padding on the elbows

What ethical principle below is accurately paired with a way that ethical principle is applied into nursing practice? a. Justice: Equally dividing time and other resources among a group of clients b. Beneficence: Doing no harm during the course of nursing care c. Veracity: Fully answering the client's questions without any withholding of information d. Fidelity: Upholding the American Nurses Association's Code of Ethics

c. Veracity: Fully answering the client's questions without any withholding of information

For the RN to practice ethical decision-making, it is most important for him or her to: a. base decision-making on whether an action is right or wrong. b. base decision-making on possible consequences. c. accurately assess a situation. d. seek the assistance of an ethics committee.

c. accurately assess a situation.

The student understands the ANA Code of Ethics for Nurses when she identifies which statement as incorrect? The Code of Ethics for Nurses: a. provides a framework for ethical decision-making. b. is non-negotiable. c. is not applicable to most practice settings. d. helps with professional self-regulation.

c. is not applicable to most practice settings

Enteric coated tablets are designed to avoid being dissolved in the highly acidic stomach. Instead, they dissolve in the intestine. Knowing this and what you know about gastrointestinal changes associated with age, what can you conclude about enteric coated tablets and older patients? a. The tablets will need to be given intravenously instead b. These tablets will probably dissolve more slowly c. The enteric coated tablets are unaffected by changes associated with age d. These tablets may dissolve more quickly

d. These tablets may dissolve more quickly not sure

Which is the best example of polypharmacy? a. Your patient is filling her medications at more than 1 drugstore. b. Your patient is taking more than 2 medications. c. Your patient is taking more than 9 medications. d. Your patient is taking a potentially inappropriate combination of medicines.

d. Your patient is taking a potentially inappropriate combination of medicines.

A 90-year-old patient comes to the clinic with a family member. During the health history, the patient is unable to respond to questions in a logical manner. The gerontological nurse's action is to: a. ask the family member to answer the questions. b. ask the same questions in a louder and lower voice. c. determine if the patient knows the name of the current president. d. rephrase the questions slightly, and slowly repeat them in a lower voice.

d. rephrase the questions slightly, and slowly repeat them in a lower voice.

An 87-year-old man, who has been living independently, is entering a nursing home. To help him adjust, the most effective action is to: a. involve him in as many activities as possible so he can meet other residents. b. move him as quickly as possible so that he does not have time to think. c. restrict family visits for the first two weeks to give him time to adjust. d. suggest that he bring his favorite things from home to make his room seem familiar.

d. suggest that he bring his favorite things from home to make his room seem familiar.