Geri Midterm
Which of the following is considered a normal part of aging? 1. Periods of clinical depression 2. Inc frequency of night time awakenings 3. Social withdrawal 4. Decrease in kidney function
2 & 4 2. Inc frequency of night time awakenings 4. Decrease in kidney function
Which of following eye conditions can lead to permanent blindness if untreated? 1. presbyopia (blurred vision) - change in acuity 2. glaucoma 3. cataracts 4. Age related macular degeneration
2, 3, & 4 2. glaucoma 3. cataracts 4. Age related macular degeneration
What percentage of personage 65 or older live in a long term care facility in the US?
4%
An 82-year-old patient has a painful, vesicular rash that burns over the left abdomen. The patient indicates that he or she has tried multiple creams that have not helped. Which question does the gerontological nurse first ask? A) "Did you have the pain before the rash appeared?" B) "Do you have any food or drug allergies?" C) "Have you been around anyone with a rash?" D) "Have your grandchildren visited recently?"
A) "Did you have the pain before the rash appeared?"
You are assessing a 64 yo male 3 days after surgery for a perforated bowel. He appears depressed and agitated. You note that he has tremors, elevated BP, tachycardia, and diaphoresis, but he is afebrile and alert. Which of the following do you suspect? A) Alcohol or benzodiazepine withdrawal B) Withdrawal from opioids (would be throwing up, diarrhea, GI stuff) C) Withdrawal from cocaine D) Infection
A) Alcohol or benzodiazepine withdrawal
Which of the following represents the 5 "A's" of counseling pts regarding smoking tobacco cessation? A) Ask, advise, assess, assist, arrange B) Airway assessment, ask about alcohol abuse, advise, arrange, assure C) Assume, advise, assess, assist, arrange D) None of the above
A) Ask, advise, assess, assist, arrange
Which ethical principle underlies nursing actions respecting each patient's values and beliefs? A) Autonomy. B) Beneficence. C) Justice. D) Responsibility.
A) Autonomy.
A 79-year-old retired actor, who continues to pursue lifelong interests in swimming and singing, exemplifies which theory of aging? A) Continuity. B) Developmental. C) Disengagement. D) Physical.
A) Continuity.
Which of the following alterations in mental status in older adults usually has the shortest onset? A) Delirium B) Depression C) Dementia D) Parkinson's Disease
A) Delirium
The home health nurse is assessing a client and determines that the client has an unsteady gait. The client tells the nurses that she has recently fallen. Which nursing action represents the advocacy role for the home health nurse? A) Find a local agency or organization that helps older adults get a walker B) Listen to the client supportively, reassure that falls are common in later life C) Instruct the client about senior day care options D) Educate the client about the types of walkers
A) Find a local agency or organization that helps older adults get a walker
As a GNP you recognize that falls are a significant source of morbidity and mortality in the elderly. Which of the following statements about falls in the elderly is false? A) For adults 65 years old and older, most falls happen in public places. B) Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes. C) Approximately 2/3 of long-term care residents experience falls each year. D) Of elderly adults who fall, 10-30% sustain moderate to severe injuries that reduced mobility and independence.
A) For adults 65 years old and older, most falls happen in public places.
Which following conditions has biggest impact on the personally of the older adults if they do not adapt to it effectively? A) Hearing loss B) Vision loss C) Physical stamina D) Physical strength
A) Hearing loss
Which of the following is NOT a sign of depression in an older adult? A) His speech is impaired. B) His speech is slow but clear. C) He reports difficulty sleeping. D) He expresses concern over being a burden to his children.
A) His speech is impaired.
Which of the following is NOT a risk posed by cardiogenic shock? A) Hypothermia. B) Liver damage. C) Brain damage. D) Kidney damage.
A) Hypothermia.
Light-moderate alcohol consumption in later life is associated with which of the following? A) Lower risk of MI B) Lower risk of ischemic stroke C) Lower risk of HTN D) Lower risk of atrial fibrillation
A) Lower risk of MI
Ms. Chatham, a 65-year-old patient is determined to have a systolic blood pressure reading of 125. This patient is ______. A) Prehypertensive. B) Stage I Hypertension. C) Stage II Hypertension. D) Normal.
A) Prehypertensive.
A state ombudsman initiates an investigation after a complaint about the care of a nursing home resident. Which statement about the investigation process is true? A) The ombudsman may proceed with the investigation without identifying the individual who made the complaint, and without obtaining a court order or written consent. B) The ombudsman must identify the individual who made the complaint. C) The ombudsman must obtain a court order to review documentation, if the resident described in the complaint does not give written permission. D) The ombudsman must obtain the written permission of the resident who is described in the complaint.
A) The ombudsman may proceed with the investigation without identifying the individual who made the complaint, and without obtaining a court order or written consent.
Bilateral shallow lesions with a red base, or covered by yellow tissue, unevenly shaped borders, surrounded by shiny, tight, warm/hot, and discolored skin just above the ankle is most likely which of the following? A) Venous stasis ulcer B) Pressure ulcer C) Contact dermatitis D) Squamous cell carcinoma
A) Venous stasis ulcer
Which group of elderly men is at the highest risk of committing suicide? A) Whites B) African americans C) Asian D) Latino
A) Whites
Which of the following is the best test for rheumatoid arthritis. A) anti-cyclic citrullinated pepetide (anti-CCP) B) uric acid level (GOUT) C) dual-energy X-ray absorptiometry (DEXA) D) Creatinine test
A) anti-cyclic citrullinated pepetide (anti-CCP)
A 65-year-old patient exhibits symptoms of hemianopsia. The most appropriate nursing intervention is to: A) arrange the patient's meal tray so that all the food is in the patient's field of vision. B) explain all tasks thoroughly to help allay the patient's fears. C) look directly at the patient when speaking to maximize comprehension. D) minimize the operating stimuli to reduce distractions to the patient.
A) arrange the patient's meal tray so that all the food is in the patient's field of vision.
A frail 80-year-old patient, who cares for a spouse at home without assistance, requires minor surgery. Lacking any family members residing in the area, the patient expresses concern about the spouse's care while the patient is recovering. The gerontological nurse's recommendation is: A) arranging inpatient respite care for the spouse. B) having the patient remain in the hospital during the post-operative period. C) hiring around-the-clock help for two weeks. D) hospitalizing the spouse.
A) arranging inpatient respite care for the spouse.
A recently admitted nursing home resident and the resident's family only speak Spanish. One evening during a visit, the resident and the family begin to wail and sob loudly. The gerontological nurse is unable to determine what is wrong. The nurse's most appropriate action is to: A) ask the supervisor to get an interpreter. B) attempt to make the resident and the family comfortable. C) contact the provider for orders. D) find an escort to take the resident and the family to the chapel for privacy.
A) ask the supervisor to get an interpreter. (Like Edwin. You should call your hubby and ask him for help. Edwin loves you so much that he'll teleport to you and restore the day.) <3
There are environmental factors that affect people and these cannot be modified. The following are all examples of these with the exception of: A) pollution B) altitude C) climate D) temperature
A) pollution
Which of the following are usually associated with pruritus (itchiness)? A) psoriasis B) Basal cell carcinoma C) Squamous cell carcinoma D) melanoma
A) psoriasis
Which of the following medications are associated increased falls? 1. antihypertensive 2. vitamin D and calcium 3. sedatives and hypnotic 4. anticholinergic eye drops A) all of the above B) 1 & 3 C) 2, 3,& 4 only D) 1,3, & 4 only
B) 1 & 3 1. antihypertensive 3. sedatives and hypnotic
Mr. French asks the GNP the maximum number he can have for his LDL Cholesterol level in order to be considered at a borderline high amount. What answer does she give him? A) 62 mg/dL. B) 159 mg/dL. C) 83 mg/dL. D) 95 mg/dL.
B) 159 mg/dL.
You are providing care to a patient who has recently begun dialysis. Her daughter, with whom she lives and who prepares many of her meals, asks what types of foods she should incorporate into her diet and which she should avoid. Which of the following is NOT a food that this patient should be advised to avoid? A) Avocado B) Lean Red Meat C) Dried Fruit D) Bananas
B) Lean Red Meat
Your 89-year-old patient presents with dyspepsia and nausea. After testing, you determine she is positive for Peptic Ulcer Disease. Of the following, which would LEAST likely be a differential diagnosis for Peptic Ulcer Disease? A) Cholecystitis. B) Migraines. C) Gastric carcinoma. D) Cardiovascular disease.
B) Migraines.
Which of the following is true regarding depression in later life? A) Depression is a normal part of aging B) Older persons often experience many events which put them at risk of depression (such as loss of spouse, child, job or abuse) C) Antidepressants generally do not work for older adults D) ECT should never be used for an older adult because it can contribute to long term memory loss.
B) Older persons often experience many events which put them at risk of depression (such as loss of spouse, child, job or abuse)
Which of the following best describes what slough is? A) Black, brown, or tan devitalized tissue that adheres to the wound bed or edges and may be firmer or softer than the surrounding skin B) Soft, moist avascular tissue that adheres to the wound bed in strings or thick clumps; may be white, yellow, tan, or green C) pink/red moist tissue comprised of new blood vessels, collagen fibers, and fibroblasts. Typically the surface is shiny and moist with a granular appearance. D) New pink and shiny tissue/skin that grows in from the edges or as islands on the wound surface
B) Soft, moist avascular tissue that adheres to the wound bed in strings or thick clumps; may be white, yellow, tan, or green
A resident in a nursing home requests a new room because he or she does not like the view from the current room. While the resident is away from the home on a provider visit, the staff moves the resident's belongings to another room with a better view. The resident and the resident's family later file a formal complaint regarding the move. Which statement gives the best justification for the resident's complaint? A) The change was made without a provider's order. B) The resident was not included in the decision making. C) The resident's belongings were moved without his or her assistance. D) The resident's family was not included in the decision making.
B) The resident was not included in the decision making.
A 75-year-old patient, whose marriage ended in divorce after two years, has lived alone for the past 50 years. Feeling as if life has had little meaning, the patient is terrified of living out the remaining years and of dying. The age-related issue to be resolved is: A) disengagement vs. activity. B) ego integrity vs. despair. C) self-determination vs. resignation. D) self-esteem vs. self-actualization.
B) ego integrity vs. despair.
For alcohol withdrawal symptoms, the preferred benzodiazepine is lorazepam. This is used when there is concomitant history of: A) folate-deficiency anemia B) hepatic disease C) seizure disorder D) multiple substance abuse
B) hepatic disease
An older patient has tourette syndrome. The GNP knows that part of the management of this condition includes all of the following except: A) Behavior therapy and biofeedback B) high doses of diazepam have been known to be effective. C) individual education plans, including classroom modifications D) family support and counseling
B) high doses of diazepam have been known to be effective.
The most common symptoms of benign prostatic hypertrophy are: A) chills, fever, and nausea. B) dysuria, abdominal pain, and urinary retention. C) intermittency, hesitancy, and dribbling. D) nocturia, bladder spasms, and hematuria.
C) intermittency, hesitancy, and dribbling.
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.
B) inquire about the patient's current food preferences and eating habits.
A 65-year-old male with suppurative conjunctivitis is in the office for treatment. The GNP has knowledge that all of the following ophthalmic preparations can be used to cure this except: A) ciprofloxacin B) penicillin C) bacitracin-polymyxin B D) Erythromycin
B) penicillin
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 GNP knows that when treating depression with selective serotonin reuptake inhibitors the patient may exhibit: A) weight gain and hypoglycemia B) weight loss and decreased libido C) cognitive changes and urinary retention D) sleepiness and decreased libido
B) weight loss and decreased libido
Which question does the gerontological nurse prioritize for an 86-year-old patient with abdominal pain, muscle weakness, and leg cramps? A) "Do you eat a lot of meat?" B) "Do you have heart problems?" C) "Do you take a diuretic?" D) "Do you walk every day?"
C) "Do you take a diuretic?"
For a person who is lactose intolerant and cannot afford lactaid tablets, which of the following foods is recommended as a source of calcium? 1. yogurt 2. Sardines 3. Kale 4. Broccoli A) 1 & 2 only B) 2 & 4 C) 2, 3, & 4 only D) all the above
C) 2, 3, & 4 only 2. Sardines 3. Kale 4. Broccoli
You are prescribing Lisinopril for your 70-year-old patient with heart failure. What is the maximum daily dosage the patient can take of this medication? A) 4 mg/day. B) 20 mg once per day. C) 40 mg/day. D) 16 mg/day.
C) 40 mg/day.
Which patient is at greatest risk for developing arteriosclerotic heart disease? A) A 60-year-old female patient with a triglyceride level of 135 mg/dL, and a high-density lipoprotein level of 68 mg/dL. B) A 70-year old male patient with a total cholesterol level of 181 mg/dL, and a low-density lipoprotein level of 90 mg/dL. C) A 75-year old female patient with a triglyceride level of 189 mg/dL, and a low-density lipoprotein level of 149 mg/dL. D) An 86-year-old male patient with a low-density lipoprotein level of 100 mg/dL, and a high-density lipoprotein level of 50 mg/dL.
C) A 75-year old female patient with a triglyceride level of 189 mg/dL, and a low-density lipoprotein level of 149 mg/dL.
In order for effective teaching to take place, it is crucial that the GNP use the proper teaching style for each patient. What teaching style would BEST suit a patient with a "Dependent Learner" style? A) Facilitator. B) Delegator. C) Authority, expert. D) Salesperson, motivator.
C) Authority, expert.
As a GNP you know that the major cause of respiratory disability in older adults is which of the following? A) pneumonia B) lung cancer C) COPD D) heart disease
C) COPD
You are providing patient education to a 65 year old male patient who will undergo a prostatectomy in the near future. He asks about possible complications of the surgery. Which of the following is NOT among the risks of this patient's procedure? A) Erectile dysfunction. B) Urine leakage. C) Fecal incontinence. D) Stress incontinence.
C) Fecal incontinence.
What of the following is best recommendation for regarding alcohol consumption for persons age 65 to 75? A) You should only have a small amount of alcohol on important social occasions. B) You should not drink any hard alcohol but red wine is fine C) If you are on prescription meds, you need to read the label to see if you can drink alcohol D) Alcohol should be avoiding if you have a poor appetite because you will eat less.
C) If you are on prescription meds, you need to read the label to see if you can drink alcohol
The cleansing of the stomach with solution delivered through a nasogastric tube is known as what? A) Gavage B) Emesis C) Lavage D) Stomach Pumping
C) Lavage
Aging involves the concept of loss. Which of the following losses is not one of the psychosocial losses associated with aging? A) Loss of spouse, children or friends. B) Loss of role in the workplace and in the family. C) Loss of intelligence level. D) Loss of socioeconomic status.
C) Loss of intelligence level.
Mrs. Frasier, an 50-year-old patient, presents with a mosquito bite that she is concerned about. How do you diagnose this? A) Cyst. B) Bulla. C) Wheal. D) Plaques.
C) Wheal.
Signs and symptoms of age-related macular degeneration include: A) decreases in depth perception. B) deficits in peripheral vision. C) distortion of lines and print. D) reports of flashes of light.
C) distortion of lines and print.
The gerontological nurse manager involves the nursing staff in the utilization of trend data and analysis for quality improvement by: A) encouraging staff to volunteer for The Joint Commission's onsite surveys. B) highlighting the quality improvement work of experts in the specialty area. C) informing how data and outcomes are directly related to the staff's daily work. D) using scatter diagrams to identify the root cause of unresolved concerns.
C) informing how data and outcomes are directly related to the staff's daily work.
The gerontological nurse is monitoring signs of suspected abuse in an 89-year-old patient who was admitted from home. When planning for the patient's discharge, the nurse's first action is to: A) delay discharge by informing the provider of the suspected abuse. B) enlist the help of family members with transitioning the patient home. C) notify Adult Protective Services of the patient's discharge. D) restrict the family members' access to the patient prior to discharge.
C) notify Adult Protective Services of the patient's discharge.
Which of the following foods is most associated with a gout flare? A) cherries B) vitamin C C) red meats D) water
C) red meats
Three months ago, an older adult patient, who lives in an apartment in a housing complex for senior citizens, began residing with an older adult patient from the same complex. Upon learning of the situation, the patient's adult child expresses concern to the housing administrator, who reports that both residents have reported satisfaction with the arrangement. When the child requests advice, the gerontological nurse's initial response is: A) I can understand why you are upset. Has he or she ever done something like this before?" B) "Why don't we all talk to your parent to get his or her side of the story?" C) "Your parent has the right to do what he or she wants because he or she is mentally competent." D) "Your parent seems to be happy with the arrangement. Have you discussed this situation with him or her?"
D) "Your parent seems to be happy with the arrangement. Have you discussed this situation with him or her?"
Your elderly patient's MCV indicates that he is Normocytic. Of the following figures, which does NOT indicate a Normocytic reading? A) 85 fL. B) 92 fL. C) 100 fL. D) 75 fL.
D) 75 fL.
Pressure ulcers/injuries are usually caused by which of the following external contributing factors? A) Shear B) Friction C) Moisture D) All of the above
D) All of the above
Which of the following are important in assessing skin lesions? A) Its location on the body B) Its characteristics (size, color, shape, etc.) C) Its pattern (if there is more than one) D) All of the above
D) All of the above
Which of the following conditions is the mostly highly associated with increase fall risk? A) Arthritis B) Parkinson's Disease C) Incontinence D) All of the above
D) All of the above
There are a good many diseases affecting the elderly that are the result of smoking. Counseling regarding smoking cessation is part of the GNP's job. The components of brief intervention for treating tobacco use are: A) Counsel, Document, Caution, Describe, Demonstrate B) Advise, Confer, Describe, Document, Prescribe C) Advise, Counsel, Intervene, Prescribe, Follow-up D) Ask, Advise, Assess, Assist, Arrange
D) Ask, Advise, Assess, Assist, Arrange
Which of the following is most likely not a part of normal aging? A) Slower thinking B) hesitates more C) Pause to find words D) Can't place the person's face
D) Can't place the person's face
Which of the following does not get at least one point (increase fall risk factor) in the Hendrich II Fall Risk Model? A) Symptomatic Depression B) Altered Elimination C) Dizziness/Vertigo D) Gender (Female)
D) Gender (Female)
When treating a client with allergic rhinitis what education information should the GNP include? A) Remain inside during allergy season. B) Avoid working in the garden or yard. C) Use a surgical-type mask when going outdoors. D) Monitor air quality and the allergy index.
D) Monitor air quality and the allergy index.
What is true regarding overweight older adults and their state of health? A) BMI is a good way to assess nutritional states in the elderly. B) There are no potential metabolic or functional benefits to weight loss in the elderly. C) There is clearly associated increased mortality with overweight older adults. D) Mortality in the elderly related to overweight states declines over time.
D) Mortality in the elderly related to overweight states declines over time.
Which of the following is false? A) Older adults are heterogeneous population with varied cultural beliefs and life experiences that contribute to individual well-being and quality of life B) Older adults seek self-fulfillment and interaction with their environment C) Older adults are capable of making, and desire to make, informed decisions On how to make life decisions D) Older adults rarely experience multiple, interacting, acute and chronic conditions
D) Older adults rarely experience multiple, interacting, acute and chronic conditions
An older adult patient, who has end-stage multiple myeloma, is receiving hospice care. Which situation illustrates that the principles of hospice care are being met? A) The caregiver asks if hospice includes weekend care. B) The caregiver has been calling the provider on his or her own. C) The patient reports enjoying daily excursions. D) The patient reports no breakthrough pain medications are needed.
D) The patient reports no breakthrough pain medications are needed.
Which of the following is true regarding opioid pain medication for older adults with acute severe pain? A) They should never be used because they can cause respiratory depression B) They should only be used after 2 non-opioid pain meds have failed to provide relief. C) They are only used in end of life care D) They often cause constipation.
D) They often cause constipation.
A 65 year female patient with chest pain is being diagnosed to determine the etiology of her atrial fibrillation. An echocardiogram was recently performed to check the function of the left ventricle, valvular function, atrial size and for the presence of cardiac thrombi. The transthoracic echo is negative, the GNP should then consider: A) Chest x-ray. B) 12-lead electrocardiogram. C) Ventilation-perfusion scan. D) Transesophageal echo.
D) Transesophageal echo.
A 67-year-old man states, "I drink way too much and don't know how to stop." According to Prochaska's change framework, the statement is most consistent with a person at the stage of: A) action B) preparation C) precontemplation D) contemplation
D) contemplation
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.
Which of the following is not an intrinsic contributing factor of pressure injury: A) malnutrition B) dehydration C) impaired mobility D) restlessness
D) restlessness
An effective way to adequately provide nourishment to a patient with moderate dementia is: A) allowing the patient to choose foods from a varied menu. B) hand feeding the patient's favorite foods. C) routinely reminding the patient about the need for adequate nutrition. D) serving soup in a mug, and offering finger foods.
D) serving soup in a mug, and offering finger foods.
For older adult patients who are taking neuroleptic medication, the primary concern is the development of: A) lethargy. B) nausea. C) poor appetite. D) tardive dyskinesia.
D) tardive dyskinesia.
An older adult patient currently takes phenytoin (Dilantin) and tolterodine (Detrol). The gerontological nurse reinforces the need for routine dental visits because these two medications decrease: A) calcium levels in the blood. B) innervations of the trigeminal nerve. C) the muscle strength of the tongue. D) the production of saliva.
D) the production of saliva.
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.
D) use repeated return demonstrations to promote the patient's retention of the involved tasks.
Which for the following has the least evidence to support for self-management of osteoarthritis of the knee? A) cardiovascular (aerobic) and/or resistance land-based exercise B) aquatic exercise C) lose weight (for persons who are overweight) D) wearing knee braces
D) wearing knee braces
The gerontological nurse works with patients with non-insulin dependent diabetes at a senior center in a predominantly Hispanic neighborhood. The nurse demonstrates competency in collaboration by: A) assisting and educating patients on diet restrictions. B) delivering care by preserving and protecting patient autonomy. C) providing written education materials in Spanish. D) working with Hispanic groups in the community.
D) working with Hispanic groups in the community.