gero exam 2 (7-11)
An older man is taking chlorpromazine (Thorazine), and the nurse helps him choose menu items. To prevent an exacerbation of potential adverse effects of therapy, which menu item does the nurse instruct the man to avoid? a. Biscuits and gravy c. Whole grain bread b. Coffee with cream d. Mixed green salad
b
A nurse is educating a patient who has been recently diagnosed with osteoporosis on foods high in calcium. The nurse should include which food choice? a. Okra b. Plain yogurt c. Turnip greens d. Whole wheat bread
b
A nursing home resident who has type 1 diabetes mellitus is gradually requiring more and more insulin on an as-needed (PRN) basis to treat hyperglycemia. Which of the following should the nurse assess to plan care for improving this individuals glucose metabolism? a. New-onset urinary tract infection b. Trends over time in activity level c. Sudden increase in caloric intake d. Big change in diabetic medication use
b
An older adult with a gastrostomy tube has difficulty using the dominant hand. Which of the following should the nurse provide to prevent complications of the gastrostomy tube? a. Use foam swabs to brush the teeth. b. Provide oral care every 4 hours. c. Supply a soft tooth brush and floss. d. Position the patient at 90 degrees for tube feedings.
b
An older man dislikes the daily meal he receives from his family because it is always cold. He is underweight and has a hemoglobin of 11.2 g/100 ml. Which recommendation should the nurse implement? a. Assess the man for a potential transfer to an assisted living facility. b. Meet with the man and his family to solve the problem. c. Collaborate with a social worker for food stamps. d. Ask the family about providing hot meals for him.
b
During a visit to the emergency department, a 92-year-old man discloses that he dribbles when he urinates. Which of the following would be a reason for this incontinence? a. Old age b. Benign prostatic hypertrophy c. Diet d. Laziness when urinating
b
Exercises are prescribed for older adults as therapy to improve which one of the following qualities? a. Relative intensity b. Muscle strength c. Muscle retraining d. Body sculpting
b
The federal government requires the use of a specific standardized documentation tool for home nursing care. Which information must a home nurse add to the approved documentation tool? a. Activity b. Vital signs c. Functional d. Demographic
b
The nurse at an assisted-living facility uses the Exercise and Screening for You (EASY) tool to plan an exercise program for a female resident who is in good health except that her height has decreased inch. Which exercise safety tip from EASY calls for the nurse to assess the resident before planning care? a. Do not exercise a red, warm, or swollen joint. b. Avoid stretches that cause you to bend at the waist. c. Evaluate your surroundings for outdoor exercising. d. Begin by warming up with low-to-moderate exercises.
b
The nurse completes an admission assessment on an older adult patient. The nurse identifies which factor that may contribute to sleep problems? a. Exposure to sunlight b. Polypharmacy c. Use of a sleep aid d. Decreased fluid intake
b
The nurse is caring for a patient who has recently had an indwelling catheter placed. The nurse should assess the patient for: a. An increase in oral fluid intake b. A change in mental status c. Upper back pain d. A decrease in activity
b
The nurse prepares to administer diltiazem (Cardizem LA) to an older adult with ischemic heart disease. When is the optimal time to administer this medication to help prevent complications of heart disease associated with rhythmical variations? a. Midday b. At bedtime c. At breakfast d. Every 4 hours
b
The nursing home staff needs assistance to feed properly the residents who need assistance with feeding. Which of the following should the nurse implement to ensure that the residents are properly fed? a. Instruct the feeding assistants to feed four people at a time. b. Draw on the availability of family members who are able to follow instructions. c. Ask some residents to self-feed for part of the mealtime. d. Assign a small group of nursing assistants to do the feeding.
b
Which increases the risk for chronic dehydration in older adults? a. Overuse of diuretic agents c. Dry mucous membranes b. Poor cognitive function d. Fluid loss from vomiting
b
Which interaction between each prescription and food or nutritional supplement is favorable? a. Warfarin (Coumadin) and ginkgo biloba b. Terazosin (Hytrin) and increased fluids c. Lithium (Eskalith) and low-sodium diet d. Warfarin (Coumadin) and leafy, green vegetables
b
Which intervention should the nurse use to decrease the risk of burns during mealtime in patients with mental and physical impairments? a. Wait until the drink has cooled. b. Assist patients with warm drinks. c. Use plastic mugs instead of ceramic. d. Serve only cold beverages to patients at risk.
b
Which is a common age-related physical change that may affect digestion and food intake? a. Loss of the majority of taste buds b. Decreased motility in the esophagus c. Decreased cholecystokinin secretion d. Loss of smell
b
Which medication is correctly matched to the condition given of an older adult patient according to current medical knowledge? a. Methylphenidate (Ritalin) for depression at bedtime b. Buspirone (BuSpar) for chronic anxiety states c. Amitriptyline (Elavil) for depression in the morning d. Haloperidol (Haldol) long-term for psychotic behavior
b
An older man is taking aripiprazole (Abilify) for agitation. Which patient assessment is the nurse's priority to prevent catastrophic effects of the medication? a. Oral and facial dyskinesia b. Mask facies, shuffling gait c. Muscle spasms of the face d. Repetitive aimless walking
a
An older woman has diabetes mellitus and requires hemodialysis for renal failure. She is discharged to home to recover from a sternal wound infection and coronary artery bypass graft surgery (CABG). A home care nurse will provide wound care. Which of the following is the major justification for the complete and accurate documentation of this older adult's care? a. Requires complex health care b. Has needs in multiple settings c. Is at risk for iatrogenic problems d. Has significant health care expenses
a
An older man has Alzheimer disease, and his wife says he is up and wandering around the house at night. Which intervention should the nurse implement to increase the mans duration of sleep? a. Instruct the wife to increase his daily physical activity. b. Collaborate with the health care provider to administer a hypnotic medication. c. Teach the wife how to apply a vest restraint during sleep. d. Help the wife plan daily periods for napping and activity.
a
During the night, an older woman complains to the nurse that she has not slept more than 2 hours since admission to the hospital. Which intervention should the nurse implement to increase the duration of this womans sleep? a. Inquire about her sleep habits used at home. b. Suggest that she avoid napping during the day. c. Tell her that sleep is fragmented in older people. d. Offer a book to her or suggest watching a movie.
a
The nurse is feeding an older adult patient with hemiparesis as a result of a stroke. Which intervention by the nurse is most important when feeding this patient? a. Allow time to empty the mouth between bites. b. Provide foods that require chewing. c. Offer small sips of fluids with each bite. d. Serve pureed foods only.
a
The nurse scans an older man's identification band in preparation for medication administration. Which step should the nurse implement next? a. Ask the patient to state his name. b. Check for allergies to the medication. c. Document the medication as given. d. Administer the patient's medication.
a
To avoid trauma to the mouth from hot food being served to a patient diagnosed with dementia, the nurse should: a. Set hot food aside to allow it to cool slightly. b. Mix the hot food item with a cold food item. c. Touch the food to check the temperature before serving. d. Request a patient menu that includes several cold foods.
a
Which of the following is a true statement about documentation? a. Nurses should keep records of patients' wishes. b. Patients do not have access to their own medical records. c. The Outcomes and Assessment Information Set (OASIS) is a complete record of the health status of a patient. d. The nurse is responsible for completing all of the Minimum Data Set (MDS).
a
Which of the following is a true statement about elimination in older adults? a. Defecation less than once each day is not necessarily constipation. b. Drinking mineral oil is recommended as a laxative for the older adult. c. Excessive sleep can be a symptom of constipation. d. Leaking liquid feces should be treated as diarrhea.
a
Which of the following is a true statement about fluid intake for older adults? a. Daily total volume should be 1500 ml to 2000 ml. b. Coffee is a suitable beverage for maintaining hydration. c. Caffeinated beverages are sometimes preferable to water. d. Total daily fluid intake should be approximately 10 ml per kg of body weight.
a
Which of the following is a true statement about sleep in older adults? a. The time spent in bed increases, but the time spent asleep decreases. b. The amount of leg movement during sleep remains steady throughout life. c. Rapid-eye-movement (REM) sleep becomes more unevenly distributed with age. d. The amount of stage III sleep increases steadily throughout life.
a
Which one of the following is connected with the nursing home reform mandated by a 1987 law? a. Resident Assessment Instrument (RAI) b. HIPAA c. OASIS d. Fulmer SPICES
a
Which process is increased in the early morning? a. Fibrinolytic activity c. Asthma symptoms b. Blood plasma d. Rheumatoid arthritis pain
a
which pharmacokinetic parameter is affected most by decreased intestinal motility related to the aging process? a. Absorption c. Metabolism b. Distribution d. Excretion
a
Which of the following is a true statement about nutrition for older adults? a. The older person should be encouraged to practice strict controls on cholesterol intake to ensure protection against heart disease. b. Transportation can be a critical factor in nutritional insufficiency in older adults. c. Soul food is a concern primarily for the African-American culture. d. No government programs promote congregate dining among older adults.
b
Which of the following is a true statement about sleeping in older adults? a. Older adults tend to fall asleep quickly but are awakened throughout the night. b. Sleep disturbances in the older adult can be caused by cardiovascular disease, arthritis, or diabetes. c. Benzodiazepine agents are the medications of choice for sleep disorders. d. Selective serotonin-reuptake inhibitors (SSRIs) can alleviate sleep disturbances caused by depression.
b
Which option is not a primary reason that documentation is important? a. Documentation enables the team to provide care to meet a resident's individual needs. b. Documentation helps defend the nurse in the event of a possible lawsuit. c. Documentation enables a patient to receive consistent care from one shift to the next. d. Documentation is the basis for reimbursement to the facility.
b
A health care provider has ordered alendronate (Fosamax) for an older adult who has been admitted for a hip fracture. Which is the best response from the nurse when educating the patient on the new medication? a. You will need to have your calcium checked monthly while on this medication. b. If you miss a dose, you will need to take the medication as soon as you remember. c. Take on an empty stomach. d. Do not take with alcohol.
c
An older adult who is on bed rest has tachycardia and dry mucous membranes after surgery. Which of the following is the nurse's priority for preventive care because of the patient's fluid volume status? a. Bowel obstruction b. Delirious behavior c.Thromboembolic events d. Delayed wound healing
c
An older woman maintains an active lifestyle playing various games with friends. She reports to the nurse that she experiences wakefulness during the night and an inability to fall asleep after waking up at night. Which intervention should the nurse implement to improve the quality of this womans sleep? a. Recommend preparation for sleep. b. Suggest trying a cup of warm milk at bedtime. c. Inquire about her nightly sleep rituals. d. Propose volunteer work at a thrift shop.
c
In questioning an older adult, which question is likely to elicit the most accurate information about the individual's adherence to the medication plan? a. "You take digoxin (Lanoxin) at the correct time, don't you?" b. "Why didn't you take all of your digoxin (Lanoxin) last month?" c. "How many doses of digoxin (Lanoxin) do you think you missed?" d. "You have never missed a dose of digoxin (Lanoxin), have you?"
c
The nurse expresses concern about a female nursing home resident in the team meeting. Which resident information determines the teams priority in planning her care? a. Experiences several interruptions with sleep b. Has had coronary bypass graft surgery during the last year c. Needs increasing help with personal hygiene d. Eats insufficient calories to maintain her weight
c
The nurse instructs the unlicensed assistive personnel to feed an older adult. If the nurse is unable to observe feeding directly, then which action should the nurse use to assess the older adult's risk for aspiration immediately after feeding? a. Note food volume eaten. c. Inspect for pocketing. b. Observe skin color. d. Monitor for bradypnea.
c
The nurse is trying to improve the nutritional status of residents in the nursing home. Which recommendations should the nurse implement? a. Develop a seating chart for the main dining room based on the unit to facilitate a more organized and efficient meal delivery. b. Replace the fluorescent lighting with candles at every table to create a cozy, restaurant-like atmosphere. c. Provide nutritious food according to the residents' expressed food preferences with a liberal use of seasonings that do not exceed any sodium restrictions. d. Distribute "med-pass" nutritional supplements.
c
The nurse must inform an older adult who does not speak English about patient rights. In addition, the nurse must have the adult sign the document about information access. Which intervention should the nurse use to maintain the confidentiality of this older adult? a. Present the patient with a Spanish version of the information access document. b. Have an English-speaking family member explain the document to the patient. c. Explain the document to the patient using an interpreter to ensure understanding. d. Instruct an interpreter to read the information access document to the resident privately.
c
The nurse prepares to administer vancomycin (Vancocin) to an older adult. Which laboratory test should the nurse review before administering this medication? a. Stool culture b. Serum potassium c. Creatinine clearance d. Alkaline phosphatase
c
The nurse provides instruction about medication safety to older adults. Which instruction should the nurse provide? a. Nausea and vomiting are common, harmless drug side effects. b. Keep a supply of medications at the bedside for convenience. c. Ask the health care provider to describe the purpose of therapy. d. Take your daily medications on an empty stomach with water.
c
Using the RAI, the nurse identifies a trigger for a male nursing home resident who requires an indwelling urinary catheter from the MDS. Which should the nurse do next? a. Develop an individualized care plan. b. Assign suitable nursing interventions. c. Use the RAPs. d. Institute agency-approved catheter care.
c
Which of the following does the nurse use to categorize the desired end result of nursing care delivered to a patient when using problem-oriented nurses' notes? a. North American Nursing Diagnosis Association (NANDA) nursing diagnosis b. Nursing Goals Classification c. Nursing Outcomes Classification (NOC) d. Nursing Interventions Classification (NIC)
c
Which of the following is a true statement about dental health in older adults? a. Most people can expect to lose most of their teeth by old age. b. Excessive saliva production is a common problem among older adults. c. Dentures should be cleaned once a day by brushing and soaking in a cleaning solution. d. A little blood on the toothbrush is normal.
c
Which of the following is important to include in the initial assessment for older adults who are frail and beginning an exercise program? a. Exercise tolerance testing (ETT) b. Financial ability to pay for training sessions c. Medical history and physical examination d. Pulmonary function tests (PFTs)
c
Which of the following should the nurse recommend for a moderate-intensity exercise for older adults who are ambulatory and in good health? a. Walk 4 miles in 60 minutes. b. Work in the garden for 45 minutes. c. Swim laps in the pool for 20 minutes. d. Wash and wax the car for 75 minutes.
c
A geriatric nurse practitioner prescribes an antidepressant for a patient. The patient asks, "How long will I have to be on this medication before I feel like my old self?" The nurse recalls that a therapeutic response to an antidepressant medication most often takes which one of the following? a. 24 hours b. 2 days c. 2 weeks d. 2 months
d
A patient receives heparin daily. The nurse should assess for which clinical response that indicates the need to discontinue heparin therapy? a. International normalized ratio (INR) of 2.5 b. Platelet count of 150,000/mm3 c. Reflux d. Hematuria
d
The nurse notices that an older adult's urine is greenish-brown. Which step should the nurse implement next? a. Increase oral fluid intake. c. Evaluate the medication list. b. Review laboratory reports. d. Determine fluid volume status.
d
The older adult residents of an assisted-living facility are preparing for a 14-day trip to Europe. Which is the most important exercise for the nurse to recommend for the group? a. Practice standing on one foot for 30 seconds. b. Move light weights in a rowing motion eight times. c. Stretch the hips by pulling the knee to the chest. d. Swim laps in the pool for 10 minutes continuously.
d
What is a SOAP note? a. Record of supplies used in patient hygiene b. Record of an event during a patient's stay, formatted according to the Simple Object Access Protocol (SOAP), enabling it to be easily transmitted between computers c. Form of bar code d. Record of patient data listing the patient's subjective complaint, objective data recorded by the nurse, the nurse's assessment of the situation, and the nurse's plan of action
d
What is the difference between rest and sleep? a. Sleep occurs with rest. b. Rest is an extension of sleep. c. Rest occurs only in brief periods. d. Sleep is restorative and recuperative.
d
When completing medication reconciliation for an older woman, the nurse notes that the patient is being discharged home on anticoagulant therapy. The nurse also notes that at admission, the patient reported that she uses herbal supplements at home. Which instruction should the nurse include during discharge teaching? a. "You may need to supplement with only ginkgo while on anticoagulant therapy." b. "You may need to increase the use of garlic supplements while on anticoagulant therapy." c. "Avoid using Hawthorn supplements while taking an anticoagulant medication." d. "Avoid using chamomile supplements while on anticoagulant therapy."
d
Which combination is suitable for the daily diet of older adults? a. Vitamin B12, 2.4 mcg; and fiber, 15 g b. Three 8-oz glasses of fluid; and 1600 calories c. Vitamin B12, 1.1 mcg; and 40% of daily calories from fat d. Calcium, 1200 mg; and vitamin D, 600 to 800 units
d
Which documentation tool does the nurse use to achieve optimal functional status for a nursing home resident? a. Narrative patient progress notes b. Problem-oriented documentation c. Resource Utilization Group (RUG) d. Resident Assessment Instrument (RAI)
d
Which of the following is a true statement? a. Urine flow gradually decreases in older age. b. Older adults generally need less fluid than younger people because of their lower body water content. c. Urine-specific gravity and skin turgor can be used to diagnose dehydration in older adults and in younger people. d. Multiple physiological changes of aging place older adults at a greater risk of dehydration than middle-aged persons or children.
d
Which of the following is on the list of drugs considered suitable for the older adult? a. Indomethacin (Indocin) c. Chlorpheniramine (Chlor-Trimeton) b. Reserpine (Reserpine) d. Bupropion (Wellbutrin)
d