Gero test 2
A clinic nurse assesses a client who has limited English-speaking ability. The child interprets for the client. Which action by the nurse is most appropriate? A) Obtain a professional interpreter. B) Talk directly to the interpreter. C) Teach the family member the appropriate medical terminology. D) Use the family member as a source for improving cultural competence.
A
A nurse leads a "Healthy Aging" class at a community health center. Which question should the nurse use to generate discussion among participants in this setting? A) "How did you adjust to your move from your house to the assisted living facility Irma?" B) "Are you satisfied with the care that you're getting from your family doctor, Elizabeth?" C) "Donald, could you tell us why your grandson is living with you?" D) "Have you had any tests done on your heart since we last met, Marie?"
A
A nurse manager of an extended care facility works to promote psychosocial health. Which of the following interventions should the nurse manager include? A) Adapt the environment to compensate for residents' sensory impairments. B) Dress residents exclusively for ease in going to and from the restroom. C) Plan dining room arrangements according to room and hall assignments. D) Position the residents who are in wheelchairs solely for ease in getting out of the dining area.
A
A nurse monitors older adults in a long-term care facility. Which of the following symptoms would require follow-up by the nurse to assess for depression in the older adult? A) Anorexia B) Weakness C) Labile affect D) Impaired perceptions
A
A nurse observes an aide asking a client what he wants for breakfast, lunch, and dinner while assisting him to toilet. Which action by the nurse is most appropriate? A) Direct the aide to present only one idea at a time. B) Encourage this small talk. C) No action is required. D) Tell the aide to avoid conversations while the client is toileting.
A
A nurse plans activities each month at an assisted living facility. Which of the following activities is most cognitively stimulating? A) Book discussions B) Movie night C) Exercise D) Reminiscence therapy
A
A nurse teaches a nursing assistant about the impact of culture on older adults' well-being. Which of the following statements by the nursing assistant indicates a need for further teaching? A) "A cultural background has little influence on individuals' standards for 'normal' or 'abnormal' behavior." B) "Western cultures often have a very rigid distinction between health and illness." C) "Culture may influence mental health and illness in individuals." D) "Culture may determine an individual's expression of symptoms or clinical manifestations."
A
A resident of a nursing home has accused several members of the care staff of stealing jewelry from the overbed table despite the fact that the facility's policy requires residents to keep such valuables in a lock box. The nurse has responded empathically to the accusations and has explained why this is impossible, to no avail. Which of the following conditions is the client experiencing? A) Delusions B) Hallucinations C) Unresolved anger D) Illusions
A
An older adult has impaired psychosocial functioning. Which of the following consequences should the nurse monitor? A) Anxiety B) Elevated blood glucose level C) Increased independence D) Resilience
A
The child of an 81-year-old client asks the nurse about vitamins, antioxidants, and age-related macular degeneration. Which of the following theories of aging is most appropriate to this topic? A) Free radicals theory B) Immunosenescence theory C) Program theory D) Wear-and-tear theory
A
Which of the following is a priority nursing intervention for the management of delirium? A) Giving the client low-dose oxygenation and maintaining his or her fluid and electrolyte balance B) Reducing noise and placing familiar objects in the client's environment C) Giving the client a clock, a watch, and calendars to provide the client with temporal orientation D) Providing psychological support through cognitive and social stimulation
A
Which of the following statements best explains the relevance of psychological theories for gerontological nursing? A) Human needs theory allows the nurse to determine priorities of nursing care for older adults. B) Life span development theories support the belief that it may be difficult to initiate behavioral changes in older adults. C) Psychological theories explain why nurses should focus their discussion more on the present than on the past when talking with older adults. D) Psychological theories explain why reminiscence groups may not be beneficial for older adults.
A
Which of the following statements by residents of a nursing home should prompt a nurse to assess for depression? A) "Lately I wake up for the day at 4:00 or 5:00 in the morning and can't fall asleep again." B) "I've got these cravings for sugary and salty snacks more than I used to." C) "I've never been too prone to headaches, but these days I always seem to have one." D) "I don't know why this sore on my ankle just won't heal this time."
A
While a nurse is performing a recently admitted hospital client's morning care, the client states, "I'm pretty sure I'll never see my own apartment again." Which of the following responses by the nurse best demonstrates effective communication? A) "What is it that makes you feel that way?" B) "I'm sure that's not going to be the case." C) "All in all, you're doing quite fine." D) "There's a lot that we can do, dear, to make sure that you do."
A
A nurse develops a plan to addressing dementia-related behaviors in an older adult with dementia. Which of the following interventions should be included in this plan? (Select all that apply.) A) Maintain a clutter-free environment. B) Implement regular rest periods. C) Place pictures of familiar people in very visible places. D) Lay out clothing in the order in which the items are to be donned. E) Test the client's memory with each conversation.
A, B, C, D
A nurse is identifying positive functional consequences as part of the development of an older client's care plan. Which of the following outcomes exemplifies the concept of positive functional consequences for an older adult? (Select all that apply.) A) The older adult with arthritis can walk 1 mile without pain. B) The older adult who is overweight develops a plan to lose 2 lb a month. C) The older adult has constipation from pain medication. D) The older adult schedules cataract surgery.
A, B, D
A nurse monitors for depression in the older adult population. Which of the following are a risk factor and a functional consequence of depression in the older adult? (Select all that apply.) A) Chronic pain B) Functional impairment C) Hypernatremia D) Nutritional deficiencies E) Renal impairment
A,B,D
An older adult has developed hallucinations. For which of the following should the nurse assess? (Select all that apply.) A) Digoxin toxicity B) Hyperglycemia C) Infection D) Myocardial infarction E) Stroke
A,C,E
A nurse recognizes that depression has functional consequences. Which of the following are functional consequences of late-life depression? (Select all that apply.) A) Decreased functioning B) Dementia C) Higher incidence of a stroke D) Higher level of pain E) Increased risk for suicide
A,D,E
A 69-year-old woman is saddened by her recent diagnosis of type 2 diabetes, which is a stressor that will make numerous demands on her life in the coming years. Which of the following actions demonstrates a problem-focused approach to this stressor? A) Eliciting support and sympathy from her sister and neighbor B) Obtaining diabetic cookbooks and learning to change her cooking habits C) Seeking out a second opinion from another physician D) Deciding to make no lifestyle changes despite her new diagnosis
B
A 75-year-old woman who often used to go out to dinner with her friends has stopped going out because she has been experiencing urinary incontinence and is afraid of having an "accident" in public. When her child asks her why she doesn't go out with her friends anymore, she says, "I'm getting too old for such foolishness." Her child asks her to go to the doctor for an evaluation, but she refuses to do so. Which of the following is occurring with this older adult? A) She is experiencing learned helplessness and low self-efficacy. B) She sees incontinence as an inevitable consequence of aging. C) She views her incontinence as a negative functional consequence of aging. D) Her doctor is sympathetic; however, the woman and the doctor are unable to find a solution.
B
A client was diagnosed 3 years ago with a cognitive impairment, a condition that worsened over the next several months and which culminated in his recent death. An autopsy revealed numerous infarcted brain regions resulting from vessel occlusions. This client most likely suffered from which type of dementia? A) Alzheimer disease B) Vascular dementia C) Lewy body dementia D) Frontotemporal degeneration
B
A long-time resident of an assisted living facility has just been diagnosed with Alzheimer disease. A nurse who provides care at the facility has remarked to a colleague, "It's a real shame, but at least she'll never know what's happening to her." What fact should underlie the colleague's response? A) Older adults with Alzheimer disease and other dementias rarely have insight into their cognitive deficits. B) Many persons with dementia are acutely aware of the fact that they are experiencing a cognitive deficit. C) Certain types of dementia are occasionally marked by older adults' awareness of their disease. D) An awareness of dementia is an indication that the condition is either latent or resolving.
B
A nurse assesses a 66-year-old woman who strained a muscle. The client attends the gym daily, and states, "I injured my muscle grouting the floor tile getting ready for the bridge class I teach." Which of the following categorizes this client's aging? A) Healthy B) Active C) Productive D) Successful
B
A nurse assesses an older adult's abstract thinking ability. Which of the following questions is most appropriate? A) "Do you know why you are in hospital right now?" B) "What do a dog and a cat have in common?" C) "What goals do you have for your treatment and recovery?" D) "What would you do if you found a stamped, addressed letter on the ground?"
B
A nurse differentiates between dementia and depression in an older adult. Which of the following assessment findings leads the nurse to believe that the client has depression? A) The client has socially unacceptable behaviors. B) The client is negativistic. C) The client's mood fluctuates. D) The client's mood is distractible.
B
A nurse has observed an increasing number of older Asian Americans in the hospital. Which of the following statements regarding Asian cultures will best assist the nurse to plan nursing care? A) Asian Americans as a group have lower mortality rates. B) Health is often viewed as a state of physical and spiritual harmony. C) Older Asian Americans are more likely than other Americans to live alone. D) Care of elders is commonly provided in institutional environments such as nursing homes.
B
A nurse has recently begun to provide care to older adults in a large, urban hospital. Having lived until recently in an ethnically homogeneous region, the nurse has begun to recognize the significant differences in priorities and perspectives of clients from other cultural groups and has taken action to learn about these groups. What stage of cultural self-assessment is this nurse demonstrating? A) Unconsciously incompetent B) Consciously incompetent C) Consciously competent D) Unconsciously competent
B
A nurse interviews a client who is 82 years old and has several chronic conditions, including type 2 diabetes and heart failure. The client expresses feeling of more satisfaction with life now than when younger. Which phenomenon is the client expressing? A) Metamemory B) The paradox of well-being C) Crystallized intelligence D) Neuroplasticity
B
A nurse plans culturally competent care for a variety of clients. Which of the following cultures is most strongly tied to the low health status? A) Hispanic in race B) Low socioeconomic status C) Member of LGBT society D) Resident of urban community
B
A nurse reads up on some of the more common cultural groups in the local area. How should the nurse interpret the information that is available about cultural groups? A) Characteristics of cultural groups are normally consistent between every member of that group. B) Cultural generalizations can be useful and accurate, but they do not replace individualized assessment and care. C) It is simplistic and problematic to make generalized claims about members of a particular cultural group. D) It is unjust to categorize individual clients as being members of a specific cultural group.
B
A nurse's colleague states, "Older people who live in the country are a lot healthier than city folk." Which statement by the nurse is most appropriate? A) "The differences aren't large, but rural adults do have better health outcomes than do city dwellers." B) "But chronic conditions are more common among rural adults." C) "Overall, yes. Higher levels of family support translate into longer average life spans for rural adults." D) "Unfortunately, no. And this is mostly attributable to the problem of homelessness."
B
An older adult has been accompanied by an adult child to visit a primary care provider. The child has expressed concern about the client's increasing apathy, isolation, and apparent sadness over the past several months; and the client acknowledges many of the symptoms of depression. Which of the following assessments should the nurse prioritize? A) Functional assessment B) Medication assessment C) Musculoskeletal assessment D) Cardiovascular assessment
B
Which of the following points should the nurse emphasize when educating older adults about memory and cognition? A) Long-term memory loss is normal. B) Using calendars, notes, and imagery can help enhance memory. C) Drinking caffeinated beverages for mental stimulation is a good idea. D) Having a diminished capacity for learning is an inevitable part of growing older.
B
A nurse assesses an older adult using a mini-mental status examination. The client is very slow to respond to the questions. Which of the following conditions may be present and will require follow-up by the nurse? (Select all that apply.) A) Lack of education B) Dementia C) Depression D) Confabulation E) Concrete thinking
B, C
Which of the following sources might nurses use to improve their cultural competence? (Select all that apply.) A) Discuss cultural norms with clients' families. B) Explore the resources in Online Learning Activities. C) Read journals and other references. D) Utilize organizations listed at the end of chapters. E) Write teaching materials in prominent local languages.
B, C, D
A nurse works to protect vulnerable populations and reduce health disparities. Which of the following nursing actions work toward that goal? (Select all that apply.) A) The nurse acknowledges that the clients in subgroups will not change beliefs or actions. B) The nurse communicates a nonjudgmental attitude toward health system beliefs. C) The nurse incorporates clients' belief systems into the plan of care. D) The nurse asks the client how the care system can incorporate the clients' health beliefs. E) The nurse teaches each client about preventive care.
B, C, D, E
An older adult is admitted to a geriatric unit in the hospital. The nurse in the emergency department states that the client is oriented to one only. Which of the following actions should the admitting nurse perform? (Select all that apply.) A) Have a conversation with the client about challenges to cognitive functioning. B) Orient the client to the room, unit, and plan of care. C) Post a calendar with dates crossed off. D) Reassess orientation status. E) Repeat orientation as needed.
B, C, D, E
A nurse assesses a 71-year-old person who has smoked for 43 years. Which of the following is a negative functional consequence of smoking for this person? (Select all that apply.) A) Children are exposed to secondhand smoke B) Low oxygen-carrying capacity C) Abnormal breath sounds D) The ability to run a 5-K race E) Pulmonary disease
B, C, E
An older adult is admitted to the hospital with weight loss and cognitive impairment. To assist in the diagnosis of major depressive disorder, for which of the following should the nurse assess? (Select all that apply.) A) Decreased deep tendon reflexes B) Loss of interest or pleasure C) Psychomotor agitation D) Respiratory difficulty E) Sleep disturbances
B,C,E
A 55-year-old client was recently diagnosed with type 2 diabetes. The client completed a diabetes education class and does water aerobics three times a week. The blood sugar and hemoglobin A1c have improved since losing 20 lb. Which of the following statements best describes this client's actions? A) Activity theory B) Age stratification theory C) Functional consequences theory D) Life-course development theory
C
A 69-year-old has recently been diagnosed with mild cognitive impairment and has asked the nurse to help her remember things better. Which of the following nursing A) Knowledge deficit B) Altered thought processes C) Health-seeking behaviors D) Altered health maintenance
C
A 69-year-old has recently been diagnosed with mild cognitive impairment and has asked the nurse to help her remember things better. Which of the following nursing diagnoses is appropriate for this older adult? A) Knowledge deficit B) Altered thought processes C) Health-seeking behaviors D) Altered health maintenance
C
A client, who retired from work this year, asks the nurse the secret to successful aging. Which of the following responses by the nurse is most helpful? A) "Later life can be a time of engagement, contribution and well-being, you must work to make it so." B) "Life is a bowl of cherries, if you are in the pits, crawl out." C) "Studies show that volunteering and helping others improve satisfaction with life." D) "The body is senescent and you will find you slow down each year."
C
A gerontological nurse conducts an assessment of an older adult who has a history of depression. Assessment reveals that the client has been drinking up to two bottles of wine each day for the last several months. What should the nurse teach the client about alcohol use and depression? A) "If you choose to use alcohol to address your depression, it's best to limit it to four to five drinks each day." B) "We recommend that everyone over the age of 70 abstain from drinking alcohol." C) "Alcohol has been shown to contribute to depression and vice versa." D) "If you quit drinking, your depression will likely improve."
C
A nurse educator teaches about theories of late-life depression. Which of the following statements by a student shows that the material is understood? A) "Adverse events impair your ability to evaluate yourself." B) "Depression is caused by decreased activity in the hypothalamic-pituitary-adrenal axis." C) "Older adults with depression and chronic illness have more serious negative functional consequences." D) "Researchers have identified a cause-and-effect relationship between depression and dementia."
C
A nurse is leading a word-quiz game with a group of nursing home residents because the nurse knows this activity will assist the residents in maintaining: A) Fluid intelligence B) Adaptive thinking C) Crystallized intelligence D) Psychomotor memory
C
A nurse is reviewing the side effects of antidepressants with a group of older adults. Which of the following statements by a member of the group indicates that the nurse's teaching has been effective? A) "I will start on the dose that I will take for life." B) "Fluoxetine should be given in the evening because it may help me sleep." C) "I need to maintain my fluid intake while on antidepressant medication." D) "The length of antidepressant treatment is usually 3 months for a first-time depression."
C
A nurse is using the Functional Consequences Theory as a lens for planning client care in a health care facility. Which of the following is a key element of this nursing theory? A) Most problems affecting older adults may be attributed to age-related changes. B) Most functional consequences cannot be addressed through nursing interventions. C) Wellness is a concept that is broader than just physiologic functioning. D) The Functional Consequences Theory is an alternative to holistic nursing care.
C
A nurse manager justifies the budget for education regarding cultural competency for the staff. Which of the following justifications will best support the need for this education? A) Life expectancies among minorities are expected to increase while those among non-Hispanic whites are expected to decrease. B) Government and health care organizations support the need for culturally competent care. C) The proportion of health care consumers who are minorities continues to increase. D) Nurses have a moral obligation to achieve cultural competency with all cultural groups.
C
An older adult is brought to the community clinic by an adult child with the concern of increasingly frequent lapses in memory. Which assessment question is most likely to identify potential risk factors for impaired cognitive functioning? A) "What did your mother and father die of?" B) "What line of work were you in?" C) "What medications are you currently taking?" D) "Where are you currently living?"
C
When risk factors to potential suicide have been identified, a nurse must further assess the actual risk for a suicide attempt. Which of the following questions would be appropriate for initial assessment to determine the presence or absence of suicidal thoughts in an older adult with risk factors? A) "Under what circumstances would you take your life? Have you ever started to act on a plan to harm yourself?" B) "Do you have a plan for taking your life? What action would you take if you were to harm yourself?" C) "Does your life feel worthless? Do you ever think about escaping from your problems?" D) "Do you think about harming yourself? Do you ever think about committing suicide?"
C
Which of the following are examples of appropriate communication techniques for dealing effectively with people with dementia? A) Ask open-ended questions so the person feels he or she can make choices. B) For people in the later stages of Alzheimer disease, talk as you would to a child. C) Maintain good eye contact and use a relaxed and smiling approach. D) When the person forgets something, remind him or her not to forget next time.
C
A 74-year-old client has recently begun integrating more fresh fruit and vitamin supplements in an effort to increase the levels of antioxidants. This client's actions indicate an understanding of what theory of aging? A) Cross-linkage theory B) Program theory of aging C) Immunosenescence D) Free radical theory
D
A 74-year-old client is diagnosed with mild Alzheimer disease. He has no other noted health issues. When speaking with the nurse, he expresses concern regarding the progression of his disease. Which statement by the nurse is most appropriate? A) As you have no other health issues, the progression is usually gradual. B) The medications stop the progression of the disease. C) We never know how fast Alzheimer disease will progress. D) Yes, progression is usually fairly fast, you might want to start making plans.
D
A gerontological nurse has been providing ongoing care for an older adult who has a diagnosis of dementia. What goal should the nurse prioritize when conducting ongoing assessment of this client? A) Identifying strategies that can be used to cure the client's dementia B) Identifying genetic or lifestyle factors that may have contributed to the client's dementia C) Determining whether the client has Alzheimer disease, Lewy body dementia, or frontotemporal lobe dementia D) Identifying factors affecting the client's functioning and quality of life
D
A nurse assesses an older adult's insight regarding the care plan. What question may the nurse ask to gauge the client's insight? A) "Where would you go if you were discharged from the hospital today?" B) "How would you spend $100 if you were given it today?" C) "What are the similarities between a doctor and a nurse?" D) "Why do you think that your doctor admitted you to the hospital?"
D
A nurse in a community setting plans wellness outcomes with a 68-year-old female client who desires to participate in a half-marathon run. Which of the following outcomes should the nurse document? A) The client will remain free of disease. B) The client will participate in daily aerobic activity class without falls. C) The client will increase activity until able to run 30 minutes. D) The client will participate in the half marathon that is scheduled in 6 months.
D
A nurse in a long-term care facility organizes a "Healthy Aging" class for residents. Which activity should be prioritized during these classes? A) Present tools that residents can use to develop better psychosocial health. B) Role-play responses to life events that may occur in their near future. C) Assess group members' strategies used to deal with life events. D) Discuss coping strategies helpful in adjusting to challenges of aging.
D
A nurse in the long-term care facility plans care to improve quality of life. Which of the following actions is most likely to enhance the older adult's connectedness? A) Teaching a client who has had a below-the-knee amputation how to care for his stump B) Organizing a client's intravenous antibiotic therapy on an outpatient basis C) Performing a focused respiratory assessment on a client who has a diagnosis of lung cancer D) Advocating for a husband and wife to remain in the same room of a long-term care facility, as is their preference
D
A nurse is teaching a colleague about the difference between age-related changes and risk factors. Which of the following examples should the nurse use when discussing age-related changes? A) An older adult with a diagnosis of diabetes mellitus B) An older adult who is obese C) An older adult with obstructive lung disease D) An older adult with decreased bowel motility
D
A nurse performs a psychosocial assessment of an older adult living in the community. Which of the following statements best captures the nature of psychosocial assessment? A) It is a formalized psychological test of the individual's condition and needs. B) It aids in identifying and analyzing personality traits of the individual. C) It helps to identify the individual's need for psychiatric care. D) It is a component of holistic nursing care of older adults.
D
A nurse speaks at a staff development in-service. Which of the following statements by a nurse participant shows the need for education? A) "I know that the consequences of racism are still present and they're linked to health disparities." B) "I'm sure the percentage of client-care hours that we spend working with minority clients is bound to increase." C) "There's a huge amount of diversity within the group that's labeled 'Asians and Pacific Islanders.'" D) "It's inaccurate to link the prevalence of particular diseases with particular minority groups."
D
An 80-year-old client was referred to a neurologist after several months of worsening cognitive deficits and has subsequently been diagnosed with Alzheimer disease. Which statement by the nurse to the client's family demonstrates appropriate use of terminology? A) "It's very difficult and stressful when a loved one becomes senile." B) "Even though your parent is demented, we will do all we can to promote his quality of life." C) "This form of organic brain syndrome is a common health problem in the ninth decade of life." D) "We always try our best to foster wellness in persons who have dementia."
D
An older woman returns to her hospital room after abdominal surgery. As the nurse completes her assessment, the client asks the nurse to pin her "prayer cloth" to her pillow. Which of the following interventions is priority? A) Say, "I will pin it on your pillow in a couple of hours after you are stable." B) Ask, "What is the purpose of a prayer cloth? Did you make it?" C) Ask, "What religion do you practice? Did your minister give the prayer cloth to you?" D) Pin the prayer cloth to her pillow since it is an essential part of her spiritual health.
D
Which of the following clients is at highest risk for suicide? A) An 18-year-old who has made an appointment with his primary health care provider B) A 60-year-old with kidney stones C) A 75-year-old woman living with her child and grandchildren D) An 85-year-old man whose spouse died 1 year ago
D
