Older Adult Exam 1

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What is the most common type of hearing loss in the older adult? a.) Conductive b.) Presbycusis c.) Otosclerosis d.) Noise induced

b.) Presbycusis

One of the most common visual changes associated with aging is: a.) macular degeneration b.) presbyopia c.) glaucoma d.) cataract

b.) presbyopia

Blurry vision. a.) Cataracts b.) Glaucoma c.) Diabetic retinopathy d.) Macular degeneration

a.) Cataracts

A nurse understands that the pathophysiology of Parkinson's Disease includes which of the following? (Select all that apply.) a.) A deficiency of the neurotransmitter dopamine b.) An inability of the neurons to absorb dopamine c.) A reduction of dopamine receptors d.) An accumulation of Lewy Bodies, especially in the basal ganglia e.) The presence of neurofibrillary tangles and amyloid plaques in the brain

a.) A deficiency of the neurotransmitter dopamine c.) A reduction of dopamine receptors d.) An accumulation of Lewy Bodies, especially in the basal ganglia

A diagnosis of Parkinson's disease is made based on the presence of which of the following symptoms? (Select all that apply.) a.) Rigidity b.) Resting tremor c.) Bradykinesia d.) Orthostatic hypotension e.) Progressive decline in cognitive function

a.) Rigidity b.) Resting tremor c.) Bradykinesia

Peripheral vision loss. a.) Cataracts b.) Glaucoma c.) Diabetic retinopathy d.) Macular degeneration

b.) Glaucoma

Spots where there is no vision. a.) Cataracts b.) Glaucoma c.) Diabetic retinopathy d.) Macular degeneration

c.) Diabetic retinopathy

A nurse is planning a fall prevention education refresher session for the residents of a long- term care facility. The individuals are all cognitively intact and range in age from 80 to 100. The previous education on fall prevention was presented 2 months ago. What special considerations should the nurse take in relation to teaching this group of older adults? (Select all that apply.) a.) Make sure that all pamphlets are in large readable font (14-16 points) and include upper and lower case lettering b.) Start education on falls from the beginning. It is unlikely that anyone remembers previous material c.) Present all the information at once in one long session d.) Ensure that there is adequate lighting in the room and that the temperature is comfortable e.) Provide ongoing positive feedback during the session

A nurse is planning a fall prevention education refresher session for the residents of a long- term care facility. The individuals are all cognitively intact and range in age from 80 to 100. The previous education on fall prevention was presented 2 months ago. What special considerations should the nurse take in relation to teaching this group of older adults? (Select all that apply.) a.) Make sure that all pamphlets are in large readable font (14-16 points) and include upper and lower case lettering d.) Ensure that there is adequate lighting in the room and that the temperature is comfortable e.) Provide ongoing positive feedback during the session

A 75-year-old female asks a nurse "I know I should be moving, but how much is the right amount of exercise for me?" The best response of the nurse is: a.) "You need to engage in 30 minutes of moderate intensity exercise on at least 5 days a week." b.) "You need to engage in at least 30 minutes of moderate intensity exercise every day of the week." c.) "Since you are 75, the recommendations are 30 minutes of moderate exercise three times a week." d.) "There are no specific recommendations for someone of your age; just keep moving."

a.) "You need to engage in 30 minutes of moderate intensity exercise on at least 5 days a week."

An older adult is concerned that if her spouse, who recently suffered a stroke, is placed in a nursing home, "they will take everything in order to pay for his care." What response will the nurse make? a.) "A spouse is allowed to keep a percentage of the family income and cash as well as the family home, car, and personal property" b.) "You should consider transferring the assets to your son so that your husband will qualify for Medicaid" c.) "Have you considered caring for your husband at home since Medicare will cover custodial care at home?" d.) "Are you aware that your children have a legal obligation to provide financial support toward the care of disabled parents?"

a.) "A spouse is allowed to keep a percentage of the family income and cash as well as the family home, car, and personal property"

A nurse demonstrates understanding of the continuity theory when the nurse provides which of the following advice to an older client? (Select all that apply.) a.) "It is important to think about the activities that have been most satisfying for you throughout your adult life and make a plan to continue them" b.) "Since you enjoyed teaching young children so much, perhaps you would enjoy volunteering in the day care center" c.) "It is important to save enough money so that you will have an adequate income during retirement" d.) "It is important to maintain an active lifestyle as you age" e.) "As you get older it is natural to slowly disengage oneself from many activities"

a.) "It is important to think about the activities that have been most satisfying for you throughout your adult life and make a plan to continue them" b.) "Since you enjoyed teaching young children so much, perhaps you would enjoy volunteering in the day care center"

Which statement best demonstrates an older adult's success at achieving self-actualization? a.) "My father was an alcoholic, but he did love us." b.) "I always feel safe when my son is visiting." c.) "My heart problems are better since I had the surgery." d.) "I've been elected president of my service organization again."

a.) "My father was an alcoholic, but he did love us."

When discussing electroconvulsive therapy (ECT) with an older, chronically depressed adult and his family, which statement will the nurse use to support this intervention? (Select all that apply.) a.) "This treatment has been shown to be effective in individuals who have not responded well to antidepressant medications." b.) "ECT has been found to be more effective in older adults than in younger adults." c.) "ECT is a safe intervention for those with psychotic ideation." d.) "While there may be some short-term memory loss, most individuals find that their memory comes back within a few days." e.) "ECT results in a more immediate response to symptoms."

a.) "This treatment has been shown to be effective in individuals who have not responded well to antidepressant medications." d.) "While there may be some short-term memory loss, most individuals find that their memory comes back within a few days." e.) "ECT results in a more immediate response to symptoms."

Based on the census reports of 2010, the typical profile of a centenarian in the United States includes which of the following characteristics? a.) A Caucasian woman who lives in an urban area of a Southern state b.) An African American woman who lives in a rural area of a Southern state c.) A Hispanic man who lives in an urban area of a Midwestern state d.) A Caucasian man who lives in a rural area of a Midwestern state

a.) A Caucasian woman who lives in an urban area of a Southern state

An older adult is diagnosed with Alzheimer's Disease. The nurse knows that this diagnosis is made on the presence of which of the following? (Select all that apply.) a.) A decline from a previous level of functioning b.) Fluctuation of symptoms over the course of a 24-hour period c.) An insidious onset d.) A gradual decline in cognitive abilities e.) The cognitive changes worsen in the evening hours

a.) A decline from a previous level of functioning c.) An insidious onset d.) A gradual decline in cognitive abilities

Primary prevention strategies for older adults include which of the following? (Select all that apply.) a.) An annual influenza immunization clinic b.) A smoking cessation program c.) A prostate screening program d.) A cardiac rehabilitation program e.) A meal planning education program for type 2 diabetics

a.) An annual influenza immunization clinic b.) A smoking cessation program

Which description would be most characteristic of a self-actualized individual? a.) An economically disadvantaged older black man who regularly checks out books from the local library to read to neighborhood children b.) A wealthy white older woman who is constantly searching for a better laxative c.) A middle-class white man who was forced into an early retirement and is living in fear of being evicted from his apartment d.) The older wife of a famous celebrity who travels the world but starves herself and seeks plastic surgery in her quest to fight the physical signs of aging

a.) An economically disadvantaged older black man who regularly checks out books from the local library to read to neighborhood children

A nurse is planning an education program on wellness in a local senior citizen center. The nurse plans to provide education on the importance of immunizations, annual physical examinations, screening for diabetes, and vision and hearing screening. It is important for the nurse to understand which of the following? a.) Approximately 40% of older adults (ages 65 and older) utilize available preventive services b.) Preventive strategies are more widely used in the 40-64 age group than in the 65 and over age group c.) The research on health promotion strategies in older adults demonstrates that they have low efficacy d.) There is an abundance of research specific to health promotion and aging

a.) Approximately 40% of older adults (ages 65 and older) utilize available preventive services

Which intervention best demonstrates that the nurse understands the spiritual needs of a terminally ill client? a.) Arranging care so that the client's prayer time is not interrupted b.) Assuming the responsibility of notifying the hospital chaplain of the client's admission c.) Providing the client with the schedule of religious services offered in the chapel d.) Suggesting that the family attend worship services with the client whenever possible

a.) Arranging care so that the client's prayer time is not interrupted

An older adult client has been voluntarily admitted for treatment of alcohol dependency. In implementing care, the nurse plans which intervention based upon knowledge about alcohol and aging? a.) Assessing the client for both depression and anxiety b.) Discussing the poor prognosis of this disorder with the client c.) Explaining the need for proper nutrition to minimize the effects of alcoholism d.) Identifying the effects of chronic alcoholism on the human body

a.) Assessing the client for both depression and anxiety

A nurse is developing an educational session for a group of older adults at a senior center. Which of the following would the nurse include in the education? (Select all that apply.) a.) Attention span, language, and communication skills typically remain stable with increasing age b.) Older brains slow down and take longer to process constantly increasing amounts of information c.) In order to preserve brain function, it is important to engage in challenging cognitive activities d.) Older adults are not able to develop new cognitive abilities e.) Individuals over age 100 have a higher prevalence of dementia than younger individuals

a.) Attention span, language, and communication skills typically remain stable with increasing age b.) Older brains slow down and take longer to process constantly increasing amounts of information c.) In order to preserve brain function, it is important to engage in challenging cognitive activities

A nurse caring for an older hospitalized woman is concerned about promoting functional status. Which of the following interventions should the nurse include in this patient's plan of care? (Select all that apply.) a.) Conduct a baseline functional status assessment of the patient b.) Request a physical therapy referral c.) Make sure that the patient has all activities of daily living performed for her d.) Progressive mobility interventions e.) Encouraging the patient to feed herself

a.) Conduct a baseline functional status assessment of the patient b.) Request a physical therapy referral d.) Progressive mobility interventions e.) Encouraging the patient to feed herself

Which activity assures the nurse that the client's wish to "leave a living legacy" has been accomplished? a.) Donating his body to the local teaching hospital for research purposes b.) Discussing his experiences as a World War II veteran in Europe to a reporter c.) Keeping a journal to be passed on to his great-grandchildren d.) Making a pilgrimage to a location with personal religious significance

a.) Donating his body to the local teaching hospital for research purposes

A nurse is assessing a patient's activities of daily living. The nurse will assess which of the following? (Select all that apply.) a.) Eating b.) Continence c.) Toileting d.) Self-medication administration e.) Bathing

a.) Eating b.) Continence c.) Toileting e.) Bathing

A nurse is assisting an older adult to cope with the loss of a spouse. The nurse encourages the person to use an emotion-focused coping strategy. Which of the following actions should the nurse take? (Select all that apply.) a.) Encourage the person to cry if he or she feels like it. b.) Teach the person relaxation breathing exercises. c.) Encourage the person to make an action plan for the future. d.) Suggest that the person reach out to his or her clergyperson. e.) Suggest that the person attend a yoga class.

a.) Encourage the person to cry if he or she feels like it. b.) Teach the person relaxation breathing exercises. e.) Suggest that the person attend a yoga class.

A nurse is caring for an 85-year-old male client with diabetes in a community setting. The nurse promotes functional wellness by which of the following activities? a.) Encouraging the client maintains current levels of physical activity b.) Assisting the client to receive all the recommended preventive screenings that are appropriate for his age group c.) Teaching the patient how to use a rolling walker so that he can ambulate for longer distances d.) Encouraging the client to attend his weekly chess games

a.) Encouraging the client maintains current levels of physical activity

An older client admitted to the hospital after having sustained a fall at home is diagnosed with a right hip fracture and experienced a surgical reduction of the fracture. At 2:30 AM, she awakens from sleep insisting that her daughter is in the other room and wants to see her. Attempts to reorient her to the surroundings are unsuccessful. In reviewing the client's record, what data would be considered a primary risk factor for the delirium? a.) History of dementia b.) Death of the client's husband last month c.) The client's age d.) History of cardiac disease

a.) History of dementia

A nurse at a senior center promotes activity by leading exercise programs. Which of the following is a benefit of such exercise? a.) Improvement of mood b.) Cardiovascular stress c.) Painful and stiff joints d.) Depression

a.) Improvement of mood

An older female resident of an assisted living facility says the following to a nurse: "I am very frightened about getting dementia. I have read a lot about brain exercises, but I am not sure what I should be doing." The nurse formulates a response based on knowledge of which of the following? (Select all that apply.) a.) Individuals should engage in some type of brain fitness activity a couple of times a week for at least 25 minutes b.) Brain fitness activities are only effective if an individual has not experienced any memory problems at all c.) Brain fitness activities may include computer-based games, memory training, board games, reading, and engaging in conversation d.) Physical activity is important for wellness but is unrelated to brain fitness e.) Individuals should choose brain exercise activities that are unfamiliar, challenging, and fun

a.) Individuals should engage in some type of brain fitness activity a couple of times a week for at least 25 minutes c.) Brain fitness activities may include computer-based games, memory training, board games, reading, and engaging in conversation e.) Individuals should choose brain exercise activities that are unfamiliar, challenging, and fun

The nurse managers of the geriatric and pediatric units arrange an intergenerational holiday party. The rationale for arranging such a partnering is based on which principle? (Select all that apply.) a.) Intergenerational activities can help all participants establish new relationships. b.) Intergenerational activities are required by state and local geriatric regulatory agencies. c.) Intergenerational activities provide the units with an opportunity to improve interagency cooperation. d.) Intergenerational activities are beneficial for older adults because they can decrease isolation and foster a sense of meaning and purpose. e.) Intergenerational activities provide youngsters with an opportunity to interact with older adults.

a.) Intergenerational activities can help all participants establish new relationships. d.) Intergenerational activities are beneficial for older adults because they can decrease isolation and foster a sense of meaning and purpose. e.) Intergenerational activities provide youngsters with an opportunity to interact with older adults.

When educating an older adult about Medicare Part D, which information will be included? (Select all that apply.) a.) It is an elective prescription drug plan with associated out-of-pocket premiums. b.) All persons with either Medicare Part A or B can voluntarily purchase a Medicare Part D prescription drug plan. c.) The plan covers all costs of drugs after a deductible is paid. d.) The plan is not available for individuals who are receive both Medicaid and Medicare. e.) This prescription drug plan requires client co-payments.

a.) It is an elective prescription drug plan with associated out-of-pocket premiums. b.) All persons with either Medicare Part A or B can voluntarily purchase a Medicare Part D prescription drug plan. e.) This prescription drug plan requires client co-payments.

An older patient is concerned that her neighbor was recently diagnosed with Alzheimer's Disease and asks a nurse what can be done to decrease the risk of Alzheimer's Disease. The nurse includes which of the following in the response to the patient? (Select all that apply.) a.) Maintain blood pressure within normal limits b.) Smoking cessation c.) Maintain control of blood sugar (hemoglobin A1C ≤7) d.) Eliminate fats from the diet e.) Maintain ideal body weight

a.) Maintain blood pressure within normal limits b.) Smoking cessation c.) Maintain control of blood sugar (hemoglobin A1C ≤7)

A 77-year-old client recently lost her husband to a chronic progressive neurological disease. She has a history of osteoarthritis and hypertension and was newly diagnosed with metastatic gastric cancer. She sold her home and moved to another state to be closer to her children, but she misses her many close friends. What makes her at risk for spiritual distress? (Select all that apply.) a.) Metastatic cancer b.) Age (77) c.) Moving far away from other family and friends d.) Loss of a spouse e.) Chronic conditions: hypertension and arthritis

a.) Metastatic cancer c.) Moving far away from other family and friends d.) Loss of a spouse

A nurse is planning care for a group of super-centenarians in an assisted living facility. The nurse considers which of the following? a.) Most super-centenarians are functionally independent or require minimal assistance with activities of daily living b.) The majority of super-centenarians have cognitive impairment c.) The number of super-centenarians is expected to decrease in coming years as a result of heart disease and stroke d.) It is theorized that super-centenarians survived as long as they have due to genetic mutations that made them less susceptible to common diseases

a.) Most super-centenarians are functionally independent or require minimal assistance with activities of daily living

A nurse is conducting an assessment of an older adult in a geriatric clinic. The patient states that he drinks two to three alcoholic beverages daily. The patient has multiple chronic comorbid conditions and is on five different medications. Which of the following medications is the nurse concerned will interact with the alcohol? (Select all that apply.) a.) Naproxen for pain b.) Daily multivitamin c.) Prozac for depression d.) Celebrex for arthritis e.) Toprol XL for hypertension

a.) Naproxen for pain c.) Prozac for depression

A nurse identifies a need to assess a patient's cognitive status. The nurse chooses to use the MMSE. The nurse knows that the patient must have which of the following abilities? (Select all that apply.) a.) Number fluency b.) Familiarity with analog clocks c.) Ability to hear and see d.) Ability to sit up for 10 minutes e.) Ability to speak English

a.) Number fluency b.) Familiarity with analog clocks c.) Ability to hear and see

The "in-between" generation (individuals born between 1915 and 1945) were subject to which of the following health challenges during their childhood? (Select all that apply.) a.) Polio b.) Lack of fluoride in the water causing teeth to be soft and cavity prone c.) "Pigeon Chest," a malformation of the rib cage due to a lack of vitamin D d.) Smallpox e.) HIV/AIDS

a.) Polio b.) Lack of fluoride in the water causing teeth to be soft and cavity prone c.) "Pigeon Chest," a malformation of the rib cage due to a lack of vitamin D

A nurse organizes a health fair for older adults. The nurse's goal is to focus on the six priority areas identified by the National Prevention Council. Which of the following activities should the nurse include? (Select all that apply.) a.) Smoking cessation b.) Depression screening c.) Recognizing elder abuse d.) Cholesterol screening e.) Fitness training

a.) Smoking cessation b.) Depression screening c.) Recognizing elder abuse

An older adult who has a balance disorder and has sustained repeated falls is recommended to start an exercise program. Which of the following exercises would be most beneficial in improving balance in this individual? (Select all that apply.) a.) Yoga b.) Tai Chi c.) Swimming d.) Pilates e.) Weight lifting

a.) Yoga b.) Tai Chi

The FANCAPES assessment tool focuses on the older adult's: a.) ability to meet personal needs to identify the amount of assistance needed. b.) ability to perform instrumental activities of daily living (IADLs). c.) cognitive abilities. d.) level of dementia present.

a.) ability to meet personal needs to identify the amount of assistance needed.

A nurse utilizes the SPICES tool (Sleep disorders, Problems with eating, Incontinence, Confusion, Evidence of falls, and Skin breakdown) to assess an older female patient in the hospital. The nurse notes that the patient has new onset urinary incontinence. The first action by the nurse is to: a.) conduct a more in-depth focused assessment of the urinary incontinence. b.) call the provider and obtain an order for an antibiotic for a suspected urinary tract infection. c.) send a urine specimen for culture and sensitivity. d.) develop a plan of care with the patient to control episodes of incontinence.

a.) conduct a more in-depth focused assessment of the urinary incontinence.

The nurse 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 the daughter of a client diagnosed with moderate Alzheimer's disease (AD) asks about the possible benefits of enrolling her mother in art classes, the nurse's response is based on the knowledge that: a.) creative activities are not limited to cognitively intact older adults; even individuals with dementia can benefit from creative activities. b.) individuals with dementia who have rational language skills can benefit from creative activities. c.) cognitively impaired elders cannot benefit from creative activities due to altered brain processes. d.) cognitively impaired elders are usually too agitated to participate in creative arts.

a.) creative activities are not limited to cognitively intact older adults; even individuals with dementia can benefit from creative activities.

An older adult is referred to a geriatric nurse practitioner because of changes in memory and reports by family members that "there is something different about her." The nurse practitioner evaluates the older adult for potentially reversible causes for the changes, which include: (Select all that apply.) a.) depression. b.) delirium. c.) osteoporosis. d.) rheumatoid arthritis. e.) medication side effects.

a.) depression. b.) delirium. e.) medication side effects.

The greatest risk for injury for a client with progressed Parkinson's disease is: a.) falls. b.) suicide. c.) bleeding ulcers. d.) respiratory arrest.

a.) falls.

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

a.) free radical theory.

A nurse completes a functional status assessment of an older person using the Lawton IADL instrument, a self-reported instrument. The nurse knows that limitations of self-reported measures include that: (Select all that apply.) a.) individuals tend to overestimate their functional ability. b.) self-reports often differ from that of proxy reports. c.) self-reports are not indicative of small changes in function. d.) self-reports do not provide a valid measurement of function. e.) older adults are not able to complete self-reported measurements.

a.) individuals tend to overestimate their functional ability. b.) self-reports often differ from that of proxy reports.

Differences in the presentation of patients with Neurocognitive Disorder (NCD) Alzheimer's Disease (AD) and NCD Lewy bodies (LB) are: (Select all that apply.) a.) individuals with LB develop motor symptoms, and individuals with AD do not. b.) individuals with AD display impairments in judgment whereas individuals with LB do not. c.) the use of traditional antipsychotic medication is contraindicated for individuals with LB. d.) LB usually occurs in individuals under age 60, and AD occurs in individuals only over age 60. e.) individuals with LB develop language symptoms, and individuals with AD do not.

a.) individuals with LB develop motor symptoms, and individuals with AD do not. c.) the use of traditional antipsychotic medication is contraindicated for individuals with LB.

A nurse is discussing the importance of exercise with a 78-year-old female who states: "I know I should be exercising, but I have arthritis in my knees and it is painful. Can you recommend a type of exercise that would be beneficial and cause me less pain?" Which of the following exercises should the nurse recommend? a.) Tennis b.) Swimming c.) Dancing d.) Use of a treadmill and elliptical machine in the gym

b.) Swimming

A nurse hears a colleague state the following: "Can you believe that Mr. Jones' daughter just bought him a tablet computer? He is 90 years old. It is ridiculous to think that he can learn to use it." The nurse formulates a response based on research that shows: (Select all that apply.) a.) older adults comprise the fastest growing population using computers and the Internet. b.) Internet use is less prevalent in individuals over age 75 than those ages 65-74. c.) older American men are the fastest growing group of social networking site users. d.) older adults use the Internet only for social networking and recreational uses. e.) technology has the potential to improve quality of life for older adults.

a.) older adults comprise the fastest growing population using computers and the Internet. b.) Internet use is less prevalent in individuals over age 75 than those ages 65-74. e.) technology has the potential to improve quality of life for older adults.

Factors that complicate assessment of older adults include: (Select all that apply.) a.) presence of multiple comorbid conditions. b.) atypical presentation of illness. c.) difficulty in differentiating symptoms of disease from normal age-related changes. d.) increase in iatrogenic illness. e.) lack of assessment instruments specific for the older adult population.

a.) presence of multiple comorbid conditions. b.) atypical presentation of illness. c.) difficulty in differentiating symptoms of disease from normal age-related changes. d.) increase in iatrogenic illness.

When assessing an older client for indications of depression, the nurse bases the intervention on the knowledge that: a.) the older client's symptoms may be atypical for the disorder. b.) depression is a common mental disorder among the older population. c.) the older client is generally willing to discuss his or her mental health symptoms. d.) depression is not as commonly seen in this population as are anxiety disorders.

a.) the older client's symptoms may be atypical for the disorder.

The nurse preparing wellness information for older adult clients is promoting interventions consistent with the concepts of the biological theories of aging when suggesting that they: (Select all that apply.) a.) use moisturizers daily to minimize dry skin. b.) discuss the use of antacids to control heartburn with their health care provider. c.) stay active by interacting with family and friends regularly. d.) practice stress reduction techniques on a regular basis. e.) consider getting a yearly influenza vaccination.

a.) use moisturizers daily to minimize dry skin. b.) discuss the use of antacids to control heartburn with their health care provider. d.) practice stress reduction techniques on a regular basis. e.) consider getting a yearly influenza vaccination.

A nurse in a long-term care facility is approached by an older resident who is crying and states: "You need to help me. The mean little men are in my room again. They are watching me from the corner and they are laughing at me. Make them go away." The nurse accompanies the resident to the room and there is no one in the corner of the room. What is the best response by the nurse? (Select all that apply.) a.) "Yup, I see them. Let me call security to haul the men away." b.) "Can you tell me what you are so frightened of?" c.) "I will do my best to keep you safe." d.) "I understand that you are very frightened and upset." e.) "You know that there is no one there. Stop carrying on like this."

b.) "Can you tell me what you are so frightened of?" c.) "I will do my best to keep you safe." d.) "I understand that you are very frightened and upset."

How should the nurse reply when an older adult asks, "How much alcohol is good for you?" a.) "Alcohol isn't good for you so avoid it as a general rule." b.) "Experts in the field recommend only one regular sized drink a day." c.) "It's been said that red wine has health benefits, but that doesn't mean drink a whole bottle." d.) "If you are only drinking on special occasions, limit yourself to two drinks."

b.) "Experts in the field recommend only one regular sized drink a day."

A 70-year-old diabetic patient has just received instruction from a nurse on glucose self- monitoring. He tells the nurse: "I hear that those test strips cost a lot. I am not sure that I can afford anything else. The only health insurance I have is Medicare Parts A and B." The best response by the nurse is: a.) "I am sorry, but Medicaid is the only insurance that covers the cost of diabetic testing supplies." b.) "Medicare Part A will cover the cost of the supplies to manage your diabetes." c.) "Medicare Part B will cover the cost of the supplies to manage your diabetes." d.) "I am sorry, but Medigap insurance is the only insurance that covers the cost of diabetic testing supplies."

b.) "Medicare Part A will cover the cost of the supplies to manage your diabetes."

The daughter of an older hospitalized patient tells a nurse: "I am worried about my father. His memory is sharper when he is at home. He is forgetful, but is functional. Since he has been hospitalized his memory problems are much worse." The best response by the nurse is: a.) "It is common for long-term memory to be more impacted by age-related changes than short-term memory." b.) "Memory changes are often worse when an individual is in an unfamiliar or stressful situation." c.) "Perhaps you are just noticing your father's memory loss now that he is hospitalized." d.) "There is a lot of new information for your father to process here in the hospital; he is overloaded."

b.) "Memory changes are often worse when an individual is in an unfamiliar or stressful situation."

A nurse is using the function-focused care approach to care for a hospitalized older adult. The nurse is assisting the patient to transfer from the bed to a chair. Which of the following statements by the nurse is most congruent with this approach to care? a.) "Place your hands across your chest and let us move you to the edge of the bed." b.) "Place both of your hands on the overbed trapeze and pull yourself up to a sitting position." c.) "How do you get yourself out of bed when you are at home? Why can't you do the same thing here?" d.) "It is taking you a long time to get yourself into a sitting position. Let me help you sit up."

b.) "Place both of your hands on the overbed trapeze and pull yourself up to a sitting position."

An older client in an adult day care program tells the nurse, "I'm very stressed because another neighbor passed away." The most therapeutic response by the nurse is: a.) "What do you mean by 'stressed'?" b.) "Tell me what you did when your other neighbor passed away." c.) "Are you worrying about your own death?" d.) "Let's get involved in some activities and not think about sad things."

b.) "Tell me what you did when your other neighbor passed away."

An older resident in a senior community tells a nurse: "I am really worried. I joined an exercise class, and I just learned everyone's name yesterday, and I cannot remember them all today. Am I developing Alzheimer's disease?" The best response by the nurse is: a.) "You should be concerned. It is very unusual to forget something that you just learned." b.) "There is no reason to be concerned. Short-term memory decreases with age." c.) "Don't worry, a decline in both short- and long-term memory is a normal part of getting older." d.) "Although it is normal to have some changes in memory, forgetting names is very unusual."

b.) "There is no reason to be concerned. Short-term memory decreases with age."

A 70-year-old person who has Medicare Part A only is discussing the cost of health care with a nurse. The nurse understands that Medicare Part A covers the cost of which of the following? (Select all that apply.) a.) Diabetic testing supplies b.) Acute hospitalization semiprivate rooms c.) Intensive care unit hospitalization d.) Skilled rehabilitative nursing care in a health care facility e.) Prescription medications

b.) Acute hospitalization semiprivate rooms c.) Intensive care unit hospitalization d.) Skilled rehabilitative nursing care in a health care facility

What is the role of the nurse in assisting older adults with travel interests? a.) Suggesting that they travel with a seniors' group b.) Addressing arrangements to have medical care, if needed, during their travels c.) Providing information regarding pet care services for their beloved dog d.) Reassuring the client that their concerns about safety are unfounded

b.) Addressing arrangements to have medical care, if needed, during their travels

A nurse is educating a group of older adults on the benefits of an exercise program. The nurse includes education on when not to exercise. Which of the following should the nurse include in the education? (Select all that apply.) a.) Do not exercise if your resting heart rate is over 80 b.) Do not exercise if your blood pressure is greater than 200 systolic and 100 diastolic c.) It is important to wait 30 minutes after a big meal before engaging in vigorous exercise d.) Do not exercise if a joint that you are using to exercise is red, warm, and painful e.) Do not exercise if you have a fever and muscle aches

b.) Do not exercise if your blood pressure is greater than 200 systolic and 100 diastolic d.) Do not exercise if a joint that you are using to exercise is red, warm, and painful e.) Do not exercise if you have a fever and muscle aches

An older adult with suspected Parkinson's Disease has a "challenge test" performed in order to confirm the diagnosis. The nurse understands that a "challenge test" will demonstrate which of the following? a.) Immediate reversal of all symptoms of Parkinson's Disease after administration of levodopa b.) Dramatic improvement of symptoms of Parkinson's Disease after administration of levodopa c.) Dramatic improvement in gait only after administration of levodopa d.) Dramatic improvement in tremor only after administration of levodopa

b.) Dramatic improvement of symptoms of Parkinson's Disease after administration of levodopa

A nursing student is preparing a presentation on the Wellness-Based Model for Healthy Aging. Which of the following concepts should the student include in the presentation? (Select all that apply.) a.) Healthy aging is defined by the absence of physical illness alone b.) Healthy aging is individually defined and can change over time c.) There are many strategies to promote healthy aging that are believed to be helpful but do not have empirical evidence to support them d.) Healthy aging cannot be achieved by only focusing on later life. It is a lifelong process e.) According to this model, an individual with a chronic disease would not be considered healthy

b.) Healthy aging is individually defined and can change over time c.) There are many strategies to promote healthy aging that are believed to be helpful but do not have empirical evidence to support them d.) Healthy aging cannot be achieved by only focusing on later life. It is a lifelong process

Which statement best demonstrates the primary benefit of intergenerational partnering and the activities that it creates? a.) These types of activities can help establish new relationships. b.) Intergenerational activities can foster a sense of meaning and purpose. c.) Such partnering can increase the self-esteem of the younger people. d.) These activities can decrease social isolation in the older people.

b.) Intergenerational activities can foster a sense of meaning and purpose.

When a terminally ill client expresses a need "for something more to help me cope with the pain," the nurse bases the recommendation of meditation on which principle concerning this alternative therapy? a.) It is efficient and usually takes less than 5 minutes to implement. b.) It has been shown to decrease anxiety and depression. c.) It improves cognitive abilities. d.) It has been known to eliminate emotional distress.

b.) It has been shown to decrease anxiety and depression.

The cost of nursing home care is significant. The primary payer for nursing home care is: a.) Medicare. b.) Medicaid and private pay. c.) Long-term care insurance. d.) Medigap insurance.

b.) Medicaid and private pay.

An older adult asks a nurse, "I saw an advertisement and went to a free breakfast to hear about Medicare Advantage Plans. They sound really good, but I am not sure. Are there benefits to joining one?" The nurse relies on which of the following information when formulating a response? (Select all that apply.) a.) All Medicare advantage plans have prescription drug coverage. b.) Medicare advantage plans must cover all services traditionally covered by Medicare Parts A and B. c.) There are no deductibles in Medicare Advantage plans. d.) Medicare advantage plans may provide a cost savings to the member. e.) Members must obtain a referral to see a specialist from an assigned primary care provider.

b.) Medicare advantage plans must cover all services traditionally covered by Medicare Parts A and B. d.) Medicare advantage plans may provide a cost savings to the member. e.) Members must obtain a referral to see a specialist from an assigned primary care provider.

A resident of a long-term care facility is assessed by a nurse upon admission to the facility. The assessment includes a comprehensive health, social, and functional profile. The tool that the nurse utilizes is: a.) Outcomes and Assessment Information Set (OASIS). b.) Resident Assessment Instrument (RAI). c.) Older Americans Resources and Services (OARS). d.) Comprehensive Geriatric Assessment (CGS). e.) Mini Mental Status Examination (MMSE).

b.) Resident Assessment Instrument (RAI).

When comparing the Older American's Resources and Services (OARS) with the Katz Index of ADLs, what is true? a.) The Katz Index and the OARS both measure only ADL performance b.) The OARS is a comprehensive assessment tool that measures ability in five areas; the Katz Index measures only ADL performance c.) The OARS is used only for older adults in the long-term care setting; the Katz Index is used in all settings d.) The OARS is not valid for use in older adults who are cognitively impaired, whereas the Katz Index is

b.) The OARS is a comprehensive assessment tool that measures ability in five areas; the Katz Index measures only ADL performance

A 66-year-old retired professional basketball player is admitted to the hospital for a total knee replacement due to osteoarthritis. In preparing preoperative teaching for this patient, the nurse includes which theory of aging to help him understand how the disease has progressed? a.) Free radical theory b.) Wear-and-tear theory c.) Gene theory d.) Cross-link theory

b.) Wear-and-tear theory

A nurse administers the Short Michigan Alcohol Screening Test Geriatric Version (S-MAST- G) to an older adult. The older adult receives a score of "2." The nurse knows that this score is indicative of: a.) no problem with alcohol. b.) a problem with alcohol. c.) a mild problem with alcohol. d.) a severe problem with alcohol.

b.) a problem with alcohol.

The nurse preparing educational information on common mental health disorders among the older adult population should include: a.) methods for reducing anxiety. b.) a written depression screening tool. c.) local schizophrenia support groups. d.) signs and symptoms of alcoholism.

b.) a written depression screening tool.

A limitation of the Katz Index of activities of daily living (ADLs) is that: a.) completion of the tool requires the joint efforts of the interdisciplinary team. b.) all ADLs are weighted equally. c.) it puts a heavier weight on the cognitive abilities necessary to perform ADLs. d.) it provides a range of performance for each task.

b.) all ADLs are weighted equally.

An older adult has recently experienced a number of stressful life events. The client comes to the ambulatory clinic and tells the nurse that, "On top of all I've had to endure, now I've got this flu!" In rendering care for this client, the nurse recognizes that: a.) the client is exhibiting attention-seeking behaviors to substitute for poor coping skills. b.) crisis and stressful situations may produce emotions that erode the health of the older people. c.) the client is exhibiting learned helplessness as a result of the recent stressors. d.) a period of crisis will ultimately lead to a lower level of physical and mental functioning.

b.) crisis and stressful situations may produce emotions that erode the health of the older people.

The original intent of Social Security was to: a.) provide a hospital insurance plan. b.) minimize the dependency of older members on younger members of society. c.) provide the blind, older adult, or disabled with adequate financial support. d.) penalize women financially for numerous zero wage years while raising children.

b.) minimize the dependency of older members on younger members of society.

A 78-year-old man is being evaluated in the geriatric clinic. His daughter reports that he has been very forgetful lately, and she is concerned that he might be "senile." The advanced practice nurse administers the clock-drawing test and the patient draws a distorted circular shape and places the numbers all on one side of the shape. Based on his performance, the nurse concludes that the patient: a.) probably has Alzheimer's disease. b.) needs further evaluation. c.) probably has delirium. d.) needs a functional status assessment.

b.) needs further evaluation.

An older adult says to the nurse, "I don't know why I can't handle booze like I used to when I was younger." The nurse's response is based on the knowledge that: a.) older adults develop higher blood alcohol levels due to age-related changes in the neurological system. b.) older adults develop higher blood alcohol levels due to age-related changes that alter absorption and distribution of alcohol. c.) older adults develop higher blood alcohol levels due to slowed reaction times. d.) older adults develop higher blood alcohol levels due to cognitive changes.

b.) older adults develop higher blood alcohol levels due to age-related changes that alter absorption and distribution of alcohol.

Gerotranscendence theory posits that: (Select all that apply.) a.) older adults withdraw from society in order to allow the transfer of power to younger individuals. b.) older adults withdraw from society in order to give the individual an opportunity for self-reflection and self-exploration. c.) time and superficial relationships become less important. d.) material possessions have less meaning. e.) status and value of elders is lost because their contributions are no longer valued.

b.) older adults withdraw from society in order to give the individual an opportunity for self-reflection and self-exploration. c.) time and superficial relationships become less important. d.) material possessions have less meaning.

Health literacy is defined as: a.) the capacity to read basic health information in order to make appropriate health decisions. b.) the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions. c.) the capacity to read and write in order to access health care. d.) the capacity to read and execute health care documents.

b.) the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions.

One reason why many "baby boomers" have multiple chronic conditions such as heart disease, diabetes, and arthritis is that: a.) they have less access to medication and other treatment regimens. b.) there was a lack of importance placed on healthy living as they were growing up. c.) they did not have access to immunizations against communicable disease when they were children. d.) they grew up in an era of rampant poverty and malnutrition.

b.) there was a lack of importance placed on healthy living as they were growing up.

In order to focus on the older population with the greatest risk for suicide, the nurse would conduct a depression screening that targets: a.) African American men. b.) white men. c.) white women. d.) African American women.

b.) white men.

The nurse shows an understanding of the error group of aging theories when stating: (Select all that apply.) a.) "Aging occurs differently for the various ethnic groups." b.) "Our genetic makeup is responsible for how we are affected by age." c.) "Aging is a result of mistakes in our RNA and DNA metabolism." d.) "The free radical theory is an example of an error theory." e.) "Aging effects are really random and unpredictable."

c.) "Aging is a result of mistakes in our RNA and DNA metabolism." d.) "The free radical theory is an example of an error theory." e.) "Aging effects are really random and unpredictable."

A nurse is working with an older individual who has recently started an exercise program. The individual tells the nurse, "This exercise thing is really hard, and I absolutely hate walking on a treadmill going nowhere. I think I am going to call it quits." Which of the following responses by the nurse will be most effective in encouraging the individual to remain in the program? a.) "If you stop exercising, you will reverse all the good effects that the exercise accomplished." b.) "I will have to report that to your physician." c.) "What types of exercise do you enjoy doing?" d.) "Most older people hate exercising, but they do it anyways."

c.) "What types of exercise do you enjoy doing?"

Which of the following is considered an eye emergency? a.) Cataract b.) Age-related macular degeneration (wet) c.) Acute angle closure glaucoma d.) DME

c.) Acute angle closure glaucoma

A nurse is caring for an older adult with Parkinson's Disease. The patient is receiving the medication levodopa-carbidopa. The nurse understands that in order to maximize effectiveness, the administration schedule for this medication should adhere to which of the following? a.) Administer with meals only b.) Administer first thing in the morning only c.) Administer on an empty stomach, 30-60 minutes before or 45-60 minutes after a meal d.) Administer with a full 8 ounces of water and have the patient sit upright for thirty minutes after

c.) Administer on an empty stomach, 30-60 minutes before or 45-60 minutes after a meal

A nurse plans programs for older adults in a senior center. She organizes a series of exercise programs. She sets one up for clients ages 65-74, one for clients 74-85, and one for clients over age 85. The nurse is utilizing which theory of aging? a.) Gerotranscendence b.) Activity theory c.) Age-stratification theory d.) Continuity theory

c.) Age-stratification theory

A community health nurse provides an annual flu prevention workshop at a local senior center. The activities include a lecture on preventing infections, which includes hand washing and limiting exposure to individuals who are ill, as well as an influenza immunization clinic. The nurse is basing her activities on what theory of aging? a.) Wear and tear b.) Oxidative stress c.) Autoimmune d.) Free radical

c.) Autoimmune

A married couple retired to a life care community after the husband had heart surgery. The wife has always been physically and socially active and joined an aerobic class, knitting groups, and a book club shortly after moving to the community. She walks on a daily basis and swims twice a week. Her husband spends his days reading and watching television. He was never a social person and enjoys being by himself. Which of the sociological theories of aging best describes the couple? a.) Role theory b.) Disengagement theory c.) Continuity theory d.) Personality theory

c.) Continuity theory

When an older adult is considering long-term care insurance (LTCI), what is important for the nurse to encourage the client to consider? a.) The older one is when applying, the lower the rates will be b.) It is financially better to avoid purchasing LTCI through a group policy c.) It is wise to scrutinize all exclusions before enrolling d.) All policies cover care at home as well as in a long-term care facility

c.) It is wise to scrutinize all exclusions before enrolling

An elder is experiencing severe chronic pain resulting from a terminal illness. Which intervention by the nurse would be most appropriate when he verbalizes a desire to find "some sort of meaning to all of this"? a.) Introduce a sensory distraction, such as television b.) Reassure him that this is normal phase that everyone experiences c.) Listen and help him express his feelings about life and death d.) Ask the doctor to order a psychiatric consult for possible depression

c.) Listen and help him express his feelings about life and death

While the older African American is at the highest risk for developing Alzheimer's disease, the nurse demonstrates an understanding of this disease process's risk factors when assessing this population's: a.) weight and elimination patterns. b.) heart rate and capillary refill status. c.) blood pressure and serum lipid levels. d.) muscle strength and reflex times.

c.) blood pressure and serum lipid levels.

When asked by new parents what the life expectancy is for their African American newborn, the nurse replies that, "2010 statistics indicate that your son: a.) will have a life expectancy of approximately 65 years." b.) can realistically expect to live into his late 80s." c.) has a good chance of celebrating his 75th birthday." d.) is likely to live into his late 90s."

c.) has a good chance of celebrating his 75th birthday."

When an older adult reports experiencing several different stressors over the last 6 months, the nurse demonstrates an understanding of the physiological effects of stress on the body by: a.) assessing the client using the Geriatric Depression Scale (GDS). b.) testing the client's urine for red blood cells. c.) screening the client for abnormally high serum glucose levels. d.) inquiring as to whether the client has lost weight during that time period.

c.) screening the client for abnormally high serum glucose levels.

A nurse who is caring for an older patient with bipolar disorder knows that the patient needs additional education when the patient states: a.) "Bipolar disorder often results in 'a leveling out' of symptoms as one ages." b.) "Relapses in bipolar disorder tend to be precipitated by medical problems." c.) "Older adults with bipolar disorder tend to be 'rapid cyclers'." d.) "Bipolar disorder is the most commonly diagnosed psychiatric disorder in older adults."

d.) "Bipolar disorder is the most commonly diagnosed psychiatric disorder in older adults."

A Navy war veteran is seeking advice about getting treatment for a chronic respiratory problem at the local veterans' hospital. The nurse's initial response is to ask: a.) "Why aren't you considering the local general hospital for the care that you need?" b.) "Are you willing to travel to a veterans' hospital that offers respiratory diagnostic services?" c.) "Have you ever been treated at a veterans' hospital before?" d.) "Is the problem related to something that occurred while you were in the Navy?"

d.) "Is the problem related to something that occurred while you were in the Navy?"

Which of the following are best practices for communicating with older adults? a.) Never assume hearing loss is from age until other causes can be ruled out. b.) Lower your tone of voice, articulate clearly, use a moderate rate of speech. c.) Inappropriate responses, inattentiveness, and apathy may be signs of hearing loss. d.) All of the above

d.) All of the above

Scotoma. Retain peripheral vision, but loss of central vision. a.) Cataracts b.) Glaucoma c.) Diabetic retinopathy d.) Macular degeneration

d.) Macular degeneration

The nurse is aware 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.


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