Older adult MIDTERM MC!!!!
A nursing home is converting to a person-centered culture from an institution-centered culture. Which nursing intervention will be suitable in the new culture? a. Maintain consistent resident assignments. b. Provide structured activities for the residents. c. Assign nursing assistants to perform bathing. d. Determine mealtime on the basis of staffing levels.
a. Maintain consistent resident assignments.
A nurse completing a hospital discharge to home understands that which of the following interventions is most important before discharge? a. Medication reconciliation b. Providing a list of community resources c. Contacting a durable medical equipment facility d. Educating the client on appropriate range-of-motion exercises
a. Medication reconciliation
Which of the following issues in the care of older adults are identified in Healthy People 2020? a. Delineating nursing staffing levels in long term care b. Eradicating pressure ulcers in all care settings c. Identifying minimum levels of training for people who care for older adults d. Instituting mandatory training in identification of elder abuse for all caregivers of older adults
c. Identifying minimum levels of training for people who care for older adults
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. b. Observe skin color. c. Inspect for pocketing.
c. Inspect for pocketing.
An older man is transferred to a hospice facility with end-stage disease. Which is a suitable nursing intervention for this older adult and his family according to the goals of long-term care? a. Decrease the analgesic dose to prevent sedation. b. Provide a basin and towels for morning self-care. c. Inform family members about strict visiting hours. d. Facilitate family rituals related to death and dying.
d. Facilitate family rituals related to death and dying.
The nurse plans care for older adults who are in good health but isolated from their families. If the nurse's goal is to move the adults toward gerotranscendence, which intervention should the nurse use in the plan of care? a. Give a daily tea party for the group. b. Call each family to encourage visiting. c. Assist them to resume midlife patterns. d. Help each person with individual activities.
d. Help each person with individual activities.
A resident's family member is concerned that the resident is not eating adequately and is at risk for malnutrition. The family member says to a nurse, "I heard that there are drugs that can make my mother eat better. Do you think she should be on one?" The best response by the nurse is: a. "Yes, there are some very effective drugs out there. Your mother should be on one of them." b. "Use of drugs results in minimal improvement in appetite and weight gain and can have some serious side effects." c. "There are no drugs that impact appetite or weight gain."
"Use of drugs results in minimal improvement in appetite and weight gain and can have some serious side effects."
An older female patient is reading a large-print magazine and states that reading is difficult for her in the evening. Which intervention should the nurse implement? a. Put a high-intensity lamp at the head of her bed. b. Explain to her that the gray-yellow ring around her cornea, arcus senilis, is interfering with visual acuity. c. Put more powerful tubes in the fluorescent room lights. d. Examine her retinas for signs of damage.
A. Put a high-intensity lamp at the head of her bed.
Which increases the risk for chronic dehydration in older adults? a. Overuse of diuretic agents b. Poor cognitive function c. Dry mucous membranes
b.Poor cognitive function
An older couple who lives in their own home is considering relocating to a continuing care retirement community (CCRC). The wife is independent in activities of daily living and volunteers at a homeless shelter twice a week. The husband recently had a stroke and is undergoing rehabilitation in a long-term care facility. One benefit of a CCRC for this couple is a. for married couples in which one spouse needs more care than the other, a CCRC allows them to live nearby in different parts of the same community. b. a CCRC provides high-quality care at a lower cost than other programs. c. a CCRC provides social and health services to adults who need supervised care in a safe setting during the day.
for married couples in which one spouse needs more care than the other, a CCRC allows them to live nearby in different parts of the same community.
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.
c. Ask the health care provider to describe the purpose of therapy.
Which approach requires the nurse to integrate and balance all aspects of an individual's life into the plan of care? a. Holistic nursing b. Healthy People 2020 c. Maslow's hierarchy of human needs d. Orem's self-care requirements
A. Holistic nursing
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.
A. Nurses should keep records of patients wishes
According to Healthy People 2020, older adults have been identified as a priority, with a goal to improve their health, function, and quality of life. Identify the targeted chronic focus areas for improvement. (Select all that apply.) a. Diabetes b. Arthritis c. Congestive heart failure d. Dementia e. Cancer f. Pressure ulcers
A, B, C, D Diabetes Arthritis CHF Dementia
A nurse is caring for an older patient in the hospital who reports: "I am worried because simple tasks such as balancing my checkbook seem to take me longer. Is there something wrong with me?" The best response by the nurse is: a. "As you age, normal changes in the brain occur that make central processing take longer, so don't worry." b. "You have every reason to be concerned. This is an abnormal finding; we need to contact your physician." c. "As you age, changes in the brain lead to decreased intellectual performance, so don't worry." d. "Any changes in function are a cause for worry. You need to be evaluated immediately."
A. "As you age, normal changes in the brain occur that make central processing take longer, so don't worry.
According to researchers, which characteristic do most centenarians share? a. Female b. Hispanic c. Living in rural areas d. Located in the Midwestern states
A. Female
In differentiating between health and wellness in health care, which of the following statements is true? a. Health is a broad term encompassing attitudes and behaviors. b. The concept of illness prevention was never considered by previous generations. c. Wellness and self-actualization develop through learning and growth. d. Wellness is impossible when one's health is compromised.
A. Health is a broad term encompassing attitudes and behaviors
An older man asks a nurse: "How do you define aging? Do I meet the criteria of a senior citizen?" The nurse understands that one can define aging in many different manners. If the nurse chooses to define aging as "social aging," the nurse would consider which of the following aspects? a. The man retired from his job as a police officer. b. The man takes six different medications multiple times over the course of the day. c. The man walks with a rolling walker. d. The man celebrated his 65th birthday.
A. The man retired from his job as a police officer
The family member of a patient asks a nurse if vitamin C will prevent aging. In formulating a response, the nurse considers which of the following theories? a. Free radical theory b. Immunological theory c. Oxidative stress theory d. Telomere theory
A. free radical theory
The latest trends in medicine encourage health care providers to prescribe nutrient-dense foods and exercise to prevent or delay the shortening of telomeres. On which biological theory of aging are these practices based? a. Genetic research b. Caloric restriction c. Oxidative stress d. Cross-link
A. genetic research
In which context are members of a cohort described when using the age-stratification theory to explain the effect of similar events, conditions, and circumstances? a. Historical b. Biological c. Sociological d. Chronological
A. historical
Identify the Healthy People 2020 emerging issues in the health of older adults. (Select all that apply.) a. Coordinating care for the older adult population b. Assisting older adults in the management of their own care c. Identifying levels of training for those caring for older adults d. Making community resources available for older adults e. Increase in health disparities for rural older adults
ABC a.Coordinating care for the older adult population b.Assisting older adults in the management of their own care c.Identifying levels of training for those caring for older adults
Which nursing intervention is a holistic approach to an older adult? a. Performs glucose testing during the weekly worship service b. Wheels ambulatory adults to exercise when running late c. Assigns female nurses to older women who are Islamic d. Allows older adults in a nursing home to eat meals alone
c. Assigns female nurses to older women who are Islamic
The nurse prepares an older woman, who is Polish, for discharge through an interpreter and notes that she becomes tense during the instructions about elimination. Which intervention should the nurse implement? a. Move on to the discussion about medication. b. Ask the older woman how she feels about this topic. c. Instruct the interpreter to repeat the instructions. d. Have the older woman repeat the instructions for clarity.
B. Ask the older woman how she feels about this topic
Which health belief system uses treatments to repair a body part? a. Holistic b. Biomedical c. Personalistic d. Magicoreligious
B. Biomedical
The nurse plans activities for older women born between 1920 and 1930 and who reside in an assisted-living facility. Which is the best intervention for the nurse to implement? a. Have them bake cookies twice a week. b. Conduct interviews for specific interests. c. Arrange dog and cat visits from volunteers. d. Take them to the library for guest speakers.
B. Conduct interviews for specific interests
An older married couple move to a continuing care retirement community. The older woman who was always very social and outgoing quickly joins an exercise group, a book club, and a knitting circle. The older man who was always very solitary adopts a routine of a long daily walk and registers for an online course in creative writing. The behaviors of the older couple are consistent with which theory of aging? a. Activity theory b. Continuity theory c. Social exchange theory
B. Continuity theory
Which age-related change contributes to anorexia and weight loss in older adults? a. Excessive saliva b. Fewer taste buds c. Wearing dentures d. Softened tooth enamel
B. Fewer taste buds
Which is the fundamental difference between Medicare Parts A and B? a. Hospice care b. Health care setting c. Home care services
B. Healthcare setting
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. Free radical theory b. Immunologic theory c. Oxidative stress theory d. Telomere theory
B. Immunologic
Which of the following is a true statement about differing health belief systems? a. Personalistic or magicoreligious beliefs have been superseded in Western minds by biomedical principles. b. In most cultures, older adults are likely to treat themselves using traditional methods before turning to biomedical professionals. c. Ayurvedic medicine is another name for traditional Chinese medicine. d. The belief that health depends on maintaining a balance among opposite qualities is characteristic of a magicoreligious belief system.
B. In most cultures, older adults are liekly to treat themseleves using traditional methods before turning to biomedical professionals
The holistic health movement has impacted health care in which of the following ways? a. It has focused health care on disease prevention. b. It has reshaped how health and health care are perceived. c. It has improved access to health care. d. It has introduced numerous alternative modalities into health care.
B. It has reshaped how health and health care are perceived
A nurse is caring for a culturally diverse patient who has missed follow-up appointments with the primary care provider three times over the past year. The patient has a chronic illness that requires periodic monitoring of blood test values. The patient tells the nurse: "You don't understand—in my culture, we don't do things like that. I cannot be troubled with worrying about appointments in the future; I deal with each day as it comes." The nurse understands which of the following about the patient's culture? a. The culture does not value Western medicine. b. The culture has a different orientation to time than Western medicine. c. The culture is an interdependent culture. d. The culture does not believe in preventative care.
B. The culture has a different orientation to time than Western medicine
The term health disparity is defined as a. the systematic elimination of the culture of another resulting in decreased wellness. b. differences in health outcomes among groups. c. the difference between an expected incidence and prevalence and that which actually occurs in a comparison population group. d. the existence of more than one group with differing values and perspective.
B. differences in health outcomes among groups
Which change in the skin is abnormal in an older person? a. Thinner and more fragile skin b. Red, swollen 3-day-old wound c. Greater number of freckles d. Loss of hair on the extremities
B. red, swollen 3 day old wound
An older patient learns that she has metastatic cancer. The patient states: "I must have angered God." This is an example of which type of belief? a. Biomedical b. Magicoreligious c. Naturalistic d. Ayurvedic
B.Magicoreligious
Researchers hypothesize that most super-centenarians survive and are in good health due to which of the following factors? (Select all that apply.) a.They have a different genetic makeup than other older adults have. b.They tend to live in wealthier areas of the world. c.The exact cause of this phenomenon is not known. d.Contributing factors to their good health include quality medical care and improved social conditions. e.They have large extended families to assist in their care.
C,D C. The exact cause of this phenomenon is not known D.Contributing factors to their good health include quality medical care and improved social conditions.
An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg and refuses to remain in the bed. Which intervention should the nurse use to promote and maintain his health? a. Have the health care provider speak to him. b. Use principles of the holistic health system. c. Ask about his perceptions and treatment ideas. d. Consult with a practitioner of Chinese medicine.
C. Ask about his perceptions and treatment ideas
Which racial or ethnic group has the highest life expectancy in the United States? a. Native Americans b. African Americans c. Hispanic Americans d. Asian and Pacific Island Americans
C. Hispanic Americans
The nurse plans care for an older African American man who is from Jamaica and resides in New York City. Which should the nurse include in planning care? a. Attribute his illness to breaking a voodoo. b. Help him improve social relationships. c. Maintain blood pressure below 120/70 mm Hg. d. Review the principles of the magicoreligious system.
C. Maintain blood pressure below 120/70
Which statement is true about living arrangements for older adults? a. Older adults are more independent in their own homes than in a residential community. b. The increase in real estate values makes home ownership essential to security. c. The Program for All-Inclusive Care for the Elderly (PACE) is a community alternative to nursing home care for frail older adults. d. Florida is an example of a naturally occurring retirement community (NORC).
C. The Program for All-Inclusive Care for the Elderly (PACE) is a community alternative to nursing home care for frail older adults.
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
Calcium, 1200 mg, and vitamin D, 600 to 800 units
The nurse observes older women learning advanced knitting techniques. The nurse concludes that this learning activity is suitable for these women because it accomplishes which of the following? a. Helps maintain joint flexibility b. Improves the group's cohesiveness c. Provides a needed social opportunity d. Adds to their existing knowledge base
D. Adds to their existing knowledge base
A man is terminally ill with end-stage prostate cancer. Which is the best statement about this man's wellness? a. Wellness can only be achieved with aggressive medical interventions. b. Wellness is not a real option for this client because he is terminally ill. c. Wellness is defined as the absence of disease. d. Nursing interventions can help empower a client to achieve a higher level of wellness.
D. Nursing interventions can help empower a client to achieve a higher level of wellness
An older man who resides in a nursing home has a total cholesterol level of 245 mg/dL. Which nursing intervention is most likely to assist this man in achieving his highest level of wellness? a.Instruct him about increasing dietary fiber. b.Ask the health care provider for a low-fat diet. c.Schedule a consultation for him with the dietitian. d.Review a menu with him to choose suitable foods.
D. Review a menu with him to choose suitable foods
Which action should the nurse take when addressing older adults? a. Speak in an exaggerated pitch. b. Use a lower quality of speech. c. Use endearing terms such as "honey." d. Speak clearly.
D. Speak clearly
Which of the following considerations is most likely to be true when working with an interpreter? a. An interpreter is never needed if the nurse speaks the same language as the patient. b. When working with interpreters, the nurse can use technical terms or metaphors. c. A patient's young granddaughter who speaks fluent English would make the best interpreter because she is familiar with and loves the patient. d. The nurse should face the patient rather than the interpreter.
D. The nurse should face the patient rather than the interpreter
4. Historical influences that have shaped the lives of the majority of the in-between cohort in the United States today include which of the following? a. Influenza epidemic of 1918 b. World War I c. Child rearing in the Depression d. World War II
D. World War II
The nurse at a nursing home wants to help decrease the risk of Alzheimer's disease (AD) in the residents. Which should the nurse do to implement this goal? a. Keep the curtains open in their rooms. b. Offer beads for them to string on yarn. c. Show movies that the residents choose. d. Assist residents with ambulation to meals.
D. assist residents with ambulation to meals
Aging ordinarily leads to decreases in which of the following? a. Creatinine clearance and insulin secretion b. Blood carbon dioxide and saliva production c. Left ventricle-wall thickness and skin healing time d. Serum triiodothyronine (T3) and gastric pepsin
D. serum triiodothyronine and gastric pepsin
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.
Dentures should be cleaned once a day by brushing and soaking in a cleaning solution.
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.
Draw on the availability of family members who are able to follow instructions.
An older adult wants to appoint an attorney in fact with le power of attorney (DPA) for a specific period around a forthcoming surgery. Which should the nurse implement? a. Help the patient find a qualified attorney. b. Explain the legal rights and responsibilities of an attorney in fact with a DPA. c. Suggest using a guardian for the surgical period.
a. Help the patient find a qualified attorney.
A nurse is caring for an older adult who asks the following: "I have heard that it is important to eat a diet that is high in fruits and vegetables to age successfully. Is that correct?" The nurse considers which of the following theories of aging when responding to the older adult's question? a. Oxidative stress theory b. Immunological theory c. Free radical theory d. Telomere theory
Free radical theory
An older person who is cognitively intact and has decision-making capacity makes a decision to stop chemotherapy for breast cancer after being told of further spread of the cancer. The patient's daughter is upset at her mother's decision and approaches the nurse, stating: "I don't agree with my mother's decision to stop treatments. I am her health care proxy. I want to override her decision." The best response by the nurse is: a. "I understand why you are so upset. I don't think she is doing the right thing either. Let us think together how we can change her mind." b. "Health care proxies only come into play when the individual can no longer make her or his own decisions. Your mother is able to make her own decisions. I suggest you talk with her." c. "As the health care proxy, you are the one who makes the decisions. Let's call your mom's doctor."
Health care proxies only come into play when the individual can no longer make her or his own decisions. Your mother is able to make her own decisions. I suggest you talk with her."
Which of the following statements is true about health care costs for older adults in the United States? a. Older adults become eligible for full Medicaid benefits upon reaching the age of 65 years. b. Medicare Part A covers physician visits, and Part B covers prescription drugs. c. Health maintenance organizations (HMOs) can obtain an exemption from Medicare's per capita spending limit.
Health maintenance organizations (HMOs) can obtain an exemption from Medicare's per capita spending limit.
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.
Provide nutritious food according to the residents' expressed food preferences with a liberal use of seasonings that do not exceed any sodium restrictions.
Decreased functioning of which physical structure is likely to result in decreased metabolism in older adults? a. Kidney b. Thyroid gland c. Brain d. Skeleton
THYROID GLAND
An older female resident in the residential facility keeps a large collection of personal items and photographs of her late husband on her bedside table, but the nursing assistant and resident frequently argue about this. Why should the nurse intervene between the resident and the nursing assistant? a. The resident is attempting to maintain her sense of personal space. b. The resident needs to accept the reality of her spouse's death. c. The resident's argumentative nature can indicate early dementia. d. Clutter from all the personal items is a safety and liability risk.
The resident is attempting to maintain her sense of personal space.
The principle of substituted judgment is defined as a. a surrogate makes a decision based on the surrogate's personal choice in a similar situation. b. a surrogate makes a decision based on what he or she believes the person would have made if he or she were able to do so. c. a surrogate finds an alternate individual to make the decision if he or she is uncomfortable with the situation.
a surrogate makes a decision based on what he or she believes the person would have made if he or she were able to do so.
When an older adult is considering long-term care insurance (LTCI), which is an important consideration? a. Carefully scrutinize all exclusions before enrolling. b. Apply at the oldest age possible for lower rates. c. Avoid purchasing LTCI through a group policy.
a. Carefully scrutinize all exclusions before enrolling.
Which of the following statements describing oral care for the older population is correct? a. Regular dental examinations can prevent tooth loss and improve the ability to chew healthful foods. b. Losing one's teeth is considered a normal part of the aging process. c. Oral malignancies seldom occur in older adults, so oral examinations are of low priority.
a. Regular dental examinations can prevent tooth loss and improve the ability to chew healthful foods.
Which gerontological nursing organization welcomes nurses from all educational backgrounds? a. The National Gerontological Nursing Association (NGNA) b. The National Conference of Gerontological Nurse Practitioners (NCGNP) c. The National Association of Directors of Nursing Administration in Long-Term Care (NADONA/LTC) d. The American Society on Aging (ASA)
a. The National Gerontological Nursing Association (NGNA)
Which of the following is a true statement about fluid intake for older adults? a. Daily total volume should be 1500 to 2000 mL. b. Coffee is a suitable beverage for maintaining hydration. c. Caffeinated beverages are sometimes preferable to water.
a. daily total volume should be 1500 to 2000
Which process is increased in the early morning? a. Fibrinolytic activity b. Blood plasma c. Asthma symptoms
a. fibrinolytic activity
An older patient presents to the geriatric practice with a 3-day history of cough and fever. The patient states: "I am feeling weak and coughing a lot." The patient's vital signs are blood pressure, 120/86 mm Hg; oxygen saturation, 92% SpO2; heart rate, 22 beats/min; and temperature, 38.6°C. The patient's chief complaint is a. "I am feeling weak and coughing a lot." b. elevated blood pressure and fever. c. a 3-day history of cough and fever.
a. i am feeling weak and coughing a lot
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
a. requires complex health care
Which one of the following is connected with the nursing home reform mandated by a 1987 law? a. Resident Assessment Instrument (RAI) b. Health Insurance Portability and Accountability Act (HIPAA) c. Outcomes and Assessment Information Set (OASIS) d. Fulmer SPICES
a. resident assessment instrument
An older woman retires after a long career as an elementary school principal and begins to volunteer in the local library reading to children. The older woman is very pleased with her volunteer activities. This is consistent with which theory of aging? a. Role theory b. Disengagement theory c. Age-stratification theory d. Social exchange theory
a. role theory
An older patient who was just diagnosed with a terminal disease states, "All my life I attended church, but I am still worried about what will happen after death." The nurse's best response is which of the following? a. "The unknown may be frightening. Do you want to talk about this?" b. "Religious people know that God is a good God." c. "People that have had near-death experiences say it is peaceful." d. "You must feel good about attending church most of your life."
a. the unknown may be frightening, do you want to talk about this?
The nurse provides opportunities for nursing home residents to read aloud to others. Which cognitive skill is this nursing intervention most likely to improve? a. Verbal fluency b. Logical analysis c. Object naming d. Visuospatial skills
a. verbal fluency
A nurse administers the Mini Nutritional Assessment (MNA) to an older patient. The patient is assessed to have a score of 11. The nurse understands which of the following? a. The next step is for the nurse to administer the assessment section of the tool. b. No further action is required at this time. c. Artificial nutrition should be considered.
a.The next step is for the nurse to administer the assessment section of the tool.
Which pharmacokinetic parameter is affected most by decreased intestinal motility related to the aging process? a. Absorption b. Distribution c. Metabolism
absorption
What is the recommended daily intake of fiber for older adults? a. 10 g b. 25 g c. 30 g
b. 25 g
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
b. Decreased motility in the esophagus
Which of the following is true about the Nurse Competence in Aging (NCA) initiative? a. It was developed to support the professional development and leadership growth of nurses who provide care to older adults in long-term care. b. It developed resources for nurses to access evidence-based information on topics related to the care of older adults. c. It provides predoctoral and postdoctoral scholarships for study and research in geriatric nursing. d. It developed the first certification in gerontological nursing.
b. It developed resources for nurses to access evidence-based information on topics related to the care of older adults.
A nurse is considering employment in an assisted living facility (ALF). The nurse understands that which of the following are true about nursing in an ALF? a. A registered nurse (RN) is required to supervise residents 24 hours per day in an ALF in all states in the United States. b. Not all states require an RN in ALFs; however, many do employ RNs. c. An RN is not required to supervise residents in all states in the United States, however, a licensed practice nurse (LPN) is required.
b. Not all states require an RN in ALFs; however, many do employ RNs.
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
b. Plain yogurt
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.
b. Provide oral care every 4 hours.
A nurse is observing a nurse aide perform denture care for a resident in the nursing home. The nurse recommends that the nurse aide receive additional education on denture care when the nurse observes which of the following? a. The nurse aide places a face cloth in the sink and fills the sink half full with water. b. The nurse aide uses toothpaste to clean the dentures. c. The nurse aide uses a specially designed denture brush to clean the dentures.
b. The nurse aide uses toothpaste to clean the dentures.
A nurse in an assisted living facility (ALF) evaluates the application for admission of an elderly woman. The woman is 87 years old, needs assistance with bathing and dressing, and is unable to prepare her own meals or do her own housekeeping. The nurse compares this applicant with the typical residents of an ALF and concludes which of the following? a. This woman is not a typical resident of an ALF and is better suited to a long-term care facility. b. This woman matches the profile of a typical resident in an ALF. c. This woman is not a typical resident of an ALF and is better suited for an adult day care program. d. This woman is not a typical resident of an ALF and is better suited for a Program for All-Inclusive Care for the Elderly (PACE) Program.
b. This woman matches the profile of a typical resident in an ALF.
Which of the following is a true statement about nutrition for older adults? a. Older people 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.
b. Transportation can be a critical factor in nutritional insufficiency in older adults.
An older patient who has a history of atrial fibrillation, myocardial infarction, and hypertension is taking warfarin, aspirin, and a beta blocker is purchasing lunch in the cafeteria after his outpatient appointment. Which of the following meals is most appropriate for this patient? a. Tuna salad on a bed of spinach and a glass of a cup of decaffeinated coffee b. Tuna salad sandwich on whole wheat bread and a cup of decaffeinated coffee c. Tuna and kale salad with a whole wheat roll and a cup of decaffeinated coffee
b. Tuna salad sandwich on whole wheat bread and a cup of decaffeinated coffee
A nurse conducts a comprehensive assessment of an older adult. The nurse uses the Mini-Cog, a valid and reliable assessment tool to assess the individual's mental status. The nurse understands that the benefit of using a standard assessment tool is that: a. a standard assessment tool is required by Medicare and Medicaid. b. a standard assessment tool will increase likelihood of obtaining accurate data. c. a standard assessment tool will increase reimbursement by Medicare and Medicaid.
b. a standard assessment tool will increase likelihood of obtaining accurate data
An older patient with type II diabetes mellitus tells a nurse: "I don't know how I am going to continue with this blood sugar testing. I know it is important, but the strips are so expensive." The nurse formulates a response based on the knowledge that a. diabetic testing supplies are covered by Medicare Part A. b. diabetic testing supplies are covered by Medicare Part B. c. diabetic testing supplies are covered by Medicare Part D.
b. diabetic testing supplies are covered by Medicare Part B.
Mandatory retirement at age 65 years is consistent with which theory of aging? a. Role theory b. Disengagement theory c. Age-stratification theory d. Social exchange theory
b. disengagement theory
A nurse assesses an older woman in an outpatient setting. The patient's height is measured at 5'1" and her weight is recorded as 100 lb. The patient is surprised by her weight and says to the nurse, "I think I lost some weight since last month." The nurse checks the medical record, and 1 month ago, the patient's weight was 106 lb. The next action by the nurse is a. continue to monitor the patient's weight on a monthly basis. b. do a thorough assessment of the patient; this is a significant weight loss and of concern. c. suggest that the patient begin to take in between meal supplements.
b. do a thorough assessment of the patient; this is a significant weight loss and of concern.
Which organization had the largest role in enhancing the specialty of gerontological nursing? a. American Association of Retired Persons (AARP) b. John Hartford Foundation c. Medicare d. Mutual of Omaha Insurance
b. john hartford foundation
Based on current demographic data, which of the following statements identifies a predictive trend regarding the health care needs of society? a. Most nurses will not need to care for older persons. b. More nursing services will be required to serve the needs of the population older than 85 years of age. c. Fewer nurses will be needed to care for older adults. d. Older adults expect their quality of life to be less than that of earlier generations at their ages.
b. more nursing services will be required to serve the needs of the poopulation older than 85
Which of the following statements is true about conservators? a. Whereas a conservatorship entails control over property, a guardianship entails control over the person. b. The most legally restricting way individuals and property can be handled are through conservatorships and guardianships.
b. most legally restricting way individuals and property can.....
An older woman was seen in her physician's office after falling at home. The patient receives a comprehensive assessment, and it is determined that she has a positive urine culture and is started on antibiotic therapy for a urinary tract infection (UTI). The patient is surprised at the diagnosis. The woman reported that she had experienced some pain on urination the previous day but did not think that she had a UTI because her temperature was only 99°F. One reason why the patient may not have developed a higher temperature is a. the patient's UTI was not yet serious enough to cause a significant increase in body temperature. b. normal age-related changes to the immune system function affect an older person's response to illness; a low-grade fever may signify serious illness. c. older adults do not run fevers when they are ill. d. this patient likely has an alteration to her immune system that impacts her response to infection.
b. normal age-related changes to the immune system function affect an older person's response to illness; a low-grade fever may signify serious illness.
An older woman asks a nurse, "You always seem to be telling me that I need to drink more water. How much water do I really need to drink?" The nurse bases her response on the knowledge that: a. older adults should consume at least 1000 mL of fluid per day. b. older adults should consume at least 1500 mL of fluid per day. c. older adults should consume at least 2000 mL of fluid per day.
b. older adults should consume at least 1500 mL of fluid per day.
An older woman is brain dead, and the attorney in fact or surrogate named in her le power of attorney (DPA) is opposed to organ donation; the law in the state allows a surrogate with a DPA to make end-of-life decisions. Although she failed to document it, her family states that she wanted to donate her organs. Given the law about a DPA, what does the nurse expect the surrogate to do? a. Deny consent. b. Provide consent. c. Refuse to decide.
b. provide consent
During a nursing assessment, an older adult tells the nurse about increasing loss of balance. Further assessment indicates musculoskeletal changes. Which patient teaching should the nurse implement to address musculoskeletal reasons for the loss of balance? a. Exercise with light weights. b. Stand on one foot at a time while supported. c. Train with the use of sit-ups. d. Work out in a swimming pool.
b. stand on one foot at a time while supported
An older patient is being discharged from the hospital to a subacute unit. The patient says to a nurse, "I am not sure I understand the difference between a subacute unit and a nursing home. Can you help me understand?" The nurse considers which of the following in formulating a response? a. Subacute care and nursing home care are identical. b. Subacute care is more intensive than traditional nursing home care. c. Subacute care is reimbursed by either Medicaid or private pay.
b. subacute care is more intensive than traditional nursing home care
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
b. vital signs
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?"
c. "How many doses of digoxin (Lanoxin) do you think you missed?"
Which statement is true about residential living for older adults? a. A residential care facility is the new term for a nursing home. b. An assisted living facility (ALF) must have a registered nurse (RN) on staff. c. Administrators are realizing that their duty is to care for the residents as people. d. A "granny flat" is an apartment in a high-rise building reserved for seniors.
c. Administrators are realizing that their duty is to care for the residents as people.
In a long-term care facility, a nurse is having a discussion with the nurse aides about ways to deal with dementia clients who are uncooperative with mouth care. Appropriate methods to use include a. speaking to the client sternly and instructing the client to open the mouth and cooperate immediately. b. having another nurse aide assist in holding the client's mouth open with a tongue depressor. c. involving the client in the process of oral hygiene, such as using the hand-over-hand technique to brush the client's teeth.
c. Involving the client in the process of oral hygiene, such as using the hand-over-hand technique to brush the client's teeth.
Identify the best statement about gerontological nursing. a. Nurses have only recently become involved in the care of older adults. b. Gerontological care was the second specialty in which the American Nurses Association (ANA) offered a certification program. c. Purposes of gerontological nursing include the promotion of health and support for maximal independence. d. ANA certification is available only for gerontological nurses in research positions.
c. Purposes of gerontological nursing include the promotion of health and support for maximal independence.
A resident of a long-term care facility has been asking to have the drain in the bathroom sink repaired for 2 months. The nurse responds by saying that when they move to the new building, the sinks will work very well. Which right of a resident of a long-term care facility has the nurse violated? a. Right to be free of all forms of abuse b. Right to be transferred for appropriate reasons c. Right to voice grievances and have them remedied d. Right to information about conditions and treatments
c. Right to voice grievances and have them remedied
A nurse is conducting a physical assessment of a 90-year-old patient. The nurse understands that special considerations when working with older adults include which of the following? It is important to complete the entire physical assessment at one time, conducting a "head-to-toe assessment." Older adults do not require a "head-to-toe assessment," so an abbreviated assessment should be done. The nurse needs to first direct the assessment to that which is most likely associated with the presenting problem.
c. The nurse needs to first direct the assessment to that which is most likely associated with the presenting problem.
A nurse is assessing an older adult's nutritional status. The nurse understands that which of the following is the most important indicator for a potential nutritional deficit? a. Decreased serum albumin levels b. Decreased vitamin D levels c. Unintentional weight loss
c. Unintentional weight loss
Which is an accurate statement regarding gerontological nursing education? a. Gerontological nursing content has long been integrated into the curriculum of the typical school of nursing. b. Undergraduate nursing programs extensively cover gerontological nursing in dedicated courses, comparable with the coverage of psychiatric nursing. c. When content is integrated throughout a curriculum, less than 25% is devoted to geriatric care. d. Accreditation of a nursing program guarantees that appropriate amounts of gerontological nursing content are included in the curriculum.
c. When content is integrated throughout a curriculum, less than 25% is devoted to geriatric care.
An older patient who is receiving haloperidol (Haldol) is noted to have a change in mental status (increasing confusion). Upon assessment, the nurse notes that the patient has a fever, with temperature,102°F; blood pressure, 92/60 mm Hg; heart rate, 118 beats/min; and respirations, 24 breaths/min. The patient is noted to have rigidity of the upper and lower extremities. The first action of the nurse is to a. administer acetaminophen (Tylenol) for the elevated temperature. b. place the patient on fall precautions because of the rigidity of the lower extremities. c. contact the medical provider immediately.
c. contact the medical provider immediately.
A nurse is caring for an older adult in a nursing home. During medication reconciliation, the nurse notes that the patient is prescribed two medications that are listed on the Beers criteria. What is the best action by the nurse? a. Refuse to administer the medications. b. Substitute an alternate medication of the same drug classification. c. Contact the prescriber and to inform the prescriber that the medications are on the list.
c. contact the prescriber and to inform the prescriber that the medications are on the list
The gerontological nurse collaborates with the wound care team about an older patient who has an ulcer. How is this nurse demonstrating leadership in the care of older people? a. Assessing older adults effectively b. Facilitating access to eldercare programs c. Coordinating members of the health care team d. Empowering older adults to manage chronic illness
c. coordinating members of the health care team
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.
c. explain the document to the patient using an interpreter to ensure understanding
An older woman accompanies her husband to the geriatric clinic. The husband has Alzheimer's disease and needs maximum assistance with activities of daily living. The wife has made the decision to place her husband in a long-term care facility because she is no longer able to care for him. The wife expresses concern about the cost of the long-term care facility and the worry that all of their funds will be used to pay for the facility, leaving no funds for her own care. The nurse formulates a response based on the understanding that a. all of the couple's assets need to be exhausted before becoming eligible for Medicaid. b. it is best for the wife to divorce her husband so she will not have to pay for his care. c. only burial funds and half of the combined value of household goods are used to determine eligibility for Medicaid.
c. only burial funds and half of the combined value of the household goods are used to determind eligibility for medicaid
A nurse is preparing to administer medications to an older patient. The nurse consults the drug reference book, which provides the half-life of the drug. The nurse understands that half-life is defined as a. the amount of time that the drug is stable after prepared. b. the amount of time that it takes for the drug to be excreted by the body. c. the amount of time that the drug remains active in the body.
c. the amount of time that the drug remains active in the body.
An older patient is admitted to the hospital for treatment of pneumonia. The patient has a court-appointed conservator who manages her finances. The nurse understands that a. the patient does not have the capacity to give informed consent for any procedures. b. he or she needs to provide all educational materials to the conservator instead of the patient. c. the presence of a conservator does not mean the patient cannot give informed consent.
c. the presence of a conservator does not mean the patient cannot give informed consent.
A nurse administers hypodermoclysis (HDC) to an older nursing home resident. The purpose of hypodermoclysis is a. to rehydrate an individual with severe dehydration. b. to quickly administer 4 to 5 L of fluid within a 24-hour period. c. to rehydrate an individual with mild to moderate dehydration.
c. to rehydrate an individual with mild to moderate dehydration.
Using the RAI, the nurse identifies a trigger for a male nursing home resident who requires an indwelling urinary catheter from the Minimum Data Set (MDS). Which should the nurse do next? a. Develop an individualized care plan. b. Assign suitable nursing interventions. c. Use the RAPs.
c. use the RAPs
A paper on culture and illness would be likely to include the statement that a. culture is the same as ethnicity. b. ethnic groups always share common geographic origin and religion. c. ethnicity involves recognized traditions, symbols, and literature. d. most members of an ethnic group exhibit identical cultural traits.
c; Ethnicity involves recognized traditions, symbols, and literature.
A nurse is caring for an older client in the community who has a diagnosis of advanced dementia. The client's caregiver reports that over time, the patient has progressively decreased her oral intake and at present is not swallowing the food put in her mouth. The patient's caregiver reports that the primary care provider has contacted her and asked her to consider placement of a feeding tube. The caregiver asks the nurse what considerations they should be thinking about in making the decision. The nurse responds based on the knowledge that a. there are significantly better outcomes in older patients with dementia who have feeding tubes. b. careful hand feeding for patients with advanced dementia is recommended instead of feeding tubes.
careful hand feeding for patients with advanced dementia is recommended instead of feeding tubes.
9. A nurse is caring for an older resident in a long-term care facility who has a history of dementia and is becoming agitated. The best response by the nurse to the patient's agitation is to a. call the prescriber and request an order for a psychotropic medication. b. ignore the behavior because psychoactive medications have potentially dangerous side effects in older patients. c. conduct a thorough nursing assessment of the patient related to the patient's behavior.
conduct a thorough nursing assessment of the patient related to the patient's behavior.
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. "Avoid using chamomile supplements while on anticoagulant therapy."
A health care provider asks the nurse about an older man's durable power of attorney (DPA) because consent is needed for a medically necessary invasive procedure. The patient has end-stage disease, is intubated, and is on mechanical ventilation. Which steps should the nurse implement? a. Refer to the patient's advance directive for a name. b. Assist with obtaining informed consent from the patient. c. Use the oral trail-making test to measure cognitive function. d. Apply the confusion assessment method for critical care.
d. Apply the confusion assessment method for critical care.
The nurse notices that an older adult's urine is greenish-brown. Which step should the nurse implement next? a. Increase oral fluid intake. b. Review laboratory reports. c. Evaluate the medication list. d. Determine fluid volume status.
d. Determine fluid volume status.
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. Multiple physiological changes of aging place older adults at a greater risk of dehydration than middle-aged persons or children.
Managed care systems are most effective for an older adult who does which of the following? a. Avoids using the system until it is really needed in an emergency b. Avoids seeing generalists and seeks health care only from specialists c. Uses high-tech treatments to reduce expenses over the long term d. Seeks regular primary care and preventive strategies to maintain health
d. Seeks regular primary care and preventive strategies to maintain health
Which physiological change in the brain is the reason the nurse allows more time for answering questions with older adults? a. Increased secretion of cholinesterase b. Decreased secretion of neurotransmitters c. Loss of spinal cord and brainstem neurons d. Atrophy of dendrites in the cerebral cortex
d. atrophy of dendrites in the cerebral cortex.
The vision of Nurses Improving Care for Health System Elders (NICHE) is a. to ensure that all older adults are only cared for by nurses who are certified in gerontological nursing. b. to decrease the cost of care for hospitalized older adults. c. to increase access to care for adults age 64 years and older. d. for patients 65 years and older to be given sensitive and exemplary care.
d. for patients 65 years and older to be given sensitive and exemplary care.
The nurse prepares to transfer an older adult to a long-term care facility and calls the facility to give a report. Which nursing actions are the responsibilities of both the transferring nurse and the receiving nurse? a. Incorporating patient goals into the plan b. Ensuring the patient is stable for transfer c. Supplying patient documents for planning d. Providing continuity of care during the transfer
d. providing continuity of care during the transfer
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. resident assessment instrument RAI
