Adult health exam 1
An older adult reflects, "Why should I go to the gym, I'm going to get fat anyway." Which response by the nurse is most appropriate? A) "Age-related changes are inevitable; however, most problems affecting older adults are related to risk factors, so it's important to do what you can to maintain a high level of functioning." B) "Older adults experience positive or negative functional consequences because of age-related changes." C) "Risk factors do impact consequences, but you can override them." D) "Many problems affecting older adults are based on genetics."
A) "Age-related changes are inevitable; however, most problems affecting older adults are related to risk factors, so it's important to do what you can to maintain a high level of functioning."
A group of nurses is involved in the planning and implementation of a health promotion campaign aimed at older adults. Which of the following questions is the best guide to such a campaign? A) "How can we help older adults maintain wellness as they age?" B) "What can we do to increase life expectancy in our region?" C) "How can we help older adults avoid age-related changes?" D) "What is stopping older adults from living longer lives?"
A) "How can we help older adults maintain wellness as they age?"
A 93-year-old asks the nurse, "I sure would like to live to get that 100 year birthday card from the president." Which of the following responses by the nurse is best? A) "Keeping fit and dealing with stress in a positive way helps your chances of living to be 100." B) "Surviving to 100 is strongly impacted by eating meat, fruits and grains." C) "Those people in your socioeconomic situation have higher chance of living to 100." D) "You have had a cancer and a stroke, so that decreases your chance of surviving to 100."
A) "Keeping fit and dealing with stress in a positive way helps your chances of living to be 100."
A diabetes nurse is providing care for a 73-year-old client who is a regular client of the hospital's out-client diabetes clinic. What assessment question most clearly addresses this client's potential for optimal function? A) "What are some goals that you have for maximizing your level of wellness?" B) "How can we help you to take ownership of your own health?" C) "Is there anything that you're doing that might be exacerbating your diabetes?" D) "How long do you think that you'll be able to live independently?"
A) "What are some goals that you have for maximizing your level of wellness?"
A nurse hears a colleague make the statement, "Most older adults have nothing to worry about financially." Which of the following responses is most appropriate? A) "You have to remember that there's a huge economic disparity among older adults." B) "Actually, the number of older people living below the poverty line has been increasing, not decreasing." C) "This isn't really true now, but it is true that the gaps that disadvantaged groups live with are expected to shrink." D) "This is true for some groups, but not for minorities who are less likely to be living with their relatives."
A) "You have to remember that there's a huge economic disparity among older adults."
A nurse identifies those who are at risk for familial stress. Which of the following persons exemplifies the sandwich generation? A) A 50-year-old who balances the care of an 82-year-old parent and a 20-year-old child B) A 58-year-old whose elderly parents have been forced to live in separate care facilities C) A 72-year-old who deals with own health problems with the care of a grandchild D) An 83-year-old who is the sole caregiver for the 79-year-old spouse
A) A 50-year-old who balances the care of an 82-year-old parent and a 20-year-old child
Active care management is often necessary in order to maintain wellness among older adults. Which of these older adults is most likely to require care management? A) A 90-year-old man who lives alone and has no living family members B) A 77-year-old woman who enjoyed good health until she suffered a severe stroke 3 days earlier C) An 81-year-old resident of a nursing home whose Alzheimer disease is progressing rapidly D) A 90-year-old man who has recently been transferred from an assisted living facility to an acute care setting
A) A 90-year-old man who lives alone and has no living family members
A nursing case manager monitors admissions into an acute care unit. Which of the following clients would be the most appropriate candidate for in-home skilled nursing care? A) A client requiring twice-daily dressing changes for a coccyx wound B) A client who has been admitted to the emergency department with a recent stroke C) A client with reoccurring urinary retention of unknown etiology D) A client who is scheduled for hip replacement surgery tomorrow
A) A client requiring twice-daily dressing changes for a coccyx wound
A nurse uses the Functional Consequences Theory to assess older adults. Which of the following situations best demonstrates the effect of physical environment on the older adult? A) A resident of a care facility experiences a fall because there are not grab bars outside his bathtub. B) A hospital client develops Clostridium difficile-related diarrhea because a care provider did not perform adequate handwashing. C) An older adult cannot afford a wheeled walker and suffers a fall while trying to ambulate using a cane. D) An assisted living resident requires care for emphysema that resulted from a 70 pack-year history of cigarette smoking.
A) A resident of a care facility experiences a fall because there are not grab bars outside his bathtub.
A gerontological nurse is aware that quality of life is an important consideration when assessing the functioning of older adults. What measure should the nurse use when appraising older adults' quality of life? A) Active life expectancy B) Gerotranscendence C) Life expectancy D) Rectangularization of the curve
A) Active life expectancy
A nurse is beginning a new job in an area with a large African American population. Which of the following statements will assist the nurse to understand this ethnic/race culture to better plan nursing care? (Select all that apply.) A) African Americans as a group have a wide range of socioeconomic conditions. B) Female-headed households are common among African Americans. C) Lifestyle and risk factors account for the health disparities with older African Americans. D) Older African Americans are more likely than other older Americans to live alone. E) Older African Americans are more likely to be caring for their grandchildren.
A) African Americans as a group have a wide range of socioeconomic conditions. B) Female-headed households are common among African Americans. E) Older African Americans are more likely to be caring for their grandchildren.
An 85-year-old client takes meals on wheels around the community. The client states, "All those old people really need me, you know how older people are. They can't get out, and are a burden to their family, and I just want to help." Most of the people on the client's delivery route are in their 60s. Which of the following characterizes this scenario? A) Ageism B) Aging anxiety C) Aging attribution D) Antiaging
A) Ageism
A nurse assesses the risk of the members of the community. Which of the following are most likely to be living at or below the poverty line? A) An 83-year-old single woman B) A couple who are both 72 years old C) A white 73-year-old man D) A Hispanic couple in their 60s
A) An 83-year-old single woman
A gerontological nurse is aware that out-of-pocket expenses for care can be onerous for many older adults. Which action can the nurse take to potentially minimize these expenses for clients? A) Become familiar with the various funding sources and their eligibility requirements. B) Teach older adults to be astute with their spending and saving patterns. C) Encourage older adults to make care providers aware of each chronic condition they live with. D) Provide care that is primarily focused on acute, rather than chronic, health problems.
A) Become familiar with the various funding sources and their eligibility requirements.
A nurse assesses older adults in their own home. Which of the following questions are appropriate to include in this assessment of the bathroom? (Select all that apply.) A) Can the person enter and exit the tub safely? B) Does the color of the toilet seat contrast with surrounding colors? C) Does the tub have skid-proof strips or a rubber mat in the bottom? D) Is the height of the toilet seat appropriate? E) Is there a lock for the bathroom door?
A) Can the person enter and exit the tub safely? B) Does the color of the toilet seat contrast with surrounding colors? C) Does the tub have skid-proof strips or a rubber mat in the bottom? D) Is the height of the toilet seat appropriate?
A nurse determines risk factors for an 81-year-old client's plan of care. Which of the following characteristics of the client would the nurse consider as a risk factor? (Select all that apply.) A) Chronic bronchitis B) Loss of bone density C) Decreased vital lung capacity D) Delayed gastric emptying E) Digoxin (Lanoxin) toxicity
A) Chronic bronchitis E) Digoxin (Lanoxin) toxicity
A nurse at a long-term care facility completes a minimum data set on each client. Which of the following categories are included in this assessment/plan of care? (Select all that apply.) A) Cognitive patterns B) Communication and hearing patterns C) Family support D) Mood and behavior patterns E) Psychosocial well-being
A) Cognitive patterns B) Communication and hearing patterns D) Mood and behavior patterns E) Psychosocial well-being
Which of the following actions exemplifies the nurses' role in home care of an older adult? (Select all that apply.) A) Coordinate a multidisciplinary team. B) Perform ADL care for clients. C) Provide resources to caregivers to reduce caregiver stress. D) Refer available community resources. E) Teach about interventions to provide quality care.
A) Coordinate a multidisciplinary team. C) Provide resources to caregivers to reduce caregiver stress. D) Refer available community resources. E) Teach about interventions to provide quality care.
The child of an 81-year-old client asks the nurse about vitamins, antioxidants, and age-related macular degeneration. Which of the following theories of aging is most appropriate to this topic? A) Free radicals theory B) Immunosenescence theory C) Program theory D) Wear-and-tear theory
A) Free radicals theory
A nurse verifies the health belief system of the Puerto Rican older adult client. Which of the following beliefs is this client most likely to hold? A) Health is a gift or reward given as a sign of God's blessing and goodwill. B) Health is obtainable by reaching a mature age. C) Health is the absence of disease. D) Health is the quality of wholeness associated with healthy functioning.
A) Health is a gift or reward given as a sign of God's blessing and goodwill.
A nurse cares for an older adult at risk for a venous stasis ulcer. Which interventions should the nurse include in the teaching with this older adult? (Select all that apply.) A) Health promotion interventions B) Functional consequences C) Wellness outcomes D) Environmental modifications
A) Health promotion interventions D) Environmental modifications
A rural community nurse sets up a monthly disease screening service. Local news coverage chooses not to cover this event. Which of the following justifications best supports the screenings? A) Health promotion is essential for older adults because they have complex health care needs. B) Older adults are less responsive to health promotion interventions. C) Older adults as a group receive fewer prevention and screening services than other populations. D) Preventive services are less effective after the onset of chronic illness.
A) Health promotion is essential for older adults because they have complex health care needs.
Which of the following statements best explains the relevance of psychological theories for gerontological nursing? A) Human needs theory allows the nurse to determine priorities of nursing care for older adults. B) Life span development theories support the belief that it may be difficult to initiate behavioral changes in older adults. C) Psychological theories explain why nurses should focus their discussion more on the present than on the past when talking with older adults. D) Psychological theories explain why reminiscence groups may not be beneficial for older adults.
A) Human needs theory allows the nurse to determine priorities of nursing care for older adults.
Which of the following interventions most closely aligns with the practices of health promotion? A) Leading a flexibility and mobility class among older adults B) Providing presurgical teaching to an older adult prior to hip replacement C) Administering an anti-inflammatory and analgesics to an older adult with osteoarthritis D) Teaching an older adult how to administer her inhaled bronchodilators independently
A) Leading a flexibility and mobility class among older adults
A nurse assesses a client admitted to the subacute care unit. The client is weak and underweight. Which of the following laboratory abnormalities would be related to undernutrition in this client? (Select all that apply.) A) Low albumin B) High hematocrit hemoglobin ratio C) Low serum iron and ferritin levels D) Decreased platelet count E) Elevated sedimentation rate
A) Low albumin C) Low serum iron and ferritin levels
A clinic nurse assesses a client who has limited English-speaking ability. The child interprets for the client. Which action by the nurse is most appropriate? A) Obtain a professional interpreter. B) Talk directly to the interpreter. C) Teach the family member the appropriate medical terminology. D) Use the family member as a source for improving cultural competence.
A) Obtain a professional interpreter.
A nurse is teaching an older adult about possible involvement in Programs of All-inclusive Care for the Elderly (PACE). Which of the following statements by the older adult shows understanding? A) PACE programs provide several social and medical services on a managed care basis. B) PACE programs provide a cost-effective alternative to hospital-based acute care. C) PACE programs are more expensive than fee-for-service models but offer better health outcomes. D) There is pressure for Medicare and Medicaid to begin funding PACE programs.
A) PACE programs provide several social and medical services on a managed care basis.
A nurse is identifying positive functional consequences as part of the development of an older client's care plan. Which of the following outcomes exemplifies the concept of positive functional consequences for an older adult? (Select all that apply.) A) The older adult with arthritis can walk 1 mile without pain. B) The older adult who is overweight develops a plan to lose 2 lb a month. C) The older adult has constipation from pain medication. D) The older adult schedules cataract surgery.
A) The older adult with arthritis can walk 1 mile without pain. B) The older adult who is overweight develops a plan to lose 2 lb a month. D) The older adult schedules cataract surgery.
Centers for Medicare and Medicaid Services (CMS), the Institute of Medicine, and the Joint Commission have developed standards to address areas of concern for older hospitalized adults. Which of the following situations is of particular concern for an older adult with a hospitalization requiring complex care? A) Transitions in care B) Hospital-acquired respiratory infections C) Need for geriatric care manager D) Placement in an acute care for elders unit
A) Transitions in care
A nurse's colleague states, "Older people who live in the country are a lot healthier than city folk." Which statement by the nurse is most appropriate? A) "The differences aren't large, but rural adults do have better health outcomes than do city dwellers." B) "But chronic conditions are more common among rural adults." C) "Overall, yes. Higher levels of family support translate into longer average life spans for rural adults." D) "Unfortunately, no. And this is mostly attributable to the problem of homelessness."
B) "But chronic conditions are more common among rural adults."
A nurse interviews a centenarian gathering data for a large study. In the interview, the centenarian defines aging as not growing older, but growing wiser. Which of the following is the best response to this definition by the nurse? A) "Aging might make you wiser, but it does lead to eventual death." B) "Healthy maturity is characterized by wisdom." C) "How did you get to live to this old?" D) "I will never make it to be 100 like you."
B) "Healthy maturity is characterized by wisdom."
A nurse is teaching nursing students about the importance of health promotion among older adults. Which of the following statements by a student indicates a need for further teaching? A) "Teaching older adults how to live with diabetes would be a useful health promotion initiative." B) "I can see why we would want to promote timely discharge back to the community following hospitalization." C) "I think that attending to spiritual growth could likely be a part of health promotion." D) "If we could promote healthy, simple diets, then some diseases could likely be prevented."
B) "I can see why we would want to promote timely discharge back to the community following hospitalization."
A nurse helps older adults increase healthy behaviors by restructuring. Which of the following communication techniques should the nurse use to help the older adult overcome barriers? A) "Could you walk with your friend for a half-hour after you both come back from the lunch program at the senior center?" B) "I know it's hard to get outside in the winter, so let's try to identify some ways of getting more exercise indoors during your usual activities." C) "Let's talk about the benefits of exercise. When you walk regularly you reduce constipation and muscle pain." D) "Your activity has been decreasing during the last 3 years and it is at the point that you are at an increased risk for heart disease."
B) "I know it's hard to get outside in the winter, so let's try to identify some ways of getting more exercise indoors during your usual activities."
An older adult is sore from "doing too much in the yard yesterday." Which statement by the nurse best promotes healthy aging? A) "It's time to start exercising and eating right." B) "Let's look at how we can improve your health so you can do more." C) "Of course you can't do as much as you did before, you need to pace yourself." D) "You need to act your age, and let others do that work."
B) "Let's look at how we can improve your health so you can do more."
A nurse is discussing an older adult's recent diagnosis of rheumatoid arthritis with a colleague. Which of the nurse's statements reflects an accurate view of the relationship between aging and wellness? A) "It's important that the individual knows this is an expected part of growing older." B) "We need to teach the older adult how he can keep living a fruitful life in spite of his diagnosis." C) "We need to make sure our teaching is not too detailed for someone of his age." D) "We need to ensure his expectations of continuing to live alone are realistic."
B) "We need to teach the older adult how he can keep living a fruitful life in spite of his diagnosis."
An 84-year-old client has been living in an assisted living facility for several years but is now faced with the prospect of relocating to a nursing home. Which of the following characteristics of the client's current situation is most likely to prompt this move? A) The development of a severe, acute health problem B) A decrease in the client's level of function and activities of daily living (ADLs) C) Exacerbation of a chronic health problem that may require medical treatment D) A change in the level of the client's social support
B) A decrease in the client's level of function and activities of daily living (ADLs)
A nurse assesses a community of older adults. Which of the following persons is at highest risk for a shortened life expectancy? A) A college professor born in 1956 B) A homemaker born in 1957 C) A nuclear engineer born in 1958 D) A nurse born in 1959
B) A homemaker born in 1957
A nurse assesses a 66-year-old woman who strained a muscle. The client attends the gym daily, and states, "I injured my muscle grouting the floor tile getting ready for the bridge class I teach." Which of the following categorizes this client's aging? A) Healthy B) Active C) Productive D) Successful
B) Active
An 89-year-old adult is dismayed that his primary care provider referred him for a driving evaluation because he experiences vision problems and slower reaction time. Which of the following concepts is illustrated in this example? A) Risk factors B) Age-related changes C) Positive functional consequences D) Wellness outcomes
B) Age-related changes
A nurse plans the care of older adults in a long-term care setting. Which of the following interventions incorporates the residents' connectedness to society? A) Ensuring that there are multiple television sets available to residents of the facility B) Arranging regular visits by schoolchildren to the facility C) Conducting reminiscence therapy D) Allowing residents to have input into the meal planning at the facility
B) Arranging regular visits by schoolchildren to the facility
A nurse conducts a functional assessment of a client who has moved to the assisted living facility. Which of the following statements best describes this functional assessment? A) Information on the client's medical diagnoses and health problems. B) Client's ability to perform self-care tasks with a focus on rehabilitation. C) Assessment of the client's activities of daily living (ADLs). D) Prioritization of the client's ability to perform roles in relationships and in society.
B) Client's ability to perform self-care tasks with a focus on rehabilitation.
A nurse has recently begun to provide care to older adults in a large, urban hospital. Having lived until recently in an ethnically homogeneous region, the nurse has begun to recognize the significant differences in priorities and perspectives of clients from other cultural groups and has taken action to learn about these groups. What stage of cultural self-assessment is this nurse demonstrating? A) Unconsciously incompetent B) Consciously incompetent C) Consciously competent D) Unconsciously competent
B) Consciously incompetent
A nurse reads up on some of the more common cultural groups in the local area. How should the nurse interpret the information that is available about cultural groups? A) Characteristics of cultural groups are normally consistent between every member of that group. B) Cultural generalizations can be useful and accurate, but they do not replace individualized assessment and care. C) It is simplistic and problematic to make generalized claims about members of a particular cultural group. D) It is unjust to categorize individual clients as being members of a specific cultural group.
B) Cultural generalizations can be useful and accurate, but they do not replace individualized assessment and care.
A nurse cares for an 81-year-old client whose current hospital admission has been prompted by an exacerbation of chronic renal failure. Which of the following actions by the nurse will best emphasize the goal of client wellness? A) Ask for the client's code status be changed to "do not resuscitate." B) Explore the client's abilities and strengths. C) Show the client others who are more ill. D) Teach the client that health problems do not have to affect daily routines.
B) Explore the client's abilities and strengths.
Which of the following sources might nurses use to improve their cultural competence? (Select all that apply.) A) Discuss cultural norms with clients' families. B) Explore the resources in Online Learning Activities. C) Read journals and other references. D) Utilize organizations listed at the end of chapters. E) Write teaching materials in prominent local languages.
B) Explore the resources in Online Learning Activities. C) Read journals and other references. D) Utilize organizations listed at the end of chapters.
A nurse plans interventions to promote wellness in older adults. Which of the following interventions is most appropriate to meet this goal? A) Talking with the physician about available treatment options for an older adult with an acute illness B) Facilitating early mobilization to prevent muscle wasting and loss of function in an older hospital client C) Deferring the final decision regarding an older adult's choice of assisted living facility to the person's son and daughter D) Placing a 76-year-old on the waitlist for a kidney transplant
B) Facilitating early mobilization to prevent muscle wasting and loss of function in an older hospital client
A graduate nurse expresses an interest in focusing future study to healthy aging. Toward which of the following fields should the experienced nurse steer the graduate nurse? A) Palliative care B) Gerontological nursing C) Nursing home administration D) Social work
B) Gerontological nursing
A nurse has observed an increasing number of older Asian Americans in the hospital. Which of the following statements regarding Asian cultures will best assist the nurse to plan nursing care? A) Asian Americans as a group have lower mortality rates. B) Health is often viewed as a state of physical and spiritual harmony. C) Older Asian Americans are more likely than other Americans to live alone. D) Care of elders is commonly provided in institutional environments such as nursing homes.
B) Health is often viewed as a state of physical and spiritual harmony.
A nurse assesses a 91-year-old client in long-term care healing from bilateral broken legs caused in a fall. Today, the client developed new onset confusion and combativeness. Which of the factors must the nurse investigate as a source of this mental status state? (Select all that apply.) A) Social separation B) Hyponatremia C) Medication interactions D) Positional pain E) Urinary tract infection
B) Hyponatremia C) Medication interactions E) Urinary tract infection
A nurse discusses driving with an older adult who continues to drive, but is probably unsafe on the road. Which statement made by the nurse is most appropriate? A) I am calling your child to take your keys. B) I am concerned about your safety, as well as the safety of others. C) We just don't want you to crash when you drive across the state. D) You shouldn't drive anymore.
B) I am concerned about your safety, as well as the safety of others.
A home health nurse performs an admission on a 90-year-old client who has a small dog. The client states that the most important problem is urinary incontinence. The client's blood pressure is 135/90 mm Hg, with last bowel movement 3 days ago. Which of the following areas addresses the person's goals? A) Safety B) Incontinence C) Blood pressure D) Constipation
B) Incontinence
Despite the fact that older adults are proportionately the highest users of health care services, many nurses harbor misconceptions and deficits in practice related to gerontological nursing. What is the most likely solution to this problem? A) A shift from the treatment of older adults in institutional settings to home care B) Increased nursing education and clinical experience specific to working with older adults C) A focus on early discharge planning for older adults in hospital settings D) Increased use of aggressive pharmacologic interventions in the treatment of acute illnesses in older adults
B) Increased nursing education and clinical experience specific to working with older adults
A nurse assesses a 71-year-old person who has smoked for 43 years. Which of the following is a negative functional consequence of smoking for this person? (Select all that apply.) A) Children are exposed to secondhand smoke B) Low oxygen-carrying capacity C) Abnormal breath sounds D) The ability to run a 5-K race E) Pulmonary disease
B) Low oxygen-carrying capacity
A nurse plans culturally competent care for a variety of clients. Which of the following cultures is most strongly tied to the low health status? A) Hispanic in race B) Low socioeconomic status C) Member of LGBT society D) Resident of urban community
B) Low socioeconomic status
Assessment of an older adult's ADLs addresses parameters such as mobility, dressing, and elimination. In addition to these, which of the following categories should the functional assessment also include? A) Pain B) Mental status C) Previous medical history D) Integumentary assessment
B) Mental status
A nurse is responsible for assessing an older adult in an acute care setting. Which of the following statements most accurately captures the complexity involved in assessing the older adult? A) Older adults manifest fewer symptoms of illness than do younger clients. B) Signs and symptoms of illness are often obscure and less predictable among older adults. C) Care must be taken to avoid assessing normal, age-related changes. D) Older adults experience fewer acute health problems but more chronic illnesses than do younger clients.
B) Signs and symptoms of illness are often obscure and less predictable among older adults
A nurse at a long-term care facility has completed the admission assessment of a 79-year-old male resident. The resident has identified himself as gay and has expressed sadness at having to leave his partner of several decades in order to move to the facility. The nurse should recognize that this resident is likely to have a history of: A) Homelessness B) Stigmatization C) Nominal employment or unemployment D) Infectious diseases
B) Stigmatization
A nurse works to protect vulnerable populations and reduce health disparities. Which of the following nursing actions work toward that goal? (Select all that apply.) A) The nurse acknowledges that the clients in subgroups will not change beliefs or actions. B) The nurse communicates a nonjudgmental attitude toward health system beliefs. C) The nurse incorporates clients' belief systems into the plan of care. D) The nurse asks the client how the care system can incorporate the clients' health beliefs. E) The nurse teaches each client about preventive care.
B) The nurse communicates a nonjudgmental attitude toward health system beliefs. C) The nurse incorporates clients' belief systems into the plan of care. D) The nurse asks the client how the care system can incorporate the clients' health beliefs. E) The nurse teaches each client about preventive care.
A nurse is working with a 79-year-old client newly diagnosed with osteoporosis. Which of the following interactions promotes achievement of wellness outcomes? A) The nurse performs strength and mobility training appropriate to the client's age and diagnosis. B) The nurse teaches the client about bone density in older women and the role of vitamin D and calcium intake. C) The nurse plans interventions in light of the body-mind-spirit interconnectedness of the client. D) The nurse teaches the client about how her risk factors are a consequence of age.
B) The nurse teaches the client about bone density in older women and the role of vitamin D and calcium intake.
A nurse in a Medicare- and Medicaid-funded nursing home performs assessments and develops care plans. Which of these statements is true of the functional assessments the nurse is likely to perform? A) The nurse will address core ADLs but not more complex IADLs. B) The nurse will identify changes in the older adult's function over time. C) The nurse will utilize various functional assessment models. D) The main goal of functional assessments will be to ensure older adult safety.
B) The nurse will identify changes in the older adult's function over time.
A nurse is teaching an older person about the concept of successful aging. Which of the nurse's questions addresses an important contributor to successful aging? A) "Are you largely free of acute or chronic illnesses?" B) "Do you feel financially secure?" C) "Do you feel like you actively engage with life?" D) "Do you have a reliable support network?"
C) "Do you feel like you actively engage with life?"
A nurse who works with older adults is teaching a colleague about the similarities and differences between gerontology and geriatrics. Which of the following questions best conveys the focus of gerontology? A) "How can we secure more funding for research and development of drugs specifically for older adults?" B) "How can we teach older adults about the relationship between their lifestyle and their health?" C) "How can we help older adults maintain wellness as they age?" D) "How can we reduce the incidence of falls among older adults who live in care facilities?"
C) "How can we help older adults maintain wellness as they age?"
A nurse teaches an older adult client about the use of the telehealth equipment to monitor congestive heart failure. Which of the following statements by the client shows understanding? A) "I will call the primary health care office everyday with my weight, and blood pressure." B) "I won't touch this fancy equipment unless you are here." C) "I need to step on this scale and use this automatic cuff each day." D) "I will watch the prescribed television show every afternoon."
C) "I need to step on this scale and use this automatic cuff each day."
Which of the following statements, made by a new nurse, are myths and need correcting? (Select all that apply.) A) "Ageism is highly influenced by stereotypes and cultural values." B) "Ageism is more common in industrialized societies." C) "In the United States, 20% of the older adults who need care are in a nursing home." D) "People consider themselves old when they are old enough to apply for Medicare." E) "With increased age, people become more diverse and people become less like their age peers."
C) "In the United States, 20% of the older adults who need care are in a nursing home." D) "People consider themselves old when they are old enough to apply for Medicare."
A client, who retired from work this year, asks the nurse the secret to successful aging. Which of the following responses by the nurse is most helpful? A) "Later life can be a time of engagement, contribution and well-being, you must work to make it so." B) "Life is a bowl of cherries, if you are in the pits, crawl out." C) "Studies show that volunteering and helping others improve satisfaction with life." D) "The body is senescent and you will find you slow down each year."
C) "Studies show that volunteering and helping others improve satisfaction with life."
A nurse is teaching a family of an older adult about the role of adult day centers. Which of the statements by the family member indicates a need for further teaching? A) "The day center can give me respite." B) "The day center can improve our quality of life." C) "The day center can be a useful alternative to medical care." D) "The day center can contribute to an actual improvement in dementia symptoms."
C) "The day center can be a useful alternative to medical care."
A healthy 65-year-old says, "I don't think I will live much past 70." The studies however show that this client should live to 84 years of age. Which of the following statements, by the nurse, summarizes the compression of morbidity for this client? A) "Let's work on extending your life expectancy." B) "The goal is to live better, not longer." C) "We should work on postponing chronic illnesses." D) "You are lucky that you are healthy."
C) "We should work on postponing chronic illnesses."
An 82-year-old client is getting advice from a family member on how to drive safely. What piece of advice should the older adult follow? A) "Avoid modifying your vehicle with devices that were not supplied by the manufacturer." B) "Realize that normal, age-related changes should not affect your ability to drive safely." C) "You can consider timing your medications to avoid their interfering with safe driving." D) "You should transition from driving to using public transportation as soon as possible."
C) "You can consider timing your medications to avoid their interfering with safe driving."
A nurse is conducting a study on the needs and living situations of older adults in the community. Which of the following statements should the nurse take into account? A) A majority of older Americans will live in a nursing home at some point. B) More older men live alone than older women. C) Assisted living arrangements have become increasingly common. D) Most older Americans reside in some form of institutional arrangement.
C) Assisted living arrangements have become increasingly common.
A nurse is aware that many health care providers prioritize the role of biology in the aging process. What is a weakness of biologic theories of aging as it applies to nursing? A) Biologic theories do not account for the differences in life expectancy between men and women. B) Biologic theories are unable to explain the role of cell division in life expectancy and the aging process. C) Biologic theories of aging do not adequately address issues of wellness and quality of life. D) Biologic theories of aging are unable to explain the significant increases in life expectancy that occurred in the 20th century.
C) Biologic theories of aging do not adequately address issues of wellness and quality of life.
A 69-year-old cigarette smoker asks the nurse questions about the potential benefits of quitting smoking, a subject avoided in past interactions. The nurse asks the client, "Would you like to quit smoking?," to which the client replies, "I will give it some serious thought." What stage of the Stages of Change model is the client demonstrating? A) Precontemplation B) Preparation C) Contemplation D) Action
C) Contemplation
A 55-year-old client was recently diagnosed with type 2 diabetes. The client completed a diabetes education class and does water aerobics three times a week. The blood sugar and hemoglobin A1c have improved since losing 20 lb. Which of the following statements best describes this client's actions? A) Activity theory B) Age stratification theory C) Functional consequences theory D) Life-course development theory
C) Functional consequences theory
A nurse at the aging center organizes exercise classes including tai chi. Which of the following principles is the nurse incorporating? A) Disease prevention B) Environmental modification C) Health promotion D) Spiritual awakening
C) Health promotion
A graduate nurse expresses an interest in focusing future study to healthy aging. Toward which of the following resources should the experienced nurse steer the graduate nurse? A) American Heart Association B) Healthy Brain Initiative C) Healthy People 2020 D) Springer Publishing Company
C) Healthy People 2020
A nurse is explaining to a new colleague the similarities and differences between gerontology and geriatrics. Which of the following situations would most likely be addressed by a geriatrician rather than a gerontologist? A) Teaching older adults techniques to identify and deal with age-related changes B) Organizing and leading exercise classes to facilitate mobility C) Identifying and treating a client's vascular dementia D) Rearranging an older adult's apartment to minimize the risk of falls
C) Identifying and treating a client's vascular dementia
A 77-year-old client was put on broad-spectrum antibiotics when hospitalized for sepsis. The client has a history of rheumatoid arthritis and a recurring problem with pneumonia. Which of the following theories best explains why the client has had these issues? A) Free radical theory B) Genetic theory C) Immunity theory D) Wear-and-tear theory
C) Immunity theory
A nurse assists an older adult who is homebound in a rural area. Which community resources might this client best benefit from? A) Skilled home nursing B) Senior center C) Personal emergency response system D) Grocery delivery
C) Personal emergency response system
A nurse performs a reflective cultural self-assessment. Which of the following outcomes should the nurse expect? A) An accurate ranking of different cultures according to their specific merits B) Identification of the flaws and weaknesses of the nurse's own culture C) Progression from judgmental views of other cultures to recognition of positive attributes D) The ability to assess clients according to their cultural affiliation rather than individual characteristics
C) Progression from judgmental views of other cultures to recognition of positive attributes
Following knee replacement surgery 10 days earlier, a 79-year-old woman has been diagnosed with an infection in the knee. A sample of synovial fluid has been cultured in order to determine the causative microorganism and to select an appropriate antibiotic. This course of events characterizes what major health belief system? A) Magico-religious paradigm B) Holistic paradigm C) Scientific paradigm D) Analytical paradigm
C) Scientific paradigm
A nurse completes the admission assessment of an 84-year-old client to the long-term care facility. Which assessment finding would direct the nurse to document a deficit in the client's ADLs? A) The client experiences chronic pain as a result of rheumatoid arthritis. B) The client is able to ambulate with a wheeled walker for 60 ft but then requires a rest break. C) The client is able to wash self but requires assistance entering and leaving the bathtub. D) The client is unable to explain the rationale for each of the prescribed medications.
C) The client is able to wash self but requires assistance entering and leaving the bathtub.
A nurse manager justifies the budget for education regarding cultural competency for the staff. Which of the following justifications will best support the need for this education? A) Life expectancies among minorities are expected to increase while those among non-Hispanic whites are expected to decrease. B) Government and health care organizations support the need for culturally competent care. C) The proportion of health care consumers who are minorities continues to increase. D) Nurses have a moral obligation to achieve cultural competency with all cultural groups.
C) The proportion of health care consumers who are minorities continues to increase.
A group of community health nurses is using the Stages of Change model as the foundation of a new health promotion campaign for older adults. What goal for the participants are the nurses likely to promote when working with older adults in the program? A) A recognition of the importance of screening for common health problems B) Increased participation in exercise programs and an awareness of the relationship between exercise and wellness C) The replacement of participants' unhealthy behaviors with healthy behaviors D) An awareness of the differences between life expectancy and active life expectancy
C) The replacement of participants' unhealthy behaviors with healthy behaviors
A nurse is using the Functional Consequences Theory as a lens for planning client care in a health care facility. Which of the following is a key element of this nursing theory? A) Most problems affecting older adults may be attributed to age-related changes. B) Most functional consequences cannot be addressed through nursing interventions. C) Wellness is a concept that is broader than just physiologic functioning. D) The Functional Consequences Theory is an alternative to holistic nursing care.
C) Wellness is a concept that is broader than just physiologic functioning.
A nurse speaks at a staff development in-service. Which of the following statements by a nurse participant shows the need for education? A) "I know that the consequences of racism are still present and they're linked to health disparities." B) "I'm sure the percentage of client-care hours that we spend working with minority clients is bound to increase." C) "There's a huge amount of diversity within the group that's labeled 'Asians and Pacific Islanders.'" D) "It's inaccurate to link the prevalence of particular diseases with particular minority groups."
D) "It's inaccurate to link the prevalence of particular diseases with particular minority groups."
A client in the skilled nursing facility refuses rehabilitation services 5 out of 7 days. An administrator tells the client that they will be transferred to the intermediate care unit. The client states, "Medicare is paying my bill; you can't transfer me." Which of the following is the best response by the nurse administrator? A) "You are making good progress it's time to move to the intermediate care unit." B) "We don't accept Medicare clients in the skilled unit." C) "Oh, I wasn't aware; you will be staying here." D) "Medicare will only pay as long as you continue to make progress toward your goals."
D) "Medicare will only pay as long as you continue to make progress toward your goals."
A nurse who provides care to many older adults recognizes the importance of implementing a wellness approach to care. What principle underlies this approach to the health care of older adults? A) Older adults have decreasing expectations for wellness as they move through the aging process. B) Health problems are a Western cultural construct that has no objective, physiologic basis. C) Older adults must come to accept a decline in wellness as they age. D) A holistic approach to caring for older adults can foster their well-being at every stage of life.
D) A holistic approach to caring for older adults can foster their well-being at every stage of life.
A nurse in the long-term care facility plans care to improve quality of life. Which of the following actions is most likely to enhance the older adult's connectedness? A) Teaching a client who has had a below-the-knee amputation how to care for his stump B) Organizing a client's intravenous antibiotic therapy on an outpatient basis C) Performing a focused respiratory assessment on a client who has a diagnosis of lung cancer D) Advocating for a husband and wife to remain in the same room of a long-term care facility, as is their preference
D) Advocating for a husband and wife to remain in the same room of a long-term care facility, as is their preference
A gerontological nurse who works in a public health setting has limited funding for initiatives. Which of the following prevention and health promotion initiatives is most likely to result in significant benefits for the older adults who participate? A) An awareness program that promotes screening sigmoidoscopy B) Teaching older adults about falls prevention in the home C) A program of bone density screening for older adults D) An exercise program for older adults who live in the community
D) An exercise program for older adults who live in the community
A nurse is teaching a colleague about the difference between age-related changes and risk factors. Which of the following examples should the nurse use when discussing age-related changes? A) An older adult with a diagnosis of diabetes mellitus B) An older adult who is obese C) An older adult with obstructive lung disease D) An older adult with decreased bowel motility
D) An older adult with decreased bowel motility
Admission to long-term care is typically a culmination in a long series of health problems and functional limitations. Which of the following problems is most likely to precipitate admission to long-term care? A) Kidney disease B) Traumatic injury C) Chronic obstructive pulmonary disease D) Dementia
D) Dementia
A nurse working in an acute care for elders unit observes that a client on the unit frequently stumbles when ambulating with a walker. Which action by the nurse is best? A) Provide a wheelchair for the client to use for the duration of the hospital stay. B) Ask the client to remain in bed as much as possible and teach the client about falls risks. C) Place a chair in the hallway so the client can take a rest break when feeling unsteady. D) Ensure that the woman's mobility is assessed and the appropriate assistive device is provided.
D) Ensure that the woman's mobility is assessed and the appropriate assistive device is provided.
A 74-year-old client has recently begun integrating more fresh fruit and vitamin supplements in an effort to increase the levels of antioxidants. This client's actions indicate an understanding of what theory of aging? A) Cross-linkage theory B) Program theory of aging C) Immunosenescence D) Free radical theory
D) Free radical theory
A hospital nurse is discussing with an older adult the possibility transfer to a nursing home for skilled care after pneumonia. Which statement by the client indicates an understanding of this possible transfer? A) Old people who go to the nursing home don't get out. B) They will take my home if I go to the nurterm-77sing home. C) I don't qualify for skilled care, I only had pneumonia. D) I have already used 45 Medicare days this year.
D) I have already used 45 Medicare days this year.
A nurse administrator is involved in strategic planning for a large long-term care facility that has locations in numerous regions of the country. What trend should the nurse administrator anticipate? A) A decrease in the proportion of older adults who are members of minority groups B) A gradual decline in overall life expectancy C) Average longevity of men exceeding that of women D) Increased use of assisted living facilities by older adults
D) Increased use of assisted living facilities by older adults
A nursing administrator of the long-term care facility implements a performance improvement program. Which of the following activities should be included in the program? A) Develop a dementia care unit. B) Decrease the use of intramuscular medications. C) Emphasize safety and medical care. D) Measure outcomes focusing on personal choice.
D) Measure outcomes focusing on personal choice.
A client has recently begun receiving Social Security benefits and is asking the nurse about what services might be included or excluded under Medicare. Which of the following services is most likely to be excluded from Medicare funding? A) Hospital care B) Hospice care C) Rehabilitation care D) Nursing home care
D) Nursing home care
Which of the following characteristics of older adults is explained by the subculture theory? A) Older adults have little control over the biologic effects of the aging process. B) Older adults have a decreased need for social interaction and peer support as they become older. C) Older adults may see their status with their peers in terms of economic achievement. D) Older adults may interact much more with other older adults than with members of other age groups
D) Older adults may interact much more with other older adults than with members of other age groups
A nurse works with a program that performs interviews, blood work, and digital rectal examinations aimed at identifying older men with benign prostatic hyperplasia (BPH). The program also facilitates bathroom alterations in older adults' homes to ensure men with BPH have easy access to a toilet. Which of the following components of health promotion has yet to be implemented in the program? A) Screening B) Risk assessment C) Environmental modification D) Risk-reduction interventions
D) Risk-reduction interventions
A nurse in a community setting plans wellness outcomes with a 68-year-old female client who desires to participate in a half-marathon run. Which of the following outcomes should the nurse document? A) The client will remain free of disease. B) The client will participate in daily aerobic activity class without falls. C) The client will increase activity until able to run 30 minutes. D) The client will participate in the half marathon that is scheduled in 6 months.
D) The client will participate in the half marathon that is scheduled in 6 months.
A home care nurse assesses the home environment of an older adult client. Which of the following environmental conditions positively affects the functioning and quality of life for the client? A) The client has thick shag carpeting in the home. B) The client shares a bathroom with a teenager. C) The client's 2-year-old great grandchild plays in the living room. D) The client's home has large south-facing windows with blinds.
D) The client's home has large south-facing windows with blinds.
As part of a functional assessment, a nurse is assessing an older adult's ADLs and instrumental activities of daily living (IADLs). What piece of assessment data would most likely be considered an IADL rather than an ADL? A) The older adult is able to ambulate to and from the bathroom at home. B) The older adult can feed herself independently. C) The older adult can dress in the morning without assistance. D) The older adult is able to clean and maintain her own apartment.
D) The older adult is able to clean and maintain her own apartment.
Which of the following circumstances would be most likely to render a screening program unnecessary? A) Treatment of the disease is available at low cost. B) The disease follows a predictable course. C) The disease is more common among older adults than among younger and middle-aged adults. D) The symptoms of the disease appear at the same time that it is detectable by screening.
D) The symptoms of the disease appear at the same time that it is detectable by screening.
Until recently, a 77-year-old client lived alone in her own home. The client fell and fractured an ankle and was placed in a long-term care facility for physical therapy. After the physical therapy was finished, the client tells the nurse, "I want to stay at the facility; I am happy living there and I like the social interaction." Which of the following theories of aging best describes the status of this client? A) Activity theory B) Feminist theory C) Life-course theory D) Theory of thriving
D) Theory of thriving
A 79-year-old client has been admitted to a long-term care facility because of the progression of Alzheimer disease from mild to the moderate stage. How should the nurse proceed with functional assessment? A) Document the fact that it is not possible to accurately gauge the woman's ADLs. B) Obtain assessment data from the woman's family members and friends. C) Perform assessment passively by observing and recording the woman's behavior and actions over the next several days. D) Use an assessment tool that is specifically designed for use with cognitively impaired clients.
D) Use an assessment tool that is specifically designed for use with cognitively impaired clients.
A nurse interviews a centenarian gathering data for a large study. In the interview, the centenarian says, "You're only as old as you feel, some days I feel like 'I'm 50.'" To which definition of aging does this response correspond? A) Chronologic aging B) Functional aging C) Perceived aging D) Subjective aging
Subjective aging
An older adult has recently begun to display unprecedented lapses in short-term memory. The nurse overhears a colleague reassuring the person by saying, "Try not to worry; it's just a part of growing older." The nurse recognizes that this is an example of what phenomenon? A) Multiple jeopardy B) Gerontophobia C) Age attribution D) Implicit ageism
c- age attribution
