Care of The Older Adult TEST BANK, Exams of Nursing

Download Care of The Older Adult TEST BANK and more Exams Nursing in PDF only on Docsity! 1 Care of The Older Adult TEST BANK A negative attitude towards aging and the aged is called: A. geriatrics B. racism C. ageism D. ethnocentrism Answer: C Which of the following is not considered a core competency for nurses caring for older adults? A. Analyze the impact of an aging society on the health care system B. Obtain certification in gerontological nursing C. Prevent or reduce common risk factors that contribute to functional decline D. Recognize one's own attitudes about aging Answer: B The nurse wishes to obtain basic certification in the specialty of gerontological nursing. Which of the following is true about this credential? A. there is an experience requirement B. one must pass an exam C. one must have a BSN D. a and b only Answer: D When the nurse reads an article and uses the findings of a study to improve the quality of the patients for whom she cares, she is implementing the role of: A. teacher B. manager C. research consumer D. advocate 2 Care of The Older Adult TEST BANK Answer: C A lawyer wishes to hire a nurse consultant who has advanced education and certification in gerontology. Based on their listed credentials, which of the following nurses best fits his wishes? A. Sally Smith, RN, BSN, BC B. Mary Malloy, RN, MS, GNP C. Andy Jones, LPN, CRRC 5 Care of The Older Adult TEST BANK Answer: C Which of the following is not true about assisted living facilities? A. if their care needs become too great, they may have to seek other living arrangements B. persons pay for assistance out of pocket C. the average resident is in his 60's D. they have assumed about 15% of the previous nursing home population Answer: C A person aged 84 would be classified, according to current systems, as: A. young B. middle C. old D. very old Answer: B The clinical nurse specialist (CNS) in gerontology differs from the GNP in that: A. the GNP usually works in a collaborative practice with a physician B. the CNS has less education than the GNP C. the GNP has a doctorate D. the CNS does less consulting than the GNP Answer: A What is the most compelling reason for health professionals to be educated in the area of gerontology? A. to address the comprehensive nursing shortage B. to make an increase in salary C. to prepare to be challenged by the educated baby boomers D. to prepare to care for the growing number of older persons in the population Answer: D An intergenerational approach to care for the aging is advisable because of what fact? 6 Care of The Older Adult TEST BANK A. baby boomers want their children to take of them in old age B. Gen X and Gen Y persons do not know anything about aging 7 Care of The Older Adult TEST BANK C. most older persons are cared for by their children D. nearly a half million grandparents are raising their grandchildren Answer: D What best explains the lack of prepared, qualified health professionals to care for the aged? A. a shortage of nursing faculty B. medical programs not including gerontology content C. not enough health professionals choosing gero as a specialty D. the current nursing shortage Answer: C There were approximately 36 million Americans over the age of 65 years in 2000 and this number is expected to grow to 71 million by 2030 A. TRUE B. FALSE Answer: A Over half of women over the age of 85 are widowed A. TRUE B. FALSE Answer: A There are more males in the population than females A. TRUE B. FALSE Answer: B 10 Care of The Older Adult TEST BANK The major causes of death in the older age group are heart disease, AIDS, and tuberculosis 11 Care of The Older Adult TEST BANK A. TRUE B. FALSE Answer: B (It's Heart Disease, Cancer and Strokes) Which ethnic/cultural group has a higher rate of diabetes, hypertension, and chronic renal disease than other ethnic groups? A. African Americans B. Hispanics C. Asians and Pacific Islanders D. American Indians and Alaskan natives Answer: A Which ethnic/cultural group is the most rapidly growing ethnic minority, and less likely to obtain preventive services such as flu vaccines and mammograms? A. African Americans B. Hispanics C. Asians and Pacific Islanders D. American Indians and Alaskan natives Answer: B Which ethnic/cultural group is comprised of many subgroups and generally have a longer life expectancy than white Americans? A. African Americans B. Hispanics C. Asians and Pacific Islanders D. American Indians and Alaskan natives Answer: C Which ethnic/cultural group makes up a small percentage of America's elderly population and have increased morbidity and mortality related to diabetes and renal disease? A. African Americans 12 Care of The Older Adult TEST BANK B. Hispanics C. Asians and Pacific Islanders D. American Indians and Alaskan natives 15 Care of The Older Adult TEST BANK D. gene/biological Answer: D When a Native American Indian elder goes out into the woods to die and the tribe does not search for him, but allows him to withdraw, this could be an example of: A. activity theory B. disengagement theory C. subculture D. person-environment fit Answer: B A 99 year old widow who has lived alone in her own home for 40 years experiences a fall and is sent by her children and grandchildren to a nursing home. The woman refuses to eat and exhibits signs and symptoms of depression and withdrawal. Which theory does this most describe? A. functional consequences B. theory of thriving C. neuroedncorine D. immunological Answer: B The physician tells his 81-year-old male patient that his health has deteriorated due to the exogenous sources of free radicals to which he has exposed himself for many years. To what is the physician most likely referring? A. the ozone layer B. the patient's cigarette smoking C. the patient's alcohol consumption D. radiation from the patient's microwave Answer: B MATCHING 1) continuity theory A. personality and coping patterns remain consistent through life 2) stochastic theories B. remaining active and involved promotes life satisfaction in later year 16 Care of The Older Adult TEST BANK 3) neuroendocrine theory C. transformation towards oneness with the universe 4) activity theory D. cells wear out with age 5) gerotranscendence theory E. five basic needs that motivate behavior 6) nonstochastic theories F. problems with gland feedback leads to disease 17 Care of The Older Adult TEST BANK 7) theory of thriving G. based on random events that cause cellular damage 8) human needs theory H. genetically programmed events cause cellular damage that lead to aging 9) functional consequences theory I. failure to thrive is from discord in relationships 10) wear and tear theory J. (Miller’s Theory) nurse’s role is risk reduction to enhance safety Answer: 1) continuity theory (A) A. personality and coping patterns remain consistent through life 2) stochastic theories (G) B. remaining active and involved promotes life satisfaction in later year 3) neuroendocrine theory (F) C. transformation towards oneness with the universe 4) activity theory (B) D. cells wear out with age 5) gerotranscendence theory (C) e. five basic needs that motivate behavior 6) nonstochastic theories (H) F. problems with gland feedback leads to disease 7) theory of thriving (I) G. based on random events that cause cellular damage 8) human needs theory (E) H. genetically programmed events cause cellular damage that lead to aging 9) functional consequences theory (J) I. failure to thrive is from discord in relationships 10) wear and tear theory (D) J. (Miller’s Theory) nurse’s role is risk reduction to enhance safety Which of the following visual changes is not usually associated with normal aging? a. presbyopia b. yellowing of the lens c. night blindness d. decreased accommodation Answer: C All of the following are considered IADLs (Instrumental Activities of Daily Living) except: a. toileting b. balancing the checkbook c. using the phone d. shopping Answer: A (this is considered an ADL) Old persons may have difficulty picking up their pills from a medicine cup because of: a. macular degeneration b. decreased touch sensation that comes with old age c. peripheral neuropathy d. all of the above 20 Care of The Older Adult TEST BANK B. ask loud, direct questions C. have the person write down the information on the chart D. ask the family member instead of the person Answer: A While speaking with a patient who is experiencing depression, which of the following strategies might be most helpful? A. speaking very loudly since they are certainly hard of hearing B. recording important information for them in a notebook to refer to later C. ignoring the person and discussing their condition with a family member D. telling them that their depression will go away on its own if they think positively Answer: B In caring for a person experiencing delirium, which of the following is least effective in enhancing communication? A. speak in simple sentences B. offer frequent reassurance C. use physical restraints to control anxious behavior D. use large print clocks and calendars Answer: C List five nursing strategies for enhancing memory in the older adults with mild dementia. Answer: Journaling, keeping a record of the day, using familiar items, posting reminders, using calendars and clocks If an older person with hearing impairment complains of not being able to hear what the nurse is saying, what could be a contributing cause of this? A. normal age-related changes B. build up of cerumen C. the nurse not facing the person when speaking D. all of the above 21 Care of The Older Adult TEST BANK Answer: D 22 Care of The Older Adult TEST BANK An older patient has had a stroke that resulted in Broca's aphasia. Which of the following would be most typical of Broca's aphasia? A. fluent speech B. impaired comprehension C. broken speech D. global problems Answer: C Which of the following signs would you consider an abnormal finding for a 75 year old female? A. blood pressure of 110/78 B. Hct (hematocrit) of .41 C. resting pulse of 80 D. urinary incontinence Answer: D A significant result of changes in the respiratory system with advanced age is: A. lower carbon dioxide levels in the bloodstream B. less useful oxygen available with each breath C. more efficient gas exchange at the alveolar level D. the ability to hold one's breath longer Answer: B One of the most significant changes in the reproductive system for older females who are sexually active is: A. decreased vaginal lubrication B. atrophy of uterus C. decreased libido D. lack of male partners Answer: A You are helping care for your 89 year old grandmother who is sick with "the flu". Her temperature is 101.2. What other information would be most useful to better assess your grandmother's condition? 25 Care of The Older Adult TEST BANK Which of the following aging changes is most significant to renal efficiency? 26 Care of The Older Adult TEST BANK A. loss of up to half of functioning nephrons B. decreased cardiac output C. nocturia D. a and b Answer: D The aging eye shows all of the following changes except: a. better ability to focus on near objects b. decreased lens accommodation c. decreased peripheral vision d. presbyopia Answer: A A 72 year old female with the following assessment factors is admitted to the acute care for elderly (ACE) unit. Which of the following requires the most immediate treatment? A. BP = 140/ 90 mm Hg B. Hgb (hemoglobin) = 7 g/dl C. hypogeusia D. presbycusis Answer: B Mrs. Jones is a 50 year old female who complains of hot flashes, moodiness, and skipping menstrual periods. She tells you that the physician suggests she is going through menopause, and asks, "aren't I too young for menopause?" What is your best response? A. Yes, you are too young. Your symptoms must be something else. B. The average age for menopause is 51, but many women experience these symptoms earlier. C. I think you should get a second opinion in case it is something serious. D. No. You are not too young for menopause, but the average age is 56. Answer: B Immunosenescence refers to: 27 Care of The Older Adult TEST BANK A. acquired immunity B. innate immunity C. aging of the immune cells D. better replication of the cells that fight infection 30 Care of The Older Adult TEST BANK C. gastrointestional D. neurological Answer: The nurse working in rehabilitation would most likely see what measure used to evaluate progress of patients in rehabilitation? A. Katz index B. MDS C. FIM D. OASIS Answer: C In assessing IADLs, the nurse will ask questions about all but which of the following patient activities? a. cooking b. shopping C. using the phone D. bathing Answer: D In assessing the circulatory system of an older adult, the nurse would recognize which of the following as abnormal? A. resting pulse rate of 120 B. blood pressure of 118/78 C. respirations of 26 D. a and c Answer: D When assessing the respiratory system of an older person, which of the following is the least essential to ask during history taking? A. use of tobacco products B. feelings of shortness of breath C. exposure to environmental toxins 31 Care of The Older Adult TEST BANK D. all are important to ask about 32 Care of The Older Adult TEST BANK Answer: D All of the following may contribute to an older patient complaining of constipation except….. A. decreased thirst mechanism B. changes in peristalsis with age C. lack of fiber in diet D. increased physical activity Answer: D 7) It is important to include sexuality in a comprehensive assessment of older persons because: A. changes occur with normal aging that may impact performance B. older adults still engage in sexual intercourse C. changes in sexual preference in later life often pose conflicts D. a and b Answer: D Neurological assessment of the older person should include: A. history of medications and herbs used B. assessment of swallowing C. checking grip strength D. all of the above Answer: D The Up and Go Test is useful for assessment because it: A. provides a quick measure of physical, especially walking, ability B. gives a precise indication of physical strength C. provide a statistically accurate number associated with grip strength D. gives an idea of cognitive function Answer: A Which of the following new findings would be considered abnormal and requiring immediate attention in the older 35 Care of The Older Adult TEST BANK Answer: B The physician orders a peak and trough to be drawn on a patient receiving Vancomycin. The nurse correctly draws the peak: A. when the highest level of medication is in the blood B. when the lowest level of medication is in the blood C. two minutes after the medication is given D. three hours prior to the medication being given Answer: A 5) Which of the following normal aging changes affects the way medications are processed in the body of an older adult? a. decreased renal clearance B. decreased cardiac output C. impaired absorption in the gut D. all of the above Answer: D Opioids are rarely prescribed for persons with dementia because of what adverse reaction? A. dry mouth B. sedation C. confusion D. constipation Answer: C Which of the following is true about the elderly and medications? A. about 1/6 of all medications are for the elderly B. medications may stay in the body longer C. there is a decreased risk of side effects with aging D. dosing should be the same for young and old adults Answer: B 36 Care of The Older Adult TEST BANK Polypharmacy is a significant problem for the elderly because: A. the more medications one takes, the greater the risk of side effects B. older persons are unable to take medications correctly 37 Care of The Older Adult TEST BANK C. older adults are not accustomed to taking multiple medications D. a and c only Answer: A Diphenhyrdramine (Benadryl) is not recommended for use in older adults because of: A. confusion and severe anticholinergic effects B. risk of seizures C. prolonged half life D. dosage problems Answer: A Which of the following questions is least appropriate to ask when taking a medication history? A. use of over the counter medications B. drug allergies C. home remedies used D. all of the above are appropriate Answer: D List five strategies for teaching older adults. Answer: stay active, see doctor regularly, maintain relationships, prevent falls, maintain healthy weight and diet The nurse is preparing a teaching session about diabetes to a group of older adults in assisted living. Which of the following is most essential to consider for this audience? A. whether they are part of the Baby boomer generation B. the accommodations needed for them to participate in the presentation C. literacy level if there are handouts D. b and c 40 Care of The Older Adult TEST BANK wellness center would be most likely to attract attention? A. Hypoglycemia and Hyperglycemia B. Understanding HemoglobinA1C C. Preventing a Stroke: Knowing This Could Save Your Life! 41 Care of The Older Adult TEST BANK D. Information about Advance Directives Answer: C In conducting a one-to-one teaching session about the role of nutrition in preventing osteoporosis, the nurse should first: A. establish rapport with the person B. assess readiness to learn C. evaluate outcomes D. provide information Answer: A Which of the following aging changes could pose a barrier to learning? A. hearing loss B. visual impairment C. literacy level D. all of the above Answer: D Which of the following techniques for developing a web page for older adults is least appropriate? A. use large font on the website B. use computer lingo in the text C. create a memorable web address D. make the site user friendly to older adults Answer: A List three activities discussed in this chapter that may prevent the course of frailty. Answer: stay active, see doctor regularly, maintain relationships, prevent falls, maintain healthy weight and diet 42 Care of The Older Adult TEST BANK Which of the following are thought to contribute to healthy aging? A. doing for others and maintaining interests B. engaging in isolated activities C. avoiding connection with religious institutions 45 Care of The Older Adult TEST BANK Answer: C Name five nursing interventions that may help promote nighttime sleep in the elderly. Answer: bedtime routine, reduce noise, relaxation, music, daytime sunlight Of the following exercise regimens, which would be most suitable for the nurse to recommend to a 77-year-old healthy woman with no restrictions from her physician? A. five miles of bicycling per day on the county roads B. walking for a total of 20 - 30 minutes, five days per week C. swimming 50 laps per day in the community swimming pool D. horse back riding in the country alone three times per week Answer: B Successful coping among older adults has been shown to include all of the following except: A. humor B. increase in number of sexual partners C. prayer D. positive social support Answer: B Of the following list, which is the least therapeutic to use as an alternative to physical restraints? A. chemical restraints B. increased staff C. safer physical design of the living area D. manipulation of the environment Answer: A According to the Delaney sisters, which of the following factors are important in healthy aging? A. engaging in enjoyable activities B. cherishing family traditions C. seeking the companionship of others D. all of the above 46 Care of The Older Adult TEST BANK Answer: D Name five nursing interventions that may help promote nighttime sleep in the elderly. 47 Care of The Older Adult TEST BANK Answer: bedtime routine, reduce noise, relaxation, music, daytime sunlight Of the following exercise regimens, which would be most suitable for the nurse to recommend to a 77 year old healthy woman with no restrictions from her physician? A. five miles of bicycling per day on the county roads B. walking for a total of 20 – 30 minutes five days per week C. swimming 50 laps per day in the community swimming pool D. horse back riding in the country alone three times per week Answer: B According to the Merck Institute on Aging and Health, older adults fell short of the Healthy People 2000 goals in all but which of the following area? A. physical activity B. influenza vaccination C. eating fruits and vegetables D. overweight Answer: B The nurse is counseling a patient regarding Medicare prevention efforts. Which of the following is included? A. initial physical examination B. smoking cessation counseling C. nutrition therapy for everyone D. a and b only Answer: D The nurse chooses to use a health contract/calendar as a behavior-changing tool for an older adult client who wants to lose weight. Which of the following principles should the nurse keep in mind when choosing this tool? A. it relies on the self-management capability of a client, after initial assistance is provided by a clinician or health educator B. it relies on the ability and skill of the educator C. it has been shown to be less effective with females who are older and widowed D. it cannot be used in older adults with less than a high school education 50 Care of The Older Adult TEST BANK a. grains b. meat/eggs c. dairy d. fruits/vegetables Answer: D Mr. Thin is a 5 foot 8 inch, 79 year old male with a history of hyperlipidemia. Which of the following risk factors does not fit with his diagnosis? A. he drinks four glasses of Jack Daniels per day B. history of hypertension C. smokes 1 pack of cigarettes per day D. weight of 125 pounds Answer: D To help Mr. Thin in the above scenario, which risk factor will the nurse focus on first in teaching lifestyle modifications? A. weight loss B. stress reduction C. smoking cessation D. food restrictions Answer: C Tobacco use is significantly related to all but which of the following cancers in older persons? A. lung B. larynx C. breast D. bladder Answer: C Of the following scales, which is least useful in assessing the cognitive function of an older adult? A. the Kenny Cognitive Scale B. the mini mental state examination (MMSE) 51 Care of The Older Adult TEST BANK C. the CLOX (clock drawing) D. the Controlled Oral Word Association Test 52 Care of The Older Adult TEST BANK Answer: A The nurse would follow all of the following guidelines when doing nutritional counseling with an older female except: A. limit alcohol to 1 drink per day B. limit water intake to 1000 cc per day C. limit fat and cholesterol D. ensure adequate calcium and vitamin D intake Answer: B The nurse is assessing an older woman with dementia, brought to the emergency room by her adult son caregiver. Which of the following signs most alert the nurse to the possibility that the woman may be abused? A. the woman has bruises of various colors on many inner aspects of her body B. the woman is confused C. the woman is stiff when she walks D. the son says his mother does dangerous things sometimes Answer: A When an elderly person is adequately physically cared for in the home by adult children, but socially isolated and expresses no purpose or will to live, this is a sign of: A. psychological or emotional neglect B. psychological or emotional abuse C. direct physical abuse D. physical neglect Answer: A The emergency room nurse is evaluating a 90-year old male that she suspects may have been abused by a caregiver. Which of the following data most supports her suspicion? A. the man has a skin tear on his hand B. the man has a small bruise on his outer leg C. the man has a numerous large bruises of different colors on various parts of his body D. the man’s explanation of his bruises fits the appearance of the injury 55 Care of The Older Adult TEST BANK complications. The following questions (13 – 16) pertain to this situation. From the information provided, which of the following is least likely true about this patient’s situation and diabetes? A. she is typical for age, gender, and ethnic background B. early diagnosis may have been difficult 56 Care of The Older Adult TEST BANK C. she will exhibit increased urine output, excessive thirst, and hunger D. she is likely to also have hypertension Answer: C What other labs/tests might the nurse least expect to see ordered for this patient? A. Fasting blood sugar B. Glucose tolerance test C. HgBA1C D. MRI Answer: D In teaching this patient about her diabetes, which has lowest priority? A. foot care B. balancing medications, diet, and exercise C. reducing risk of complications D. importance of attending support groups Answer: D A 70 year old male is exhibiting signs of weight loss, heat intolerance, insomnia, sensitivity to light, and heart palpitations. The doctor writes the admitting diagnosis of hypothyroidism on the chart. What is the nurse’s most appropriate reaction to the doctor’s diagnosis? A. discuss the disease process with the patient and family so they know what to expect B. ask the doctor if this was the diagnosis he intended to record on the chart C. do nothing – you have to wait for lab tests D. continue the usual plan of care for a person with hypothyroidism Answer: B Which of the following is true about subclinical hypothyroidism? A. TSH is mildly elevated 57 Care of The Older Adult TEST BANK B. T3 is elevated C. T4 is elevated D. TSH is normal 60 Care of The Older Adult TEST BANK Sundowner syndrome is characterized by which of the following that the nurse may observe in an older adult? A. early morning confusion B. oversleeping C. nocturnal confusion 61 Care of The Older Adult TEST BANK D. violent behavior after sundown Answer: C If the nurse suspects that a patient has delirium, which of the following factors should be further investigated? A. UTI b. medications c. oxygen saturation d. all of the above Answer: D Recent research suggests that most incontinence among the elderly is due to: A. stress B. overactive bladder C. lack of Kegel exercises D. multiple pregnancies Answer: B Which of the following best describes a characteristic of the earliest phase of Alzheimer’s disease? A. impaired speech B. personality changes C. total dependence upon others for care D. progressive forgetfulness Answer: D The nurse is asked to assist a family with finding help to care for their terminally ill grandfather who was just diagnosed with inoperable brain cancer. To which of the following programs would the nurse refer the family? A. the hospital B. respite care 62 Care of The Older Adult TEST BANK C. hospice D. visiting nurse association 65 Care of The Older Adult TEST BANK If the nurse wishes to know about the patient’s overall nutritional health, what is the best lab value to look at? A. triglycerides B. iron C. serum albumin D. red blood cells Answer: C An older person with GERD should avoid which of the following? A. laying flat after meals B. caffeine C. chocolate D. all of the above Answer: D The physician is discussing an older person who has just had a stroke. He says that he will try to give t-PA to minimize the ischemic penumbra. What does this tell you? A. he believes the person will die B. he believes the person has had a hemorrhagic stroke that can be helped by medication C. he believes the person has had a stroke from a clot which, if eliminated, may result in less damage D. he doesn’t know what he is talking about Answer: C Which of the following signs exhibited by an older female at home is one that would cause you to call 911? A. a bad headache B. sudden coughing C. forgetting where her car keys are D. sudden numbness of her right arm Answer: D Match the type of incontinence with the associated symptoms. 1. sudden, unexpected need to void A. stress incontinence 66 Care of The Older Adult TEST BANK 2. frequent or continual incontinence of small to moderate amounts B. urge incontinence 3. inability to get to bathroom facilities C. overflow incontinence 4. triggered by laughing, coughing, sneezing D. reflex incontinence 5. no warning; large amounts urine lost E. functional incontinence 67 Care of The Older Adult TEST BANK Answer: 1. sudden, unexpected need to void (B) A. stress incontinence 2. frequent or continual incontinence of small to moderate amounts (c)B. urge incontinence 3. inability to get to bathroom facilities (E) C. overflow incontinence 4. triggered by laughing, coughing, sneezing (A) D. reflex incontinence 5. no warning; large amounts urine lost (D) E. functional incontinence An African American male, age 72, is admitted to the nurse’s unit for a blood pressure of 180/100. Based on this information, what does the nurse suspect? A. this patient eats too much salt, causing a rise in blood pressure B. this patient probably has hypertension and is at increased risk for stroke C. this patient is overweight and does not exercise D. all of the above Answer: B The nurse is teaching a 69 year old female with congestive heart failure about self-management of her disease. Which of the following would be considered appropriate to teach this patient? A. maintain healthy weight, limit sodium intake, exercise regularly, take meds as ordered B. lose 20 pounds, weigh daily at home, report weight gain of more than 1 pound to the physician C. see the doctor weekly, take meds as ordered, limit sodium intake D. keep blood pressure at 160/90, eat a diet low in fats, exercise twice per week Answer: A A 90 year old female with no significant history is admitted to the ER for acute ischemic stroke with symptoms that began 7 hours prior to admission. Which of the following interventions would the nurse reasonably expect to be done for this patient? A. diagnostic testing such as MRI B. discussion of t-Pa as immediate treatment C. stroke team consult D. a and c only Answer: D Of the following nursing interventions, which would be least appropriate for a person in rehabilitation post-stroke who states “I just can’t believe this happened to me. I can’t wait for this to be over so I can go back to my normal life”? 70 Care of The Older Adult TEST BANK C. there is no known cure D. a surgery called pallidotomy can cure severe tremors in 80% of cases 71 Care of The Older Adult TEST BANK Answer: D A patient with BPPV complains of dizziness because: A. he has Meniere’s disease B. he has a history of stroke C. he has otoconia that are dislodged D. the Epley maneuver is working Answer: C Which of the following best represents the percentage of elderly persons with co-morbid conditions who suffer from depression. A. 15% B. 25% C. 37% D. 50% Answer: C Which of the following is true about depression? A. it does not affect community dwelling elders B. some symptoms can mimic dementia C. usually occurs in early stages of dementia D. leads to suicide in 50% of older males Answer: B Which of the following is true about elderly suicide? A. rates are highest among elderly Black females B. 10% of all suicides are elderly persons C. older women tend to use more lethal means than men D. older men tend to use more lethal means than women Answer: D 72 Care of The Older Adult TEST BANK Common causes for urinary incontinence that the nurse should always check in the elderly include: A. lack of mobility and no toilet facilities 75 Care of The Older Adult TEST BANK Answer: A Of the following nursing interventions for fall prevention, which is the least helpful? A. minimize clutter in the environment 76 Care of The Older Adult TEST BANK B. physical restraints C. strengthening exercises D. walking Answer: B An older person presents in the emergency with symptoms such as tachycardia, shortness of breath, light-headedness, and trembling. Having ruled out any physical causes, what might be the most likely discharge diagnosis seen on the chart? A. generalized anxiety disorder B. panic attack/panic disorder C. delirium D. depression Answer: B Drugs that can cause or worsen anxiety include all the following except: A. baclofen B. theophylline C. acetaminophen D. caffeine Answer: C In providing nursing care for the older adult with anxiety, which of the following interventions is least appropriate? A. increase environmental stimuli B. stay with the patient. C. speak slowly in a soft, calm voice. D. avoid reciprocal anxiety Answer: A The nurse is instructing a group of older women living in the community about ways to minimize the risk of UI. Which of the following is least appropriate to include in the discussion? 77 Care of The Older Adult TEST BANK A. limit fluids B. avoid bladder irritants C. avoid constipation D. strengthen and tone the pelvic floor muscles 80 Care of The Older Adult TEST BANK receptor antagonist such as Namenda. The nurse would instruct the patient and family that this medication: A. stops the decline of the disease B. is taken over a long period of time to achieve best results C. may result in significantly higher function over time 81 Care of The Older Adult TEST BANK D. b and c only Answer: D A patient presents to the clinic with confusion and provides a list of medications to the nurse. Which of the following medications could be a source of this problem? A. meperidine B. aspirin C. benzodiazapines D. a and c Answer: D An older adult who presents with complaints of insomnia, loss of energy, impaired concentration and diminished pleasure in activities she once enjoyed is showing signs of: a. delirium B. dementia C. depression D. confusion Answer: C In educating patients and families about depression, the gerontological nurse recognizes that depression is: A. a prevalent condition B. often undertreated c. common cause of excess disability D. all of the above Answer: D Environmental interventions for patients with dementia include all of the following except: A. a cool room temperature B. alarms on exits C. disguising exits D. areas for safe wandering 82 Care of The Older Adult TEST BANK Answer: A If an older adult wishes to have another person make health care decisions in his behalf should he become unable to do so himself, he should appoint: A. a living will B. a health care representative C. a durable power of attorney for healthcare D. b or c Answer: D A family member asks the nurse to witness the signing of a Living Will at the bedside of a mentally competent, alert, adult patient. In signing as a witness, the nurse is stating: A. the signature of this person was valid and not coerced B. the person was mentally competent to sign C. the person is terminally ill at the time D. a and b only Answer: D If an older person wishes to have a DNR status on himself, which of the following is true? A. he needs to have the physician sign a form that states this B. he will receive less quality care than those who are not DNR status C. he should place a copy on his refrigerator at home D. a and c only Answer: D The nurse is caring for a healthy older patient who tells her that he is going to die and wishes no heroic measures to be taken. There are no advance directives on the chart. The nurse leaves the room and returns minutes later to find the patient with no pulse and not breathing. What should the nurse do? A. call a code or 911 and begin CPR B. quickly write and sign advance directives C. leave the room and close the door D. call the doctor before beginning CPR 85 Care of The Older Adult TEST BANK D. palliative care 86 Care of The Older Adult TEST BANK Answer: A In describing the benefits of hospice to a dying older patient’s family, the nurse correctly states that hospice care may include: A. counseling services B. medical supplies C. social services d) all of the above Answer: D Using the Five Wishes with patients at end of life is beneficial because: A. it allows them to make their desires more specifically known B. it tells their wishes for their family after death C. it tells the five things that are most important to them D. none of the above Answer: A To treat dyspnea at end of life, the nurse would expect to give which of the following medications? A. Codeine B. Oxycontin C. Morphine D. Lasix Answer: C The common causes of delirium at end of life may include: A. constipation, dyspnea, pain B. dyspnea, happiness, frustration C. tachycardia, diarrhea D. none of the above Answer: A 87 Care of The Older Adult TEST BANK The dying older person may be under-medicated for pain due to which of the following misconceptions? A. pain perception decreases with age B. pain is an inevitable part of aging 90 Care of The Older Adult TEST BANK Answer: D The nurse is caring for an older person from a different culture than her own. What is her best approach to providing holistic care to this patient? A. provide care as she would to all other patients B. learn more about the person’s culture C. talk to family members about the person’s medical condition D. ask other nurses what they do to care for this person Answer: B The nurse is assigned to a patient in home care who is an 89 year old African American woman widowed and living alone. Before even making the first visit, which of the following might the nurse expect, based on her knowledge? A. the patient will be cared for by relatives in a middle class neighborhood B. the patient may have fewer financial resources and have a number of health problems C. the patient is likely to be healthy and financially secure D. the patient is most likely able to pay for all her medications without difficulty Answer: B Which of the following should the nurse include in his teaching about hypertension to a group of African American seniors at the community wellness center? A. hypertension is less prevalent among people of color B. vitamin D deficiency is thought to be a factor in hypertension C. hypertension may be caused by overexposure to the sun D. persons with hypertension are at lower risk for heart attack and stroke Answer: A Nancy is a nurse of Hispanic background who is working with a population of older white males on an Alzheimer’s unit at the Veteran’s Hospital. One of the patients makes an angry racist comment to Nancy about all Latinos being lazy. What is Nancy’s best response? A. consider his disease process and excuse the behavior B. report the incident to the nurse manager C. correct the patient by saying, “I am not lazy” D. ask to be removed from caring for that patient 91 Care of The Older Adult TEST BANK Answer: B Which of the following is important for nurses to remember when providing spiritually competent care to older adults? A. older adults tend to avoid religion B. prayer and faith are commonly used coping strategies by religious elders C. participation in an organized religion has no effect on depression or coping D. religion and spirituality are the same terms Answer: B In addressing the sexual needs of an older couple, the nurse should remember that all of the following may be recognized as common problems the nurse may intervene with except: A. dyspareunia B. utertine prolapse C. incontinence D. vaginal dryness Answer: B The nurse is caring for a 70 year old male in the emergency room who is admitted after a car accident. What is the best question for her to ask the patient when trying to contact a loved one? A. should I call your wife? B. do you have a wife? C. who should I call? D. do your children live around here? Answer: C The nurse is giving an educational program about HIV to a group of seniors living in a retirement community in Florida. Many of the attendees are widows and widowers. Which of the following information is appropriate for the nurse to include in her discussion? A. Persons over 50 comprise approximately 10% of HIV cases. B. There is an increase in heterosexual transmission of HIV in older adults. C. African American and Hispanic women report higher levels of risk taking behaviors. D. all of the above 92 Care of The Older Adult TEST BANK Answer: A 95 Care of The Older Adult TEST BANK List the five behavioral determinants of healthy aging as described in this chapter. Answer: Smoking, activity, nutrition, alcohol, medication adherence Name three options that a nurse could teach an older person about regarding smoking cessation. Answer: personal counseling, smoking cessation groups, smoke free organization(s) Strength building is the primary intervention for preventing what medical condition, the gradual loss of muscle mass with age? A. Osteopenia B. Osteoporosis C. Osteosarcoma D. Sarcopenia Answer: D RATIONALE: The first 3 answers relate to bone (osteo). The correct answer is different and relates to muscle, which is what the question is asking. Among military personnel, what medical condition can be a result of retirement and having more time to dwell on war experiences or other common changes occurring with age? A. Alzheimer’s disease B. Huntington’s disease C. Post Traumatic Stress Disorder (PTSD) D. Late Onset Stress Symptomology (LOSS) 96 Care of The Older Adult TEST BANK Answer: D 97 Care of The Older Adult TEST BANK Even if you do not know the correct answer, it sometimes helps to match up key words in the “stem” of the question to key words in the answer. The purpose of which of the following is to identify drugs to avoid in older adults and improve medication selection for older adults? Select All That Apply: A. Beers Criteria B. START criteria C. STOPP criteria D. Black box warning Answer: A, B, C What is the most important discussion of the interdisciplinary team at regularly scheduled meetings? A. Standardized testing results B. Risk reduction assessments C. Compliance issues D. Care access issues Answer: B RATIONALE: All of these topics might be appropriate for discussion in an interdisciplinary meeting, but “B” is best because it is most patient-focused. A vigorous recent widower visited his primary care team and stated he was lonely. Which recommendation should the team make for this patient? A. Take a sleeping pill B. Take an antidepressant