Caring for Older Adults: Addressing Unique Needs and Challenges, Exams of Nursing

Download Caring for Older Adults: Addressing Unique Needs and Challenges and more Exams Nursing in PDF only on Docsity!

NUR 3311 FINAL EXAM 2024 VERIFIED UPDATE

1.A nurse who works on a subacute medical unit of a hospital has noticed that the population of

older adults being admitted to the unit has been increasing over the past few years. The nurse engages a colleague in a discussion about this finding. Which statement by the colleague would be most reflective of current thinking about older adults? A)"Fortunately, Social Security ensures a sufficient level of income for people over 65." B)"It helps that older people don't have to incur any costs for their medical care." C)"Most of the older clients on the unit will have come to us from nursing homes." D)"It's reas- suring older adults are receiving more concern than in decades past.":

D)"It's reassuring older adults are receiving more concern than in decades past."

2. A public health nurse who directs a homecare program that serves an area

with a large population of older adults is conducting a long-term strategic plan. Which phenomenon would be most important for the nurse to integrate when planning for the future? A)While life expectancy will continue to rise, the percentage of older adults in the United States relative to the overall pop- ulation will decrease. B)By 2030, it is expected that the number of adults over age 85 will triple. C)Both life expectancy and the percentage of people over 65 in the population will increase in coming decades. D)Chronic conditions are expected to gradually cause a decrease in the number of older adults

in 10 years.: C)Both life expectancy and the percentage of people over 65 in the population

will increase in coming decades.

3. A nurse who practices in a long-term care facility is providing care for a 101-year-old black female. The nurse's coworker states, "It's gratifying that black people in this country are finally reaching the same levels of health that white people are enjoying." Which response would be most appropriate? A)"Actually, the difference in life expectancy between blacks and whites is growing, not shrinking." B)"We've not yet arrived at a place where the life expectancies are equal between black and white people, but the gap is de- creasing gradually." C)"Black women do tend to live longer than white women, but the overall life expectancies when men are included are not yet equal." D)"Since the 1980s, the life expectancies of black and white Americans have remained

nearly the same.": A)"Actually, the difference in life expectancy between blacks and whites is

growing, not shrinking."

4. A nurse is providing care to a group of older adults who attend activities at the local senior center. When interacting with the group, the nurse notes that more of the women than men live alone. Which phenomena would the nurse most likely attribute to this situation? A)Women tend to live longer than men and marry men older than themselves. B)Men tend to have greater access to care facilities due to higher incomes and savings. C)Men are more likely to

live with younger family members following the death of a spouse. D)Social pressures tend to

stigmatize older men who live alone.: A)Women tend to live longer than men and marry men

older than themselves.

5. A nurse is conducting a class for a group of nurses who are employed at the local community health center that serves a large older adult population. As part of the class, the nurse discusses the impact of the older adult's financial status on their life. The nurse determines that the teaching was successful based on which statement by the group? A)"The percentage of older people living below the poverty level has been increasing." B)"The financial needs of most older adults are well met by Social Security income alone." C)"The recent decline in housing prices has made many older adults 'asset rich and cash poor.'" D)"Women 65 years of age and older are the fastest growing group of

employment.": C)"The recent decline in housing prices has made many older adults 'asset rich

and cash poor.'"

6. A nursing care aide employed on a medical unit of a hospital expresses frustration that "old people get sick so much more often than young people." Which response by the nurse would be most appropriate? A)"Truthfully, the prevalence of obesity and accompanying chronic illnesses mean that young people actually have more chronic conditions than older adults." B)"It's ac- tually a myth that older adults require more hospitalization than young peo- ple." C)"Actually, older adults experience fewer acute illnesses than younger people; it's just that they tend to take longer to recover from them." D)"With the increase in life expectancies in recent years,

most older people actually live free of chronic diseases until very late in life.": C)"Actually, older

adults experience fewer acute illnesses than younger people; it's just that they tend to take

longer to recover from them."

7. ) A nurse is conducting a presentation for a group of older adults at the local community center about chronic illnesses. When describing the effect of chronic illness on this population, which concept would be most important for the nurse to integrate into the discussion? A)Chronic illnesses constitute the leading cause of death for older adults. B)More older adults die from acute illnesses than from chronic diseases. C)While chronic diseases used to be the leading cause of death, this trend is no longer true. D)While cancer rates have fallen, other chronic diseases

remain a common cause of death.: A)Chronic illnesses constitute the leading cause of death for

older adults

8. The board of a large chain of hospitals has commissioned a strategic plan to meet the care needs of baby boomers in coming years. When developing a plan for the future, which characteristic would be most important to incorpo- rate into the plan? Select all that apply. A)Baby boomers typically have fewer

children to help with care later than those of earlier generations. B)Adjusting for inflation, baby boomers have lower incomes than their parents had. C)Due to technology, baby boomers have more leisure time than other adults. D)Baby boomers perform physical exercise more frequently than other adults. E)The educational level of baby boomers is usually lower than preceding genera-

tions.: A)Baby boomers typically have fewer children to help with care later than those of

earlier generations

D)Baby boomers perform physical exercise more frequently than other adults.

9. An 85-year-old man has been admitted to the hospital with exacerbation of his chronic obstructive pulmonary disease (COPD). His family has expressed concern about their ability to pay for his present and future care. The nurse of- fers support and guidance to the family, offering suggestions based on which aspect associated with the payment for care services by older adults? A)The financial burden of care for most older adults is minimal due to ownership of high-value assets. B)Private insurers most often cover the payment for long-term care of older adults. C)Most older adults have their basic care needs provided in a long-term facility. D)Federal

money pays for more care than do older adults or private insurers.: D)Federal money pays for

more care than do older adults or private insurers.

10. A nurse is providing care to an 89-year-old female resident of a nursing home. While visiting, the resident's daughter makes a statement about older adults. Which statement, if made by the resident's daughter, would require the nurse to respond? A)"It seems like more and more people are living well into their 80s like my mom." B)"My mom has a house worth loads of money but

little cash flow, like many older adults." C)"It seems like heart disease is getting more common even though people live longer than they used to." D)"There are more

women living to my mother's age than there are men.": C)"It seems like heart disease is getting

more common even though people live longer than they used to."

11.A gerontological nurse is preparing a plan of care for an older adult applying the error theory of aging as the foundation of the plan. Which concept would the nurse most likely integrate into the plan? A)Perpetuation of DNA mu- tations results in organ and system malfunction. B)Age-related dysfunction of organs and body systems results in DNA mutation. C)The number of cell divisions is genetically predetermined. D)Errors in organ function contribute to changes in the cells' genetic

code: A)Perpetuation of DNA mutations results in organ and system malfunction

12. A gerontological nurse is conducting an in-service presentation to a group of nurses working at a long-term care facility about the various theories of

aging. When describing the error theory of aging, the nurse explains the steps involved. Which step would the nurse describe first? A)Organ, tissue, and system malfunction B)Perpetuation of mutation during cell divisions C)DNA mutation D)Overall decline in body functions E)Decline in body function:

• C)DNA mutation 13.A nurse is explaining to an older adult client that many of the changes in his body that are currently causing him frustration may have their origins in genetic changes that may have in fact benefited him during his younger years. Which theory of aging underlies the nurse's explanation? A)Disposable soma theory B)Free radical theory C)Mutation accumulation theory D)Antagonistic

pleiotropy theory: D)Antagonistic pleiotropy theory

14.An 80-year-old female client who enjoys good health explains to the nurse that she attributes her health status to her regular intake of berries, fruit juices, and green tea, which she states "help cleanse the damaging molecules out of my body." The nurse interprets this statement as reflecting which theory of aging? A)Free radical theory B)Biogerontology C)Disposable soma theory D)Cross-

linking theory: A)Free radical theory

15.A nurse is discussing an older adult client's apparent increased suscep- tibility to infection with his family. Which explanation by the nurse would be most congruent with current thought around the autoimmune role in the aging process? A)"Changes that we call 'mutations' in your father's cells make his organs more vulnerable to chronic illness and germs." B)"Older adults often have more difficulty fighting off infections because of their weaker immune systems, and their bodies can even attack themselves." C)"Diseases such as arthritis, which we term 'autoimmune,' make older people

more likely to catch viruses and other bugs." D)"Our bodies seem to have an 'expiration date,' after

which we are far more likely to get infections and develop chronic illness.": B)"Older adults often

have more difficulty fighting off infections because of their weaker immune systems, and their

bodies can even attack themselves."

16. A clinical nurse specialist is espousing the disengagement theory of ag- ing when teaching staff how best to meet the needs of older clients. Which teaching points best captures the disengagement theory of aging? A)"Older adults often benefit from a gradual and controlled withdrawal of their own interests from society's interests." B)"The disengagement between an older adult's abilities and desires can lead to frustration and, ultimately, to illness." C)"The lack of synchronicity between older adults' immune systems and their environments can be the root of many problems." D)"It is imperative that we ensure older adults remain engaged with interests and events beyond them-

selves.": A)"Older adults often benefit from a gradual and controlled withdrawal of their own

interests from society's interests."

17. The nurse manager of a long-term care facility is developing programs for the residents, integrating the concepts of the activity theory of aging. When explaining these programs to the staff, which statement would be most appropriate? A)"We need to facilitate older adults' desire to step back from the responsibilities and roles they had in earlier years." B)"It's hard to overestimate the importance of regular, physical exercise in maintaining health and healthy aging." C)"We need to remember that the psychological roles and characters of our residents change profoundly in later years of life." D)"We have to treat our residents like younger people and

keep them engaged in meaningful acts.": D)"We have to treat our residents like younger people

and keep them engaged in meaningful acts."

18.A nurse is assessing several older adult clients. Which client would the nurse identify as continuing to struggle with achieving Erikson's task of reconciling ego integrity with despair? A)An 80-year-old man is struggling to determine his identity apart from his lifelong career as a business leader. B)A 79-year-old woman has established habits that promote her financial independence despite a lack of savings. C)An 80-year-old man revels in his large, happy family rather than focusing on his mobility limitations resulting from Parkinson disease. D)A 77-year-old man is trying

to determine whether his life has had deep significance and meaning.: B)A 79-year-old woman

has established habits that promote her financial independence despite a lack of sav- ings.

19. A gerontological nurse working at an assisted living facility is developing

programs for the clients to promote healthy aging. Which area would the nurse most likely include? Select all that apply. A)Discussing current events with clients who read and watch television. B)Placing a bib on each client during meal times to ensure cleanliness C)Challenging clients to learn new skills and develop pre-existing talents D)Facilitating introductions between new and existing

clients E)Fostering a focus on the here and now instead of reminiscing about the past: A)Discussing

current events with clients who read and watch television.

C)Challenging clients to learn new skills and develop pre-existing talents

D)Facilitating introductions between new and existing clients

20. A nurse notes that a 90-year-old male client on a hospital medical unit with a high population of older adults has been talking about death frequently. Given that the nurse has good rapport with the client, which response by the nurse would be most appropriate? A)"Try to focus more on the positive

benefits of healing rather than what might happen." B)"Remember that in this day and age, many people can live far beyond 90 years of age." C)"I've noticed you've brought up the issue of dying a lot. How do you feel about that?" D)"You'll find that aiming for health rather than thinking about

death will have positive results.": C)"I've noticed you've brought up the issue of dying a lot. How

do you feel about that?"

21.A gerontological nurse is planning care for older adult clients on the unit. The nurse would focus attention on which health problem due to an increased occurrence in older adults? Select all

that apply. A)Cellulitis B)Pneumonia C)HIV/AIDS D)Diverticulitis E)Endocarditis: B)Pneumonia

D) Diverticuliti

s E)Endocarditis

22.A gerontological nurse is providing care to a 79-year-old widow. Based on the nurse's understanding of the microenvironment, which aspect would the nurse expect the client to focus on first? A)The decor of the house is several decades out of date. B)The home was recently burglarized and the television was stolen. C)The front steps of the house are decaying and pose a safety risk.

D)The home is unbearably hot in the summer and has cockroaches: D)The home is unbearably hot

in the summer and has cockroaches

23..A nurse manager is consulting with the planning committee of a new longterm care facility being built. Which lighting scheme would the nurse man- ager most likely suggest? A)Placement of multiple diffuse lighting sources B)The use of large banks of windows to maximize direct sunlight C)Placement of large fluorescent lighting panels centered in each room D)Low levels of lighting to

reduce glare and address clients with light sensitivity: A)Placement of multiple diffuse lighting

sources

24.An older individual with mobility issues is touring an assisted living facility with the family to find a place to live after the death of his spouse. Which characteristic of the facility would be most problematic? A)The temperature of common areas is kept between 75 °F and 77 °F B)Aromatherapy is used in the facility to provide a pleasant scent environment C)Area rugs are placed in front of each sink in washrooms to ensure warmth D)Carpets, when used in place of tiled floors, are glued to

the floor: C)Area rugs are placed in front of each sink in washrooms to ensure warmth

25. A gerontological nurse is working with a design firm contracted to remodel a long-term care facility. Which bathroom design component would the nurse emphasize as most conducive to safety and quality of life for the older adult residents? A)Throw rugs will be placed on the tile floors B)Bathrooms will include bathtubs rather than showers C)A small independent light to remain

lit in the bathroom at all times D)A single, rotating faucet installed at the sink to control water flow

and temperature: C)A small independent light to remain lit in the bathroom at all times

26.The nurse is on a task force to reduce the incidence of falls among resi- dents of a long-term care facility. Which measure should the nurse recommend to prevent the most falls? A)The use of diffuse, natural lighting on the unit B)A fall history and fall risk assessment of each client on admission C)Psy- chosocial interventions aimed at reducing individuals' fear of falling D)Use of

physical restraints on new clients who have delirium or dementia: B)A fall history and fall risk

assessment of each client on admission

27. A gerontological nurse is working as part of a team tasked with developing a restraint policy for the long-term care facility. Which information should the team incorporate into the policy? A)Restraints should never be used. B)Physical restraints should only be used with verifiably agitated clients. C)Restraints should only be used when one-to-one staff supervision is not possible. D)Alternatives must be explored before any restraints are utilized.-

: D)Alternatives must be explored before any restraints are utilized.

28. During a morning assessment, the nurse notes that the oral temperature of an older client is 96°F (35.6°C). Which information would the nurse incorporate into the decision- making process about this finding? A)Older adults are at increased risk for hyperthermia. B)Low temperature constitutes a risk to cardiac health. C)Older adults often lose body heat in response to infection. D)The normal older adult body temperature is

often lower than younger adults.: D)The normal older adult body temperature is often lower

than younger adults.

29.While conducting a home visit, the nurse learns that the older adult client has developed cataracts. Which statement would be most appropriate related to the client's ability to drive? A)"You might want to consider planning to avoid nighttime driving." B)"This is likely a good time for you to consider giving up your license." C)"The myth of older drivers being more dangerous is exactly that: a myth." D)"It's probably best to consider asking your children to drive you around

from now on.": A)"You might want to consider planning to avoid nighttime driving."

30. A gerontological nurse is providing care to an older adult client with a history of heart failure, type 2 diabetes, and hypertension. Which self-care activity would be most appropriate for the nurse to teach the client how to do? A)Monitor pulse rate and lung sounds B)Start a course of antibiotics with temperature increases C)Accurately measure total daily fluid intake and

output D)Adjust blood pressure medication dosage based on home blood pressure readings:

A)Monitor pulse rate and lung sounds

31.A gerontological nurse is conducting an in-service program for a group of nurses working at a large urban health care center that serves a widely diverse older adult population. When describing the projections for the future related to the diversity of older Americans, which information would the nurse most likely include? A) By 2020, more than 50% of older Americans will belong to a non- Hispanic white group. B) The percentage of black older adults will decrease slightly due to lower life expectancies. C) The number of Hispanic older adults is projected to grow dramatically. D) Within 40

years, a minority of older Americans will be white related to immigration.: C) The number of

Hispanic older adults is projected to grow dramatically

32.A nurse is providing care for an 81-year-old woman of Hispanic descent who was admitted to the older adult medical unit of a hospital. When devel- oping the client's plan of care, which factor would the nurse need to integrate into the plan? A) The client's family advocating for her placement in a nursing home at an early stage. B) The client prioritizing the role of spirituality in the healing process. C) The client foregoing traditional treatment due to a fatalistic view of illness. D) The client's

family delegating responsibility for care to the hospital care team: B) The client prioritizing the role

of spirituality in the healing process

33.A nurse who works in an inner-city clinic provides care for a large number of the older black clients. Which health promotion activity best reflects the specific health needs of this population? A) A blood sugar and blood pressure monitoring program. B) An education session on the positive

health effects of good nutrition. C) A screening mammography campaign for older black women. D)

A program that teaches black men the importance of prostate health screening.: A) A blood sugar

and blood pressure monitoring program

34. A nurse works in the emergency department of a large, urban hospital. When assessing the following older black adults who have recently presented to the department, which assessment technique would the nurse need to modify for this population? A) Assessment of the strength and gait of an 80-year-old male client with a history of failure to thrive. B) Assessment of peripheral sensation in a 76-year-old male client with poorly controlled diabetes mellitus. C) Assessment of cyanosis in a 78-year-old female with peripheral vascular disease. D) Assessment of a client's chest pain who has a history of myocardial

infarction.: C) Assessment of cyanosis in a 78-year-old female with peripheral vascular disease.

35. A nurse is assessing an 84-year-old female Chinese American's pain following her left hemiarthroplasty 2 days prior. Which characteristic of this cultural group would the nurse need to keep in mind during this assessment? A) Chinese Americans often underreport pain based on the view that pain as a virtue. B) Chinese Americans see analgesia as inappropriate and unde- served. C) Chinese women often overstate pain due to health care providers' reluctance to provide analgesia. D) Chinese Americans often exhibit a

reluc- tance to acknowledge pain.: D) Chinese Americans often exhibit a reluctance to

acknowledge pain.

36. A nurse is providing care to an older female Jewish American who is dying. Which intervention would the nurse most likely identify as being problematic for this client and her family? A) The client required transfusions of packed red blood cells during her care. B) Assessment by a male physician was required. C) An autopsy was ordered due to the client's unique disease etiology. D) A do-not-resuscitate

(DNR) order was recommended by the care team when the client's disease progressed.: C) An

autopsy was ordered due to the client's unique disease etiology

37.A newly hired nurse is being orientated to the position in a community health center that provides care to the adjacent large Indian reservation. Which statement by the nurse indicates a sound understanding of the Native American population? A) "I suppose that we will see a disproportionately high number of clients with lung and oral cancers." B) "The high prevalence of diabetes and hypertension mean that strokes are likely to be relatively frequent in the area." C) "It's

unfortunate that many of the older Native Ameri- cans are unlikely to have family members involved their care." D) "The unique skin pigmentation of Native Americans means that I'll have to

modify my assessment techniques.": B) "The high prevalence of diabetes and hypertension mean

that strokes are likely to be relatively frequent in the area."

38. A nurse is working in an assisted living facility that has a culturally diverse older adult population. Which statement by the nurse best demonstrates cultural sensitivity? A) "We need to ensure that both minorities and Americans have their health needs met." B) "It's important to remember that minority groups do not usually express their pain explicitly." C) "We need to build our knowledge of residents who belong to cultural and ethnic groups that we're not familiar with." D) "We need to teach Hispanic and Native American residents that their health problems are not

necessarily the result of punish- ment.": C) "We need to build our knowledge of residents who

belong to cultural and ethnic groups that we're not familiar with."

39. A nurse is reviewing the client population of a local community health center and identifying the health care needs of the group. The nurse decides to develop a screening program for hypertension. With which client popula- tion would the nurse most likely be working? A) A seniors' group based at a Jewish community center in Brooklyn. B) An Indian reservation in rural, western Oklahoma. C) A predominantly Chinese-American neighborhood in the San Francisco Bay area. D) A minimum-

security prison serving young, rehabilitating offenders.: B) An Indian reservation in rural,

western Oklahoma.

40.A gerontological nurse is conducting an in-service program for a group of nurses who work in various areas of the city with a wide range of culturally diverse older adults. After teaching the group about the impact of culture on health and illness, the nurse determines that the teaching was successful when the group identifies which reason as underlying the need to understand culture? A) Ensure that clients get the respect customary in their own ethnic group B) Provide individualized and culturally sensitive care C) Ensure that medical treatments comply with cultural expectations D)

Increase compliance among minority patients: B) Provide individualized and culturally sensitive

care

41. During an assessment of an 82-year-old woman, a gerontological nurse learns that the woman has lost over 4 inches in height over the last several years. Which factor would the nurse most likely identify as contributing to this phenomenon? Select all that apply. A) The woman's overall proportion of body water has decreased. B) The client has experienced a loss of cartilage.

C) The woman's thyroid hormone levels have declined since the sixth decade. D) The client's vertebrae have thinned. E) Loss of stature is a consequence of the woman's diet. F)

The woman's long bones have decreased in length.: A) The woman's overall proportion of body

water has decreased. B) The client has experienced a loss of cartilage. C) The woman's thyroid

hormone levels have declined since the sixth decade.

42.A 78-year-old man has received a recent diagnosis of community-acquired pneumonia. Potential pathological findings on a recent chest x-ray have prompted his health care provider to order a bronchoscopy and lung function tests. The nurse is reviewing the client's medical record. Which finding would lead the nurse to suspect a pathological process rather than a normal, age-re- lated respiratory change? A) The client has fewer cilia than would be found in a younger client. B) Maximum breathing and vital capacity are diminished since his last test. C) Accumulation of serous fluid is seen between the lungs and the pleural membrane. D) The lungs are smaller than younger

adults' and there are fewer alveoli: C) Accumulation of serous fluid is seen between the lungs

and the pleural membrane

43.An 80-year-old resident of an assisted living facility is proud of the fact that he was an elite athlete during his younger years. Despite his concerted efforts to remain physically active and maintain his stamina, he is lamenting his loss of exercise tolerance in recent years. Which response of the nurse would be most appropriate? A) "It's inevitable that your heart increases in size as you age, and this is associated with a loss of cardiac efficiency." B) "It's normal for your heart to contract less strongly as you age, and this makes you somewhat less able to exercise vigorously." C) "As you age, it's common for your heart rate to become less regular and this often results in fatigue." D) "The normal increase in blood pressure that accompanies aging leaves you with less cardiac reserve

capacity than when you were young.": B) "It's normal for your heart to contract less strongly as

you age, and this makes you somewhat less able to exercise vigorously."

44. A nurse is providing care to several clients on the geriatric medical unit. The nurse reviews each client's diagnostic and assessment findings. Which result would lead the nurse to investigate further? A) An 81-year-old woman's glomerular filtration rate (GFR) is low. B) A 78-year-old male's stomach pH is increased. C) A 71-year-old male client's echocardiogram reveals slight left ventricular hypertrophy. D) A 78-year-old man has recently developed urinary

incontinence.: C) A 71-year-old male client's echocardiogram reveals slight left ventricular

hypertrophy

45. A nurse is providing care to a 66-year-old man who has undergone a digital-rectal exam (DRE) during a visit to his primary health care provider. The exam revealed that the client's prostate has become enlarged since his last DRE. Based on this information, which condition

would be most likely? A) Prostate cancer B) A risk of malignancy that should be followed up C) A normal age-related

change unlikely to have consequences D) A urinary tract infection: B) A risk of malignancy that

should be followed up

46.A 74-year-old woman has presented to the emergency department with a suspected hip fracture following a fall on the sidewalk outside her home. While gathering the client's history, the nurse suspects that which underlying factor most likely contributed to the suspected injury? A) Bone remodeling in long bones ceases in the seventh or eighth decade. B) Bone minerals and mass are reduced as part of the aging process. C) Bone marrow production of cellular components declines with age. D) Thinning disks and shortened vertebrae are common findings in older adults.:

B) Bone minerals and mass are reduced as part of the aging process.

47. An 82-year-old client is undergoing an endocrine diagnostic workup to diagnose his increasing fatigue of unknown etiology. Which finding would

his care team recognize as potentially pathological? A) Apparent decreased thyroid gland activity. B) Decreased somatotropic growth hormone (GH) lev- els. C) Delayed and insufficient release of insulin

by the b-cells. D) Increased secretion of adrenocorticotropic hormone: D) Increased secretion of

adrenocor- ticotropic hormone

48.A nursing assistant at a long-term care facility has assured the family of a resident that their father's increasing forgetfulness is a normal part of the aging process. How can the nurse best respond to the nursing assistant's statement to the family? A) "It's actually a myth that older people experi- ence changes to their memory." B) "Memory losses are a normal age-related change many people experience." C) "Older adults have less working memory and slower retrieval, but this still requires further assessment." D) "There is no reason for healthy older adults to experience changes

in their memory unless they are experiencing dementia.": C) "Older adults have less working

memory and slower retrieval, but this still requires further assessment."

49. A nurse practitioner is teaching a 90-year-old client about her new med- ication regimen. Which principle would be most important for the nurse to integrate into the teaching session? A) Numerous factors can interfere with learning but learning ability is not seriously altered with age. B) Older adults require simplified learning objectives and slower introduction of new direc- tions. C) Simple association is well executed by older adults but complex analysis is normally absent. D) Successful learning late in life requires a multisensory teaching

approach: A) Numerous factors can interfere with learning but learning ability is not seriously

altered with age.

50. An 83-year-old man comes to the clinic complaining of hearing loss. Fur- ther examination reveals that this hearing loss is progressive, but otherwise unremarkable. Which phenomenon would the nurse most likely identify as contributing to the client's status? A) Multiple changes in the structures of the inner ear. B) The effect of cognitive changes on the interpretation of auditory stimuli. C) Cellular atrophy of the cells in the outer and middle ear.

D) Age-related deterioration of the neural pathways associated with hearing acuity.: A) Multiple

changes in the structures of the inner ear.

51. A nursing assistant notices that an older client's oral intake has been poor since being admitted to the care area. The assistant reports this finding to the nurse, but says, ìI'm not concerned since older people don't need to eat much anyway.î Which response by the nurse would be most appropriate? A) "Actually, that is a myth; older adults have increased caloric and nutritional needs." B) "Older adults who are sick require more calories than younger people do during their recovery." C) "You're right, but it's still important that

we provide vitamin supplements especially when a client is recovering from an illness." D) "Even though older adults don't need quite as many calories, they need as many nutrients as you or I.":

D) "Even though older adults don't need quite as many calories, they need as many nutrients

as you or I."

52. A health-conscious resident of an assisted living facility is promoting the value of fiber to a fellow resident. In addition to improving bowel activity, which additional benefit would be most appropriate for the health-conscious resident to cite? A) Increased metabolic rate B) Decreased serum cholesterol

C) Improved gastric emptying D) Increased nutrient absorption: B) Decreased serum cholesterol

53. During a home visit, the nurse is asked by an older couple if vitamin and nutritional supplements can compensate for poor food intake. Which response by the nurse would be most appropriate? A) "Supplements can be useful but avoid those that contain calcium." B) "The risks of excess dosages mean that supplements are best avoided entirely." C) "Supplements should be thought of as supplements, not replacements, so don't use them." D) "Vitamin and nutrient supplements can be useful short-term, but only if they don't

interact with prescribed medications.": D) "Vitamin and nutrient supplements can be useful

short-term, but only if they don't interact with prescribed medications."

54.An older woman asks what she can do to reduce the risk of developing osteoporosis. Which response by the nurse would be most appropriate? A) "The primary key to preventing osteoporosis is to remain physically active on a regular basis." B) "For women who have complete menopause,