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geri midterm practice Q's
A negative attitude towards aging and the aged is called: a) geriatrics b) racism c) ageism d) ethnocentrism - ANSWER c) ageism** 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) Obtain certification in gerontological nursing** 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) a and b only** 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 - ANSWER c) research consumer** 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 d) Greg Reed, RN, MSN - ANSWER b) Mary Malloy, RN, MS, GNP**
The AACN/John A. Hartford Foundation Competencies are helpful to nurses because they: a) offer suggestions about how to gain employment in geriatrics b) provide a guideline for the knowledge that is expected to provide quality care to older adults c) were designed to prepare nurses to pass the State Board Exam d) were written for nurses working on a graduate degree in gerontology - ANSWER b) provide a guideline for the knowledge that is expected to provide quality care to older adults** The nurse has a question about the appropriateness of an older patient's medication dose. Which of the following professionals would be best qualified to answer such a question? a) the geropsychologist b) the geropharmacist c) the financial gerontologist d) the gerontological rehabilitation nurse - ANSWER b) the geropharmacist** The health care professional who wants to gain experience in working with older adults who are post-acutely recovering from serious illness or injury, have challenging medical issues needing 24 hour per day nursing, but who cannot yet tolerate a full rehabilitation program may be best suited for employment in what setting: a) acute care hospital b) assisted living c) rehabilitation d) subacute care - ANSWER d) subacute care ** Which of the following levels of care would be most appropriate for a healthy 84 year old man who can take care of himself, but wants to live in a place where he can socialize and have help available if needed? a) a group foster home b) a transitional care unit c) an independent unit in a senior living complex d) assisted living in a nursing home - ANSWER c) an independent unit in a senior living complex ** Which of the following is not true about assisted living facilities?
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) not enough health professionals choosing gero as a specialty ** T/F 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 - ANSWER true T/F Over half of women over the age of 85 are widowed - ANSWER true T/F There are more males in the population than females - ANSWER false T/F Most centenarians (people over the age of 100 years) are White and female - ANSWER true T/F Minority elderly groups are growing and thus present unique challenges for nurses today - ANSWER true T/F The majority of older persons live alone - ANSWER false T/F Older women who live alone tend to be more from lower income groups than those who are married - ANSWER true T/F Elderly Hispanics rate their overall health significantly higher than those from other ethnic groups - ANSWER false T/F
Older persons tend to die from acute illnesses more than chronic diseases
- ANSWER false T/F The major causes of death in the older age group are heart disease, AIDS, and tuberculosis - ANSWER false (heart disease, strokes, and cancer) Have a higher rate of diabetes, hypertension, and chronic renal disease than other ethnic groups. - ANSWER African Americans Most rapidly growing ethnic minority, and less likely to obtain preventive services such as flu vaccines and mammograms. - ANSWER Hispanics Is comprised of many subgroups and generally have a longer life expectancy than white Americans. - ANSWER Asians and Pacific Islanders Make up a small percentage of America's elderly population and have increased morbidity and mortality related to diabetes and renal disease. - ANSWER American Indians and Alaskan natives List the three leading causes of death in the elderly: - ANSWER heart disease, stroke, cancer The theory of aging that says that personality and coping patterns remain consistent through life is: a) continuity b) gerotranscendence c) human needs d) life course - ANSWER a) continuity ** Erikson's stages of personality development for a person that is 76 years old would be: a) autonomy versus shame b) integrity versus despair c) generativity versus isolation d) trust versus mistrust - ANSWER b) integrity versus despair ** A biological theory of aging that is based on random events that cause cellular damage versus genetically programmed events is called: a) nonstochastic
stochastic theories - ANSWER based on random events that cause cellular damage neuroendocrine theory - ANSWER problems with gland feedback leads to disease activity theory - ANSWER remaining active and involved promotes life satisfaction in later years gerotranscendence theory - ANSWER transformation towards oneness with the universe nonstochastic theories - ANSWER genetically programmed events cause cellular damage that lead to aging theory of thriving - ANSWER failure to thrive is from discord in relationships human needs theory - ANSWER five basic needs that motivate behavior (physiological, safety, belonging and love, esteem, self-actualization, and self-transcendence) functional consequences theory - ANSWER nurse's role is risk reduction to enhance safety wear and tear theory - ANSWER cells wear out with age 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. night blindness ** 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. toileting ** (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 - ANSWER d. all of the above ** An older adult who complains of a dark spot in the center of the visual field is showing signs of: a) cataracts b) macular degeneration c) acute glaucoma d) diabetic retinopathy - ANSWER b) macular degeneration ** An older adult who complains of seeing dark shadows around the center of the visual field is showing signs of: a) cataracts b) macular degeneration c) glaucoma d) diabetic retinopathy - ANSWER c) glaucoma ** An older adult who complains of blurry vision and has a bluish-white coating that can be seen on the lens is showing signs of: a) cataracts b) macular degeneration c) acute glaucoma d) diabetic retinopathy - ANSWER a) cataracts ** Which of the following factors could contribute to an older person's inability to hear instructions given by the nurse? a) cerumen impaction b) nurse not facing the person when giving directions c) loss of high frequency pitches d) all of the above - ANSWER d) all of the above **
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) broken speech ** Which of the following signs would you consider an abnormal finding for a 75 year old female? a) blood pressure of 110/ b) Hct (hematocrit) of. c) resting pulse of 80 d) urinary incontinence - ANSWER d) urinary incontinence ** 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) less useful oxygen available with each breath ** 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) decreased vaginal lubrication ** 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? a) what her temperature was yesterday b) how long she has felt sick c) what her usual temperature is d) how much she ate today - ANSWER c) what her usual temperature is ** Which of the following would be an abnormal finding in assessment of an 80 year old male? a) decreased cardiac output
b) decreased stage IV sleep c) loss of hearing of low frequency tones d) age spots on the hands and face - ANSWER c) loss of hearing of low frequency tones ** Which of the following changes in the skeletal system is least characteristic of normal aging? a) decreased range of motion b) loss of height up to 10 cm c) chronic inflammation of joints d) loss of some muscle mass - ANSWER c) chronic inflammation of joints ** All of the following are intrinsic changes in the integumentary system except: a) increased skin temperature b) sagging and wrinkling c) age spots d) increased risk of bruising - ANSWER a) increased skin temperature ** Which of the following is true about normal aging changes in the GI system? a) absorption of nutrients does not change with age b) absorption of certain vitamins does change with age c) small intestine transit rate is relatively unchanged with age d) all of the above - ANSWER d) all of the above Which of the following aging changes is most significant to renal efficiency? a) loss of up to half of functioning nephrons b) decreased cardiac output c) nocturia d) a and b - ANSWER d) a and b ** 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. better ability to focus on near objects **
d. Gibson self-care scale - ANSWER d. Gibson self-care scale ** The nurse working in rehabilitation would most likely see what measure used to evaluate the progress of patients in rehabilitation? a. Katz index of ADL (distinguishes between IADLs and ADLs) b. MDS (Minimum Data Set, Physical, Psych and Psychosocial needs of residents in LTC facilities) c. FIM (Functional Independence Measure) d. OASIS - ANSWER c. FIM (Functional Independence Measure) ** 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. bathing ** In assessing the circulatory system of an older adult, the nurse would recognize which of the following as abnormal? a. resting heart rate of 120 b. blood pressure of 118/ c. respiration rate of 26 d. a and c - ANSWER d. a and c ** 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 d. all are important to ask about - ANSWER d. all are important to ask about 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. increased physical activity
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. a and b 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. all of the above ** The Up and Go Test is useful for assessment because: 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. provides a quick measure of physical, especially walking ability ** Which of the following new findings would be considered abnormal and requiring immediate attention in the older adult? a. presbyopia b. presbycusis c. MMSE (Mini-Mental State Examination) score of 12 d. liver spots - ANSWER c. MMSE (Mini-Mental State Examination) score of 12 ** Which of the following would not be considered a normal aging change when assessing an older adult? a. presbyopia b. presbycusis c. a score of 3 on the geriatric depression scale (GDS) d. macular degeneration - ANSWER d. macular degeneration ** The nurse is administering medications in the nursing home to over 40 residents. Which of the following is not one of the five rights that she should check on each person? a. right patient b. right route
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 c. older adults are not accustomed to taking multiple medications d. a and c only - ANSWER a. the more medications one takes, the greater the risk of side effects ** 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. confusion and severe anticholinergic effects ** 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. all of the above are appropriate 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 d. pushing oneself into new situations - ANSWER a. doing for others and maintaining interests ** Which of the following is most true of older widowers? a. they may focus more on themselves b. they have an increased self esteem c. they may lose interest in social activities d. they experience a heightened sense of sexuality - ANSWER c. they may lose interest in social activities For an older person (living with an adult child) who needs some help and social interaction during the day while their family member is at work, which of the following care settings would the nurse most likely recommend?
a. hospice b. assisted living c. adult day care d. nursing home - ANSWER c. adult day care When an older adult lives with family members, which of the following principles would not be appropriate for the nurse to apply in assisting the family to promote quality of life for their older loved one? a. help them recognize their own needs and limitations b. provide referrals to community resources c. recommend nursing home placement immediately to avoid stress d. respect all family caregivers as an important part of the team - ANSWER c. recommend nursing home placement immediately to avoid stress 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. walking for a total of 20 - 30 minutes, five days per week 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. increase in number of sexual partners 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. chemical restraints 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?
c. research has shown that older adults need to burn more calories than younger adults in order to obtain cardiac benefit from exercise d. all of the above are true - ANSWER a. the emphasis is on being more physically active rather than a narrow adherence to a rigid exercise regimen ** An older client is discussing his desire to continue walking during the winter months, but expresses fear of being out in the colder weather. The nurse appropriately recommends for him to: a. suspend all walking activities until the weather is favorable b. walk inside at the local shopping mall c. join a health club and walk on the treadmill d. continue to walk outside no matter what the weather - ANSWER b. walk inside at the local shopping mall ** Nutrition counseling is thought to be important for older adults because of which factors? a. older adults are more vulnerable to obesity than other age groups b. older adults are more vulnerable to malnutrition than other age groups c. eating and drinking habits are linked to several leading causes of death d. all of the above - ANSWER d. all of the above ** Which of the following foods should the nurse encourage the older client to eat 5 - 13 servings of per day? a. grains b. meat/eggs c. dairy d. fruits/vegetables - ANSWER d. fruits/vegetables 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. weight of 125 pounds 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. smoking cessation 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. breast Which of the following screenings would the nurse not routinely recommend to an older adult? a. mammogram every 1 - 2 years for females b. annual physical c. dementia d. flexible sigmoidoscopy and FOBT - ANSWER a. mammogram every 1 - 2 years for females 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) c. the CLOX (clock drawing) d. the Controlled Oral Word Association Test - ANSWER a. the Kenny Cognitive Scale ** 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. limit water intake to 1000 cc per day 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
