Gerontological Nursing: Caring for Older Adults, Exams of Advanced Education

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ANCC GERONTOLOGICAL

NURSING SAMPLE QUESTIONS

(OLDER VERSION) COMPLETE

UPDATE SOLUTION

A 75-year-old female patient, whose marriage ended in divorce after two years, has lived alone for the past 50 years. Feeling as if her life has had little meaning, the patient is terrified of living out her remaining years and of dying. The age-related issue to be resolved is: A) disengagement versus activity. B) ego integrity versus despair. C) self-determination versus resignation. D) self-esteem versus self-actualization. - Answer B An 80-year-old male patient, who lives at home with his wife, is instructed to follow a 2-g sodium diet. The patient states, "I've always eaten the same way all my life, and I'm not going to change now." To promote optimal dietary adherence, the gerontological nurse's initial approach is to: A)inform the patient about the need to follow the diet. B) inquire about the patient's current food preferences and eating habits. C) list the variety of foods that are allowed on the diet. D) provide dietary instruction to the patient's wife who prepares the meals. - Answer B Signs and symptoms of age-related macular degeneration include: A) deficits in peripheral vision. B) decreases in depth perception. C) distortion of lines and print. D) reports of flashes of light. - Answer C

A 90-year-old patient comes to the clinic with a family member. During the health history, the patient is unable to respond to questions in a logical manner. The gerontological nurse's action is to: A) ask the family member to answer the questions. B) ask the same questions in a louder and lower voice. C) determine if the patient knows the name of the current president. D) rephrase the questions slightly, and slowly repeat them in a lower voice.

• Answer D An effective way to adequately provide nourishishment to a patient with moderate dementia is: A) allowing the patient to choose foods from a varied menu. B) hand-feeding the patient's favorite foods. C) routinely reminding the patient about the need for adequate nutrition. D) serving soup in a mug, and offering finger foods. - Answer D The American Nurses Association's Gerontological Nursing: Scope and Standards of Practice emphasizes: A) the role of the older adult as the sole decision maker in planning his or her care. B) the unchanging nature of the goals and plans of care for older adult patients. C) that abnormal responses to the aging process determine the appropriate nursing diagnoses. D) that the health status data of older adults be documented in a retrievable form. - Answer D A 65-year-old patient exhibits symptoms of hemianopia. The most appropriate nursing intervention is to: A) arrange the patient's meal tray so that all the food is in the patient's field of vision. B) explain all tasks thoroughly to help allay the patient's fears. C) look directly at the patient when speaking to maximize comprehension. D) minimize the operating stimuli to reduce distractions to the patient. - Answer A

For older adults who are taking neuroleptic medication, the primary concern is the development of: A) lethargy. B) nausea. C) poor appetite. D) tardive dyskinesia. - Answer D After a complaint about the care of a nursing home resident is made, a state ombudsman initiates an investigation. Which statement about the investigation process is true? A) The ombudsman may proceed with the investigation without identifying the individual who made the complaint, and without obtaining a court order or written consent. B) The ombudsman must identify the individual who made the complaint. C) The ombudsman must obtain a court order to review documentation, if the resident described in the complaint does not give written permission. D) The ombudsman must obtain the written permission of the resident who is described in the complaint. - Answer A When teaching an independent, older adult patient how to self-administer insulin, the most productive approach is to: A) facilitate involvement in a small group where the skill is being taught. B) gather information about the patient's family health history. C) provide frequent, competitive skills testing to enhance learning. D) use repeated, return demonstrations to promote the patient's retention of the involved tasks. - Answer D The gerontological nurse assesses a 78-year-old patient, who has had a thyroidectomy, for spasm or edema of the vocal chords by: A) auscultating the patient's neck over the vocal chords. B) checking the patient's tone of voice and ability to speak. C) monitoring the patient for dysphagia. D) observing the patient for changes in mental status. - Answer B A male resident in a nursing home requests a new room because he does not like the view from his current room. While the resident is away from the

home on a provider visit, the staff moves the resident's belongings to another room with a better view. The resident and his family later file a formal complaint regarding the move. Which statement gives the best justification for the resident's complaint? A) The change was made without a provider's order. B) The resident was not included in the decision making. C) The resident's belongings were moved without his assistance. D) The resident's family was not included in the decision making. - Answer B A nursing home resident, who was recently admitted, and her family only speak Spanish. One evening during a visit, the resident and her family begin to wail and sob loudly. The gerontological nurse is unable to determine what is wrong. The nurse's most appropriate action is to: A) ask the supervisor to get an interpreter. B) attempt to make the resident and her family comfortable. C) contact the provider for orders. D) find an escort to take the resident and her family to the chapel for privacy. - Answer A Which condition do older adults with Down syndrome tend to develop? A) Alzheimer disease B) Muscular dystrophy C) Paget disease D) Parkinson disease - Answer A Which ethical principle underlies nursing actions respecting each patient's values and beliefs? A) Autonomy B) Beneficence C) Justice D) Responsibility - Answer A An older adult woman, who lives in an apartment in a housing complex for senior citizens, began residing with an older adult man from the same complex three months ago. Upon learning of the situation, the woman's

daughter expresses concern to the housing administrator, who reports that both residents have reported satisfaction with the arrangement. When the daughter requests advice, the gerontological nurse's initial response is: A) "I can understand why you are upset. Has she ever done something like this before?" B) "Why don't we all talk to your mother to get her side of the story?" C) "Your mother has the right to do what she wants because she is mentally competent." D) "Your mother seems to be happy with the arrangement. Have you discussed this situation with her?" - Answer D Which patient is at greatest risk for developing arteriosclerotic heart disease? A) A 60-year-old female patient with a triglyceride level of 135 mg/dL, and a high-density lipoptrotein level of 68 mg/dL B) A 70-year old male patient with a total cholesterol level of 181 mg/dL, and a low-density lipoprotein level of 90 mg/dL C) A 75-year old female patient with a triglyceride level of 189 mg/dL, and a low-density lipoprotein level of 149 mg/dL D) An 86-year-old male patient with a low-density lipoprotein level of 100 mg/dL, and a high-density lipoprotein level of 50 mg/dL - Answer C An 82-year-old male patient has a painful, vesicular rash that burns over his left abdomen. The patient indicates that he has tried multiple creams which have not helped. Which question does the gerontological nurse first ask? A) "Did you have the pain before the rash appeared?" B) "Do you have any food or drug allergies?" C) "Have you been around anyone with a rash?" D) "Have your grandchildren visited recently?" - Answer A Which question does the gerontological nurse prioritize for an 86-year-old male patient with abdominal pain, muscle weakness, and leg cramps? A) "Do you eat a lot of meat?" B) "Do you have heart problems?" C) "Do you take a diuretic?"

D) "Do you walk everyday?" - Answer C A frail 80-year-old woman, who cares for her husband at home without assistance, requires minor surgery. Lacking any family members residing in the area, the wife expresses concern about her husband's care while she is recovering. The gerontological nurse's recommendation is: A) arranging inpatient, respite care for the husband. B) hiring around-the-clock help for two weeks. C) hospitalizing the husband. D) remaining in the hospital during the postoperative period. - Answer A An older adult patient currently takes phenytoin (Dilantin) and tolterodine (Detrol). The gerontological nurse reinforces the need for routine dental visits because these two medications decrease: A) calcium levels in the blood. B) innervations of the trigeminal nerve. C) the muscle strength of the tongue. D) the production of saliva. - Answer D An older adult, who is terminally ill with multiple myeloma, is followed by hospice. Which situation best illustrates that the principles of hospice care are being met? A) The caregiver asks if hospice includes weekend care. B) The caregiver has been calling the provider on his or her own. C) The patient reports enjoying daily excursions. D) The patient reports no breakthrough pain medications are needed. - Answer D A 76-year-old male patient reports hesitancy, decreased force of the urinary flow, a sensation of incomplete emptying of the bladder, and dribbling. The gerontological nurse first asks: A) "Have you experienced abdominal pain?" B) "Have you had a daily bowel movement?" C) "Have you had low back pain?" D) "Have you noticed blood in your urine?" - Answer D

A gerontological nurse is monitoring signs of suspected abuse in an 89- year-old patient who was admitted from home. When planning for the patient's discharge, the nurse's first action is to: A) delay discharge by informing the provider of the suspected abuse. B) enlist the help of family members with transitioning the patient home. C) notify Adult Protective Services of the patient's discharge. D) restrict the family members' access to the patient prior to discharge. - Answer C The gerontological nurse manager involves the nursing staff in the utilization of trend data and analysis for quality improvement by: A) encouraging staff to volunteer for The Joint Commission's onsite surveys. B) highlighting the quality improvement work of experts in the specialty area. C) informing how data and outcomes are directly related to the staff's daily work. D) using scatter diagrams to identify the root cause of unresolved concerns. - Answer C