Understanding Gerontological Nursing: Providing Quality Care for Older Adults, Exams of Nursing

Download Understanding Gerontological Nursing: Providing Quality Care for Older Adults and more Exams Nursing in PDF only on Docsity! Sas-Care For Adults Exam Quiz And Correct Answers 2023-2024 Gra ded A+ SAS 1 Which of the following improves attitudes toward aging and older adults?* Staying away from older adults Education about older adults Travelling to older communities Watching the portrayals of older adults in movies and on TV What is the rationale?* Geriatric nurses are educated to understand and treat the often complex physical and mental health needs of older people. They try to help their patients protect their health and cope with changes in their mental and physical abilities, so older people can stay independent and active as long as possible. What best describes nurses as a care provider?* Determine client’s need Provide direct nursing care Help client recognize and cope with stressful psychological situation Works in combined effort with all those involved in patient’s care What is the rationale?* Therefore, the best description of a care provider is the accurate and prompt determination of the client's need to be able to render an appropriate nursing care. Manage r Advocat e Teacher Provider of Care What is the rationale?* Advocacy may take many forms, including active involvement at the political level or helping to explain medical or nursing procedures to family members on a unit level What role involves gerontological nurses being aware of current research literature, continuing to read and put into practice the results of reliable and valid studies?* Research Consumer Advocate Teacher Provider of Care What is the rationale?* The appropriate level of involvement for nurses at the baccalaureate level is that of research consumer. As a nurse manager, Nurse Beth knows that she needs to develop the following skills except;* Time management Assertiveness Staff insubordination Communication What is the rationale?* Except for staff insubordination, as a nurse manager you need to develop skills in staff coordination, time management, assertiveness, communication and organization. A primary care provider’s order indicate that a consent form needs to be signed. Since the nurse was not present when the primary care provider discussed the procedure, which statement best illustrates the nurse fulfilled the client advocate role?* “The doctor has asked that you sign this consent form.” “Do you have any questions about the procedure?” “What were you told about the procedure you are going to have?” “Remember that you can change your mind and cancel the procedure.” What is the rationale?* This is the best answer because the nurse is assessing the client's level of knowledge as a result of the discussion with the primary care provider. A nurse who reads research articles and incorporates research findings into nursing practice would demonstrate which of the following roles?* Collaborator Primary Investigator Producer What is the rationale?* The repeated return demonstration approach is an approach to teaching that involves demonstrating a skill or concept multiple times to a learner. This approach is often used when teaching complex tasks or skills that require a high level of coordination. This approach allows the learner to see the skill or concept being demonstrated multiple times, which can help them to better understand and learn the task or skill. 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:* ask the family member to answer the questions. ask the same questions in a louder and lower voice. determine if the patient knows the name of the current president. rephrase the questions slightly, and slowly repeat them in a lower voice. What is the rationale?* It is possible that the patient does not understand the language or words the nurse used. Older patients have difficulty hearing high-pitched sounds, so a lower voice must be used in talking to them. The American Nurses Association's Gerontological Nursing: Scope and Standards of Practice emphasizes:* that abnormal responses to the aging process determine the appropriate nursing diagnoses. that the health status data of older adult patients be documented in a retrievable form. the role of the older adult patient as the sole decision maker in planning his or her care. the unchanging nature of the goals and plans of care for older adult patients. What is the rationale?* Gerontological nursing is concerned with the aging process , as well as the preservation, enhancement, restoration, as well as optimization of health and function, as well as the prevention of disease but also damage and indeed the stimulation of recovery What is the rationale?* The language used in the statement sends a certain level of misunderstanding or incomprehension on the side of the caregiver on the situation of the patient. This needs further education. SAS 3 Nurse Bianca is aware that the theory of aging most likely to explain why the older population is at risk for autoimmune disorder is known as:* cross-link theory. free radical theory. error theory. autoimmune theory. What is the rationale?* The immunity theory proposes that cellular errors in the immune system have been found to lead to an auto-aggressive phenomenon in which normal cells are misidentified as alien and are destroyed by the body's own immune system. This phenomenon is used to explain the increase of autoimmune disorders as we age. The family member of a patient asks if vitamin C will prevent aging. In formulating an appropriate response, the nurse considers what theory?* free radical theory. autoimmune theory. wear-and- tear theory. continuity theory. What is the rationale?* According to the free radical theory, random free radical damage causes ageing. The ability of compounds with antioxidant properties to thwart the effects of free radicals is still being studied. For a very long time, it was believed that taking more antioxidants, such vitamin C, may slow down or even reverse the consequences of ageing. However, it is now understood that consuming additional antioxidants might be harmful to one's health. Nurse Maria implements the concepts of the activity theory of aging when instructing the older client with osteoarthritis to:* continue her daily walking routine. curtail further increases in physical activity. document preferred end-of-life interventions. avoid exposing herself to crowds. What is the rationale?* You can prevent bone loss with regular exercise, such as walking. If you have osteoporosis or fragile bones, regular brisk walking can help to keep your bones strong and reduce the risk of a fracture in the future. The 45-year-old patient reports to the nurse he feels he is going through a "mid-life crisis." The nurse recognizes this phenomenon refers to the theory developed by which psychologist?* Jung Erikson Newman Havighurst What is the rationale?* Carl Jung's theory of development proposes that an individual progresses through life searching and setting goals for him or herself in an ongoing search for one's "true self." The "mid-life crisis" is the caused by free radicals. Damage to DNA, protein cross-linking and other changes have been attributed to free radicals. Over time, this damage accumulates and causes us to experience aging. The nurse would recognize successful aging according to Jung’s theory when a long-term care facility resident demonstrates which of the following behaviors?* The resident takes special care to dress for dinner in a manner that pleases his tablemates. The resident asks permission to sit on the patio with other residents. The resident asks persons in his hall if his television is bothering them. The resident wears a large cowboy hat at all times because he likes it. What is the rationale?* Jung describes a successful adjustment to aging as being accepting and valuing of self regardless of the view of others. The nurse in the long term care facility who cares for primarily order adults knows these adults are in which stage of Erikson’s developmental tasks?* Trust vs mistrust Integrity vs Despair Industry vs Inferiority Generativity vs stagnation What is the rationale?* Ego integrity versus despair is the eighth and final stage of Erik Erikson's stage theory of psychosocial development. This stage begins at approximately age 65 and ends at death. It is during this time that we contemplate our accomplishments and can develop integrity if we see ourselves as leading a successful life. Which theory suggests that older people who have low levels of social activity have a high degree of life satisfaction?* Activity Age stratification Disengagemen t Exchange Based on the free theory of aging, what would be an appropriate behavior that might increase one’s life expectancy?* Exercise for 45 minutes at least three times a week. Eat food rich in antioxidants. Eat a low-calorie, high protein diet. Do nothing. Life expectancy is determined through genetic programming. What is the rationale? Free radicals can damage your cells if they're present at high levels. That's where antioxidants come in. These molecules stabilize free radicals so they're unable to cause damage. SAS 4 Which is the best example of polypharmacy?* Your patient is filling her medications at more than 1 drugstore. Your patient is taking more than 2 medications. Your patient is taking more than 9 medications. Your patient is taking a potentially inappropriate combination of medicines. Of decreased gastrointestinal motility What is the rationale?* That's because aging, though it does not affect the digestive system the same way it does other organs in the body, is a risk factor for some issues, including colon cancer, acid reflux, stomach sensitivity to medications and a decreased absorption of some vitamins. Enteric coated tablets are designed to avoid being dissolved in the highly acidic stomach. Instead, they dissolve in the intestine. Knowing this and what you know about gastrointestinal changes associated with age, what can you conclude about enteric coated tablets and older patients?* The tablets will need to be given intravenously instead These tablets will probably dissolve more slowly The enteric coated tablets are unaffected by changes associated with age These tablets may dissolve more quickly What is the rationale?* Aging is associated with a reduction in first-pass metabolism. This is probably due to a reduction in liver mass and blood flow. As a result, the bioavailability of drugs undergoing extensive first-pass metabolism such as propranolol and labetalol can be significantly increased In an older population we can expect that drugs will be:* Absorbed more quickly Metabolized more quickly Excreted more rapidly by the kidneys Excreted less readily What is the rationale?* Once drugs have had their desired effect, they need to be eliminated by the body. Excretion predominantly occurs via renal elimination in the kidneys. The total size of the kidneys decreases with age, as does the number of functioning nephrons. There is also decreased renal blood flow with increasing age. Which of the following is an age-related physiologic change that may affect the absorption of drugs?* Xerostomia Faster stomach emptying Altered pH of the stomach contents Increased gastrointestinal tract motility What is the rationale?* Increase in pH led to decrease in solubility and percentage of unionized form of weakly basic drug and an increase in its distribution coefficient. The effect of solubility and partition coefficient on skin permeability is a well-documented phenomenon. The nurse is caring for a group of older adult patients who are all receiving multiple medications. The nurse understands that it is essential to individualize each patient's therapy. Which is the best rationale for this practice?* The percentage of drug absorbed often is decreased in older adults. Most older adults have decreased body fat and increased lean mass. Hepatic metabolism tends to increase in older adults, resulting in decreased drug levels. Renal function declines with age, leading to decreased drug excretion. problems, and death. The study is based on data from 1.2 million people with dementia and covered by Medicare. The single most important thing we can do as healthcare providers to prevent polypharmacy is:* Encourage our patients to carry a list of home medications in their wallet Tell our patient to appoint a lead doctor Educate our patients on each of their new medications Tell our patients to Google all of their medications What is the rationale?* The most important measure that patients can take to prevent polypharmacy is to ensure that all of their healthcare providers have a complete and up-to-date list of their medications, including dosages and when they should be taken. This list should include OTC medications, supplements, and vitamins SAS 5 You are caring for a client at the end of life. The client tells you that they are grateful for having considered and decided upon some end of life decisions and the appointments of those who they wish to make decisions for them when they are no longer able to do so. During this discussion with the client and the client’s wife, the client states that “my wife and I are legally married so I am so glad that she can automatically make all healthcare decisions on my behalf without a legal durable power of attorney when I am no longer able to do so myself” and the wife responds to this statement with, “that is not completely true. I can only make decisions for you and on your behalf when these decisions are not already documented on your advance directive.” How should you, as the nurse, respond to and address this conversation between the husband and wife and the end of life?* You should respond to the couple by stating that only unanticipated treatments and procedures that are not included in the advance directive can be made by the legally appointed durable power of attorney for healthcare decisions. You should be aware of the fact that the wife of the client has a knowledge deficit relating to advance directives and durable powers of attorney for healthcare decisions and plan an educational activity to meet this learning need. You should be aware of the fact that the client has a knowledge deficit relating to advance directives and durable powers of attorney for healthcare decisions and plan an educational activity to meet this learning need. You should reinforce the wife’s belief that legally married spouses automatically serve for the other spouse’s durable power of attorney for health care decisions and that others than the spouse cannot be legally appointed while people are married What is the rationale?* Both the client and the client’s spouse have knowledge deficits relating to advance directives. Legally married spouses do not automatically serve for the other spouse’s durable power of attorney for health care decisions; others than the spouse can be legally appointed while people are married. Your client is in the special care area of your hospital with multiple trauma and severe bodily burns. This 75 year old male client has an advance directive that states that the client wants all life saving measures including cardiopulmonary resuscitation and advance cardiac life support, including mechanical ventilation. As you are caring for the client, the client has a complete cardiac and respiratory arrest. This client has little of no chance for survival and they are facing imminent death according to your professional judgement, knowledge of pathophysiology and your critical thinking. You believe that all life saving measures for this client would be futile. What is the first thing that you, as the nurse, should do?* Call the doctor and advise them that the client’s physical status has significantly dignified condition, no photographs can be legally taken without the residents’ permission and consent. Which is most closely aligned with ethics?* Morals Laws Statutes Client rights What is the rationale?* Morals are most closely aligned with ethics. Ethics is a set of beliefs and principles that guide us in terms of the right and wrong thing to do which is the most similar to ethics. What ethical principle below is accurately paired with a way that ethical principle is applied into nursing practice?* Justice: Equally dividing time and other resources among a group of clients Beneficence: Doing no harm during the course of nursing care Veracity: Fully answering the client’s questions without any withholding of information Fidelity: Upholding the American Nurses Association’s Code of Ethics What is the rationale?* Fully answering the client’s questions without any withholding of information is an example of the application of veracity into nursing practice. Veracity is being completely truthful with patients; nurses must not withhold the whole truth from clients even when it may lead to patient distress. One of the roles of the registered nurse in terms of informed consent is to:* Serve as the witness to the client’s signature on an informed consent. Get and witness the client’s signature on an informed consent. Get and witness the durable power of attorney for health care decisions’ signature on an informed consent. None of the above What is the rationale?* One of the roles of the registered nurse in terms of informed consent is to serve as the witness to the client’s signature on an informed consent. Other roles and responsibilities of the registered nurse in terms of informed consent include identifying the appropriate person to provide informed consent for client, such as the client, parent or legal guardian, to provide written materials in client’s spoken language, when possible, to know and apply the components of informed consent, and to also verify that the client comprehends and consents to care and procedures. Which of the following is most closely aligned with the principles and concepts of informed consent?* Justice Fidelity Self determination Nonmalficence What is the rationale?* Self-determination is most closely aligned with the principles and concepts of informed consent. Self-determination supports the client’s right to choose and reject treatments and procedures after they have been informed and fully knowledgeable about the treatment or procedure. The student understands the ANA Code of Ethics for Nurses when she identifies which statement as incorrect? The Code of Ethics for Nurses:* seek the assistance of an ethics committee. What is the rationale?* As with all nursing functions, the first step is assessment. Basing a decision on whether an action is right or wrong is an ethical decision-making framework based on deontology. Basing a decision on the possible consequences reflects the theory of utilitarianism. Seeking the assistance of an ethics committee would occur after assessment if the ethical dilemma cannot be resolved among the patient, family, and caregivers. SAS 6 Which of the following is NOT a priority for patients with a life-limiting illness receiving palliative care? A) Relieving burden B)Prolonging life at all costs C)Obtaining a sense of control D)Strengthening relationships with loved ones RATIONALE: An early survey of patients with life-limiting diseases identified five priorities for palliative care: receiving adequate treatment for pain and other symptoms, avoiding inappropriate prolongation of life, obtaining a sense of control, relieving burden, and strengthening relationships with loved ones 2.The family of a client with a terminal illness hesitates to agree to palliative care because of not wanting to give up on a possible cure. How should the nurse respond while also including a principle of palliative care? a."Most people don't realize that palliative care means there is no cure." b."There will not be another opportunity if palliative care is refused now." c. "The client can continue to receive treatment intended to cure the disease." d."Palliative care and curative treatments cannot be provided at the same time." RATIONALE: The Principles of Palliative care includes to Affirm life and regarding dying as a normal process, to Neither hastens nor postpones death, to Provide relief from pain and other distressing symptoms,to Integrate the psychological and spiritual aspects of care. 3.The family of a client receiving palliative care for a terminal illness hesitate to call for the nurse since all staff seem to be too busy to address the client's needs. Which action should the nurse take to improve the connection with the family? a.Vary the number and type of caregivers who respond to the client's needs b.Enter the room and stand or sit at the bedside to talk with the client and family c. Provide the family with reading material that explains the role of palliative care d.Attend to infusions and environmental issues while talking with the client and family RATIONALE : The principles of Palliative Care includes Offering a support system to help patients live as actively as possible until death and Offering a support system to help patients’ families cope during the patient’s illness and in their own bereavement 4.Which of the following is NOT a barrier to the optimum use of palliative care at the end of life? A) Reimbursement policies B)Easily determined prognoses C)Lack of well-trained healthcare professionals D)Attitudes of patients, families, and clinicians RATIONALE: Among the most important barriers to the optimum use of palliative care at the end of life are the lack of well-trained healthcare professionals; reimbursement policies; difficulty in determining accurate prognoses; and attitudes of patients, families, and clinicians. 5.An 80-year-old patient is receiving palliative care for heart failure. What are the primary purposes of her receiving palliative care (select all that apply)? A. Improve her quality of life. B.Assess her coping ability with disease. C.Have time to teach patient and family about disease. D.Focus on reducing the severity of disease symptoms. E.Provide care that the family is unwilling or unable to give. RATIONALE: The focus of palliative care is to reduce the severity of disease symptoms. The goals of palliative care are to prevent and relieve suffering and to improve quality of life for patients with serious, life-limiting illnesses. 6.The home health nurse visits a 40-year-old breast cancer patient with metastatic breast cancer who is receiving palliative care. The patient is experiencing pain at a level of 7 (on a 10-point scale). In prioritizing activities for the visit, you would do which of the following first? A. Auscultate for breath sounds. B. Administer prn pain medication. C. Check pressure points for skin breakdown. D. Ask family members about patient's dietary intake. RATIONALE: Meeting the patient's physiologic and safety needs is the priority. The priority is to treat the severe pain with pain medication.