1. A nurse assesses the risk of the members of an older adult community. Which
individuals is most likely to be living at or below the poverty line?
• ... [Show More] A couple who are both 72 years old
• A Hispanic couple who are both in their 60s
• A white 73-year-old man
• An 83-year-old single woman
Rationale: Women and those over the age of 75 are most likely to live in poverty.
Couples and those 65 to 74 are less likely to live in poverty. Five percent of older
white men live in poverty.
2. A nurse care for an older adult client whose current hospital admission is prompted by
an exacerbation of chronic renal failure. Which action by the nurse will best emphasize
the goal of client wellness?
• Teach the client that health problems do not have to affect daily routines
• Ask that the client’s code status be changed to “do not resuscitate”
• Explore the client’s abilities and strengths
• Show the client others who are more ill
Rationale: A focus on existing strengths and abilities can foster wellness in older
adults, even when they are experiencing health challenges. It is inappropriate to
compare clients with each other, and changing client’s code status unlikely to
promote wellness, even if this is necessary. It is inaccurate to claim that health
problems do not affect daily routines.
3. A nurse assesses a community of older adults. Which person is at highest risk for a
shortened life expectancy?
• A nurse born in 1957
• A homemaker born in 1957
• A college professional born in 1956
• A nuclear engineer born in 1958
Rationale: Socioeconomic characteristics that are most strongly correlated with
healthy aging are poverty and lower educational level. Limited English proficiency
and poor health literacy skills are two variables that have a negative impact on
health and functioning. The college professor, engineer, and nurse positions
require more education that a homemaker.
4. A diabetes nurse is providing care for an older adult client who is a regular client of the
hospital’s outpatient diabetes clinic. What assessment question most clearly addresses
this client’s potential for optimal function?
• “How can we help you to take ownership of your own health?”
• “What are some goals that you have for maximizing your level of wellness?”
• “Is there anything that you’re doing that might be exacerbating your diabetes?”
• How long do you think that you’ll be able to live independently?”
Rationale: Eliciting and older adult’s goals for wellness and high functioning can
help promote these outcomes. Questions about a client’s living situation, disease
management, and personal responsibility may or may not promote wellness.
5. A nurse performs a reflective cultural self-assessment. Which outcome should the nurse
expect?
• Progression from judgmental views of other cultures to recognition of positive
attributes
• An accurate ranking of different cultures according to theirspecific merits
• The ability to assess clients according to their cultural affiliation that their
individual characteristics
• Identification of the flaws and weakness of the nurse’s own culture
Rationale: The process of cultural competence is a progression from judgmental
attitudes and practices to positive approaches. It does focus primarily on the
deficits of one’s own culture, and it does not replace individualized assessment
and care with cultural generalizations. Culturally competent care does not involve
“ranking” different cultures.
6. A nurse has observed an increasing number of older Asian Americans in the hospital.
Which statement regarding Asian cultures will best assist the nurse to plan nursing care
for this group?
• Asian Americans view health as a state of physical and spiritual harmony
• Older Asian Americans are more likely than Americans to live alone
• Asian Americans as a group have lower mortality rates
• Asian Americans commonly care for older adults by placing them in institutional
environments.
Rationale: While it is true that Asian Americans as a group have lower mortality
rates at all ages, the statement that best assists the nurse to plan care of the
Asian client is that a common view of health from the Asian perspective is that of
harmony in the spiritual and physical contexts. Asian Americans are less likely to
live alone. It is more common for older Asian Americans to live with family than
in nursing homes.
7. A nurse at a long-term care facility has completed the admission assessment of an older
adult resident. The resident identifies as gay and has expressed sadness at having to
leave the resident’s partners of several decades in order to move to the facility. The
nurse should recognize which in this individual’s history?
• Homelessness
• Nominal employment or unemployment
• Stigmatization
• Infectious diseases
Rationale: Stigma is a common experience among LGBT (lesbian, bisexual, and
transgender) older adults, and the likelihood of this is greater than the likelihood
of homelessness, unemployment, or infectious diseases.
8. Following knee replacement surgery 10 days earlier, an older adult client diagnosed with
an infection in the knee has a synovial fluid culture ordered. Obtaining the sample helps
to determine the causative microorganism and to select an appropriate antibiotic. The
above course of events characterizes what major health belief system?
• Holistic paradigm
• Analytical paradigm
• Scientific paradigm
• Magico-religious paradigm
Rationale: The scientific (biomedical) health paradigm prioritizes cause-andeffect relationships (i.e., microorganisms and infection) along with manipulation
of these through pharmacologic interventions and surgery. The holistic paradigm
emphasizes the interconnectedness of mind, body, and spirit, and the magicoreligious paradigm emphasizes supernatural factors. The “analytical paradigm” is
not among the three major health belief systems.
9. A nurse in the long-term care facility plans care to improve an older adult client’s quality
of life. Which action is most likely to enhance an older adult’s connectedness with
family?
• Advocating for a married couple to remain in the same room of a long-term care
facility, as is the couple’s preference
• Performing a focused respiratory assessment on a client who has a diagnosis of
lung cancer
• Organizing a client’sintravenous antibiotic therapy on an outpatient basis
• Teaching a client who has had a below-the-knee amputation about how to care
for the stump
Rationale: Advocating for a married couple to remain in the same room of a longterm care facility, as is the couple’s preference, fosters connectedness, a
component of older adult’s quality of life. Teaching wound care, organizing
treatment, and adequately assessing a client are aspects of good care, but these
are not direct contributors to connectedness.
10. A home health nurse performs an admission on an older adult client. The client
expresses concern over “embarrassing urinary issues.” The client’s blood pressure
135/90 mm Hg, with the client’s last bowel movement 1 day ago. Which area addresses
the client’s goals?
• Blood pressure
• Constipation
• Incontinence
• Safety
Rationale: Although nurses address safety, blood pressure, and constipation as
part of a comprehensive care plan, it is imperative to begin by addressing the
older adult’s priority concerns.
11. A nurse is using the Functional Consequences Theory for planning client care in a health
care facility. Which statement would assist the nurse in implementing this theory?
• “Most functional consequences cannot be addressed through nursing
interventions.”
• “The Functional Consequences Theory is an alternative to holistic nursing care.”
• “Wellnessis a concept that is broader than just physiologic functioning.”
• “Most problems affecting older adultsrelate to issues of aging.”
Rationale: Within the Functional Consequences Theory, wellness is a central
concept that encompasses more than the older adult’s level of physiological
functional. Most problems affecting older adults are attributable to risk factors,
even though age-related changes are indeed relevant and inevitable. Nursing
interventions can address functional consequences. Holistic care is not an
alternative to Functional Consequences Theory, but rather a component of the
theory.
12. An older adult reflects, “Why should I go to the gym, I’m going to get fat anyway.” Which
response by the nurse is most appropriate?
• “Risk factors do impact consequences, but you can override them.”
• “Older adults experience positive or negative functional consequences because
of age-related changes.”
• “Most problems affecting older adults are related to risk factors with poor
lifestyle choices, so it’s important to do what you can to maintain a high level of
functioning.”
• “Many problems affecting older adults are based on genetics.”
Rationale: Although are-related changes are inevitable, most problems affecting
older adults occur as the result of risk factors. Older adults experience positive or
negative functional consequences because of a combination of age-related
changes and additional risk factors. Interventions should be directed toward
alleviating or modifying the negative functional consequences of risk factors.
13. An older cigarette smoker asks the nurse questions about the potential benefits of
quitting smoking, a subject avoided in past interactions. The nurse asks the client,
“Would you like to quit smoking.?”
• Preparation
• Contemplation
• Action
• Precontemplation
Rationale: Contemplation is the second stage of the Stages of Change model and
is characterizes by an intention to change in the near future based on some
acknowledgment of the negative consequences of current behaviors and
consequences of different behaviors. The client is likely to ask questions and seek
information about the short-and long-term risks and benefits of various
behaviors. Precontemplation involves a lack of acknowledgment that there is a
problem, and preparation involves specific measures to achieve change. The
actual execution of change is known as action.
14. A nurse helps older adults increase healthy behaviors by restructuring. Which
communication technique should the nurse use to help the older adult overcome
barriers?
• “I know it’s hard to get outside in the winter, so let’s try to identify some ways of
getting more exercise indoors during your usual activities.”
• “Your activity has been decreasing during the last 3 years and it is at the point
that you are at an increased risk for heart disease.”
• “Could you walk with your friend for a half hour after you both come back from
the lunch program at the senior center?”
• “Let’stalk about the benefits of exercise. When you walk regularly you reduce
constipation and muscle pain.”
Rationale: Restructuring assists the client to use positive thinking to focus on way
of overcoming barriers (e.g., getting outside in winter). Giving suggestions about
when and where to walk might be helpful, but it is best if the client develops the
plan of action. Talking about the benefits of exercise reinforces reward.
Discussing consequences of inactivity raises the consciousness of the older adult. [Show Less]
