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ATI GERONTOLOGY FINAL EXAMS AND QUIZ BUNDLE | Includes Gerontological Nursing Test banks
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GERONTOLOGICAL NURSING 9TH EDITION ELIOPOULOS TEST BANK
Gerontological Nursing 9th Edition Eliopoulos Test Bank Chapter 1 The Aging Population Test Bank MULTIPLE CHOICE 1. The nurse explains that in the late ... [Show More] 1960s, health care focus was aimed at the older adult because: a. disability was viewed as unavoidable. b. complications from disease increased mortality. c. older adults needs are similar to those of all adults. d. preventive health care practices increased longevity. ANS: D Increased preventive health care practices, disease control, and focus on wellness helped people live longer. DIF: Cognitive Level: Comprehension REF: 2 OBJ: 2 TOP: Aging Trends KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 2. The nurse clarifies that in the terminology defining specific age groups, the term aged refers to persons who are: a. 55 to 64 years of age. b. 65 to 74 years of age. c. 75 to 84 years of age. d. 85 and older. ANS: C FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 The term aged refers to persons who are 75 to 84 years of age. DIF: Cognitive Level: Comprehension REF: 2, Table 1-1 OBJ: 1 TOP: Age Categories KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 3. The nurse cautions that ageism is a mindset that influences persons to: a. discriminate against persons solely on the basis of age. b. fear aging. c. be culturally sensitive to concerns of aging. d. focus on resources for the older adult. ANS: A Ageism is a negative belief pattern that influences persons to discriminate against persons solely on the basis of age and can lead to destructive behaviors toward the older adult. DIF: Cognitive Level: Comprehension REF: 5 OBJ: 3 TOP: Ageism KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 4. The nurse points out that the most beneficial legislation that has influenced health care for the older adult is: a. Medicare and Medicaid. b. elimination of the mandatory retirement age. c. the Americans with Disabilities Act. d. the Drug Benefit Program. ANS: A FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 The broadest sweeping legislation beneficial to the older adult is Medicare and Medicaid. DIF: Cognitive Level: Application REF: 16 OBJ: 6 TOP: Legislation KEY: Nursing Process Step: Implementation MSC: NCLEX: N/A 5. The nurse clarifies that a housing option for the older adult that offers the privacy of an apartment with restaurant-style meals and some medical and personal care services is the: a. government-subsidized housing. b. long-term care facility. c. assisted-living center. d. group housing plan. ANS: C Assisted-living arrangements offer the privacy of an apartment or condominium with meals prepared and served, limited medical care, and a variety of personal services. DIF: Cognitive Level: Application REF: 14 OBJ: 9 TOP: Housing Options KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The 75-year-old man who has been hospitalized following a severe case of pneumonia is concerned about his mounting hospital bill and asks if his Medicare coverage will pay for his care. The nurses most helpful response is Yes. Medicare: a. pays 100% of all medical costs for persons older than 65. b. Part B pays hospital costs and physician fees. c. Part A pays for inpatient hospital costs. d. Part D pays 80% of the charges made by physicians. ANS: C FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 Medicare Part A pays inpatient hospital costs, Part B pays 80% of physicians charges, and Part D helps defray prescription drug costs. DIF: Cognitive Level: Application REF: 16 OBJ: 6 TOP: Medicare Provisions KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 7. The daughter of a patient who has been diagnosed with terminal cancer asks which documents are required to allow her to make health care decisions for her parent. The nurses most informative response is: a. Advance directives indicate the degree of intervention desired by the patient. b. A Do Not Resuscitate document signed by the patient transfers authority to the next of kin. c. A durable power of attorney for health care transfers decision-making authority for health care to a designated person. d. A living will transfers authority to the physician. ANS: C A durable power of attorney for health care transfers the authority for decision making to a designated person. DIF: Cognitive Level: Application REF: 19 OBJ: 11 TOP: Advance Directives KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 8. The daughter of a resident in a long-term care facility is frustrated with her 80-year-old mothers refusal to eat. The nurse explains that the refusal to eat is a behavior that is an: a. effort to maintain a portion of independence and self direction. b. indication of approaching Alzheimer disease. c. effort to gain attention. d. indication of the dislike of the institutional food. FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 ANS: A Loss of independence and control is a significant issue for the older adult. Some residents will exercise whatever control they may retain. DIF: Cognitive Level: Application REF: 21 OBJ: 11 TOP: Loss of Independence KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 9. The nurse clarifies that the conditions of a living will go into effect when: a. the patient declares that desire in writing. b. a family member indicates the desire for curative therapy to cease. c. two physicians agree in writing that the criteria in the living will have been met. d. the physician and a family member agree that the criteria in the living will have been met. ANS: C Two physicians must agree in writing that the criteria of the living will have been met before the document can go into effect. DIF: Cognitive Level: Application REF: 19 OBJ: 11 TOP: Living Wills KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 10. In the 1980s, Medicare initiated a program of diagnosis-related groups (DRGs) to reduce hospital costs by: a. classifying various diagnoses as ineligible for hospitalization. b. allotting a set amount of hospital days and prospective payment on the basis of the admitting diagnosis. FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 c. specifying particular physicians to treat specified diagnoses. d. using frequency of a particular diagnosis to set a payment schedule. ANS: B DRGs set up a system of preset hospitalization time and payment on the basis of the admitting diagnosis. DIF: Cognitive Level: Comprehension REF: 16 OBJ: 6 TOP: DRGs KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 11. When discussing extended care with a patient who has had a hip replacement and needs physical therapy, the nurse would recommend a(n): a. basic care facility. b. skilled care facility. c. subacute care facility. d. assisted-living residence. ANS: B Skilled care facilities offer not only basic care but also services from trained licensed professionals such as nurses, physical therapists, speech therapists, and occupational therapists. DIF: Cognitive Level: Application REF: 16 OBJ: 9 TOP: Extended-Care Facilities KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 12. The 80-year-old woman who is recovering from a stroke is being sent to an extended-care facility. She is concerned about the expense. The nurse can allay anxiety by explaining that Medicare will cover extended-care facility costs: FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 a. for a period of 30 days. b. for a period of 45 days for physical therapy. c. for a period of 100 days for needed skilled care. d. until she is able to be discharged home. ANS: C Medicare will cover extended-care costs for 100 days while skilled care is being applied to the resident. After 100 days, the resident must revert to private pay or ancillary long-term care insurance. DIF: Cognitive Level: Application REF: 16 OBJ: 8 TOP: Extended Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 13. The senior citizen political action group that uses volunteers and lobbyists to advance the interests of older adults is the: a. American Association of Retired Persons (AARP). b. National Council of Senior Citizens (NCSC). c. National Alliance of Senior Citizens (NASC). d. Gray Panthers. ANS: A The AARP uses volunteers and lobbyists to advance the interests and welfare of older adults. DIF: Cognitive Level: Knowledge REF: 12 OBJ: 7 TOP: Political Action Groups KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 14. The nurse gives an example of the caregiver who is guilty of elder abuse as the: a. daughter who uses her mothers Social Security money to purchase her mothers medication. FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 b. son who puts an alarm on the front door to prevent his mother from wandering out of the house. c. wife who allows her mentally competent husband to refuse to take a bath for a week. d. frail spouse who is unable to bathe or change the clothes of her physically dependent husband. ANS: D Unintentional abuse or neglect can occur when the caregiver lacks the stamina to meet care needs. Even though physically unable, the frail wife is guilty of elder abuse. The wife should seek assistance to prevent neglect. DIF: Cognitive Level: Analysis REF: 22 OBJ: 13 TOP: Elder Abuse KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 15. The nurse cautions that the most frequent response to elder abuse by the abused older adult is: a. anger. b. physical retaliation. c. notification of authorities. d. nothing at all. ANS: D Fear of retaliation or abandonment keeps most abused elders silent. DIF: Cognitive Level: Application REF: 25-26 OBJ: 14 TOP: Response to Abuse KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 16. Many nurses today do not seek careers in gerontology because: a. the physical work is too difficult. b. their technological skills are not used. FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 c. there is not enough challenge. d. there are limited options for employment. ANS: B Many nurses feel that their technical skills will not be used in the care of the older adult. There are many employment options that offer challenge and fulfillment. DIF: Cognitive Level: Application REF: 5 OBJ: 2 TOP: Employment Options KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 17. The nurse clarifies that the term baby boomers refers to persons who: a. entered school in 1945. b. served in the military in World War II. c. were born between 1946 and 1964. d. were eligible for Social Security benefits in 2000. ANS: C Baby boomers are those born between 1946 and 1964. The impact of the retirement of this cohort is unprecedented in terms of the impact on society. DIF: Cognitive Level: Comprehension REF: 8 OBJ: 5 TOP: Baby boomers KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 18. Restraining an older adult in a recliner to prevent wandering is an example of: a. physical abuse. FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 b. neglect. c. emotional abuse. d. self-neglect. ANS: A Physical abuse is any action that causes physical pain or injury. Inappropriate use of drugs, force-feeding, physical restraints, or punishment of any kind are examples of physical abuse. DIF: Cognitive Level: Application REF: 23 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 19. Nonprovision of medical care because of lack of finances is an example of: a. physical abuse. b. neglect. c. emotional abuse. d. self-neglect. ANS: B Neglect is a passive form of abuse in which caregivers fail to provide for the needs of the older person under their care. Failure to provide necessary medical care may constitute neglect because with no means of going to the doctor or pharmacy, the older person may suffer or even die. DIF: Cognitive Level: Application REF: 23 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 20. Health care workers eating a residents candy without permission is an example of: a. physical abuse. b. neglect. FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 c. emotional abuse. d. self-neglect. ANS: C Emotional abuse is more subtle and difficult to recognize than physical abuse or neglect. It often includes behaviors such as isolating, ignoring, or depersonalizing older adults. Health care workers eating a residents candy without permission is an ignorant behavior that can be depersonalizing. DIF: Cognitive Level: Application REF: 23 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX: N/A MULTIPLE RESPONSE 1. The nurse is aware that a persons attitude about aging is influenced mainly by his or her . (Select all that apply.) a. life experiences b. income level c. level of education d. current age e. occupation ANS: A, D A persons current age and life experiences are the main influences on his or her attitude relative to aging. DIF: Cognitive Level: Comprehension REF: 4 OBJ: 2 TOP: Attitudes toward Aging KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 2. Gerontology encompasses application to . (Select all that apply.) FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 a. appropriate housing b. health care c. public education d. business ventures e. government-sponsored pensions ANS: A, B, C, D Gerontological concerns extend and influence provision of appropriate housing, health care, public education, business ventures, and political stands relative to the welfare of the older adult. DIF: Cognitive Level: Application REF: 2 OBJ: 1 TOP: Gerontology KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 3. Medicare Part C allows eligible persons to receive Medicare benefits via the services of private insurance companies through the services of a . (Select all that apply.) a. health maintenance organization (HMO) b. preferred provider organization (PPO) c. provider-sponsored organization (PSO) d. private fee for service organization (PFFS) e. medical service organization (MSO) ANS: A, B, C, D Medicare Part C allows benefits via the services of managed care organizations. Medical service organization is not one of them. DIF: Cognitive Level: Comprehension REF: 17 OBJ: 6 TOP: Medicare Part C KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 4. The nurse is aware that a familys emotional response to an aging loved ones attempts to cope FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 with diminishing abilities and increased care needs would include apply.) a. grief b. anger c. frustration d. loss e. resentment . (Select all that ANS: A, B, C, D As the family witnesses the decline of a loved one and attempts to respond to the increasing care needs, the emotional responses are varied and changing. The responses include grief, anger, frustration, loss, and confusion. DIF: Cognitive Level: Application REF: 21 OBJ: 11 TOP: Impact of Aging on the Family KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 5. The nurse outlines the characteristics of the typical caregiver for an aging family member as . (Select all that apply.) a. 32 years of age b. female c. having full-time employment d. having a care recipient older than 70 e. giving care for an average of 18 years ANS: B, C, D, E The average age of the caregiver is 46. FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 DIF: Cognitive Level: Application REF: 20 OBJ: 11 TOP: Characteristics of Family Caregiver KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 6. The nurse reminds a family that indicators of self-neglect in the aging person include . (Select all that apply.) a. misbalanced check book b. reduced personal hygiene c. increased alcohol consumption d. irritability e. loss of weight ANS: A, B, C, E Indicators may be to manage personal finances, reduced hygiene, substance abuse, and loss of weight due to inability to obtain adequate food. Irritability is not a consistent characteristic. DIF: Cognitive Level: Application REF: 22 OBJ: 11 TOP: Self-Neglect KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 7. The nurse reminds a group of prospective caregivers that elder abuse may take the form of . (Select all that apply.) a. causing physical harm b. misappropriation of finances c. psychological intimidation d. emotional depersonalization FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 e. abandonment ANS: A, B, C, D, E Elder abuse may take the form of physical injury, misusing the older persons finances for personal gain, psychological intimidation, and depersonalization and abandonment. DIF: Cognitive Level: Application REF: 25-26 OBJ: 13 TOP: Elder Abuse KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Reduction of Risk 8. The nurse explains that research done by the National Institute on Aging found that . (Select all that apply.) a. older patients receive less information regarding health management than younger patients b. information on lifestyle changes were directed at younger people c. older patients were denied timely appointments for evaluation of acute illnesses d. rehabilitation programs offered limited services to the older adult e. older patients receive less evaluation and fewer treatment options for acute illnesses ANS: A, B, D, E The study showed there was less information on health management and lifestyle changes. Rehabilitation programs were limited in their service to the older adult, and only 47% of physicians interviewed felt the older patient received the same evaluation for acute illnesses. DIF: Cognitive Level: Application REF: 5 OBJ: 2 TOP: Attitudes toward Aging KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 9. The Nursing Competence in Aging initiative advocates enhancing nurses . (Select all that apply.) a. knowledge in gerontics b. skills in geriatrics c. opportunities for employment d. political sensitivity for the older adult FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 e. attitudes related to the older adult ANS: A, B, E The Nursing Competence in Aging initiative advocates for all nurses greater knowledge, skills, and broader attitudes toward the older adult. Chapter 2 Theories of Aging MULTIPLE CHOICE 1. A theory differs from a fact in that a theory: a. proves how different influences affect a particular phenomenon. b. attempts to explain and give some logical order to observations. c. is a collection of facts about a particular phenomenon. d. shows a relationship among facts about a particular phenomenon. ANS: B A theory is an unproven concept that attempts to explain and give some logical order to observations. For a theory to become a fact, there must be reproducible evidence. DIF: Cognitive Level: Comprehension REF: 28 OBJ: 1 TOP: Fact vs. Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 2. The biological theory of aging uses a genetic perspective and suggests that aging is a programmed process in which: a. each person will age exactly like those in the previous generation. b. a biological clock ticks off a predetermined number of cell divisions. c. genetic traits can overcome environmental influences. d. age-related physical changes are controlled only by genetic factors. FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 ANS: B The biological theory of programmed process suggests that there is a biologic clock set with a predetermined number of cell divisions that will occur before the introduction of the aging process. DIF: Cognitive Level: Application REF: 28 OBJ: 2 TOP: Biological Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 3. The Gene Theory of aging proposes that: a. the presence of a master gene prolongs youth. b. genes interact with each other to resist aging. c. specific genes target specific body systems to initiate system deterioration. d. the activation of harmful genes initiates the aging process. ANS: D The Gene Theory suggests that there is an activation of harmful genes that initiate the aging process. DIF: Cognitive Level: Application REF: 28 OBJ: 2 TOP: Gene Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 4. The theory that identifies an unstable molecule as the causative factor in aging is the theory. a. free radical b. molecular c. neuroendocrine d. crosslink ANS: A The free radical theory identifies free radicalsunstable moleculesthat will cause aging after accumulation in the body. FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 DIF: Cognitive Level: Application REF: 29 OBJ: 2 TOP: Free Radical Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 5. The nurse assesses that the patient who uses good health maintenance practices believes in the aging theory known as the theory. a. wear-and-tear b. free radical c. neuroendocrine d. molecular ANS: A The wear-and-tear theory suggests that health maintenance practices will prevent wear and tear on the cells of the body and will delay the aging process. DIF: Cognitive Level: Analysis REF: 29 OBJ: 2 TOP: Wear-and-Tear Theory KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 6. The nurse describes the neuroendocrine theory of aging as a complex process of: a. relating thyroid function to age-related changes. b. the effects of adrenal corticosteroids, which inhibit the aging process. c. stimulation and/or inhibition of the hypothalamus, causing age-related changes. d. adrenal medulla inhibition of epinephrine, causing age-related changes. ANS: C The neuroendocrine theory proposes that the hypothalamus stimulates or inhibits the pituitary gland to produce hormones that initiate the aging process. FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 DIF: Cognitive Level: Application REF: 29 OBJ: 2 TOP: Neuroendocrine Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 7. The nurse explains that psychosocial theories differ from biologic theories in that psychosocial theories: a. focus on methods to delay the aging process. b. are directed at decreasing depression in the older adult. c. are organized to enhance the perception of aging. d. attempt to explain responses to the aging process. ANS: D Psychosocial theories attempt to explain the various responses of persons to the aging process. DIF: Cognitive Level: Comprehension REF: 30 OBJ: 3 TOP: Focus of Psychosocial Therapies KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 8. The major objection to the disengagement theory is that the theory: a. justifies ageism. b. addresses the diversity of older adults. c. does not clarify the aging process. d. diminishes the self-esteem of the older adult. ANS: A FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 The disengagement theory seems to justify ageism by proposing that there is a mutual desire between the community and the older adult to be disengaged. According to the theory, this desire apparently does not diminish self-esteem because the older adult desires to be disengaged. DIF: Cognitive Level: Application REF: 30 OBJ: 3 TOP: Disengagement Theory KEY: Nursing Process Step: N/A MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 9. The 80-year-old who teaches Sunday school every week and delivers food for Meals on Wheels is following theory. a. Newmans developmental b. the life course c. the activity d. the disengagement ANS: C Purposeful activity increases self-esteem and maintains cognitive function well into older age. DIF: Cognitive Level: Application REF: 30 OBJ: 3 TOP: Activity Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 10. The nurse would recognize successful aging according to Jungs theory when the nurse notes that a resident at a long-term care facility: a. takes special care to dress for dinner in a manner that pleases his tablemates. b. asks permission to sit on the patio with other residents. c. asks persons in his hall if his television is bothering them. d. wears a large cowboy hat at all times because he likes it. ANS: D Jung describes a successful adjustment to aging as being accepting and valuing of self regardless of the view of others. FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 DIF: Cognitive Level: Application REF: 30 OBJ: 3 TOP: Jungs Developmental Theory KEY: Nursing Process Step: Evaluation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 11. The older adult female patient is positive that the free radical lipofuscin can be counteracted by: a. avoiding animal fat. b. use of antioxidants. c. building up muscle mass. d. outdoor exercise. ANS: B Individuals who follow this theory believe that free radicals can be reduced by antioxidants such as vitamins A, C, E, zinc, and phytochemicals. DIF: Cognitive Level: Comprehension REF: 29 OBJ: 2 TOP: Antioxidants KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 12. A recently widowed woman moved to an assisted living community because of her hypertension and joined a group to learn how to do water color painting with other women her age. The nurse assesses that the patient is following the aging theory of: a. Jung. b. Havighurst. c. Erikson. d. Newmon. ANS: B FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 Havighurst proposes that the process of aging is defined by adjusting to the loss of a spouse, establishing a relationship with ones own age group, and establishing a satisfactory living arrangement. DIF: Cognitive Level: Application REF: 30 OBJ: 3 TOP: Havighurst KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease MULTIPLE RESPONSE 1. The nurses list of age-related illnesses thought to cause the accumulation of free radicals includes . (Select all that apply.) a. arthritis b. colon cancer c. osteoporosis d. diabetes e. atherosclerosis ANS: A, D, E Cancer and osteoporosis are not considered to be diseases that accumulate free radicals. DIF: Cognitive Level: Application REF: 29 OBJ: 2 TOP: Free Radical Influence KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 2. The nurse emphasizes that the relatively new theory that correlates restricted caloric intake to slowing of the aging process would probably extend the life span of the person, provided that the person .(Select all that apply.) a. consistently eats high-nutrient, low-calorie foods FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 b. maintains a regular exercise program c. consumes 2000 to 3000 mL of fluid a day d. supports the diet with adequate fat-soluble vitamins e. eats only organically grown foods ANS: A, B This new theory encourages high-nutrient, low-calorie foods combined with regular exercise to delay the aging process. DIF: Cognitive Level: Application REF: 30 OBJ: 2 TOP: Calorie Restriction Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 3. The nurse points out that the positive outcomes from a life review, according to Erikson, would include . (Select all that apply.) a. wisdom and integrated self-image b. comparing self with others c. understanding self and relationships d. seeking anothers opinion of his or her achievement e. acceptance of self ANS: A, C, E Acceptance of self and understanding self and relationships with accumulated wisdom is the goal of Erikson. Seeking the opinion of others suggests that the older adult is experiencing doubt and gloom, which are negative outcomes according to Erikson. DIF: Cognitive Level: Application REF: 30 OBJ: 2 TOP: Eriksons Developmental Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 4. When a patient asks what can be done to neutralize the free radicals in his system, the nurse responds that antioxidant therapy is thought to inhibit free radicals. Antioxidants include FOR MORE NURSING MATERIALS-EXAMS GUIDES- https://www.facebook.com/kris.stuvia.35 . (Select all that apply.) a. fruits b. vegetables c. organ meat d. folic acid e. vitamin D ANS: A, B, D Antioxidants can be obtained largely from fruits and vegetables. Organ meat and vitamin D are not antioxidants. [Show Less]
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Touhy & Jett- Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 5th Edition
Touhy & Jett- Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 5th Edition Chapter 01: Introduction to Healthy Aging Touhy & Jett: Ebersole a... [Show More] nd Hess’ Gerontological Nursing & Healthy Aging, 5th Edition MULTIPLE CHOICE 1. A man is terminally ill with end-stage prostate cancer. Which is the best statement about this man‘s wellness? a. Wellness can only be achieved with aggressive medical interventions. b. Wellness is not a real option for this client because he is terminally ill. c. Wellness is defined as the absence of disease. d. Nursing interventions can help empower a client to achieve a higher level of wellness. ANS: D Nursing interventions can help empower a client to achieve a higher level of wellness; a nurse can foster wellness in his or her clients. Wellness is defined by the individual and is multidimensional. It is not just the absence of disease. A wellness perspective is based on the belief that every person has an optimal level of health independent of his or her situation or functional level. Even in the presence of chronic illness or while dying, a movement toward wellness is possible if emphasis of care is placed on the promotion of well-being in a supportive environment. PTS: 1 DIF: Apply REF: p. 7 TOP: Nursing Process: Diagnosis MSC: Health Promotion and Maintenance 2. In differentiating between health and wellness in health care, which of the following statements is true? a. Health is a broad term encompassing attitudes and behaviors. b. The concept of illness prevention was never considered by previous generations. c. Wellness and self-actualization develop through learn- ing and growth. d. Wellness is impossible when one‘s health is compro- mised. ANS: A Health is a broad term that encompasses attitudes and behaviors; holistically, health includes wellness, which in- volves one‘s whole being. The concept of illness prevention was never considered by previous generations; through- out history, basic self-care requirements have been recognized. Wellness and self-actualization develop through learning and growth—as basic needs are met, higher level needs can be satisfied in turn, with ever-deepening rich- ness to life. Wellness is possible when one‘s health is compromised—even with chronic illness, with multiple dis- abilities, or in dying, movement toward a higher level of wellness is possible. PTS: 1 DIF: Understand REF: p. 7 TOP: Nursing Process: Evaluation MSC: Health Promotion and Maintenance 3. Which racial or ethnic group has the highest life expectancy in the United States? a. Native Americans b. African Americans c. Hispanic Americans d. Asian and Pacific Island Americans ANS: C As shown in Figure 1.4, Hispanic men and women have the highest life expectancy of all. In 2011, for those of His- panic origin of any race, the overall life expectancy at 65 years of age was 20.7 more years in 2011 (19.1 years for men and 21.8 years for women). PTS: 1 DIF: Understand REF: p. 6 TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment 4. Historical influences that have shaped the lives of the majority of the in-between cohort in the United States today include which of the following? a. Influenza epidemic of 1918 b. World War I c. Child rearing in the Depression d. World War II ANS: D Those who are in the in-between cohort in 2016 were born between 1915 and 1945. The men were likely to have fought in World War II. The last of the Holocaust survivors are in this group. A person who survived the influenza epidemic would be at least 98 years old in 2016 and therefore would be considered old-old or a centenarian. Most of those who are of the in-between cohort had not reached childbearing age by the end of the Depression. Individuals in the in-between cohort would not have been old enough to fight in World War II. PTS: 1 DIF: Understand REF: p. 5 TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment 5. According to researchers, which characteristic do most centenarians share? a. Female b. Hispanic c. Living in rural areas d. Located in the Midwestern states ANS: A Based on the U.S. census report of 2010, centenarians were overwhelmingly white, female, and living in the urban areas of the Southern states. PTS: 1 DIF: Remember REF: p. 5 TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment 6. Which nursing intervention is a holistic approach to an older adult? a. Performs glucose testing during the weekly worship service b. Wheels ambulatory adults to exercise when running late c. Assigns female nurses to older women who are Islamic d. Allows older adults in a nursing home to eat meals alone ANS: C The nurse uses a holistic approach to the care of an older female adult who is Islamic because the woman and her family are more likely to be willing participants in a therapeutic regimen that respects a tenet of their culture. Inter- rupting an older adult‘s worship with glucose testing can be interpreted as a lack of respect for spiritual needs. The nurse can provide for and respect the physical and spiritual aspects of the older adult‘s life by testing for glucose before the service begins. In transporting ambulatory adults to the exercise program in wheelchairs to save time, the nurse disregards the need for self-esteem and exercise, both important aspects of physical well-being. Ambulatory adults can walk with assistance, if needed, to exercise programs and can benefit from the additional activity and independence. The nurse can be tempted to allow an older adult to eat meals alone in his or her room if this will motivate the person to eat or if the older adult has dysphasia and is embarrassed. However, although focusing on physical needs, the nurse ignores psychosocial and other aspects of health and well-being. PTS: 1 DIF: Understand REF: p. 7 TOP: Nursing Process: Evaluation MSC: Health Promotion and Maintenance 7. An older man who resides in a nursing home has a total cholesterol level of 245 mg/dL. Which nursing intervention is most likely to assist this man in achieving his highest level of wellness? a. Instruct him about increasing dietary fiber. b. Ask the health care provider for a low-fat diet. c. Schedule a consultation for him with the dietitian. d. Review a menu with him to choose suitable foods. ANS: D The nurse collaborates with the older adult to choose suitable foods, which is likely to be an effective nursing inter- vention to help an older adult with hyperlipidemia achieve optimal health and well-being; it gives him some control over the regimen and thus engages him in the process of lowering serum cholesterol. Informing the older man about dietary fiber offers no control to him because he is not part of the decision. Nursing interventions developed with the older adult‘s collaboration are most likely to help the older adult achieve health and wellness. Collaborating with the health care provider for a low-fat diet is a reasonable approach to help this man with hyperlipidemia to achieve health and wellness. However, he is more likely to have motivation and enthusiasm for a therapeutic regimen over which he has had some control. Scheduling a consultation with a dietitian is a reasonable approach to an older adult with hyperlipidemia and is a part of a multifaceted approach to optimizing his health. However, the older adult is more likely to engage in a regimen over which he has input. PTS: 1 DIF: Analyze REF: p. 7 TOP: Nursing Process: Planning MSC: Health Promotion and Maintenance 8. Which approach requires the nurse to integrate and balance all aspects of an individual‘s life into the plan of care? a. Holistic nursing b. Healthy People 2020 c. Maslow‘s hierarchy of human needs d. Orem‘s self-care requirements ANS: A Holistic nursing integrates all aspects of an individual‘s life into the plan of care by balancing an individual‘s inter- nal and external environment with psychosocial, spiritual, cultural, and physical processes. Healthy People 2020, an updated document from 2000 that outlines the goals for achieving health in this country, is a mandate for health care professionals to follow with 467 objectives in 28 focus areas. Maslow‘s hierarchy of human needs provides a basis for understanding individuals in context and for ranking nursing assessments, diagnoses, goals, and interventions in order of importance. Dorothea Orem‘s self-care requirements lists human needs, including the need for air, fluids, nutrition, hygiene, elimination, activity, comfort, relief from suffering, and skin integrity. The nurse helps individu- als meet these needs to achieve optimal health and wellness. PTS: 1 DIF: Remember REF: p. 7 TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment 9. The nurse plans activities for older women born between 1920 and 1930 and who reside in an assisted-living facility. Which is the best intervention for the nurse to implement? a. Have them bake cookies twice a week. b. Conduct interviews for specific interests. c. Arrange dog and cat visits from volunteers. d. Take them to the library for guest speakers. ANS: B The nurse conducts individual interviews with the women to determine their interests and to avoid generalizing; as people live longer, they become more and more unique. Because most of these women are in their 80s and 90s were born between 1920 and 1930 and have generally spent their lives as homemakers, the nurse presumes to know what activities they will enjoy. The nurse avoids arranging group activities until individual interests are determined. In addition, the nurse must assess for allergies and individual fears of animals before exposing an older adult to a pet visit. Unless it is organized on a voluntary basis, the nurse avoids arranging visits by guest speakers. In addition, the nurse will assess each older woman before an outside visit to avoid embarrassing events, including incontinence and hearing and vision problems. PTS: 1 DIF: Analyze REF: p. 5 TOP: Nursing Process: Implementation MSC: Safe, Effective Care Environment 10. Which of the following issues in the care of older adults are identified in Healthy People 2020? a. Delineating nursing staffing levels in long term care b. Eradicating pressure ulcers in all care settings c. Identifying minimum levels of training for people who care for older adults d. Instituting mandatory training in identification of elder abuse for all caregivers of older adults ANS: C Identifying minimum training levels for people who care for older adults is one of the issues identified in Healthy People 2020. The rest of the issues are not discussed in Healthy People 2020. PTS: 1 DIF: Remember REF: p. 8 TOP: Teaching and Learning MSC: Health Promotion and Maintenance 11. An older man asks a nurse: ―How do you define aging? Do I meet the criteria of a senior citizen?‖ The nurse understands that one can define aging in many different manners. If the nurse chooses to define aging as ―social aging,‖ the nurse would consider which of the following aspects? a. The man retired from his job as a police officer. b. The man takes six different medications multiple times over the course of the day. c. The man walks with a rolling walker. d. The man celebrated his 65th birthday. ANS: A Social aging is determined by changes in roles. Taking multiple medications multiple times over the course of the day and walking with a rolling walker are functional determinants of aging. Age refers to chronological aging. PTS: 1 DIF: Understand REF: p. 7 TOP: Nursing Process: Assessment MSC: Health Promotion and Maintenance 12. The holistic health movement has impacted health care in which of the following ways? a. It has focused health care on disease prevention. b. It has reshaped how health and health care are per- ceived. c. It has improved access to health care. d. It has introduced numerous alternative modalities into health care. ANS: B The holistic paradigm has reshaped how health and health care are perceived. Wellness is seen as a state of being which can be defined anywhere along the continuum of health. PTS: 1 DIF: Understand REF: p. 7 TOP: Teaching and Learning MSC: Health Promotion and Maintenance MULTIPLE RESPONSE 1. According to Healthy People 2020, older adults have been identified as a priority, with a goal to improve their health, function, and quality of life. Identify the targeted chronic focus areas for improvement. (Select all that apply.) a. Diabetes b. Arthritis c. Congestive heart failure d. Dementia e. Cancer f. Pressure ulcers ANS: A, B, C, D In a push toward wellness, older adults were identified as a priority area for the first time. The targeted chronic areas of focus were identified as diabetes, arthritis, congestive heart failure, and dementia. PTS: 1 DIF: Remember REF: p. 8 TOP: Nursing Process: Planning MSC: Health Promotion and Maintenance 2. Identify the Healthy People 2020 emerging issues in the health of older adults. (Select all that apply.) a. Coordinating care for the older adult population b. Assisting older adults in the management of their own care c. Identifying levels of training for those caring for older adults d. Making community resources available for older adults e. Increase in health disparities for rural older adults ANS: A, B, C According to United States Department of Health and Human Services‘ Healthy People 2020, emerging issues in the health of older adults include coordinating care, helping older adults manage their own care, establishing quality measures, identifying minimum levels of training for people who care for older adults, and researching and evaluat- ing appropriate training to equip providers with the tools they need to meet the needs of older adults. PTS: 1 DIF: Remember REF: p. 8 TOP: Nursing Process: Planning MSC: Health Promotion and Maintenance 3. Researchers hypothesize that most super-centenarians survive and are in good health due to which of the following factors? (Select all that apply.) a. They have a different genetic makeup than other older adults have. b. They tend to live in wealthier areas of the world. c. The exact cause of this phenomenon is not known. d. Contributing factors to their good health include quali- ty medical care and improved social conditions. e. They have large extended families to assist in their care. ANS: C, D The exact cause of super-centenarians‘ longevity is not known; researchers describe it as attributable to ―rare and unpredictable reasons.‖ Contributing factors include medical care and improved sociopolitical conditions. There is no known difference in biological or sociological factors between super-centenarians and other older adults. Super- centenarians exist all over the world. PTS: 1 DIF: Understand REF: p. 4-5 TOP: Nursing Process: Assessment MSC: Health Promotion and Maintenance 4. The nurse in an assisted living facility (ALF) is preparing a lecture on aging for the residents. The philosophy of the ALF is to approach aging from the viewpoint of health. Based on this philosophy, the nurse includes which of the following topics? (Select all that apply.) a. ―The Many Chronic Illnesses of Aging‖ b. ―Channeling Your Inner Strength Toward Wellness‖ c. ―Maximizing Function As You Age‖ d. ―Conserving Your Strength As You Age‖ e. ―Keep Moving, Maintain Your Mobility‖ ANS: B, C, D A wellness perspective is based on the belief that every person has an optimal level of wellness independent of func- tional ability. This viewpoint approaches aging with an emphasis on resilience, strength, resources, and capabilities rather than focusing on existing pathological conditions. PTS: 1 DIF: Analyze REF: p. 6-7 TOP: Teaching and Learning MSC: Health Promotion and Maintenance Chapter 02: Cross-Cultural Caring and Aging Touhy & Jett: Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 5th Edition MULTIPLE CHOICE 1. Which of the following is a true statement about differing health belief systems? a. Personalistic or magicoreligious beliefs have been superseded in Western minds by biomedical principles. b. In most cultures, older adults are likely to treat themselves using traditional methods before turning to bio- medical professionals. c. Ayurvedic medicine is another name for traditional Chinese medicine. d. The belief that health depends on maintaining a balance among opposite qualities is characteristic of a magi- coreligious belief system. ANS: B Older adults in most cultures usually have had experience with traditional methods that have worked as well as expected. After these treatments fail, older adults turn to the formal health care system. Even in the United States, it is common for older adults to pray for cures or wonder what they did to incur an illness as punishment. The Ayurvedic system is a natu- ralistic health belief system practiced in India and in some neighboring countries. This belief is characteristic of a holistic or naturalistic approach. PTS: 1 DIF: Understand REF: p. 16-17 TOP: Nursing Process: Assessment MSC: Health Promotion and Maintenance 2. Which of the following considerations is most likely to be true when working with an interpreter? a. An interpreter is never needed if the nurse speaks the same language as the patient. b. When working with interpreters, the nurse can use technical terms or metaphors. c. A patient‘s young granddaughter who speaks fluent English would make the best interpreter because she is familiar with and loves the patient. d. The nurse should face the patient rather than the interpreter. ANS: D The nurse should face the patient rather than the interpreter is a true statement; the intent is to converse with the patient, not with a third party about the patient. Many reasons may prevent the patient from speaking directly to a nurse. Technical terms and metaphors may be difficult or impossible to translate. Cultural restrictions may prevent some topics from being spoken of to a grandparent or child. PTS: 1 DIF: Understand REF: p. 18-19 TOP: Nursing Process: Implementation MSC: Safe, Effective Care Environment 3. An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg and refuses to remain in the bed. Which intervention should the nurse use to promote and maintain his health? a. Have the health care provider speak to him. b. Use principles of the holistic health system. c. Ask about his perceptions and treatment ideas. d. Consult with a practitioner of Chinese medicine. ANS: C Using the LEARN model (listen with sympathy to the patient‘s perception of the problem, explain your perception of the problem, acknowledge the differences and similarities, recommend treatment, and negotiate agreement), the nurse gathers information from the patient about cultural beliefs concerning health care and avoids stereotyping the patient. In the as- sessment, the nurse determines what the patient believes about caregiving, decision making, treatment, and other pertinent health-related information. Speaking with the health care provider is premature until the assessment is complete. Unless he accepts the beliefs, principles of the holistic health system can be potentially unsuitable and insulting for this patient. Un- less he accepts the treatments, consulting with a practitioner of Chinese medicine can also be unsuitable and insulting for this patient. PTS: 1 DIF: Apply REF: p. 18 TOP: Nursing Process: Implementation MSC: Health Promotion and Maintenance 4. Which action should the nurse take when addressing older adults? a. Speak in an exaggerated pitch. b. Use a lower quality of speech. c. Use endearing terms such as ―honey.‖ d. Speak [Show Less]
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ATI GERONTOLOGY FINAL QUIZ 2020 with Rationales
ATI GERONTOLOGY FINAL QUIZ 2020 with Rationales 1. A public health nurse is planning an immunization clinic for older adults. Which of the following tim... [Show More] es should an older adult client receive the influenza vaccine? A- Once during the client’s lifetime B- Every 10 years C- every 5 years D- annually in the fall Answer- d The nurse should recommend that older adult clients receive the influenza vaccine annually. Influenza outbreaks occur annually, and the influenza virus changes constantly. Consequently, an influenza vaccine from a previous year will not protect a client exposed to this year’s influenza strain. Influenza in older adults can result in the development of primary viral influenza pneumonia, which causes several deaths a year. An influenza vaccine given in the fall, prior to the onset of flu season, will be most effective in preventing influenza in this target population. A- The nurse should recognize that the older adult is at increased risk for developing influenza due to changes in the immune system that occur with age. Prior immunization with the influenza vaccine does not guarantee continued life-long immunity from the illness. B- The nurse should recognize that the influenza virus changes constantly, eliminating the possibility of long-term immunity. C- The nurse should recognize that because of constant changes in the influenza virus itself, an immunization received 5 years previous will not protect the client from the illness currently. 2. A nurse is assessing an older adult client who has right-sided heart failure. Which of the following findings is the nurses priority? A- Oxygen saturation is 92% on room air B- the client consumes 20% of males C- weight has increased 0.91 kg or to lbs in 24 hours D- the client has 1 + edema in the lower extremities Answer- c The nurse should apply the urgent versus nonurgent priority-setting framework. Using this framework, the nurse should consider urgent needs to be the priority need because they pose more of a threat to the client. The nurse might also need to use Maslow’s hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. The nurse should evaluate daily weight of client’s experiencing heart failure. A weight gain of 0.45 to 0.91 kg (1 to 2 lb) overnight or 1.36 kg (3 lb) within one week is an indication of worsening heart failure. A- The nurse should monitor the oxygen saturation of the client because a decrease in oxygen saturation below 90% indicates a worsening of condition and, potentially, pulmonary edema. Although the client’s oxygen saturation rate is less than the expected reference range of greater than 93%, another finding is the priority. B- The nurse should evaluate the client’s food intake and appetite. Anorexia and nausea are common manifestations of right-sided heart failure and place the client at risk for nutritional deficiencies; however, another finding is the priority. D- The nurse should report pitting edema because this is an indication of fluid retention; however, another finding is the priority. 3. A nurse is teaching an older adult client about osteoporosis. Which of the following statements should the nurse include in the teaching? A- Cottage cheese is a good source of calcium B- increase your caffeine intake C- brisk walking will help prevent bone loss D- hormone replacement therapy with estrogen will increase your risk of osteoporosis Answer- c The nurse should encourage weight-bearing exercises to help minimize bone loss in the older adult client. A sedentary lifestyle, on the other hand, leads to a loss of minerals in the bones, especially calcium and phosphorus. A- The nurse should include dietary sources of calcium and vitamin D in the teaching. Cottage cheese, however, is not a good source of calcium as it loses the calcium during processing. B- The nurse should encourage the client to limit caffeine intake because it enhances the excretion of calcium. D- The nurse should provide information about medications for prevention and treatment of osteoporosis. Estrogen can reduce the fracture rate in women who have osteoporosis, although there are other complications related to its use, such as cancer. 4. A nurse is managing an adult day care is developing a treatment plans for older adult clients. Which of the following therapeutic strategies should the nurse use to help the clan Chief Erikson's developmental tasks for this age group? A- Music therapy B- reminiscence therapy C- meditation therapy D- pet therapy Answer- b The nurse should incorporate reminiscence therapy as a therapeutic strategy for the purpose of encouraging clients to engage in life review. The process of sharing memories helps clients to achieve a sense of fulfillment and self-worth and allows a positive outcome to Erikson’s developmental task of integrity vs despair. A- The nurse should use music therapy for the purposes of providing sensory and intellectual stimulation, as well as maintaining or increasing the clients' levels of physical, mental, social, or emotional functioning. C- The nurse should encourage meditation therapy to quiet the mind and improve overall health, such as promoting sleep, decreasing pain, and improving cognitive function. D- Pet therapy is beneficial for older adult clients by mitigating loneliness, promoting better physical and mental health, and providing loving companionship. 5. A nurse is admitting an older adult client who has urinary incontinence and smells strongly of urine. The clients partner, who has been caring for her at home, states that he is sorry and embarrassed about the unpleasant smell. Which of the following responses should the nurse make? A- A lot of clients who are cared for at home have the same problem B- don't worry about it. She will get a bath, and that will take care of the odor C- it must be difficult to care for someone who has incontinence D- when was the last time that she had a bath? Answer- c The nurse should use therapeutic responses such as acknowledgement and empathy when addressing the client’s partner. This response is nonjudgmental and acknowledges the effort the client’s partner has made. The use of therapeutic communication also encourages further discussion and provides the nurse with an opportunity to teach and to evaluate the need for assistance in the home. A- This response is judgmental and implies that the caregiver is not able to keep the client odor-free. B- The nurse should avoid using automatic responses that devalue the caregiver’s feelings and attempts to care for the client. D- This response is judgmental and implies to the client’s caregiver that the odor of urine developed because he has not bathed his partner for some time. 6. A nurse is performing an assessment on an older adult client who has chronic pain. Which of the following effects of unrelieved pain should the nurse identify as a priority finding to report? A- Impaired mobility B- decreased Independence C- decreased self-esteem D- impaired socialization Answer- a The nurse should apply the safety and risk reduction priority-setting framework. This framework assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one positing the greatest threat is the highest priority. The nurse should use Maslow’s hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the greatest threat to the client. The nurse should identify that limited mobility will have an effect on the client’s skin integrity, respiratory function, and elimination. Complications of the immobility resulting from unrelieved pain include pressure ulcers, pneumonia, and constipation. B- The nurse should address the limitations to the client’s independence that unrelieved pain causes and the increased need for assistance with ADLs because this can negatively impact the client’s self-esteem and well-being; however, there is another finding that is the priority. C- The nurse should more fully assess the effect that a decrease in self-esteem has on the client as this can negatively affect nutrition, motivation, and well-being; however, there is another finding that is the priority. D- The nurse should evaluate the impact the impaired socialization has on the client and assist the client in finding ways to regain social contacts since impaired socialization can have a negative effect on mood and cognition; however, there is another finding that is the priority. 7. A home health nurse is caring for a client who has cancer and is using a fentanyl transdermal patch for pain control. Which of the following actions should the nurse take when caring for this client? A- Avoid using a heating pad on the area with the patch B- to decrease the dose, cut the patch in half C- dispose of the used patch by placing it in the trash can D- assess the client for urinary retention every 8 hours Answer- a Applying heat over the site of the transdermal patch will increase the rate of absorption of the opioid medication and might cause respiratory depression. B- The nurse should obtain a new patch with the appropriate dosage of medication. Cutting the patch will effect delivery of the medication and will result in inappropriate dosage delivery. C- The nurse should dispose of a used patch by folding it with the adhesive edges together and placing it in a tamper-proof receptacle. D- The nurse should assess the client using a fentanyl patch for urinary retention every 4 to 6 hr. 8. A nurse is assessing an older adult client who reports feeling anxious about financial concerns and having difficulty sleeping for several months. Which of the following factors should the nurse identify as a factor in the client's sleep pattern? A- Older adults require much less sleep than younger adults B- older adults sell them awake at night once they have fallen asleep C- older adults have an increase in stages 3 and 4 of sleep D anxiety can cause Disturbed sleep patterns Answer- d The sleep patterns of older adults are different from those of young adults. However, anxiety and emotional stress can result in sleep disturbances in people of all ages. The nurse should further assess the client’s sleep problems and anxiety. A- The sleep needs of older adults are similar to those of young adults. However, older adult clients experience more awakenings during the night along with shorter time periods spent in deep sleep. B- Older adults tend to awaken several times during the night, limiting their ability to obtain the rest they require. C- Altered sleep patterns in older adult clients result in a decreased amount of time spent in stages III and IV, which is where deep sleep occurs. 9. A nurse is caring for an older adult client who is unresponsive following a stroke. Which of the following actions should the nurse take while providing Oral Care? A- Turn the client on his side before starting Oral Care B- use the thumb and index finger to keep the clients mouth open C- cleanse the clients oral mucosa with a toothbrush D- perform oral care using sterile gloves Answer- a The nurse should place the client in a lateral position to allow excess fluids to run out of his mouth into a basin, which reduces the risk of aspiration of fluids and secretions. B- The nurse should use a padded tongue blade or an oral airway, not a thumb and index finger, to keep the client’s mouth open. The client might suddenly bite down and injure the nurse’s fingers. C- The nurse should use a moistened foam swab to clean the oral mucosa. The nurse should cleanse each area of the mouth with a separate swab to avoid transferring microorganisms from one area to another. D- The nurse should apply clean gloves prior to performing oral care for a client. 10. A nurse is caring for an older client who is on bed rest. Which of the following foods should the nurse plan to include on the client's breakfast tray to prevent constipation? A- A banana B- hash brown potatoes C- egg and cheese omelet D- stewed prunes Answer- d The nurse should include foods that are high in dietary fiber, such as stewed prunes, to help prevent constipation for the client who is on bed rest. A- The nurse should include fruits as a part of a healthy diet; however, bananas are low in fiber and will not prevent constipation. B- The nurse should include a variety of vegetables as part of a healthy diet; however, potatoes are low in fiber and will not prevent constipation. C- The nurse should encourage the client to consume proteins such as eggs and cheese; however, they are not high in fiber and can cause constipation. 11. A nurse is teaching a client who has chronic obstructive pulmonary disease COPD and has been losing weight about ways to improve his nutritional intake. Which of the following statements by the client indicates an understanding of the teaching? A- I will choose hot foods to decrease the sense of fullness when eating B- I should add grated cheese to sauces and vegetables C- I will eat my largest meal of the day in the evening D- I should consume a diet high in carbohydrates Answer- b The nurse should reinforce that adding cheese to side dishes will increase the protein and calcium intake as well as increase calories. This will assist the client in regaining weight and stamina. A- The nurse should emphasize to the client that consuming cold foods will decrease his sense of satiety, allowing him to consume more calories. C- The nurse should recommend that the client consumes his largest meal early in the day, when energy is highest. This will allow him to consume more calories without causing fatigue. D- The nurse should emphasize that the client who has COPD should consume a high- protein diet. The client should limit carbohydrates because these break down into carbon dioxide and increase food-related dyspnea. 12. A nurse is conducting an in-service for a group of assistive Personnel about the basic needs of older adult clients. Which of the following statements should the nurse include in the teaching? A- Caloric needs are increased B- renal function is increased C- deep sleep is decreased D- exercise needs are decreased Answer- c The sleep architecture, or time spent in [Show Less]
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ATI 2.0 GERONTOLOGY EXAM 2020 | N212
ATI 2.0 GERONTOLOGY EXAM 2020 N212 1. A nurse is providing teaching to an older adult client who has osteoarthritis of the right hip and lower lumbar vert... [Show More] ebrae. Which of the following statements by the client indicates an understanding of the teaching? A- I should avoid the use of a heating pad on my back B- to relieve the pressure on my hip, I can use a cane while ambulating C- I will have steroid injections to my joint has the first medication of choice to treat my pain D- I will exercise even when it causes pain Answer- b Using a cane as an assistive device enables the client to compensate for weakness in the spine by providing some relief of hip pressure. Use of a cane can provide joint support and safety for self-care activities. A- The use of heat and cold are therapeutic treatments in the management of arthritic pain. The preference of the client drives the decision between the two therapies. C- Acetaminophen is the first medication of choice to treat the older adult client’s pain from osteoarthritis. The nurse should instruct the client to take the medication as prescribed and not to wait until the pain is severe. Steroid joint injections are used for persistent and disabling pain in the joints. D- The nurse should teach the client to not exercise if exercise causes pain. Goals for clients who have osteoarthritis include balancing rest with activity and avoiding activities that cause pain or discomfort. Consistent activity is not beneficial for a client who has an arthritic joint disease because it can produce further damage to the joints and tissues. 2. A nurse is admitting an older adult client who fell at home 3 days ago. The client has a fractured hip, malnutrition, and dehydration. Which of the following laboratory values, noted on admission, should indicate to the nurse prolonged malnutrition? A- Increased sodium B- decreased albumin C- increased BUN D- decrease blood glucose Answer- b Decreased albumin is indicative of inadequate protein intake, which is a common finding in a client who has prolonged malnutrition. A- Increased sodium is indicative of dehydration, which is due to a fluid volume deficit. C- Increased BUN is indicative of renal failure, or dehydration, which is due to a fluid volume deficit. D- Decreased blood glucose is indicative of inadequate intake of glucose, which is a manifestation that can occur rapidly in any client who has not eaten in several days. It is not indicative of prolonged malnutrition. 3. A nurse is planning care for an older adult client following abdominal surgery for a bowel obstruction. Which of the following information about pain management should the nurse consider when planning care? A- Older adult clients have a diminished capacity to perceive pain B- older adult clients should not take narcotics for pain control C- older adult clients have increased pain as a normal part of aging D- older adult clients are sensitive to the analgesic effects of opiates Answer- d An older adult client is likely to require a decreased dose of opiates to provide the same level of analgesia as a younger client, with a reduced risk of side effects. A- Older adults do not have a diminished capacity to perceive pain. However, older adult clients might have developed excellent coping skills that make it difficult to observe for cues of pain. B- The nurse can administer narcotic medications safely to older adult clients. Although older adult clients might be more sensitive to narcotics, it does not justify withholding narcotic medication for pain control. C- Pain is not an expected finding of the aging process. The nurse should assess, diagnose, and manage pain in older adult clients similar to any other client, regardless of age. 4. A nurse and Ophthalmology Clinic is assessing a client referred by the provider for a potential cataract. Which of the following clients report should the nurse recognize is consistent with cataracts? A- Halos when looking at lights B- loss of peripheral vision C- bright flashes of light and floaters D- eye strain and headache with close work Answer- a A cataract is a cloudy or opaque area in the lens of the client's eye. Cataracts in adults usually develop with advancing age and can be hereditary. Cataracts develop slowly and painlessly with a gradual onset of difficulty with vision. Visual problems include difficulty seeing at night, halos around lights or glare sensitivity, and decreased visual acuity, even in daylight. Cataracts are accelerated by environmental factors, such as cigarette smoke or other toxic substances, or in response to metabolic diseases, such as diabetes mellitus. B- Loss of peripheral vision is an initial report by a client who has open-angle glaucoma. Glaucoma is a condition characterized by increased fluid pressure inside the eye, called intraocular pressure. This increased pressure damages the optic nerve, causing partial vision loss, with blindness as a possible outcome. C- Bright flashes of light, especially in the peripheral visual field, and floaters are associated with retinal detachment. Retinal detachment refers to the separation of the light-sensitive membrane in the back of the eye from its supporting layers. Trauma, the aging process, severe diabetes mellitus, or an inflammatory disorder can cause retinal detachment, but it frequently occurs spontaneously. D- Eyestrain and headache with close work is associated with decreased visual acuity. Both nearsightedness, which is an error of visual focusing that makes distant objects appear blurred, and farsightedness, which is an age-associated progressive loss of the focusing power of the lens that results in difficulty seeing objects close-up, can cause eyestrain and headache. Changes in visual acuity may represent primary eye disease, aging, eye trauma, or a generalized, systemic, illness, but whatever the cause, the nurse should not ignore visual changes. Decreased vision is a significant threat to the quality of life of older adult clients. 5. The nurse at an assisted living center is conducting an orientation session for a group of newly hired assistive Personnel AP. Which of the following instructions should the nurse include regarding clients who are hearing impaired? A- Maintain eye contact with the clients B- stand to one side of the clients and speak into their good ears C- speak loudly with exaggerated enthusiasm D- ask only questions with yes or no answers Answer- a Many older adult clients who are hearing impaired use lip-reading and gestures to help understand what is said to them. Maintaining eye contact and speaking slowly will promote lip-reading. B- Many older adult clients who are hearing impaired use lip-reading and gestures to help understand what is said to them. Speaking to one side of the client will not give him the ability to use lip-reading or see gestures. C- Many older adult clients who are hearing impaired use lip-reading and gestures to help understand what is said to them. The client can hear better when the nurse speaks in a moderate tone of voice. D- This is not a helpful action. To respond, even with just a yes or no, the clients must be able to hear or understand what is being said to them. 6. A nurse is caring for an older adult client who has moderate hearing loss. Which of the following actions should the nurse take to enhance communication? A- Speak with exaggerated lip movements B- speak at a moderate rate C- speak in a louder voice D- speak using a higher pitch Answer- b The nurse should slow the rate of speech for an older adult client who has hearing loss. However, the nurse should not speak with an exaggerated slowness because this can distort words and make it difficult for the client to understand. A- The nurse should avoid using exaggerated lip movement as this distorts sounds and might make lip reading more difficult for the client. C- The nurse should speak in a normal voice when working with an older adult client. A louder voice can distort words, making them more difficult to understand. D- The nurse should use a medium or lower pitch when speaking with an older adult client. Higher pitches are more difficult to understand for the individual who has hearing loss. 7. A nurse is caring for a client who is using a continuous passive motion CPM device following a right total knee replacement. Which of the following actions should the nurse take when applying the CPM device? A- Apply the CPM device in the flex position B- line up the frame joints of the CPM device with the clients knee C- check the range of motion settings on the CPM device daily D- place the head of the clients bed at 45 degrees during CPM use Answer- b To avoid damage to the operative knee, the nurse should line up the joints of the CPM machine with the client’s operative knee. A- The nurse should apply the CPM device while it is in the extended position for client comfort and to ensure proper placement. C- The nurse should assess the settings on the CPM device every 8 hr to ensure the appropriate flexion and extension cycle is occurring. D- The nurse should initially place the client in a supine position when applying the CPM device. Following placement, the nurse should place the head of the bed at 20º if the client is able to tolerate this angle. 8. A public health nurse is planning an immunization clinic for older adults. Which of the following times should an older adult client receive the influenza vaccine? A- Once during the clients lifetime B- every 10 years C- every 5 years D- annually in the fall Answer- d The nurse should recommend that older adult clients receive the influenza vaccine annually. Influenza outbreaks occur annually, and the influenza virus changes constantly. Consequently, an influenza vaccine from a previous year will not protect a client exposed to this year’s influenza strain. Influenza in older adults can result in the development of primary viral influenza pneumonia, which causes several deaths a year. An influenza vaccine given in the fall, prior to the onset of flu season, will be most effective in preventing influenza in this target population. A- The nurse should recognize that the older adult is at increased risk for developing influenza due to changes in the immune system that occur with age. Prior immunization with the influenza vaccine does not guarantee continued life-long immunity from the illness. B- The nurse should recognize that the influenza virus changes constantly, eliminating the possibility of long-term immunity. C- The nurse should recognize that because of constant changes in the influenza virus itself, an immunization received 5 years previous will not protect the client from the illness currently. 9. A nurse is teaching an older adult client about osteoporosis. Which of the following statements should the nurse include in the teaching? A- Cottage cheese is a good source of calcium B- increase your caffeine intake C- brisk walking will help prevent bone loss D- hormone replacement therapy with estrogen will increase your risk of osteoporosis Answer- c The nurse should encourage weight-bearing exercises to help minimize bone loss in the older adult client. A sedentary lifestyle, on the other hand, leads to a loss of minerals in the bones, especially calcium and phosphorus. A- The nurse should include dietary sources of calcium and vitamin D in the teaching. Cottage cheese, however, is not a good source of calcium as it loses the calcium during processing. B- The nurse should encourage the client to limit caffeine intake because it enhances the excretion of calcium. D- The nurse should provide information about medications for prevention and treatment of osteoporosis. Estrogen can reduce the fracture rate in women who have osteoporosis, although there are other complications related to its use, such as cancer. 10. A nurse is performing an assessment on an older adult client who has chronic pain. Which of the following effects of unrelieved pain should the nurse identify as a priority finding to report? A- Impaired mobility B- decreased Independence C- decreased self-esteem D- impaired socialization Answer- a The nurse should apply the safety and risk reduction priority-setting framework. This framework assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one positing the greatest threat is the highest priority. The nurse should use Maslow’s hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the greatest threat to the client. The nurse should identify that limited mobility will have an effect on the client’s skin integrity, respiratory function, and elimination. Complications of the immobility resulting from unrelieved pain include pressure ulcers, pneumonia, and constipation. B- The nurse should address the limitations to the client’s independence that unrelieved pain causes and the increased need for assistance with ADLs because this can negatively impact the client’s self-esteem and well-being; however, there is another finding that is the priority. C- The nurse should more fully assess the effect that a decrease in self-esteem has on the client as this can negatively affect nutrition, motivation, and well-being; however, there is another finding that is the priority. D- The nurse should evaluate the impact the impaired socialization has on the client and assist the client in finding ways to regain social contacts since impaired socialization can have a negative effect on mood and cognition; however, there is another finding that is the priority. 11. A nurse is caring for an older adult client who has a hip fracture and is writing his pain at 8 on a scale of 0-10. Which of the following medications should the nurse administer? A- Capsaicin topical gel B- oxycodone/acetaminophen 7.5/325 tablet PO C- Celecoxib 200 mg capsule PO D- aspirin 325 mg tablet PO Answer- b A client who rates his pain as 8 on a scale of 0 to 10 is experiencing severe pain, and the nurse should administer an opioid for this type of pain. Oxycodone/acetaminophen is a combination of an opioid and a nonopioid analgesic medication and is an appropriate medication to administer to the client. The nurse should monitor the client for adverse effects, such as respiratory depression, and proactively address constipation that occurs with opioid use. A- The nurse should administer capsaicin topical gel to a client who has minor pain. C- The nurse should administer celecoxib, an NSAID, to treat mild to moderate pain. D- The nurse should administer aspirin, an NSAID, to treat mild to moderate pain. 12. The nurse is reviewing the medical record of an older adult client. For which of the following medications should the nurse conduct a hearing assessment of the client? A- Omeprazole B- ferrous sulfate C- digoxin D- Furosemide Answer- d Furosemide can cause ototoxicity, especially in the older adult client, because there is a decrease in medication metabolism in the kidneys. The nurse should monitor clients taking ototoxic medications, such as furosemide, and teach the client the signs and symptoms of ototoxicity, such as tinnitus and difficulty hearing. A- The nurse should monitor the client who is taking omeprazole for bone loss. B- The nurse should monitor the client who is taking ferrous sulfate for gastrointestinal effects, such as bloating or changes in elimination. C- The nurse should monitor the client who is taking digoxin for manifestations of hypokalemia, such as muscle weakness. 13. A nurse is teaching an older adult client who had a total hip arthroplasty about ambulating with a standard Walker. Which of the following actions by the client indicates an understanding of the teaching? A- The client adjust the height of the Walker so the hand grips are at the level of his waist B- the client moves the Walker ahead about 15.24 CM or 6in and then steps into the Walker C- the client uses the Walker to pull himself up from a sitting to a standing position D- the client uses the Walker to climb the stairs Answer- b The correct technique for using a walker is to balance on both feet; lift the walker and place it in front; walk into the walker, using it for support when standing on the affected limb; and then balance on both feet before repeating the sequence. This provides maximum support for the client. A- The nurse should instruct the client that placing the walker at this height will increase the strain on his upper extremities. The client s [Show Less]
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ATI GERONTOLOGY QUIZ 2020
ATI GERONTOLOGY QUIZ 2020 1. A nurse is teaching a group of older adult female clients who are postmenopausal about dietary requirements, which of the fol... [Show More] lowing statements about the role of folic acid, should the nurse made clients who are postmenopausal to A) limit their intake of folic acid to reduce their risk of stroke, B) dietary folic acid is not of significant importance after bearing child C) very healthy client to our postmenopausal require a daily folic acid supplement, D) adequate folic acid intake is associated with reduced risk for heart disease. D) adequate folic acid intake is associated with reduced risk for heart disease. 2. A nurses teaching an older adult client who is on bedrest following development of deep vein thrombosis, about methods to increase peristalsis, which of the following high fiber food choices should the nurse recommend A) navy bean soup B) can fruit juice, C) white rice pudding, D) soy milk. A) navy bean soup 3. A nurse is associated in older adult client for signs of dehydration, which of the following findings should the nurse consider an expected part of the aging process, A)elevation of urine specific gravity B) decreased creatinine clearance C) dry oral mucous membranes D) poor skin turgor over the sternum. B) decreased creatinine clearance 4. A nurse Reviewing the medical record of a client who is postmenopausal and osteoporosis, the client has a new prescription for alendronate sodium, which of the following findings in the client history should the nurse recognize is a contradiction to this medication. A) glaucoma, B) pagets disease C) esophageal stricture D) long term corticosteroid use C) esophageal stricture Clients who have a history of esophageal abnormalities, such as stricture or achalasia, have delayed esophageal emptying, which greatly increases the client’s risk for esophageal erosion, bleeding, and perforation. Alendronate sodium is a bisphosphonate, which prevents or slows weakening of bone. It is used to prevent and treat postmenopausal osteoporosis. The nurse should instruct the client to wait at least 30 min after taking alendronate sodium before eating, drinking, or taking other medications, and caution her not to lie down for at least 30 min after taking the medication. Standing or sitting upright ensures that the client gets the full dose and decreases heartburn or the risk of injury to the esophagus. 5. A nurses caring for an older adult clients with the following physiological changes associated with aging can affect medication dosage in this client. A) Increased glomerular filtration rate B) decreased, body fat, C) decreased gastric motility D) decreased gastric pH C) decreased gastric motility Decreased gastric motility results in medications remaining in the digestive tract for longer periods of time, leading to slow absorption of the medication. The provider might have to allow for a longer time for medication onset and peak by extending the length of time between doses. A nurse is collecting data from an older client for signs of dehydration. WOTF findings should the nurse consider an expected part of the aging process? Decreased Creatinine Clearance 6. A nurse is at a long term care facility and is providing teaching to a group of adolescents who are new volunteers. The nurse explain that older clients are most likely to exhibit a decrease in which of the following A) short term memory, B) creative ability C) decision making skills D) cognitive capacity. A) short term memory, 7. A nurse at an ophthalmology clinic is assessing a client referred by the provider for a potential cataract, which of the following client reports should the nurse recognize is consistent with cataracts. A) Halos when looking at lights, B) loss of peripheral vision, C) bright flashes of lights and floaters, D) eye strain and headache with close work. A) Halos when looking at lights, 8. For nurses caring for an older client who has pneumonia, what do the following physiological changes is associated with aging, puts the client at risk for pneumonia A) decreased anterior posterior diameter B) increased diameter of the small airways C) decreased number of cilia, D) increased alveolar surface area. C) decreased number of cilia, 9. A nurse at an assisted living center is conducting an orientation session for a group of newly hired assistive personnel, which of the following instructions should the nurse include regarding clients who are hearing impaired A) Maintain eye contact with the clients, B) stand along one side of the client and speak into their good ear, C) speak loudly with exaggerated enunciation. D) Ask only questions with yes or no answers. A) Maintain eye contact with the clients, 10. A nurse is teaching a group of healthy older clients about health screening after age 50 years, which of the following health screenings should the nurse recommend that a client completes annually, A) cholesterol B) colonoscopy, C) diabetes mellitus D) visual acuity. D) visual acuity. 11. A nurse is caring for an older adult client who has gout and refuses to eat the clients provider has approved the family to bring food from home, which of the following foods should the nurse recommend that the client not eat A) lentil soup, B) sandwich C) yogurt, D) raisins. A) lentil soup, [Show Less]
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ATI GERONTOLOGY FINAL EXAM & QUIZ
ATI GERONTOLOGY FINAL EXAM & QUIZ 1. A nurse is caring for an older adult client who was admitted to a long term care facility and requires total care. Wh... [Show More] ich of the following is an appropriate nursing action while providing mouth care? Turn the client on his side before starting mouth care 2. A nurse is educating a group of assistive personnel about the care of older adult clients. The nurse educator is including information about the developmental tasks of older adults. Which of the following should the nurse use as an example of a nursing action that best meets the psychosocial tasks of older adults, according to Erikson? -Providing the client’s opportunity to discuss their lives and losses 3. A nurse working in a community health center is completing an assessment of an older adult female client. To which of the following findings should the nurse give immediate action? - Rales in the bases 4. An older adult client with a moderate hearing loss seeks medical attention in the clinic The nurse can best meet the needs of the hearing impaired client by doing which of the following? Understanding that not all hearing impaired clients communicate the same way 5. A nurse is educating a group of older adult clients regarding their diet choices. Which of the following diet modifications should the nurse recommend to the older adult clients? Increased calcium older adults have lost bone density and are prone to fractures; therefore, it is appropriate to recommend a diet that is high in calcium. 6. A nurse is asked to speak to a group of healthy, older adult clients about normal aging and sexual response. The nurse should include in the discussion techniques to help the clients adapt to which of the following? Decreased vaginal lubrication older adult female pts may report painful intercourse related to vaginal narrowing and decreased vaginal secretions. The nurse should suggest the use of water-soluble lubricants with intercourse to ameliorate the effects of these normal changes. 7. A nurse in a long term care facility is caring for an older adult client who has ben giving a cane t assist with ambulation. Which of the following nursing actions puts the client at risk? Placing the can on the side of the client's weak side 8. A nurse is caring for an 85 year old client. Which of the following assessment findings should the nurse report to the provider immediately? -Cannot discriminate between hot and cold sensations below the knee of the left extremity lack of feeling or sensation below the knee of the leg can be a manifestation of poor circulation to that extremity. 9. A nurse is caring for an older adult client who is receiving multiple medication. Which of the following is an appropriate statement by the nurse? -Receiving multiple medications can lead to drug interactions 10. A nurse is caring for an older adult client who is being admitted to the hospital with abdominal pan. During the initial assessment, the nurse notes that the client just nods and smiles in response to the questions asked. Which of the following common developmental concerns is the client exhibiting? -hearing loss the senses often diminish with age and it is not unusual for older adult clients to be hard of hearing. The nurse may not be receiving appropriate responses because the client is hard of hearing. Hearing loss is not necessarily a normal physiological change of older adults and should be further evaluated and treated. 11. A nurse is caring for an older adult client who is dying. The client tells the nurse, "I just want to live one more month so I can see my grandchild get married." The nurse should recognize that, according to Kubler-Ross' stages of grief, the client is in which stage? -Bargaining 12. A nurse in a long-term care facility recognizes that there is potential for physical and psychological abuse of older adult residents. Which of the following is the best nursing action? Provide staff with education about the abuse of older adult clients and stress management proactive intervention that will give staff members the information and skills that are necessary to prevent abuse in this setting. The nurse should recognize that caring for older adult clients can be stressful and frustrating at times. Giving staff members training for stress-management skills addresses this aspect of potential abuse. 13. A nurse is taking an older adult client's history. The client reports being depressed and having difficulty sleeping for several months. In evaluating the client's sleep disturbance, the nurse should be guided by the knowledge of which of the following? -Anxiety and depression frequently cause disturbed sleep patterns 14. A nurse is caring for a client who is in pain and is receiving a transdermal patch. The nurse should understand that transdermal medication should be applied to which of the following places on older adult clients? Hairless area of the torso circulation in the extremities decreases with age, therefore when caring for an older adult client, topical or transdermal skin patches should be applied to the torso where circulation is better. 15. A nurse is caring for an older adult client who is recovering from a left sided cerebrovascular accident (CVA) and who has hemiparesis of the right arm and leg. Which of the following is the best place for the nurse to arrange the items used for hygiene when setting up the client's morning hygiene care supplies? -Within the client's reach on the left side 16. A nurse is caring for an older adult client who came to the clinic reporting insomnia. Which of the following questions should the nurse ask to asses the quality of the client's sleep? -Do you feel rested in the morning? 17. A nurse on a surgical unit reports that an older adult client is having periods of agitation at night that include screaming out loudly for help. The nurse manager suggest several interventions to decrease this behavior. Which of the following interventions should the nurse recognize is least appropriate for an older adult client? -requesting that the client’s PCP prescribe a sedative medication. screaming usually indicates that the client is afraid. Medication may sedate the client, but it will not remove the fear. Sedative medication should be used very sparingly in a postoperative older adult client who may also be receiving pain medication. 18. A nurse in the ED is caring for an older adult client. Which of the following behaviors should indicate to the nurse neglect of an older adult client by a caregiving family member? -the client hasn’t been taking necessary medications because the prescriptions have not been filled by the family member neglect occurs when the client’s needs is not being met by the caregiver 19. A nurse in a long-term care facility is caring for an older adult client who has dementia. Which of the following assessment findings should the nurse recognize is most likely t be seen in this client? -Agnosia dementia refers to a group of symptoms involving progressive impairment of brain function. Disorders that cause dementia include conditions that impair the vascular or neurologic structures of the brain. Agnosia, the inability to identify familiar objects is a key finding in dementia. 20. A nurse is evaluating the plan of care for an older adult client that will be discharged home with a home health aide. Currently, the client has a home health aide 4 hr a day to assist with meal preparation and hygiene care. Which of the following should be the nurse’s primary consideration when making changes to the client’s plan of care? -effectiveness of the interventions for the client’s care. 21. A nurse in a day care center is conducting an in-service for assistive personnel (AP) about the basic needs of older adult clients. Which of the following is an appropriate statement made by the nurse? -sleep cycles are impaired. 22. A nurse is performing an assessment on an older adult client. Which of the following effects of the aging process should the nurse expect to see? -Increased urinary frequency 23. A nurse is performing a skin assessment on an older adult client Which of the following findings should the nurse recognize as a benign, age related skin change commonly seen in older adult clients? -Liver spots age spots or lentigines are flat, brownish black macules that usually occur in sun-exposed areas of the body. Unrelated to the liver or liver function. 24. A nurse runs a day care treatment group for older adult clients. Which of the following intervention strategies should the nurse recognize is the most appropriate to help the clients achieve their developmental task, according to Erikson? -Reminiscence therapy 25. A nurse is an assisted living facility is assessing an older adult client who moved in 3 months ago following the death of a spouse. The nurse notes that the client has frequently forgotten to take prescribed medications and has been skipping meals. The client reports awakening early in the morning and admits to feeling very sd. which of the following statements should guide the nurse in planning care for this client? -Unresolved grief in response to loss is a major factor in depression and subsequent suicide in older adults 26. A nurse is transferring an older adult client wh [Show Less]
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