HESI Gerontology Questions and Answers
GERO EXAM 1
1. Which is a common age-related physical change that may affect digestion and food intake?
... [Show More] DECREASED MOTILITY IN THE ESOPHAGUS
2. Which of the following is true about nutrition for older adults? TRANSPORTATION CAN BE A CRITICAL FACTOR IN NUTRITIONAL INSUFFICIENCY IN OLDER ADULTS
3. Which of the following is a true statement about dental health in older adults? DENTURES SHOULD BE CLEANED ONCE A DAY BY BRUSHING AND SOAKING IN A CLEANSING SOLUTION
4. Which intervention should the nurse use to decrease the risk of burns during mealtime in pts with mental and physical impairments? ASSIST PTS WITH WARM DRINKS
5. The nurse is trying to improve the nutritional status of residents in the nursing home. Which recommendations should the nurse implement? PROVIDE NUTRITIOUS FOOD ACCORDING TO THE RESIDENTS’ EXPRESSED FOOD PREFERENCES WITH A LIBERAL USE OF SEASONINGS THAT DO NOT EXCEED ANY SODIUM RESTRICTIONS
6. The nurse instructs the UAP to feed an older adult. If the nurse is unable to observe feeding directly, then which action should the nurse use to access the older adult’s risk for aspiration immediately after feeding? INSPECT FOR POCKETING
7. An older adult with a G-tube has difficulty using the dominant hand. Which of the following should the nurse provide to prevent complications of the G-tube? PROVIDE ORAL CARE Q4H
8. The nursing home staff needs assistance to properly food the residents who need assistance with feeding. Which of the following should the nurse implement to ensure that the residents are properly feed? DRAW ON THE AVAILABILITY OF FAMILY MEMBERS WHO ARE ABLE TO FOLLOW DIRECTIONS
9. The nurse is feeding an older adult pt with hemiparesis as a result of a stroke. Which intervention by the nurse is most important when feeding this pt? ALLOW TIME TO EMPTY MOUTH BETWEEN BITES
10. The nurse is educating the pt who has been recently dx with osteoporosis on foods high in Ca. the nurse should include which food choice? PLAIN YOGURT
11. Which increases the risk for chronic dehydration in older adults? POOR COGNITIVE FUNCTION
12. Which of the following is true about fluid intake for older adults? 1500-2000 mL DAILY
13. The nurse notices that the older adult’s urine is greenish-brown. Which step should the nurse implement next? DETERMINE FLUID VOLUME STATUS
14. Which of the following is a true statement about sleep in older adults? THE TIME SPENT IN BED INCREASES, BUT THE TIME SPENT ASLEEP DECREASES
15. An older man has AD, and his wife says he is up and wandering around the house at night. Which intervention should the nurse implement to increase the man’s duration of sleep? INSTRUCT THE WIFE TO INCREASE HIS DAILY PHYSICAL ACTIVITY
16. Exercise is prescribed for an older adults as therapy to improve which of the following qualities? MUSCLE STRENGTH
17. Which of the following is important to include in the initial assessment for older adults who are frail and beginning an exercise program? MED HX AND PHYSICAL EXAM
18. During the night, an older woman complains to the nurse that she has not slept more than 2 hrs since admission to the hospital. Which intervention should the nurse implement to increase the duration of this woman’s sleep? INQUIRE ABOUT HER SLEEP HABITS USED AT HOME
19. What is the difference between rest and sleep? SLEEP IS RESTORATIVE AND RECUPERATIVE
20. An older woman maintains an active lifestyle playing various games with friends. She reports to the nurse that she experiences wakefulness during the night and an inability to fall asleep after waking up at night. Which intervention should the nurse implement to improve the quality of this woman’s sleep? INQUIRE ABOUT HER NIGHTLY SLEEP RITUALS
21. The nurse completes an admission assessment on the older adult pt. the nurse identifies which factor that may contribute to sleep problems? POLYPHARMACY
22. The nurse expresses concern about a female nursing home resident in the team meeting. Which resident information determines the team’s priority in planning her care? NEEDS INCREASING HELP WITH PERSONAL HYGIENE
23. A nursing home resident who has type 1 DM is gradually requiring more and more insulin on a PRN basis to treat hyperglycemia. Which of the following should the nurse assess to plan care for improving this individual’s glucose metabolism? TRENDS OVER TIME IN ACTIVITY LEVEL
24. Which one of the following is a true statement about motility and safety for older adults? LOWERING THE BED AND FLOURESCENT TAPES ARE INTERVENTIONS TO INCREASE SAFETY
25. The nurse can place an older adult into one of 4 pt rooms. Which is the most suitable room for an older pt? ROOM WITH ORANGE CARPETING AND SOFT LIGHTING
26. Which of the following is a true statement about assistive devices to aid older adults with impaired mobility? A CANE IS MOST USEFUL FOR UNILATERAL DISABILITIES BUT NOT BILATERAL PROBLEMS
27. The HCP has not ordered the use of a restraint for an alert pt at high risk for falling. The nurse should implement which side rail use? ONE ½ LENGTH RAIL
28. The nurse assess the quality of which of the following pt characteristics when applying the Get-Up and Go test from the Hendrich II Fall Risk Model? BALANCE
29. An older woman who receives IV fluids is making wide gesticulations with her arms and loudly insulting the nursing staff. Which intervention should the nurse implement to maintain safe, effective nursing care initially? DETERMINE THE PTS NEEDS
28. The nurse determines that the older adult who has chronic bronchitis is at high risk for falls, but he repeatedly tries to ambulate without assistance. Which alternative measure to restraints is contraindicated for this older adult? HELP HIM LEARN HOW TO USE AN ASSISTIVE DEVICE
29. The nurse is discharging an older woman who uses a walker from rehabilitative care. Which observation does the nurse use to determine whether the pt is prepared for discharge? SHE TAKES THE WALKER TO THE ELEVATOR
30. Which of the following statements is true about the role of grandparents? TODAY, MANY GRANDPARENTS ARE THE PRIMARY CAREGIVERS OF THEIR GRANDCHILDREN
31. An older man is being abused by his daughter, a single working mother of 4 children, with whom he lives. The nurse investigates and learns that the abuse is due to situational stress. Which of the following interventions should the nurse implement to address the ST crisis? ARRANGE RESPITE CARE OR DAY CARE FOR THE PT
32. Which disease has become known as the “great imitator?” HIV
33. Which is the most important element for older adults to have for enhancing the transition into retirement? PRERETIREMENT PLANNING
34. Which one of the following older adults is most likely to need preretirement counseling to avoid significant concerns in retirement? MEXICAN-AMERICAN WOMAN WHO RECEIVES CASH FOR CLEANING SERVICES
35. The community health nurse delivers a program to middle-aged adults about retirement planning and wants them to choose the yr of their retirement. Which is the most important area of which the participants should focus to ease the transition to retirement? ABILITY TO MAINTAIN A STABLE STANDARD OF LIVING
36. Which of the following older adults has the highest economic risk in retirement at the beginning of retirement? DIVORCED WOMAN WHO HAS LIVED IN THIS COUNRTY FOR 3 YRS
37. As the wife of a university president, an older woman met exciting people and traveled extensively until her husband died. Besides losing an intimate partner, the nurse identifies that this woman is most likely to grieve for the loss of which area of her life? STATUS IN THE COMMUNITY
38. Which of the following statements is true about Parkinson Disease? OLDER ADULTS TAKING RASAGILINE (AZILECT) MUST AVOID EATING FOODS CONTAINING TYRAMINE
39. Which of the following statements is true about dysarthria? DOES NOT AFFECT INTELLIGENCE
40. The nurse prepares to discharge an older man who has HF and is in stable condition, when his wife states that she will avoid sexual activities with him because of his heart disease. Which of the following factors should the nurse use in pt teaching about sexual activity for an older adult with HF? FEAR AND LACK OF KNOWLEDGE CAN CAUSE OLDER PEOPLE TO REDUCE THEIR SEXUAL ACTIVITY UNNECESSARILY
41. An older woman recently lost her brother, provides care for her husband who has health needs, and must move to a new location after 35 yrs in the same home. When she comes to the primary care facility with clinical indicators of influenza, the nurse recognizes which of the following? CRISIS AND STRESSORS CAN IMPAIR PHYSICAL HEALTH
42. Which of the following statements is true about the mental health of older adults? THE NURSE AVOIDS ANTIANXIETY MEDS WITHOUT AN ASSESSMENT FOR FACTORS ASSOCIATED WITH ANXIETY
43. An older female resident lowers her voice and tells the nurse that another resident is looking at her behind her back and is going to make her move tonight with a male staff member. Which ideas should the nurse include in the response to this individual? USE THE CALL BELL If SHE BEOMES FRIGHTENED
44. Which of the following statement is true concerning suicide among older adults? A MAJOR CRISIS EXPERINCED BY THE PT CAN CONTRIBUTE TO THE RISK OF SUICIDE
45. You are evaluating the POC for an older adult who is alcohol-dependent. Which pt documentation indicates the need for follow-up nursing interventions by the nurse? PT STATES THAT HE INTENDS TO DECREASE HIS ALCOHOL CONSUMPTION
46. Which assessment finding for an older adult living in an ALF indicated the highest risk for suicide? OLDER ADULT DECLINES COMPANY, IS PREOCCUPIED WITH LEATHAL WEAPONS
47. To help older adults maintain a healthy mental state, the nurse plans activities at a community center to promote the developmental stages of older adulthood. Which nursing intervention is suitable for the nurse’s plan? PARTICIPATE AT A SOUP KITCHEN FOR OTHER PEOPLE WHO ARE HOMELESS
48. Name the theory of aging that suggests that the adverse physical effects of aging are the result of a gradual loss of control mechanisms in the pituitary and hypothalamus. NEUROENDOCRINE THEORY
GERO EXAM 1
1. Which statement is true about rehab and restorative care for older adults? A PERSON CAN LEARN SKILLS
AND GAIN ABILITIES THAT ENABLE FUNCTIONING
2. An older adult is in the hospital because of HF and has become incontinent of urine. Which EB resource should the nurse use to guide continence care for this pt? NURSING STANDARD PRACTICE PROTOCOL
3. The nurse understands that stress incontinence occurs? AS A RESULT OF INCEASED INTRAABDOMINAL PRESSURE
4. A large residual urine volume characterizes what type of incontinence? OVERLFOW
Which action should be included in all bladder-retraining programs? TOILETING AT BEDTIME
5. The nurse assess a male resident in a NH for urinary incontinence and determines that he is unaware of the problem. Which recommendation should the nurse implement? PROVIDE REGULAR TOILETING
6. The nurse wants to begin helping a resident who is overweight and has urinary incontinence with healthy bladder behavior skills. Which intervention should the nurse implement? SCHEDULE VOIDING AT 2-4 HR INTERVALS
7. What is the most important aspect of care for the nurse to maintain when assisting an older pt with urinary incontinence? MAINTAINING AN ATTITUDE THAT IS RESPECTFUL ABOUT RESLOVING THE PROBLEM
8. An older woman tells the NP that she fears her family will place her in a NH because she developed stress incontinence. Which recommendation should the nurse implement? RECOMMEND EXERCISES TO STRENGTHEN THE PELVIC FLOOR
9. The nurse is caring for a pt who has recently had an indwelling catheter placed. The nurse should assess the pt for? A CHANGE IN MENTAL STATUS
10. An older adult who is on bedrest after surgery is prescribed morphine for pain. Which of the following is the nurse’s priority for preventive care? CONSTIPATION
11. Which of the following statements is a true about elimination in older adults? DEFACATION < 1 DAY IS NOT NECESSARILY CONSTIPATION
12. Which option is part of the program that addresses bowel incontinence in an older adult pt? ENSURING THAT A TOILET OR COMMODE IS READILY ACCESSIBLE TO THE PT
13. Which is an important consideration about the skin of an older adult person? THE SKIN BECOMES MORE VULNERABLE TO DAMAGE
14. Which topical agent is safe to apply? LIGHT MINERAL OIL TO MOISTEN SKIN AFTER BATHING
15. A 70 yr old woman complains of dry skin and asks for advice. Which advice should the nurse offer to this woman for improving dry skin? KEEP BATH WATER BETWEEN 90* AND 105*F
16. The nurse monitors for which clinical indicator when the older adult complains of pruritus? COARSE SKIN
17. Which infection control practice should the nurse implement when caring for an older adult who has active herpes zoster? COVER RUPTURED SKIN LESIONS WITH A NONABSORBENT DRESSING
17. The nurse is conducting an admission assessment on an older adult and notes a small lesion with a multicolor appearance. Which assessment approach should the nurse use? ABCD RULE (ASYMMETRY, BORDER, COLOR, DIAMETER)
18. The nurse cares for an older man who has a malignant melanoma. Which intervention should the nurse implement for this man to prevent a recurrence or advancement of this condition in the future? INSTRUCT HIM TO WEAR SUN-PROTECTIVE CLOTHING AND A HAT AT ALL TIMES
19. Which of the following is a true statement about impaired skin integrity? MUSCLE AND FAT CANNOT REGENERATE
20. An older adult is vitamin deficient. Which of the following does the nurse offer to the older adult to provide the important missing vitamin for maintaining healthy skin and enhancing tissue repair? ORANGE SLICES
21. An older adult woman complains of foot plain from a corn. After assessing her feet, which intervention should the nurse implement to alleviate her from discomfort? CUT OUT AN OVAL CORN PAD TO MAKE A U SHAPE
22. Which of the following statements is true about Medicare for older adults? 80% OF MEDICARE’S ANNUAL EXPENDITURES ARE FOR INDIVIDUALS WITH CHRONIC ILLNESS
23. Acute illness is to chronic illness as to which of the following comparisons? AN ER IS TO A NH
24. An older female pt is dx with a chronic illness. Which principle should the nurse apply when answering her questions? CHRONIC ILLNESS IS UNENDING AND COPING CAN BE INFLUENCED BY THE PERCEPTION OF UNCERTAINTY
25. Over 50% of the population, aged 65 + yrs, suffers from which one of the following chronic health conditions? HTN AND ARTHRITIS
26. Which older adult has the most characteristics associated with becoming frail? MALE, HISPANIC AMERICAN, WITH HYPOPROTEINEMIA
27. Which of the following describes the nurse’s role for an older pt with a chronic illness? PROVIDE CARING TO HELP THE PT LIVE AT THE OPTIMAL LEVEL OF HEALTH AND WELLNESS
28.Which of the following statements is the most suitable for establishing goals when teaching an older adult with a chronic illness about potential changes in the health maintenance regimen? MANAGEMENT OF THE PT’S CHRONIC DISEASE RESTS ON THE PT AND THE CAREGIVER; THEREFORE, THE GOALS SHOULD BE COLLABORATIVELY SET
29. Compared with acute pain, the following is true of persistent pain? IT CAN BRING ABOUT CHANGES IN LIFESTYLE
30. The nurse admits an older male pt who had ABD surgery. On admission, VS signs are: P-73, R-20, BP-136/84. He is receiving IV fluids but has not requested pain meds since surgery. 7 hrs later, his VS are: P-98, R-26, BP-164/90, and he denies pain. Which intervention should the nurse implement? ASK HIM ABOUT DISCOMFORT AT THE SURGICAL SITE. (USE OLD CART – onset, location, duration, characteristics, aggravation, relieving factors, and treatments previously used)
31. An older female adult had hip replacement surgery 1 day ago, and the nurse thinks that the woman also has dementia. Which pt assessment does the nurse use to determine that this woman is experiencing pain? HOLDS ABD TIGHTLY
32. An older male adult who is Hispanic states he is not having pain, but he had knee replacement surgery 2 days ago. Which is the best assessment tool as recommended by the Hartford Institute for Geriatric Nursing from “Try This” for the nurse to apply for this man? FACES PAIN SCALE-REVISED
The safest opioid analgesic choice for an older pt who has severe acute pain is which of the following? MORPHINE SULFATE (MORPHINE)
33. An older adult admitted for back surgery asks for opioid pain meds. The nurse knows the pt asked for meds 15 min before it is due. Which recommendation should the nurse implement? ADMINISTER THE PAIN MEDS AS PRESCRIBED
34. The nurse administers an opioid analgesic to an older male postoperative pt on a surgical unit. Which is the most important intervention for the nurse to implement before leaving the pt? INSTRUCT HIM TO ASK FOR HELP BEFORE GETTING UP
POSITION THE PT COMFORTABLY
35. The nurse plans the care of an older female resident of a NH who has experienced a sudden deterioration in visual acuity. The nurse administers an opioid analgesic to an older male postoperative pt on a surgical unit. Which is the most important intervention for the nurse complete first? EXAMINE HER MOOD AND FUNCTIONAL STATUS
36. The most detrimental illness or condition that an older adult with deafness that occurred at birth can experience is which one of the following? CATARACTS
37. Which of the following diseases affects the eyesight of an older adult by damaging the central part of the retina? MACULAR DEGENERATION
Which population groups are at most risk for macular degeneration?
• 60 + YRS
• WHITES AND ASIANS
• WHITE WOMAN 80 +
• GENETIC PREDISPOSITION
• SMOKERS
• FAMILY HX
• EXCESSIVE SUNLIGHT
What does the nurse teach the pt with retinopathy to slow its progression?
• CONSTANT, STRICT CONTROLS OF BLOOD GLUCOSE, CHOLESTEROL, BP, AND LASER PHOTOCOAGULATION TREATMENTS CAN HALT DISEASE
• LASER TREATMENT CAN REDUCE VISION LOSS IN 50% OF PTS AND RECENT EVIDENCE SUGGESTS THAT TREAMENT WITH VARIOUS DRUGS MAY BE BETTER
• AVOID WIND, AND HAIR DRYERS
• USE HUMIDIFIERS AT HOME
• USE ARTIFICAL TEAR OINTMENT AT HS
An older adult complains about experiencing dry eyes daily. Which of the following should the nurse assess to help determine the cause of the pt’s complaint?
• ANTIHISAMINE PRESCRIPTION
• DIURETICS
• BETA BLOCKERS
• SOME SLEEPING PILLS
• VITAMIN A DEFICIENCY
37. The nurse is teaching older adults maintaining health and wellness. Which recommendation should the nurse include in the teaching to maintain optimal vision? WEAR SUNGLASSES THAT BLOCK SUN RAYS
How does the nurse approach the hearing impaired elder for conversation?
• FACE THE PT, SIT OR STAND ON THE SAME LEVEL, DON’T TURN AWAY WHILE SPEAKING
• GAIN THE ATTENTION BEFORE SPEAKING, LOOK DIRECTLY AT PT AT EYE LEVEL
• CAREFUL ARTICULATION AND MODERATE SPEED OF SPEECH
• USE NONVERBAL APPROACHES- GESTURES, DEMONSTRATIONS, VISUAL AIDS, WRITTEN MATERIALS
• PAUSE BETWEEN SENTENCES OR PHRASES TO CONFIRM UNDERSTANDING
• REDUCE BACKGROUND NOISE
• VERIFY THAT INFO HAD BEEN CLEARLY UNDERSTOOD – REMEMBER PT MAY AGREE WITH EVERYTHING YOU SAY
38. Persons with normal age related sensory changes are likely to have most difficulty distinguishing which of the following? SPOKEN PAIRS OF PHRASES LIKE “SHE’S PRAISED” AND “FEES RAISED”
39. Which of the following is used to treat the most common cause of impairment to an older adults hearing? EAR CANAL IRRIGATION
40. A medical illustration shows a man the blunt end of a tuning fork pressed to the center of his forehead. The man is being tested for which of the following? UNILATERAL CONDUCTIVE HEARING LOSS
An older man who is non-Hispanic Caucasian has a fasting blood sugar level above 130 mg/dl. Which pt assessment does the nurse use to confirm a high risk for DM in this man?
• RISK FACTORS:
• 65 + YRS OLD
• FASTING GLUCOSE > 126
• NO SMOKING OR SMOKING CESSATION
• BP < 130/80
• CHOLESTEROL < 200
• LDL < 100
• HDL > 40
• TRIGLYCERIDES > 150
41. Which co-morbidity commonly associated with type 2 DM enhances the development of the microvascular complications of DM? HYPERLIPIDEMIA
What concerns the nurse regarding pt with DM that confirms progression to chronic illness?
• DIABETIC + TOE REMOVAL = HEALTH PROBLEMS (CHRONIC ILLNESS)
• THE FOCUS OF MANAGEMENT IS GEARED MORE TOWARD LIFE EXPECTANCY AND THE REDOGNITION OF THE IMPORTANCE OF CARDIOVACULAR HEALTH PROMOTING STRATEGIES
• SELF MANAGEMENT SKILLS:
• NUTRITION
• EXERCISE PLAN
• MED USE
• BLOOD GLUCOSE
• FEET CARE
42. The nurse assists an older man who has DM type 2 to improve his glucose control. Which of the following instructions does the nurse give to this individual when he plans to walk more than usual in one day? SUPPLEMENT CALORIC INTAKE
• MEN – 60+ NEED 2000-2600
• WOMEN 60+ NEED 1600-2000
• LIMIT SATURATED FATS FROM DIET
• BALANCE EXERCISE AND DIET
43. Which is a true statement about osteoporosis? A HIGH RISK OF DEATH FOLLOWS AN OSTEOPOROSIS-RELATED RX
• NEEDS: Vitamin D, Ca, NO SMOKING
44. An older female pt seeks advice from the nurse about preventing further bone loss after being dx with osteopenia. To achieve the woman’s goal, which teaching should the nurse provide to enhance activity of osteoblasts? EXERCISE WITH WEIGHTS (brisk walking with weights)
45. Which are characteristics of RA that are unlike OA? IT IS SYSEMIC AND SYMMETRICAL
• RA – degenerative joint disorder, asymmetrical, pain doesn’t resolve
• OA – systemic and symmetrical, pain resolves within 30min
46. Which statement is true about joints in older adults? SURGICAL JOINT REPLACEMENT CAN CURE OA (cannot be “cured” without joint replacement – arthroplasty)
47. An osteoporosis related fall necessitated hip replacement surgery for an older female adult who is entering a rehab facility. Which id the nurse’s priority goal during this woman’s rehab? RECAPTURE PREOPERATIVE MOBILITY STATUS
48. Which of the following statements is true about RA? CAN AFFECT BODY SYSTEMS RATHER THAN JOINTS
Which of the following nursing interventions are suitable for a pt who has gout?
• COLCHICINE (COLSALIDE) BY MOUTH
• ALLOPURINOL
• PROBENECID
• ENCOURAGE 2L/DAY FLUIDS TO FLUSH URIC ACID FROM KIDNEYS
49. Which of the following is a true statement about heart disease in men and women? WOMEN GENERALLY RECEIVE LESS AGFRESSIVE TREAMENT THAN MEN DO
• MEN > 55 are dx with ANGINA & ICS
• WOMEN > 55 are dx with VAGUE chest pain only – receive fewer meds – same as BLACKS
50. Which assessment is typical for a pt with OA? NARROW JOINT SPACES WITH CREPITUS
51. The nurse prepares an older male adult who has OA for discharge. Which instruction does the nurse include in pt teaching to maintain safety for this man? REPORT JOINT INSTABILITY TO THE HEALTH CARE PROVIDER
52. An older male adult who has OA tells the nurse that he has experienced fatigue for the past 2 weeks. Which nursing intervention should the nurse implement to help him manage fatigue? HELP HIM PLAN EXERCISE AND REST
53. Which classic sign of an AMI can be absent in an older man with an AMI? CRUSHING CHEST PAIN
54. An African-American 58 yr old man in good health has a BP at 120/73 at his annual physical exam. Which of the following is the best goal for the nurse to assist him in maintaining his health and wellness into older age? PREVENT CARDIOVASCULAR DISEASE
55. An older woman has severe ischemic heart disease, HTN, and low cardiac output. Which medication does the nurse administer to counteract the neurohormonal activation of this pt’s cardiovascular status? BETA-ADRENERGIC BLOCKER
56. Which of the following is the most important plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults who have HF? CONTROL FLUID BALANCE
57. An older man in a cardiac rehab exercise class refuses to participate in the cool- down phase of the activity; consequently, 2 minutes later, he passes out but quickly regains consciousness. Which instruction does the nurse include in pt teaching to reinforce the importance of cooling down after exercising to this man? BARORECEPTOR FUNCTION DIMINISHES WITH AGE
58. Which condition is a COPD? BRONCHITIS, ASTHMA, EMPHYSEMA
59. An older woman who has COPD wants to perform self-care activities. Which instruction should the nurse include in pt teaching to help her achieve this goal? BATHE AND EAT SLOWLY WITH PERIODIC REST
60. Which of the following statements is true about cardiopulmonary disease in older adults? MOUTH HYGIENE IS ESSENTIAL TO PREVENT AND TREAT PNEUMONIA
61. Which of the following is a true statement about TB in older adults? OLDER PERSONS, PARTICULARLY THOSE IN NH, ARE AT RISK FOR TB (Homeless too)
62. An older man who is right-handed works as a carpenter, but he has been left with a flaccid right arm after a thrombus occluded a cerebral artery. Which is the most important goal for the POC to help this man achieve his optimal state of health and wellness? COLLABORATE WITH OT
63. Which is the fundamental difference between Medicare part A and Medicare part B? HEALTH CARE SETTING
64. Which of the following statements is true about health care costs for older adults in the US? HMOs CAN OBTAIN AN EXEMPTION FROM MEDICARE’S PERCAPITA SPENDING LIMIT
65. Managed care systems are most effective for an older adult who does which of the following? SEEKS REGULAR PRIMARY CARE AND PREVENTIVE STRATEGIES TO MAINTAIN HEALTH
66. The older adult wants to appoint an attorney-in-fact with DPA for a specific period around a forthcoming surgery. Which should the nurse implement? HELP THE PT FIND A QUALIFIED ATTORNEY
67. Which of the following qualities does the nurse need to provide caring? ABILITY TO CREATE A TRUSTING ENVIRONMENT
68. Which of the following statements describes one of the following standards of case management during hospitalization? BEGIN DISCHARGE PLANNING ON THE FIRST DAY OF HOSPITALIZATION
GERO EXAM 3
1. An older woman recently lost her brother, provides care for her husband who has health needs, and must move to a new location after 35 years in the same home. When she comes to the primary care facility with clinical indicators of influenza, the nurse recognizes which of the following? CRISIS AND STRESSORS CAN IMPAIR PHYSICAL HEALTH
2. Which of the following statements is true about the mental health of older adults? THE NURSE AVOIDS ANTIANXIETY MEDS WITHOUT AN ASSESSMENT FOR FACTORS ASSOCIATED WITH ANXIETY
3. Which of the following is a true statement about psychotic behavior in older adults? AN OLDER ADULT WITH PSYCHOTIC BEHAVIOR SHOULD BE ASSESSED FOR A VARIETY OF CAUSES
4. Which of the following statements is true about loss in older adulthood? REFERRING TO THE DECEASED IN THE PAST TENSE CAN ACKNOWLEDGE THE DEATHS REALITY
5. The HCP believes an older woman has approximately 6 weeks to live. After 2 months, the family remains at the bedside but, in the last few days, are becoming increasingly impatient and irritable. This pattern is least indicative of which of the following statements? FAMILY DESIRES THAT THE PT BE RELIEVED OF HER MISERY
6. After the older adult dies, the brother who has a hx of alcohol abuse upsets the family by going on a drinking binge instead of attending the funeral. Which of the following is the best description of the brother’s behavior? DISENFRANCHISED GRIEF
7. Which of the following interventions is recommended for an older adult in the final stages of dying? SUPPORT THE PRESERVATION OF ENERGY
8. Which of the following of statements is true about end-of-life care? THE PROXY APPOINTED IN A LIVING WILL CANNOT SPEAK FOR THE TESTATOR IN HEALTH CARE MATTERS OTHER THAN TERMINAL ILLNESS
9. After the loss and burial of a beloved pet, an older man loses weight because he eats very little. 3 months later, he starts to paint pictures of the pet and his appetite slowly improves. Describe the individual’s mourning for his pet. PET’S BURIAL AND PAINTING PICS OF THE PET
10. The primary difference between the Loss Response Model (LRM) and the Worden model of grief is which of the following? THE LRM USES A SYSTEMS APPROACH THAT ACTS TO UPHOLD STABILITY
11. When the older who is close to death asks the family to leave after short visits and acts withdrawn in their presence, the family becomes distraught. Which of the following does the nurse include in family teaching to explain the pt’s behavior? SHE CAN BE EXPERIENCING ANTIPATORY GRIEF
12. The son of an older couple ends his life suddenly and violently. The husband proceeds with living as usual. After 1 year, the wife remains in seclusion and is hospitalized for dehydration. Which steps should the nurse implement to help improve the wife’s mental health and wellness? ESTABLISH A TRUSTING, CARING RELATIONSHIP WITH HER
13. A pt loses her husband of a sudden MI, and she blames herself for not recognizing the warning signs. Which pt outcome associated with her loss should the nurse use to plan care? EXPRESS FEELINGS OF GUILT, FEAR, ANGER, OR SADNESS
14. The actions of a family member of an older adult who just died are chaotic, and they are unable to decide on a funeral home. Which recommendation should the nurse implement? SUGGEST THEY CALL SOMEONE WHO CAN HELP
15. While awaiting the imminent death of her sister, an older woman makes arrangements to bury her sister in the survivor’s home state because she cannot reach the other family members. Which step should the nurse implement? ASK QUESTIONS, INCLUDING QUESTIONS ABOUT THE LOCATION OF HER SISTER’S FAMILY
16. An older pt who has end-stage pulmonary disease decides to accept care from the palliative care nurse. The older adult will most likely benefit from the palliative care nurse in which pt needs of Weisman’s six needs of the dying? CONTROL
17. Which of the following is true about loss, dying, and death for older adults? THE GRIEVING PROCESS IS NOT RIGIDLY STRUCTURED
18. Which pharmacokinetic parameter is affected most by decreased intestinal motility r/t the aging process? ABSORPTION
19. Which process is increased in the early morning? FIBRINOLYTIC ACTIVITY
20. Which interaction between each prescription and food or nutritional supplement is favorable? TERAZOSIN (HYTRIN) AND INCREASED FLUIDS
21. Which med is correctly matched to the condition given of an older adult pt according to current med knowledge? BUSPIRONE (BUSPAR) FOR CHRONIC ANXIETY STATES
22. In questioning an older adult, which question is likely to elicit the most accurate information about the individual’s adherence to the med plan? HOW MANY DOSES OF DIGOXIN (LANOXIN) DO YOU THINK YOU MISSED?
23. Which of the following is on the list of drugs considered suitable for the older adult? BUPROPION (WELLBUTRIN)
24. A pt receives heparin daily. The nurse should assess for which clinical response that indicated the need to discontinue heparin therapy? HEMATURIA
25. A geriatric nurse practitioner prescribes an antidepressant for a pt. The pt asks, “How long will I have to be on this med before I feel like my old self?” The recalls that a therapeutic response to an antidepressant med most often takes which one of the following? 2 MONTHS
26. The nurse prepares to administer vancomycin (Vancocin) to an older adult. Which lab test should the nurse review before administering this med? CREATININE CLEARANCE
27. The nurse prepares to administer diltiazem (Cardizem LA) to an older adult with ischemic heart disease. What is the optimal time to administer this med to help prevent complications of heart disease associated with rhythmical variations? AT BEDTIME
28. A HCP has ordered alendronate (Fosamax) for an older adult who has been admitted for a hip fx. Which is the best response from the nurse when educating the pt on the new med? TAKE ON AN EMPTY STOMACH
29. When completing reconciliation for an older woman, the nurse notes that the pt is being discharged home on anticoagulant therapy. The nurse also notes that at admission, the pt reported that she uses herbal supplements at home. Which instruction should the nurse include during discharge teaching? AVOID USING CHAMOMILE SUPPLEMENTS WHILE ON ANTICOAGULANT THERAPY
30. The nurse provides instruction about med safety to older adults. Which instruction should the [Show Less]