Hesi Gerontology Questions & Answers exams 3
Gerontology Questions & Answers exams 3
1.
The nurse is explaining to a new colleague the similarities
... [Show More] and differences between gerontology and geriatrics. Which of the following situations would most likely be addressed by a geriatrician rather than a gerontologist?
A) Teaching older adults techniques to identify and deal with age-related changes
B) Organizing and leading exercise classes to facilitate mobility
C) Identifying and treating a patient's vascular dementia
D) Rearranging an older adult's apartment to minimize the risk of falls
2. The nurse works with a program that performs interviews, blood work, and digital rectal exams aimed at identifying older men with benign prostatic hyperplasia (BPH). The program also facilitates bathroom alterations in older adults' homes to ensure men with BPH have easy access to a toilet. Which of the following components of health promotion has yet to be implemented in the program?
A) Screening
B) Risk assessment
C) Environmental modification
D) Risk reduction interventions
3. The nurse is teaching nursing students about the importance of health promotion among older adults. Which of the following statements by the students indicates a need for further teaching?
A) “Teaching older adults how to live with diabetes would be a useful health promotion initiative.”
B) “I can see why we would want to promote timely discharge back to the community following hospitalization.”
C) “I think that attending to spiritual growth could likely be a part of health promotion.”
D) “If we could promote healthy, simple diets, then some diseases could likely be prevented.”
4. Which of the following interventions most closely aligns with the practices of health promotion?
A) Leading a flexibility and mobility class among older adults
B) Providing presurgical teaching to an older adult prior to hip replacement
C) Administering an anti-inflammatory and analgesics to an older adult with osteoarthritis
D) Teaching an older adult how to administer her inhaled bronchodilators independently
5. Which of the following circumstances would be most likely to render a screening program unnecessary?
A) Treatment of the disease is available at low cost.
B) The disease follows a predictable course.
C) The disease is more common among older adults than among younger and middle-aged adults.
D) The symptoms of the disease appear at the same time that it is detectable by screening.
6. A nurse who works with older adults is teaching a colleague about the similarities and differences between gerontology and geriatrics. Which of the following questions best conveys the focus of gerontology?
A) “How can we secure more funding for research and development of drugs specifically for older adults?”
B) “How can we teach older adults about the relationship between their lifestyle and their health?”
C) “How can we help older adults maintain wellness as they age?”
D) “How can we reduce the incidence of falls among older adults who live in care facilities?”
7. Despite the fact that older adults are proportionately the highest users of health care services, many nurses harbor misconceptions and deficits in practice related to gerontological nursing. What is the most likely solution to this problem?
A) A shift from the treatment of older adults in institutional settings to home care
B) Increased nursing education and clinical experience specific to working with older adults
C) A focus on early discharge planning for older adults in hospital settings
D) Increased use of aggressive pharmacological interventions in the treatment of acute illnesses in older adults
8. Mr. Dey is a 69-year-old man who has been a cigarette smoker since his late teens. In recent weeks, he has asked the nurse who helps manage his diabetes numerous questions about the potential benefits of quitting smoking, a subject that he has normally avoided in past interactions. The nurse has now explicitly asked Mr. Dey if he would like to quit smoking, to which he has replied that he will “give it some serious thought.” Mr. Dey is demonstrating what stage of the transtheoretical model (TTM)?
A) Precontemplation
B) Preparation
C) Contemplation
D) Action
9. A gerontological nurse who works in a public health setting has limited funding for initiatives. Which of the following prevention and health promotion initiatives is most likely to result in significant benefits for the older adults who participate?
A) Awareness program that promotes screening sigmoidoscopy
B) Teaching older adults about falls prevention in the home
C) A program of bone density screening for older adults
D) An exercise program for older adults who live in the community
10. A group of community health nurses is using the transtheoretical model (TTM) as the foundation of a new health promotion campaign for older adults. What goal for the participants are the nurses likely to promote when working with older adults in the program?
A) A recognition of the importance of screening for common health problems
B) Increased participation in exercise programs and an awareness of the relationship between exercise and wellness
C) The replacement of participants' unhealthy behaviors with healthy behaviors
D) An awareness of the differences between life expectancy and active life expectancy
Chapter 7
1. The nurse is responsible for assessing an older adult in an acute care setting. Which of the following statements most accurately captures the complexity involved in assessing the older adult?
A) Older adults manifest fewer symptoms of illness than do younger patients.
B) Signs and symptoms of illness are often obscure and less predictable among older adults.
C) Care must be taken to avoid assessing normal, age-related changes.
D) Older adults experience fewer acute health problems but more chronic illnesses than do younger patients.
2. An 82-year-old man is getting advice from a family member on how to drive safely. What piece of advice should the older adult follow?
A) “Avoid modifying your vehicle with devices that were not supplied by the manufacturer.”
B) “Realize that normal, age-related changes should not affect your ability to drive safely.”
C) “You can consider timing your medications to avoid their interfering with safe driving.”
D) “You should transition from driving to using public transportation as soon as possible.”
3. The nurse is conducting a functional assessment of a resident who has recently moved to the assisted-living facility. Which of the following statements best describes functional assessment?
A) It excludes information on the resident's medical diagnoses and health problems.
B) It is a rehabilitative approach focused on the resident's ability to perform self-care tasks.
C) It is an alternative to assessing the resident's activities of daily living (ADLs).
D) It prioritizes the resident's ability to perform roles in relationships and in society.
4. As part of a functional assessment, the nurse is assessing an older adult's activities of daily living (ADLs) and instrumental activities of daily living (IADLs). What piece of assessment data would most likely be considered an IADL rather than an ADL?
A) The older adult is able to ambulate to and from the bathroom at home.
B) The older adult can feed herself independently.
C) The older adult can dress in the morning without assistance.
D) The older adult is able to clean and maintain her own apartment.
5. The nurse is employed in a Medicare- and Medicaid-funded nursing home. Which of these statements is true of the functional assessments the nurse is likely to perform?
A) The nurse will address core activities of daily living (ADLs) but not more complex instrumental activities of daily living (IADLs).
B) The nurse will identify changes in the older adult's function over time.
C) The nurse will utilize various functional assessment models.
D) The main goal of functional assessments will be to ensure older adult safety.
6. A nurse who provides care in a nursing home has completed the admission assessment of an 84- year-old man who has just moved from an assisted living facility. The nurse would document a deficit in the resident's activities of daily living (ADLs) in light of what assessment finding?
A) The man experiences chronic pain as a result of rheumatoid arthritis.
B) The man is able to ambulate with a wheeled walker for 60 ft but then requires a rest break.
C) The man is able to wash himself but requires assistance entering and leaving the bathtub.
D) The man is unable to explain the rationale for each of the medications that he receives.
7. A 79-year-old woman has been admitted to a nursing home primarily because her diagnosis of Alzheimer disease has progressed from the mild stage to the moderate stage. How should the nurse proceed with functional assessment in light of the woman's cognitive deficits?
A) Obtain assessment data from the woman's family members and friends.
B) Utilize an assessment tool that is specifically designed for use with cognitively impaired clients.
C) Perform assessment passively by observing and recording the woman's behavior and actions over the next several days.
D) Document the fact that it is not possible to accurately gauge the woman's activities of daily living.
8. A nurse who works in an acute care for elders (ACE) unit has observed that a female patient on the unit frequently stumbles when she ambulates with her walker. How should the nurse best follow up this observation?
A) Provide a wheelchair for the patient to use for the duration of her hospital stay.
B) Ask the patient to remain in her bed or in a chair as much as possible and teach her about falls risks.
C) Place a chair in the hallway so the patient can take a rest break when she feels unsteady on her feet.
D) Liaise with an occupational therapist to ensure that the woman's mobility is thoroughly assessed and an appropriate assistive device is provided.
9. Staff members at a nursing home have been reminded by management of their responsibility to utilize the Minimum Data Set (MDS) for Resident Assessment and Care Screening. When should the MDS be used?
A) Upon resident admission and every 3 months after that
B) Once per week for the first month after admission and once per month after that
C) Whenever a registered nurse or physician documents a significant change in a resident's level of function
D) Daily, as part of routine assessment in the facility
10. Assessment of an older adult's activities of daily living (ADLs) addresses parameters such as mobility, dressing, and elimination. In addition to such functional parameters, assessment of ADLs should also address
A) pain and range of motion.
B) mental status.
C) previous medical history.
D) integumentary assessment.
Chapter 8
1. A 75-year-old man has iron deficiency anemia, for which he takes iron three times a day. You ask him about his eating habits to determine whether he may be sufficiently absorbing the iron supplements. Which of the following statements by him indicates a need for further teaching?
A) “I drink orange juice with breakfast.”
B) “I drink coffee with my meals.”
C) “I limit my intake of fiber in my meals.”
D) “I eat cereal for breakfast.”
2. A healthy 70-year-old man has been having trouble sleeping at night. In addition, he has been having difficulties with gastroesophageal reflux. He buys generic Benadryl to help him sleep and buys generic Tagamet for his reflux. After 7 days of taking these over-the-counter medications, he exhibits signs of confusion and disorientation. His wife calls the primary care facility to speak with the nurse. What should the nurse suspect first?
A) The older adult has an electrolyte imbalance, leading to delirium.
B) The older adult is having transient ischemic attacks.
C) The older adult has an overwhelming infection.
D) The older adult is experiencing mental changes as an adverse drug effect.
3. An older adult, age 72, with type 2 diabetes is recovering from a myocardial infarction and is admitted to a long-term care facility. He takes an oral hypoglycemic agent, a beta-blocker, and furosemide, and administers nitroglycerin tablets as needed. His medical history states he has drunk a pint of whiskey per day for the past few years. Which of the following should be a priority for his admitting nurse?
A) Assess and observe him for depression.
B) Assess him for toxic effects of his medication.
C) Observe him for changes in his mental status.
D) Evaluate his blood work for changes in electrolytes.
4. An older adult wants to take ginkgo biloba to help improve his memory. He takes valsartan (Diovan) and hydrochlorothiazide for hypertension. He also takes an aspirin a day because he heard it was “good for his heart.” Which of the following statements best reflects the advice his nurse should give him?
A) “Ginkgo biloba may cause postprandial hypotension in older adults.”
B) “Ginkgo biloba has the potential to interact with hydrochlorothiazide.”
C) “Ginkgo biloba can interact with Diovan, reducing its effectiveness.”
D) “Ginkgo biloba taken with aspirin can potentially cause a drug interaction.”
5. Which of the following questions best links medical assessment with the overall assessment of an older adult?
A) “Do you have any difficulty taking your pills at any time?”
B) “What did your health care practitioner tell you about the medications?”
C) “Do you take any caffeine-containing medications or drink a lot of caffeine?”
D) “What do you do to help you sleep when you have a problem falling asleep?”
6. A nurse who works in an acute care for elders (ACE) unit recognizes the unique pharmacokinetics and pharmacodynamics that often occur in older adults. Which of the following factors should the nurse take into account when administering medications to older adults on the unit?
A) Older adults tend to achieve clearance of medication faster than do younger patients.
B) Drug metabolism shifts from the liver to the kidneys as individuals age.
C) Older adults tend to need either higher doses or more frequent doses of a drug to achieve therapeutic effect.
D) As a result of age-related changes, older adults face an increased risk of adverse medication effects.
7. A gerontological nurse is conducting a medication assessment of a new patient on a subacute medicine unit. Which of the patient's statements should signal to the nurse a need for patient education?
A) “Overall, I much prefer to prevent getting sick than having to rely on different drugs to stay healthy.”
B) “I've made a reminder system for myself so that I don't miss any of my pills during the day.”
C) “My family doctor has me on so many different pills now, so I want to talk with her about whether they're all necessary.”
D) “I use a lot of herbs and supplements, but I'm careful to make sure that they're all natural.”
8. A medical nurse is aware that older adults tend to have a significantly decreased rate of hepatic blood flow compared with younger adults. What effect is this likely to have on pharmacokinetics and pharmacodynamics in an older adult?
A) Drug clearance is likely to be slower.
B) Elimination half-time is likely to be faster.
C) The kidneys will likely compensate for decreased hepatic capacity.
D) Multiple bioactive substances will be needed for therapeutic effect.
9. A nurse is conducting a medication assessment of an older adult client who will soon be receiving home care. Which of the following questions should the nurse include in this assessment? Select all that apply.
A) “Are you a smoker?”
B) “What is your typical diet?”
C) “What over-the-counter drugs do you use?”
D) “Do you use any herbs or dietary supplements?”
E) “Do you drink alcohol?”
10. Having completed a medication assessment and physical assessment of a new client, a home care nurse is now creating nursing diagnoses and choosing interventions appropriate to these diagnoses. What factor should the nurse prioritize in this process?
A) The need to maintain the client's autonomy.
B) The nurse's responsibility to teach the patient and minimize liability.
C) The importance of the patient's safety.
D) The importance of fostering patient compliance.
Chapter 22
1. A nurse is teaching health interventions to an older adult with osteoarthritis. Which of these statements indicates that the individual needs additional teaching?
A) “I will avoid high-impact exercises.”
B) “I will get adequate intake of vitamins C, D, and
C) “I will try to limit my use of walkers and assistive devices.”
D) “I will lose weight if it turns out that I need to.”
2. A nurse is teaching older adults at a senior center how to reduce the incidence of falls. Which of the following statements indicates that the nurse's teaching has been effective?
A) “Benadryl is a safe medication to take for sleep.”
B) “It is safe to have rugs in my kitchen and bathroom.”
C) “It is safe to take a low dose of Ativan when I am anxious.”
D) “I understand that over-the-counter medications as well as prescription medications can cause falls.”
3. Which of the following is accurate about functional consequences related to mobility and safety?
A) A functional consequence related to mobility and safety for older adults is impaired vision.
B) Range of motion may be limited in all joints, causing some difficulties in the performance of some activities of daily living (ADLs).
C) A functional consequence of age-related changes and risk factors is decreased susceptibility to falls.
D) Fallaphobia and postfall syndromes are not recognized as functional consequences for older adults.
4. Which of the following nursing interventions should be the priority for a nurse working in a community of older adults?
A) Using restraints to keep nursing home residents from getting out of chairs unattended
B) Establishing a fall-prevention program for residents at risk
C) Using cordless phones or emergency call systems for residents in assisted living
D) Using a monitoring device for people who live alone in their own home
5. Which of the following older adults is most at risk to develop osteoporosis?
A) A 65-year-old white female with COPD who takes corticosteroids
B) A 65-year-old white male with rheumatoid arthritis
C) A 70-year-old African American male with a seizure disorder
D) A 68-year-old Hispanic female who recently had a partial hysterectomy
6. A 79-year-old woman is scheduled to undergo hip replacement surgery after a fracture that was caused by a fall. Which of the following age-related changes may have contributed to the woman's susceptibility to bone fracture?
A) Increased protein synthesis
B) Infections within the synovial capsules of the knees and ankles
C) Loss of neural control of balance
D) Increased bone resorption
7. A nurse was recently assisting an 84-year-old resident of a nursing home with the resident's biweekly bath. While the nurse was helping the resident transfer out of the bathtub the resident grabbed on to the nurse forcefully, became rigid, and exclaimed, “Help me quick,” despite the fact that the nurse was performing a safe and controlled transfer. Why might this resident have exhibited sudden anxiety during the transfer?
A) The resident may be developing a cognitive deficit.
B) The resident is experiencing age-related changes.
C) The resident may have a fear of falling.
D) The resident is ensuring safety.
8. Mr. Roth is an 81-year-old hospital patient whose health problems include Alzheimer's disease and failure to thrive. The nurses who provide care for Mr. Roth have emphasized the importance of ringing his call light for assistance when he has the urge to void, but to this point he has failed to do so. During the night, the nurse discovered Mr. Roth attempting to scale his bed rails to go to the bathroom. What nursing diagnosis is most appropriate for Mr. Roth?
A) Impaired Mobility
B) Risk for Falls
C) Ineffective Health Maintenance
D) Activity Intolerance
9. A 70-year-old woman has expressed interest in preventing osteoporosis as a result of the high prevalence of the disease in her peer group. What dietary measures should the nurse recommend?
A) High intake of calcium and vitamin D
B) A high-protein, low-carbohydrate diet
C) High intake of organic fruits and vegetables
D) Vitamin C supplements and a high-potassium diet
10. A nursing home has been the site of numerous falls by residents in recent months, a trend that management and care providers are eager to reverse. Which of the following factors is the most likely contributor to falls?
A) There are long, narrow hallways that lead to the dining room and common areas.
B) Each room has a private sink and toilet but there are only two designated rooms for bathing in the facility.
C) The bedrails on each resident's bed are kept in a raised position whenever the resident is in bed.
D) The majority of care is provided by nursing assistants, with one registered nurse overseeing the care team.
Chapter 23
1. Which of the following observations is a normal cultural variation when assessing the skin and its appendages in older adults?
A) Early skin changes are more obvious in people with darkly pigmented skin.
B) Asians and Native Americans may have Mongolian spots, which may indicate bleeding tendencies.
C) Mongolian spots occur most commonly in African Americans, Asians, and Native Americans.
D) Skin cancers are rare in light-skinned individuals of northern European ancestry.
2. Which of the following would be appropriate to include in health teaching to older adults about skin care?
A) Use firm rubbing motions when drying your skin.
B) Avoid sunscreens with a sun protection factor (SPF) higher than 14.
C) Gently apply rubbing alcohol to actinic keratosis growths to remove them.
D) Include adequate amounts of fluid and vitamins A and C in the daily diet.
3. Which of the following would be the most reliable method for assessing skin turgor in an 85- year-old man who takes furosemide and a tricyclic antidepressant?
A) Ask him to open his mouth and stick out his tongue so you can examine his oral mucous membranes for dryness.
B) Gently pinch the skin over his lower arms to see if it remains pinched or is slow to return to normal.
C) Gently pinch the skin over his sternum to see if it remains pinched or is slow to return to normal.
D) Examine the skin on his lower legs to see if it is dry, scaly, and rough.
4. Which of the following is essential in the assessment of pressure ulcers?
A) The PUSH tool scores pressure ulcers according to moisture, activity, mobility, and friction and rub.
B) A stage V pressure ulcer can become a stage II pressure ulcer with appropriate treatment.
C) Softness of the tissue and differences in skin temperature can be estimated and then documented.
D) Assessment of pressure ulcers involves visual inspection and other factors.
5. Which of the following functional consequences of skin changes will impact the nursing care of older adults?
A) Older adults have an increased incidence of moles requiring intervention.
B) There is a decreased incidence of skin cancer in older adults because of an increase in melanocytes.
C) In older adults, tactile sensitivity increases and there is an intense response to cutaneous stimulation.
D) Collagen changes interfere with tensile strength of older adults' skin, causing the skin to be less resilient.
6. A gerontological nurse is aware of the changes in the structure and function of the skin and accessory glands that occur with aging. Which of the following changes is a normal accompaniment to the aging process?
A) Thickening of collagen in the dermal layers of the skin
B) Cessation of eccrine and apocrine sweat gland function
C) Increases in the number of melanocytes in the epidermis
D) Decrease in the vascular bed of the dermis
7. A nurse is participating in a health fair that is being sponsored by a local seniors' center. What teaching point should the nurse emphasize in an effort to address older adults' risk factors related to skin wellness?
A) “As much as possible, try to keep your skin protected from direct sunlight.”
B) “Many drugs can have an effect on your skin, so it's important to avoid most over-the-counter medications?”
C) “The health of your skin is primarily determined by your genes, so all you can do is try to maintain your overall level of health.”
D) “Even if you find it difficult to do, it's important to bathe once a day.”
8. One of the functional consequences of age-related changes to the skin is an increased susceptibility to injury. Which of the following factors contributes to this susceptibility? (Select all that apply)
A) Decreased sensation of cutaneous pain and discomfort
B) Changes in vitamin D synthesis
C) Increased healing time for skin wounds
D) Decreased resistance to shearing forces
E) Changes in skin pigmentation
9. A nurse on an acute care for elders unit is disturbed by the increasing incidence of pressure ulcers among patients. What measure should the nurses on the unit prioritize in order to prevent the formation of pressure ulcers?
A) Frequent repositioning of immobilized patients
B) A high-protein diet
C) Use of massage and other forms of tactile stimulation
D) Use of prophylactic antibiotics
10. A nurse in a long-term care facility assists several residents with bathing each day. What measure should the nurse implement in order to promote and protect the health of residents' skin?
A) Cleanse skin with isopropyl alcohol to eliminate potential pathogens.
B) Apply emollient products to maintain the moisture of the skin.
C) Apply perfumed products after bathing to promote hygiene and self-esteem.
D) Leave skin surfaces partially wet after bathing to promote moisture in the skin. [Show Less]