C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+, Exams of Nursing

Download C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ and more Exams Nursing in PDF only on Docsity! C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ A negative attitude towards aging and the aged is called: A. geriatrics B. racism C. ageism D. ethnocentrism Answer: C Which of the following is not considered a core competency for nurses caring for older adults? A. Analyze the impact of an aging society on the health care system B. Obtain certification in gerontological nursing C. Prevent or reduce common risk factors that contribute to functional decline D. Recognize one's own attitudes about aging Answer: B The nurse wishes to obtain basic certification in the specialty of gerontological nursing. Which of the following is true about this credential? A. there is an experience requirement B. one must pass an exam C. one must have a BSN D. a and b only Answer: D When the nurse reads an article and uses the findings of a study to improve the quality of the patients for whom she cares, she is implementing the role of: A. teacher B. manager C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C. research consumer D. advocate Answer: C A lawyer wishes to hire a nurse consultant who has advanced education and certification in gerontology. Based on their listed credentials, which of the following nurses best fits his wishes? A. Sally Smith, RN, BSN, BC B. Mary Malloy, RN, MS, GNP C. Andy Jones, LPN, CRRC Greg Reed, RN, MSN Answer: B The AACN/John A. Hartford Foundation Competencies are helpful to nurses because they: A. offer suggestions about how to gain employment in geriatrics B. provide a guideline for the knowledge that is expected to provide quality care to older adults C. were designed to prepare nurses to pass the State Board Exam D. were written for nurses working on a graduate degree in gerontology Answer: B The nurse has a question about the appropriateness of an older patient's medication dose. Which of the following professionals would be best qualified to answer such a question? A. the geropsychologist B. the geropharmacist C. the financial gerontologist D. the gerontological rehabilitation nurse C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C. most older persons are cared for by their children D. nearly a half million grandparents are raising their grandchildren Answer: D What best explains the lack of prepared, qualified health professionals to care for the aged? A. a shortage of nursing faculty B. medical programs not including gerontology content C. not enough health professionals choosing gero as a specialty D. the current nursing shortage Answer: C There were approximately 36 million Americans over the age of 65 years in 2000 and this number is expected to grow to 71 million by 2030 A. TRUE B. FALSE Answer: A Over half of women over the age of 85 are widowed A. TRUE B. FALSE Answer: A C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ There are more males in the population than females A. TRUE B. FALSE Answer: B Most centenarians (people over the age of 100 years) are White and female A. TRUE B. FALSE Answer: A Minority elderly groups are growing and thus present unique challenges for nurses today A. TRUE B. FALSE Answer: A The majority of older persons live alone A. TRUE B. FALSE Answer: B Older women who live alone tend to be more from lower income groups than those who are married A. TRUE B. FALSE C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: A Elderly Hispanics rate their overall health significantly higher than those from other ethnic groups A. TRUE B. FALSE Answer: B Older persons tend to die from acute illnesses more than chronic diseases A. TRUE B. FALSE Answer: B The major causes of death in the older age group are heart disease, AIDS, and tuberculosis A. TRUE B. FALSE Answer: B (It's Heart Disease, Cancer and Strokes) Which ethnic/cultural group has a higher rate of diabetes, hypertension, and chronic renal disease than other ethnic groups? A. African Americans B. Hispanics C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ D. stochastic Answer: B A scientist who believes that people have a genetic programming that determines or predicts longevity is a supporter of which theory? A. age stratification B. cross-link C. free radical D. gene/biological Answer: D When a Native American Indian elder goes out into the woods to die and the tribe does not search for him, but allows him to withdraw, this could be an example of: A. activity theory B. disengagement theory C. subculture D. person-environment fit Answer: B A 99 year old widow who has lived alone in her own home for 40 years experiences a fall and is sent by her children and grandchildren to a nursing home. The woman refuses to eat and exhibits signs and symptoms of depression and withdrawal. Which theory does this most describe? A. functional consequences B. theory of thriving C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C. neuroedncorine D. immunological Answer: B The physician tells his 81-year-old male patient that his health has deteriorated due to the exogenous sources of free radicals to which he has exposed himself for many years. To what is the physician most likely referring? A. the ozone layer B. the patient's cigarette smoking C. the patient's alcohol consumption D. radiation from the patient's microwave Answer: B MATCHI NG 1)continuity theory A. personality and coping patterns remain consistent through life 2)stochastic theories B. remaining active and involved promotes life satisfaction in later year 3)neuroendocrine theory C. transformation towards oneness with the universe 4)activity theory D. cells wear out with age 5)gerotranscendence theory E. five basic needs that motivate behavior 6)nonstochastic theories F. problems with gland feedback leads to disease C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ 7)theory of thriving G. based on random events that cause cellular damage 8)human needs theory H. genetically programmed events cause cellular damage that lead to aging 9)functional consequences theory I. failure to thrive is from discord in relationships 10) wear and tear theory J. (Miller’s Theory) nurse’s role is risk reduction to enhance safety Answer: 1)continuity theory (A) A. personality and coping patterns remain consistent through life 2)stochastic theories (G) B. remaining active and involved promotes life satisfaction in later year 3)neuroendocrine theory (F) C. transformation towards oneness with the universe 4)activity theory (B) D. cells wear out with age 5)gerotranscendence theory (C) e. five basic needs that motivate behavior 6)nonstochastic theories (H) F. problems with gland feedback leads to disease 7)theory of thriving (I) G. based on random events that cause cellular damage 8)human needs theory (E) H. genetically programmed events cause cellular damage that lead to aging 9)functional consequences theory (J) I. failure to thrive is from discord in relationships 10) wear and tear theory (D) J. (Miller’s Theory) nurse’s role is risk reduction to enhance safety Which of the following visual changes is not usually associated with normal aging? a. presbyopia b. yellowing of the lens c. night blindness d. decreased accommodation Answer: C All of the following are considered IADLs (Instrumental Activities of Daily Living) except: a. toileting b. balancing the checkbook c. using the phone C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ While speaking with a patient who is experiencing depression, which of the following strategies might be most helpful? A. speaking very loudly since they are certainly hard of hearing B. recording important information for them in a notebook to refer to later C. ignoring the person and discussing their condition with a family member D. telling them that their depression will go away on its own if they think positively Answer: B In caring for a person experiencing delirium, which of the following is least effective in enhancing communication? A. speak in simple sentences B. offer frequent reassurance C. use physical restraints to control anxious behavior D. use large print clocks and calendars Answer: C List five nursing strategies for enhancing memory in the older adults with mild dementia. Answer: Journaling, keeping a record of the day, using familiar items, posting reminders, using calendars and clocks If an older person with hearing impairment complains of not being able to hear what the nurse is saying, what could be a contributing cause of this? A. normal age-related changes B. build up of cerumen C. the nurse not facing the person when speaking D. all of the above C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: D An older patient has had a stroke that resulted in Broca's aphasia. Which of the following would be most typical of Broca's aphasia? A. fluent speech B. impaired comprehension C. broken speech D. global problems Answer: C Which of the following signs would you consider an abnormal finding for a 75 year old female? A. blood pressure of 110/78 B. Hct (hematocrit) of .41 C. resting pulse of 80 D. urinary incontinence Answer: D A significant result of changes in the respiratory system with advanced age is: A. lower carbon dioxide levels in the bloodstream B. less useful oxygen available with each breath C. more efficient gas exchange at the alveolar level D. the ability to hold one's breath longer Answer: B C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ One of the most significant changes in the reproductive system for older females who are sexually active is: A. decreased vaginal lubrication B. atrophy of uterus C. decreased libido D. lack of male partners Answer: A You are helping care for your 89 year old grandmother who is sick with "the flu". Her temperature is 101.2. What other information would be most useful to better assess your grandmother's condition? A. what her temperature was yesterday B. how long she has felt sick C. what her usual temperature is D. how much she ate today Answer: C Which of the following would be an abnormal finding in assessment of an 80 year old male? A. decreased cardiac output B. decreased stage IV sleep C. loss of hearing of low frequency tones D. age spots on the hands and face Answer: C Which of the following changes in the skeletal system is least characteristic of normal aging? A. decreased range of motion B. loss of height up to 10 cm C. chronic inflammation of joints D. loss of some muscle mass C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ A. acquired immunity B. innate immunity C. aging of the immune cells D. better replication of the cells that fight infection Answer: C Which of the following is a reason why older females may develop vaginitis? A. lower estrogen levels B. atrophy of the vaginal canal C. decreased lubrication of the vagina D. all of the above Answer: D The nurse wishes to use a tool to help assess the functional status of the older residents in the nursing home where she works. Which of the following would be least appropriate for this purpose? a. Katz index b. MDS c. Barthel Index d. Gibson self-care scale Answer: D Which of the following is the best example of an open-ended question/statement that would promote verbalization from an older person? A. tell me about your major problem today B. do you have any complaints today? C. are you having any major problems? D. do you want to talk about your major complaint? C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: Name four essential areas to address to promote communication as discussed in this chapter. Answer: Invite-respect, Environment, Understanding, Communication Changes in which of the following body systems are generally most noticeable to the naked eye? A. respiratory B. integumentary C. gastrointestional D. neurological Answer: The nurse working in rehabilitation would most likely see what measure used to evaluate progress of patients in rehabilitation? A. Katz index B. MDS C. FIM D. OASIS Answer: C In assessing IADLs, the nurse will ask questions about all but which of the following patient C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ activities? a. cooking b. shopping C. using the phone D. bathing Answer: D In assessing the circulatory system of an older adult, the nurse would recognize which of the following as abnormal? A. resting pulse rate of 120 B. blood pressure of 118/78 C. respirations of 26 D. a and c Answer: D When assessing the respiratory system of an older person, which of the following is the least essential to ask during history taking? A. use of tobacco products B. feelings of shortness of breath C. exposure to environmental toxins D. all are important to ask about Answer: D All of the following may contribute to an older patient complaining of constipation except….. A. decreased thirst mechanism B. changes in peristalsis with age C. lack of fiber in diet D. increased physical activity C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ D. right place Answer: D Which of the following lab results would alert the nurse to an abnormality in an older adult? A. glucose = 100 B. albumin = 2.5 C. TSH = 4.0 D. blood culture = negative Answer: B The physician orders a peak and trough to be drawn on a patient receiving Vancomycin. The nurse correctly draws the peak: A. when the highest level of medication is in the blood B. when the lowest level of medication is in the blood C. two minutes after the medication is given D. three hours prior to the medication being given Answer: A 5) Which of the following normal aging changes affects the way medications are processed in the body of an older adult? a. decreased renal clearance B. decreased cardiac output C. impaired absorption in the gut D. all of the above Answer: D C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Opioids are rarely prescribed for persons with dementia because of what adverse reaction? A. dry mouth B. sedation C. confusion D. constipation Answer: C Which of the following is true about the elderly and medications? A. about 1/6 of all medications are for the elderly B. medications may stay in the body longer C. there is a decreased risk of side effects with aging D. dosing should be the same for young and old adults Answer: B Polypharmacy is a significant problem for the elderly because: A. the more medications one takes, the greater the risk of side effects B. older persons are unable to take medications correctly C. older adults are not accustomed to taking multiple medications D. a and c only Answer: A Diphenhyrdramine (Benadryl) is not recommended for use in older adults because of: A. confusion and severe anticholinergic effects B. risk of seizures C. prolonged half life C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ D. dosage problems Answer: A Which of the following questions is least appropriate to ask when taking a medication history? A. use of over the counter medications B. drug allergies C. home remedies used D. all of the above are appropriate Answer: D List five strategies for teaching older adults. Answer: stay active, see doctor regularly, maintain relationships, prevent falls, maintain healthy weight and diet The nurse is preparing a teaching session about diabetes to a group of older adults in assisted living. Which of the following is most essential to consider for this audience? A. whether they are part of the Baby boomer generation B. the accommodations needed for them to participate in the presentation C. literacy level if there are handouts D. b and c Answer: D C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ D. Information about Advance Directives Answer: C In conducting a one-to-one teaching session about the role of nutrition in preventing osteoporosis, the nurse should first: A. establish rapport with the person B. assess readiness to learn C. evaluate outcomes D. provide information Answer: A Which of the following aging changes could pose a barrier to learning? A. hearing loss B. visual impairment C. literacy level D. all of the above Answer: D Which of the following techniques for developing a web page for older adults is least appropriate? A. use large font on the website B. use computer lingo in the text C. create a memorable web address D. make the site user friendly to older adults C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: A List three activities discussed in this chapter that may prevent the course of frailty. Answer: stay active, see doctor regularly, maintain relationships, prevent falls, maintain healthy weight and diet Which of the following are thought to contribute to healthy aging? A. doing for others and maintaining interests B. engaging in isolated activities C. avoiding connection with religious institutions D. pushing oneself into new situations Answer: A Which of the following is most true of older widowers? A. they may focus more on themselves B. they have an increased self esteem C. they may lose interest in social activities D. they experience a heightened sense of sexuality Answer: C For an older person (living with an adult child) who needs some help and lessinteraction during C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ the day while their family member is at work, which of the following care settings would the nurse most likely recommend? A. hospice B. assisted living C. adult day care D. nursing home Answer: C When an older adult lives with family members, which of the following principles would not be appropriate for the nurse to apply in assisting the family to promote quality of life for their older loved one? A. help them recognize their own needs and limitations B. provide referrals to community resources C. recommend nursing home placement immediately to avoid stress D. respect all family caregivers as an important part of the team Answer: C When an older adult lives with family members, which of the following principles would not be appropriate for the nurse to apply in assisting the family to promote quality of life for their older loved one? A. help them recognize their own needs and limitations B. provide referrals to community resources C. recommend nursing home placement immediately to avoid stress D. respect all family caregivers as an important part of the team Answer: C Name five nursing interventions that may help promote nighttime sleep in the elderly. C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: B The nurse is counseling a patient regarding Medicare prevention efforts. Which of the following is included? A. initial physical examination B. smoking cessation counseling C. nutrition therapy for everyone D. a and b only Answer: D The nurse chooses to use a health contract/calendar as a behavior-changing tool for an older adult client who wants to lose weight. Which of the following principles should the nurse keep in mind when choosing this tool? A. it relies on the self-management capability of a client, after initial assistance is provided by a clinician or health educator B. it relies on the ability and skill of the educator C. it has been shown to be less effective with females who are older and widowed D. it cannot be used in older adults with less than a high school education Answer: A The advantages of using a health contract for behavior change include all of the following except: a. it identifies and enhances motivation b. it assures that change will occur c. it clarifies measurable and modest goals d. it suggests tips to remember new behaviors Answer: B The nurse is instructing a new patient on the benefits of exercise. She would include which of C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ the following in providing the most current recommendations for older adults? a. the emphasis is on being more physically active rather than a narrow adherence to a rigid exercise regimen B. older adults should exercise one solid hour per day to achieve benefits C. research has shown that older adults need to burn more calories than younger adults in order to obtain cardiac benefit from exercise d. all of the above are true Answer: A An older client is discussing his desire to continue walking during the winter months, but expresses fear of being out in the colder weather. The nurse appropriately recommends for him to: a. suspend all walking activities until the weather is favorable b. walk inside at the local shopping mall c. join a health club and walk on the treadmill d. continue to walk outside no matter what the weather Answer: B Nutrition counseling is thought to be important for older adults because of which factors? A. older adults are more vulnerable to obesity than other age groups B. older adults are more vulnerable to malnutrition than other age groups C. eating and drinking habits are linked to several leading causes of death D. all of the above Answer: D C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Which of the following foods should the nurse encourage the older client to eat 5 – 13 servings of per day? a. grains b. meat/eggs c. dairy d. fruits/vegetables Answer: D Mr. Thin is a 5 foot 8 inch, 79 year old male with a history of hyperlipidemia. Which of the following risk factors does not fit with his diagnosis? A. he drinks four glasses of Jack Daniels per day B. history of hypertension C. smokes 1 pack of cigarettes per day D. weight of 125 pounds Answer: D To help Mr. Thin in the above scenario, which risk factor will the nurse focus on first in teaching lifestyle modifications? A. weight loss B. stress reduction C. smoking cessation D. food restrictions C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ D. call his doctor Answer: A Which of the following do some persons living in long term care facilities use to cope with arthritic pain? A. self-massage B. exercise C. positive thinking D. all of the above Answer: D One of the most difficult activities for an older woman with upper extremity hemiplegia due to stroke would be: A. ambulating B. putting on a long-sleeved shirt C. putting hair in a pony tail D. washing her face Answer: B In caring for a person with middle to late stage or moderately severe Alzheimer’s disease, which of the following concerns takes priority? A. safety B. socialization C. body-image D. coping C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: A The nurse is caring for a 65 year old Black female patient with newly diagnosed diabetes who already has numerous complications. The following questions (13 – 16) pertain to this situation. From the information provided, which of the following is least likely true about this patient’s situation and diabetes? A. she is typical for age, gender, and ethnic background B. early diagnosis may have been difficult C. she will exhibit increased urine output, excessive thirst, and hunger D. she is likely to also have hypertension Answer: C What other labs/tests might the nurse least expect to see ordered for this patient? A. Fasting blood sugar B. Glucose tolerance test C. HgBA1C D. MRI Answer: D In teaching this patient about her diabetes, which has lowest priority? A. foot care B. balancing medications, diet, and exercise C. reducing risk of complications D. importance of attending support groups C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: D A 70 year old male is exhibiting signs of weight loss, heat intolerance, insomnia, sensitivity to light, and heart palpitations. The doctor writes the admitting diagnosis of hypothyroidism on the chart. What is the nurse’s most appropriate reaction to the doctor’s diagnosis? A. discuss the disease process with the patient and family so they know what to expect B. ask the doctor if this was the diagnosis he intended to record on the chart C. do nothing – you have to wait for lab tests D. continue the usual plan of care for a person with hypothyroidism Answer: B Which of the following is true about subclinical hypothyroidism? A. TSH is mildly elevated B. T3 is elevated C. T4 is elevated D. TSH is normal Answer: A An older adult diagnosed with Hashimoto’s disease would probably display which of the following signs/symptoms? A. perspiration and alcoholism B. fatigue and weakness c. weight loss and lack of appetite d. diarrhea and tachycardia C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ A. delirium has a slower onset B. dementia patients have a higher mini mental status exam result C. delirium is considered temporary D. dementia patients are more easily treated Answer: C Sundowner syndrome is characterized by which of the following that the nurse may observe in an older adult? A. early morning confusion B. oversleeping C. nocturnal confusion D. violent behavior after sundown Answer: C If the nurse suspects that a patient has delirium, which of the following factors should be further investigated? A. UTI b. medications c. oxygen saturation d. all of the above Answer: D Recent research suggests that most incontinence among the elderly is due to: A. stress B. overactive bladder C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C. lack of Kegel exercises D. multiple pregnancies Answer: B Which of the following best describes a characteristic of the earliest phase of Alzheimer’s disease? A. impaired speech B. personality changes C. total dependence upon others for care D. progressive forgetfulness Answer: D The nurse is asked to assist a family with finding help to care for their terminally ill grandfather who was just diagnosed with inoperable brain cancer. To which of the following programs would the nurse refer the family? A. the hospital B. respite care C. hospice D. visiting nurse association Answer: C Which of the following is least likely a risk factor associated with those who abuse the elderly? A. history of mental illness B. overwhelmed C. poor self-image D. female Answer: D C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ A 60 year old African American male with known hypertension comes to the emergency room with complaints of bad indigestion that has continued all night and a little bit of numbness in his left arm. What action should the admitting nurse take? A. have the patient sit in the waiting room to be seen in order B. treat him as if it he could be having a heart attack C. give him some antacids immediately after checking with the physician D. call 911 and let the paramedics decide what to do Answer: B One of the most significant changes in the reproductive system for older females that are sexually active is: A. decreased vaginal lubrication B. atrophy of uterus C. decreased libido D. lack of male partners Answer: A The nurse is helping an older patient with a history of angina ambulate in the hallway after minor surgery. The patient complains of chest tightness. What should the nurse do first? A. administer nitroglycerin sublingually B. call for help C. have the patient sit and rest D. take the vital signs Answer: C If the nurse wishes to know about the patient’s overall nutritional health, what is the best lab C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: 1. sudden, unexpected need to void (B) A. stress incontinence 2. frequent or continual incontinence of small to moderate amounts (c)B. urge incontinence 3. inability to get to bathroom facilities (E) C. overflow incontinence 4. triggered by laughing, coughing, sneezing (A) D. reflex incontinence 5. no warning; large amounts urine lost (D) E. functional incontinence An African American male, age 72, is admitted to the nurse’s unit for a blood pressure of 180/100. Based on this information, what does the nurse suspect? A. this patient eats too much salt, causing a rise in blood pressure B. this patient probably has hypertension and is at increased risk for stroke C. this patient is overweight and does not exercise D. all of the above Answer: B The nurse is teaching a 69 year old female with congestive heart failure about self-management of her disease. Which of the following would be considered appropriate to teach this patient? A. maintain healthy weight, limit sodium intake, exercise regularly, take meds as ordered B. lose 20 pounds, weigh daily at home, report weight gain of more than 1 pound to the physician C. see the doctor weekly, take meds as ordered, limit sodium intake D. keep blood pressure at 160/90, eat a diet low in fats, exercise twice per week Answer: A A 90 year old female with no significant history is admitted to the ER for acute ischemic stroke with symptoms that began 7 hours prior to admission. Which of the following interventions would the nurse reasonably expect to be done for this patient? A. diagnostic testing such as MRI B. discussion of t-Pa as immediate treatment C. stroke team consult C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ D. a and c only Answer: D Of the following nursing interventions, which would be least appropriate for a person in rehabilitation post-stroke who states “I just can’t believe this happened to me. I can’t wait for this to be over so I can go back to my normal life”? A. teach all of the information the person will need to know to adapt to life after stroke B. provide reassurance and emotional support C. provide essential information, but avoid teaching at this stage D. provide direct care, ensure safety, and involve the family Answer: A Which of the following would be the most appropriate bowel program for an older person with constipation who is recovering from a stroke? A. daily soap suds enema B. increase fiber, fluids, and activity C. Colace four times per day D. digital stimulation every morning after a suppository Answer: B Which of the following signs is most indicative of prostate cancer in a 75 year old male? A. PSA of 12 ng/ml B. hard, nodular lump on physical palpation through rectal exam C. blood in the urine D. all of the above may be signs of prostate cancer C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: D Side effects of Viagra reported by an older person that would require immediate attention include: A. headache B. nasal congestion C. visual problems D. flushing Answer: C A patient newly diagnosed with Parkinson’s disease wishes some information. Which of the following would not be accurate for the nurse to teach the patient? A. the cardinal signs include bradykinesia, tremor, and rigidity B. the disease is chronic and progressive C. there is no known cure D. a surgery called pallidotomy can cure severe tremors in 80% of cases Answer: D A patient with BPPV complains of dizziness because: A. he has Meniere’s disease B. he has a history of stroke C. he has otoconia that are dislodged D. the Epley maneuver is working Answer: C Which of the following best represents the percentage of elderly persons with co-morbid conditions who suffer from depression. C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ If a person is suffering from dementia, what could have caused this? A. Creutzfeld-Jacob disease B. Lewy body disorder C. Alzheimer’s disease D. All of the above Answer: D A large stage 4 pressure ulcer that occur in the nursing home on a resident who was admitted with intact skin one week prior is most likely a sign of: A. direct physical abuse B. an albumin of 4.5 C. inadequate nursing care D. being give the wrong tube feeding Answer: C A patient the nurse has recently given medications to complaints of nausea and vomits up the pills, stating that they “make her sick”. This is an example of: A. toxicity B. dependence C. addiction D. adverse drug reaction Answer: D The nurse is teaching a patient and his family about medication safety. Which of the following statements should not be included in the teaching? A. With older adults, the general rule for medications is start low and go slow. B. The more medications a person takes, the greater the risk of interactions and side effects. C. Medicare covers all medications for Seniors. D. Medication regimens may often be enhanced by lifestyle modifications that also address the individual’s health. C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: C If the nurse is assessing for extrinsic factors for falls, which of the following should be included? A. throw rugs B. ataxia C. cognition D. dizziness Answer: A Of the following nursing interventions for fall prevention, which is the least helpful? A. minimize clutter in the environment B. physical restraints C. strengthening exercises D. walking Answer: B An older person presents in the emergency with symptoms such as tachycardia, shortness of breath, light-headedness, and trembling. Having ruled out any physical causes, what might be the most likely discharge diagnosis seen on the chart? A. generalized anxiety disorder B. panic attack/panic disorder C. delirium D. depression C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: B Drugs that can cause or worsen anxiety include all the following except: A. baclofen B. theophylline C. acetaminophen D. caffeine Answer: C In providing nursing care for the older adult with anxiety, which of the following interventions is least appropriate? A. increase environmental stimuli B. stay with the patient. C. speak slowly in a soft, calm voice. D. avoid reciprocal anxiety Answer: A The nurse is instructing a group of older women living in the community about ways to minimize the risk of UI. Which of the following is least appropriate to include in the discussion? A. limit fluids B. avoid bladder irritants C. avoid constipation D. strengthen and tone the pelvic floor muscles Answer: A Nursing interventions to prevent pressure ulcers include all of the following except: A. use lift devices for transferring or moving patient in bed B. assess each patient for risk C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ The nurse screening for Alzheimer’s Disease recognizes the diagnostic criteria to include all but which of the following? A. impaired short or long-term memory B. aphasia C. apraxia D. dysphagia Answer: D An older patient has recently been diagnosed with moderate stage AD. The nurse practitioner orders a noncompetitive receptor antagonist such as Namenda. The nurse would instruct the patient and family that this medication: A. stops the decline of the disease B. is taken over a long period of time to achieve best results C. may result in significantly higher function over time D. b and c only Answer: D A patient presents to the clinic with confusion and provides a list of medications to the nurse. Which of the following medications could be a source of this problem? A. meperidine B. aspirin C. benzodiazapines D. a and c Answer: D An older adult who presents with complaints of insomnia, loss of energy, impaired C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ concentration and diminished pleasure in activities she once enjoyed is showing signs of: a. delirium B. dementia C. depression D. confusion Answer: C In educating patients and families about depression, the gerontological nurse recognizes that depression is: A. a prevalent condition B. often undertreated c. common cause of excess disability D. all of the above Answer: D Environmental interventions for patients with dementia include all of the following except: A. a cool room temperature B. alarms on exits C. disguising exits D. areas for safe wandering Answer: A If an older adult wishes to have another person make health care decisions in his behalf should he become unable to do so himself, he should appoint: A. a living will B. a health care representative C. a durable power of attorney for healthcare D. b or c C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: D A family member asks the nurse to witness the signing of a Living Will at the bedside of a mentally competent, alert, adult patient. In signing as a witness, the nurse is stating: A. the signature of this person was valid and not coerced B. the person was mentally competent to sign C. the person is terminally ill at the time D. a and b only Answer: D If an older person wishes to have a DNR status on himself, which of the following is true? A. he needs to have the physician sign a form that states this B. he will receive less quality care than those who are not DNR status C. he should place a copy on his refrigerator at home D. a and c only Answer: D The nurse is caring for a healthy older patient who tells her that he is going to die and wishes no heroic measures to be taken. There are no advance directives on the chart. The nurse leaves the room and returns minutes later to find the patient with no pulse and not breathing. What should the nurse do? A. call a code or 911 and begin CPR B. quickly write and sign advance directives C. leave the room and close the door D. call the doctor before beginning CPR C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ To treat dyspnea at end of life, the nurse would expect to give which of the following medications? A. Codeine B. Oxycontin C. Morphine D. Lasix Answer: C The common causes of delirium at end of life may include: A. constipation, dyspnea, pain B. dyspnea, happiness, frustration C. tachycardia, diarrhea D. none of the above Answer: A The dying older person may be under-medicated for pain due to which of the following misconceptions? A. pain perception decreases with age B. pain is an inevitable part of aging C. if a person does not state they have pain, they must not be in pain D. all of the above Answer: D Which of the following screenings would the nurse not routinely recommend to an older adult? A. mammogram every 1 - 2 years for females C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ B. annual physical C. dementia D. flexible sigmoidoscopy and FOBT Answer: C An older person with a spinal cord injury wishes to be taken off of life support three months after his injury occurred. The physician will not allow this or sign the order for it. What two principles are in conflict in this situation? A. autonomy versus paternalism B. autonomy versus justice C. nonmaleficence versus beneficence D. veracity versus fidelity Answer: A When a nurse tells a patient the truth about his terminal condition, she is engaging in: A. beneficence B. autonomy C. veracity D. fidelity Answer: C One nursing strategy to use when striving to make persons comfortable in the hospital setting in relation to their dietary habits is: A. assure them that the hospital food is nutritious B. insist that they eat at least 80% of all meals C. provide nutritious snacks D. provide foods that are culturally familiar Answer: D C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ The nurse is caring for an older person from a different culture than her own. What is her best approach to providing holistic care to this patient? A. provide care as she would to all other patients B. learn more about the person’s culture C. talk to family members about the person’s medical condition D. ask other nurses what they do to care for this person Answer: B The nurse is assigned to a patient in home care who is an 89 year old African American woman widowed and living alone. Before even making the first visit, which of the following might the nurse expect, based on her knowledge? A. the patient will be cared for by relatives in a middle class neighborhood B. the patient may have fewer financial resources and have a number of health problems C. the patient is likely to be healthy and financially secure D. the patient is most likely able to pay for all her medications without difficulty Answer: B Which of the following should the nurse include in his teaching about hypertension to a group of African American seniors at the community wellness center? A. hypertension is less prevalent among people of color B. vitamin D deficiency is thought to be a factor in hypertension C. hypertension may be caused by overexposure to the sun D. persons with hypertension are at lower risk for heart attack and stroke Answer: A Nancy is a nurse of Hispanic background who is working with a population of older white males on an Alzheimer’s unit at the Veteran’s Hospital. One of the patients makes an angry racist comment to Nancy about all Latinos being lazy. What is Nancy’s best response? C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Which of the following should the nurse recognize as untrue about sexuality and aging? A. male erections may take longer to achieve and not be as full as in younger years B. male orgasm may not occur with each encounter C. sexual desire will permanently disappear after years without a partner D. decreased vaginal lubrication is often a problem for women Answer: C Teams in geriatrics are generally focused on…. A. education, consultation, treatment B. assessment, consultation, management C. management, counseling, treatment D. diagnosis, counseling, evaluation Answer: B The model from which GITTs came involved which of the following disciplines? A. speech therapy B. advanced practice nursing C. pastoral care D. all of the above Answer: D One of the major differences between a multidisciplinary and interdisciplinary geriatric team is: A. more physicians on an interdisciplinary team B. the number of therapists C. team members sharing common goals C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ D. the amount of outcome evaluation Answer: C Name three of the most commonly used natural CAM products among older adults. Answer: include: Echinacea, ginseng, gingko biloba, garlic, glucosamine, St. John’s wort, peppermint, fish oils, ginger, soy) List the five behavioral determinants of healthy aging as described in this chapter. Answer: Smoking, activity, nutrition, alcohol, medication adherence Name three options that a nurse could teach an older person about regarding smoking cessation. Answer: personal counseling, smoking cessation groups, smoke free organization(s) Strength building is the primary intervention for preventing what medical condition, the gradual loss of muscle mass with age? A. Osteopenia C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ B. Osteoporosis C. Osteosarcoma D. Sarcopenia Answer: D RATIONALE: The first 3 answers relate to bone (osteo). The correct answer is different and relates to muscle, which is what the question is asking. Among military personnel, what medical condition can be a result of retirement and having more time to dwell on war experiences or other common changes occurring with age? A. Alzheimer’s disease B. Huntington’s disease C. Post Traumatic Stress Disorder (PTSD) D. Late Onset Stress Symptomology (LOSS) Answer: D Even if you do not know the correct answer, it sometimes helps to match up key words in the “stem” of the question to key words in the answer. The purpose of which of the following is to identify drugs to avoid in older adults and improve medication selection for older adults? C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Two hours after a liver biopsy, the nurse finds the client lying on the left side. What is the best nursing action at this time? A. Check for bleeding. B. Turn the client onto the right side. Answer: B Both options are correct, but choose option 2 because it incorporates option 1; it is possible to check for bleeding while turning the client over onto the right side (where the liver is), to put pressure on the site (as a preventive measure when postbiopsy bleeding is possible). What is the priority nursing care for a client after ECT? A. Reorient to time and place. B. Put the side rails up. C. Explain that memory loss is an expected outcome. Answer: B When all three options are good (as in this case), select the physical aspect of care first (option B) rather than either of the two psychosocial options. C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ What is most important for the nurse to ask a client immediately after a paracentesis? A. “Are you in pain?” B. “Do you feel dizzy?” C. “Does your underwear fit better around the belt line?” D. “Do you need to urinate?” Answer: B The first clue is in the question stem: most important, immediately after. Then, based on rereading the options, you can reword the question to, “What is an untoward reaction (complication) after this procedure?” The answer choices relate to expected outcomes (A, C), a question that is not relevant to ask after the procedure (D), and a complication (B), which is the correct option. During a home visit, the nurse finds that an elderly client with presbycusis is living alone in his or her house. Which nursing instruction is most beneficial to this client? A. “You should not rearrange furniture in your home.” B. “You should not install burglar alarms in your home.” C. “You should install blinking lights synced with your doorbell in your home.” D. “You should install an air conditioner in your home.” C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+ Answer: C Presbycusis is the process of hearing loss due to aging. Blinking lights can alert the client to an incoming call or a doorbell. The nurse is teaching a client about measures to follow while taking and storing medications at home. Which action of the client indicates the need for further teaching? A. Keeping the medications above the television, in bottles with child safety caps B. Avoiding taking the medication in front of the child C. Storing the medications in a locked cabinet D. Avoiding referring to the medication as candy Answer: A. Child safety caps are not the primary prevention for accidental ingestion of medication. Therefore, the client should not keep the medications within the reach of children. The nurse is preparing to discharge a client with a femur fracture. Which nursing intervention helps to promote the client’s safety at home? A. Identifying a client’s anxiety B. Teaching the client about care guidelines C. Assessing for risk of falls C475-Care of The Older Adult Test Pack 2021/2022-Western Governors University GRADED A+