NURS 245 Comprehensive Final Exam Modules 1-7 Latest Updated 2023, Exams of Nursing

Download NURS 245 Comprehensive Final Exam Modules 1-7 Latest Updated 2023 and more Exams Nursing in PDF only on Docsity! [Date] NURS 245 Comprehensive Final Exam Modules 1-7 1. A nurse is planning care for a group of super-centenarians in an assisted living facility. The nurse considers which of the following ? a. Most super-centenarians are functionally independent or require minimal assistance with activities of daily living b. The majority of super-centenarians have cognitive impairment c. The number of super-centenarians is expected to decrease in coming years as a result of heart disease and stroke d. It is theorized that super-centenarians survived as long as they have due to genetic mutations that made them less susceptible to common diseases: Most super-centenarians are functionally independent or require minimal assistance with activities of daily living 2. One reason why many baby boomers have multiple chronic conditions such as heart disease, diabetes, and arthritis is that: a. they have less access to medication and other treatment regimens b. there was a lack of importance placed on healthy living as they were growing up c. they did not have access to immunization against communicable disease when they were children d.they grew up in an era of rampant poverty and malnutrition: there was a lack of importance placed on healthy living as they were growing up 3. A nurse is planning an education program on wellness in a local senior citizen center. The nurse plans to provide education on the importance of immunizations, annual physical examinations, screening for diabetes, and vision and hearing screening. It is important for the nurse to understand which of the following? a. Less than 50% of older adults (ages 65 and older) utilize available preven-tive services. [Date] NURS 245 Comprehensive Final Exam Modules 1-7 b. Preventive strategies are more widely used in the 50-64 age-group than in the 65 and over age-group. c. The research on health promotion strategies in older adults demonstrates that they have low efficacy. d. There is an abundance of research specific to health promotion and ag-ing.: Less than 50% of older adults (ages 65 and older) utilize available preventive services 4. A nurse is caring for an 85-year-old male client with diabetes in a community setting. The nurse promotes functional wellness by which of the following activities? a. Encouraging the client to maintain current levels of physical activity b. Assisting the client to receive all the recommended preventive screenings that are appropriate for his age- group c. Teaching the patient how to use a rolling walker so that he can ambulate for longer distances d. Encouraging the client to attend his weekly chess games: encouraging the client to maintain current levels of physical activity 5. Based on the census reports of 2015, the typical profile of a centenarian includes which of the following characteristics? a. An American woman with no signs of dementia b. A Japanese woman with chronic inflammation c. A Chinese man with an immune disorder d. An American man who is a lifelong vegetarian: An American woman with no signs of dementia 6. Primary prevention strategies for older adults include which of the following? (Select all that apply.) a. An annual influenza immunization clinic [Date] NURS 245 Comprehensive Final Exam Modules 1-7 c. has a good chance of celebrating his 75th birthday." d. is likely to live into his late 90s.": has a good chance of celebrating his 75th birthday 11. Serious and well-controlled research studies on aging have been available: a. only in the past 60 years. b. since the turn of the 20th century. c. following the Great Depression. d. since the year 2000.: only in the past 60 years 12. The son of a nursing home resident asks a nurse: "What is the significance of being certified in gerontology? I see that you are, but not all of the nurses are." The best response by the nurse is which of the following? a. "National certification as a gerontological nurse is a way to demonstrate special knowledge in caring for older adults." b. "National certification in gerontology is required for all nurses who have worked in this setting for 2 or more years." c. "National certification is only available to nurses who have a Baccalaure-ate degree in nursing." d. "Only advanced practice nurses, like nurse practitioners, are certified ingerontology.": "National certification as a gerontological nurse is a way to demonstrate special knowledge in caring for older adults." 13. The major goal of the NICHE (Nurses Improving Care for Health System Elders) program includes which of the following? a. Improve outcomes for hospitalized older adults. [Date] NURS 245 Comprehensive Final Exam Modules 1-7 b. Increase the number of older adults cared for in hospitals. c. Increase the number of iatrogenic complications that occur in hospitalized older adults. d. Decrease 30-day readmission rates for hospitalized older adults.: Improve outcomes for hospitalized older adults 14. The impact of the Hospital Readmission Reduction Program (HRRP) on avoidable readmissions includes which of the following? (Select all that apply.) a. Readmission rates for the selected conditions have dropped nationwide. b. Many hospitals have instituted system-wide interventions to prevent read-missions. c. Hospitals are keeping patients longer to avoid readmissions. d. Potentially avoidable hospitalizations among nursing home residents is increasing. e. Hospitals have a financial incentive to develop programs to reduce read-missions.: Readmission rates for the selected conditions have dropped nationwide. Many hospitals have instituted system-wide interventions to prevent readmissions. Hospitals have a financial incentive to develop programs to reduce readmissions. 15. Which of the following are true statements about the current health care workforce? (Select all that apply.) a. Approximately 10% of registered nurses (RNs) are certified in gerontolog-ical nursing. b. The number of geriatricians is expected to increase about 50% over the next 25 years. c. The professions of social work, physical therapy, and psychiatry are demonstrating the same trends as nursing. [Date] NURS 245 Comprehensive Final Exam Modules 1-7 d. Europe and the developing countries are experiencing similar shortages in health care workers with geriatric expertise as in the United States. e. It is anticipated that there will be a need for approximately 3.5 million addi-tional direct care and professional health care workers by the year 2030.: The professions of social work, physical therapy, and psychiatry are demonstrating the same trends as nursing. Europe and the developing countries are experiencing similar shortages in health care workers with geriatric expertise as in the United States. It is anticipated that there will be a need for approximately 3.5 million additional direct care and professional health care workers by the year 2030. 16. Best practice recommendations for nursing education in relation to gerontology include which of the following? (Select all that apply.) a. Provision of a "stand-alone" course in gerontological nursing b. Integration of gerontological content throughout the curriculum c. Replacement of acute care pediatric clinical experiences with gerontolog-ical clinical experiences d. Recruitment of nurses with Masters and Doctoral degrees and a specialty in gerontology to faculty roles e. Requiring all undergraduate nursing students to obtain gerontological certification as a requirement for graduation: Provision of a "stand-alone" course in gerontological nursing Integration of gerontological content throughout the curriculum Recruitment of nurses with Masters and Doctoral degrees and a specialty in gerontology to faculty roles 17. Current initiatives to enhance the specialty of gerontological nursing include which of the following? (Select all that apply.) 10[Date] NURS 245 Comprehensive Final Exam Modules 1-7 21. Which of the following factors contribute to poor outcomes for older adults during transitions of care? (Select all that apply.) a. Inability to read and understand discharge instructions b. Inadequate financial resources to purchase medications c. Lack of desire to comply with discharge instructions d. Improved medication reconciliation during hospitalization e. High levels of nurse-patient engagement: Inability to read and understand discharge instructions Inadequate financial resources to purchase medications 22. The nurse is aware inflamm-aging most likely explains why the older population is at risk for autoimmune disorder. What common strategy has been found to have deleterious effects on immunity? a. Judicious use of herbal supplements b. Regular exercise c. Annual influenza vaccination d. Use of supplemental antioxidants: Use of supplemental antioxidants 23. The nurse implements the concepts of the activity theory of aging when instructing the older client with osteoarthritis to: a. continue her daily walking routine. b. curtail further increases in physical activity. c. document preferred end-of-life interventions. 11[Date] NURS 245 Comprehensive Final Exam Modules 1-7 d. avoid exposing herself to crowds.: continue her daily walking routine 24. The family member of a patient asks if vitamin C will prevent aging. In formulating an appropriate response, the nurse considers the: a. free radical theory. b. autoimmune theory. c. wear-and-tear theory. d. continuity theory.: free radical theory 25. A community health nurse provides an annual flu prevention workshop at a local senior center. The activities include a lecture on preventing infections, which includes hand washing and limiting exposure to individuals who are ill, as well as an influenza immunization clinic. The nurse is basing her activities on what component of aging? a. Wear and tear b. Oxidative stress c. Inflamm-aging d. Free radical aging: Inflamm-aging 26. A 66-year-old retired professional basketball player is admitted to the hospital for a total knee replacement due to osteoarthritis. In discussing discharge planning for this patient, the nurse includes which theory of aging to help him understand the importance of early and ongoing exercise postoperatively? a. Role theory b. Activity theory c. Socioemotional selectivity theory 12[Date] NURS 245 Comprehensive Final Exam Modules 1-7 d. Cross-link theory: activity theory 27. A married couple retired to a life care community after the husband had heart surgery. The wife has always been physically and socially active and joined an aerobic class, knitting groups, and a book club shortly after moving to the community. She walks on a daily basis and swims twice a week. Her husband spends his days reading and watching television. He was never a social person and enjoys being by himself. Which of the sociological theories of aging best describes the couple? a. Role theory b. Disengagement theory c. Continuity theory d. Personality theory: continuity theory 28. A nurse plans programs for older adults in a senior center. She asks a retired teacher to lead an art class and a retired nurse to assist with a health fair. The nurse is utilizing which theory of aging? a. Gerotranscendence b. Activity theory c. Role theory d. Continuity theory: role theory 29. The nurse shows an understanding of how telomeres relate to aging and longevity when stating: (Select all that apply.) a. "Healthy lifestyle choices lengthen telomeres as we age." b. "Cigarette smoking affects longevity by accelerating telomere shorten-ing." 15[Date] NURS 245 Comprehensive Final Exam Modules 1-7 a. culture is the same as ethnicity. b. ethnic groups always share common geographic origin and religion. c. ethnicity involves recognized traditions, symbols, and literature. d. most members of an ethnic group exhibit identical cultural traits.: ethnicity involves recognized traditions, symbols, and literature 34. Ethnocentrism is defined as: a. an understanding of another's cultural beliefs and practices. b. a conflict that occurs when an individual interacts with another whose beliefs differ from his own. c. application of limited knowledge about one person with characteristics specific to another person. d. a belief that one's ethnic group is superior to that of another.: a belief that one's ethnic group is superior to that of another 35. An older female patient tells a nurse the following: "In my culture, women are the silent partner in the family. Men make all of the decisions. However, when we came to the United States, all that changed. I became an American. I am in charge of my family just like my husband." This is an example of: a. enculturation. b. acculturation. c. ethnicity. d. culture competence.: enculturation 36. A home care nurse is caring for an older patient from a different culture who is bed-bound and high risk for development of a pressure ulcer. The nurse discusses the plan of care with the patient's daughter, emphasizing the importance of turning every 2 hours and posts a turning clock on the wall. When the nurse 16[Date] NURS 245 Comprehensive Final Exam Modules 1-7 returns later in the week, the turning clock has been removed, and the patient's daughter reports that she turns her mother occasionally. She states, "I am taking very good care of my mother. You just don't understand; our ways do not involve doing things on schedules." The best response by the nurse is: a. "You must follow my guidelines and turn her every 2 hours, or I will not be able to take care of her." b. "I understand that you value your culture, but culture cannot stop you from providing good care to your mother." c. "I understand that you care very much for your mother. Perhaps caring for her is too much for you." d. "How can we best work together to provide the best care for your moth-er?": "How can we best work together to provide the best care for your mother?" 37. An older patient learns that he has metastatic cancer. The patient states: "I must have angered God." This is an example of which type of belief? a. Biomedical b. Magico-religious c. Naturalistic d. Ayurvedic: Magico-religious 38. A female nurse is caring for an older woman from the Hasidic Jewish community. The woman's son is at the patient's bedside. The nurse notes that when she communicates with the patient and her son, the son does not maintain eye contact with her and also notes that he withdraws when she attempts to shake his hand. The best response by the nurse is to: a. carry on conversation with the patient only, ignoring the son. b. continue conversing with both the patient and the son. c. ask the son to leave since he is not comfortable with her. 17[Date] NURS 245 Comprehensive Final Exam Modules 1-7 d. ask the patient why the son will not engage with her.: continue conversing with both the patient and the son 39. The nurse in a clinic setting that provides care for an ethnically diverse population of older clients shows an understanding of the LEARN Model to direct the assessment process when: (Select all that apply.) a. recognizing that the client's hands are clenched as she answers the assessment questions. b. asking the client to describe what he thinks will help him feel better. c. explaining to the client that herbal remedies may not be sufficient treat-ment for his chest congestion. d. acknowledging that the client has a different view of the appropriate treatment. e. suggesting to the client that it would be beneficial if she would trust her health care provider to prescribe the correct treatment.: recognizing that the client's hands are clenched as she answers the assessment questions. asking the client to describe what he thinks will help him feel better. explaining to the client that herbal remedies may not be sufficient treatment for his chest congestion. acknowledging that the client has a different view of the appropriate treatment. e. suggesting to the client that it would be beneficial if she would trust her health care provider to prescribe the correct treatment. 40. A nurse completes a cultural assessment of an older adult who is being admitted to an assisted living facility. Reasons for completing a cultural assessment include: (Select all that apply.) a. culture guides decision-making about health, illness, and preventive care. b. culture provides direction for individuals on how to interact during health care encounters. c. culture impacts attitudes toward aging. d. all members of a culture react in the same way in similar situations. 20[Date] NURS 245 Comprehensive Final Exam Modules 1-7 a. Attention span, language, and communication skills typically remain sta-ble with increasing age. b. Older brains slow down and take longer to process constantly increasing amounts of information. c. In order to preserve brain function, it is important to engage in challenging cognitive activities. d. Older adults are not able to develop new cognitive abilities. e. Individuals over age 100 have a higher prevalence of dementia than younger individuals.: Attention span, language, and communication skills typically remain stable with increasing age. Older brains slow down and take longer to process constantly increasing amounts of information. In order to preserve brain function, it is important to engage in challenging cognitive activities. 46. An older female resident of an assisted living facility says the following to a nurse: "I am very frightened about getting dementia. I have read a lot about brain exercises, but I am not sure what I should be doing." The nurse formulates a response based on knowledge of which of the following? (Select all that apply.) a. Individuals should engage in some type of brain exercising activity a couple of times a week for at least 25 minutes. b. Brain exercising activities are only effective if an individual has not expe-rienced any memory problems at all. c. Brain exercising activities may include computer-based games, memory training, board games, reading, and engaging in conversation. d. Physical activity is important for wellness but is unrelated to brain health. e. Individuals should choose brain exercise activities that are unfamiliar, challenging, and fun.: Individuals should engage in some type of brain exercising activity a couple of times a week for at least 25 minutes. 21[Date] NURS 245 Comprehensive Final Exam Modules 1-7 Brain exercising activities may include computer-based games, memory training, board games, reading, and engaging in conversation. Individuals should choose brain exercise activities that are unfamiliar, challenging, and fun. 47. A nurse is planning a fall prevention education refresher session for the residents of a long-term care facility. The individuals are all cognitively intact and range in age from 80 to 100. The previous education on fall prevention was presented 2 months ago. What special considerations should the nurse take in relation to teaching this group of older adults? (Select all that apply.) a. Make sure that all pamphlets are in large readable font (14-16 points) and include upper and lower case lettering. b. Start education on falls from the beginning. It is unlikely that anyone remembers previous material. c. Present all the information at once in one long session. d. Ensure that there is adequate lighting in the room and that the temperature is comfortable. e. Provide ongoing positive feedback during the session.: Make sure that all pamphlets are in large readable font (14-16 points) and include upper and lower case lettering. Ensure that there is adequate lighting in the room and that the temperature is comfortable. Provide ongoing positive feedback during the session. 48. A nurse hears a colleague state the following: "Can you believe that Mr. Jones' daughter just bought him a tablet computer? He is 90 years old. It is ridiculous to think that he can learn to use it." The nurse formulates a response based on research that shows: (Select all that apply.) a. older adults comprise the fastest growing population using computers and the Internet. b. Internet use is less prevalent in individuals over age 75 than those ages 65-74. 22[Date] NURS 245 Comprehensive Final Exam Modules 1-7 c. older American men are the fastest growing group of social networking site users. d. older adults use the Internet only for social networking and recreational uses. e. technology has the potential to improve quality of life for older adults.-: older adults comprise the fastest growing population using computers and the Internet. Internet use is less prevalent in individuals over age 75 than those ages 65-74. technology has the potential to improve quality of life for older adults. 49. The FANCAPES assessment tool focuses on the older adult's: a. ability to meet personal needs to identify the amount of assistance need-ed. b. ability to perform instrumental activities of daily living (IADLs).c. cognitive abilities. d. level of dementia present.: ability to meet personal needs to identify the amount of assistance needed 50. A limitation of the Katz Index of activities of daily living (ADLs) is that: a. completion of the tool requires the joint efforts of the interdisciplinary team. b. all ADLs are weighted equally. c. it puts a heavier weight on the cognitive abilities necessary to perform ADLs. d. it provides a range of performance for each task.: all ADLs are weighted equally 51. A 78-year-old man is being evaluated in the geriatric clinic. His daughter reports that he has been very forgetful lately, and she is concerned that he might be "senile." The advanced practice nurse administers the clock-drawing test and the patient draws a distorted circular shape and places the numbers all on one side of the shape. Based on his performance, the nurse concludes that the patient: 25[Date] NURS 245 Comprehensive Final Exam Modules 1-7 a. presence of multiple comorbid conditions. b. atypical presentation of illness. c. difficulty in differentiating symptoms of disease from normal age-related changes. d. increase in iatrogenic illness. e. lack of assessment instruments specific for the older adult population.: presence of multiple comorbid conditions. atypical presentation of illness. difficulty in differentiating symptoms of disease from normal age-related changes. increase in iatrogenic illness. 57. A nurse completes a functional status assessment of an older person using the Lawton IADL instrument, a self-reported instrument. The nurse knows that limitations of self-reported measures include that: (Select all that apply.) a. individuals tend to overestimate their functional ability. b. self-reports often differ from that of proxy reports. c. self-reports are not indicative of small changes in function. d. self-reports do not provide a valid measurement of function. e. older adults are not able to complete self-reported measurements.: individuals tend to overestimate their functional ability. self-reports often differ from that of proxy reports. 58. A nurse is assessing a patient's activities of daily living. The nurse will assess which of the following? (Select all that apply.) a. Eating 26[Date] NURS 245 Comprehensive Final Exam Modules 1-7 b. Continence c. Toileting d. Self-medication administration e. Bathing: eating continence toileting bathing 59. Factors that affect the pharmacokinetics of lipophilic medications in older adults include: a. greater adipose tissue ratio to body mass. b. decreased total body water. c. increased glomerular filtration rate. d. increased creatinine clearance.: greater adipose tissue ratio to body mass 60. Which age-related change affects absorption? a. Reduced saliva b. Reduced body water c. Increased adipose tissue d. Reduced enzyme activity: reduced saliva 61. What factor is an important contribution to polypharmacy in older adults? a. Inadequate communication among medical care providers 27[Date] NURS 245 Comprehensive Final Exam Modules 1-7 b. Implementation of Medicare Part D prescription drug benefit c. Use of generic medications d. Increasing popularity of dietary and herbal supplements: inadequate communication among medical care providers 62. The area in which nurses have the greatest effect on the safe, effective medication therapy of an older client is: a. educating the client to all aspects of the medication. b. assessing for adverse reactions to the medication. c. monitoring overall health of the client as it is affected by the medication. d. evaluating the outcomes resulting from the medication.: educating the client to all aspects of the medication 63. When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse best ensures an understanding of oral hypoglycemic medications when providing: a. the package insert and assessing the client's reading skills. b. the client with the website address for the American Diabetes Association. c. oral explanations and sending the client home with a written copy. d. the information in paragraph form as opposed to numbered line fashion.-: oral explanations and sending the client home with a written copy 64. The nurse suspects that a client is experiencing tardive dyskinesia when observing that: a. the client can't seem to stop moving. 30[Date] NURS 245 Comprehensive Final Exam Modules 1-7 70. A 77-year-old Hispanic Catholic nun (retired) who immigrated to the United States 15 years ago lives alone but in an apartment complex where her biological sister lives as well. She is being discharged home after a hospitalization for congestive heart failure with prescriptions for eight different medications. She is considered at risk for medication misuse due to contributing factors that include: a. language barrier. b. living alone. c. large number of medications. d. ethnic background. e. religious background.: a. language barrier. b. living alone. c. large number of medications. 71. An older client prescribed a transdermal morphine patch for severe chronic pain is being educated on the appropriate administration of the medication. The nurse shows an understanding of essential information regarding this route of drug administration when stating: (Select all that apply.) a. "This is an effective route for delivering small doses of medication over long periods of time." b. "Since you have problems with digestion, this is a good way to take your medication." c. "Please show me how you would apply your patch." d. "Be careful to put the patch only on your chest but change locations with each application." e. "Be sure to avoid placing the patch on injured skin.": a. "This is an effective route for delivering small doses of medication over long periods of time." 31[Date] NURS 245 Comprehensive Final Exam Modules 1-7 b. "Since you have problems with digestion, this is a good way to take your medication." c. "Please show me how you would apply your patch." e. "Be sure to avoid placing the patch on injured skin." 72. An antihypertensive medication has been prescribed for an older patient with hypertension. The patient tells a clinic nurse that he would like to take an herbal substance to help lower his blood pressure instead of the prescription medication. Which of the following should the nurse do? (Select all that apply.) a. Tell the patient that herbal substances are less effective than prescriptionmedications. b. Encourage the patient to discuss the use of an herbal substance with his primary care provider. c. Explore with the patient which herbal substance he is planning on taking. d. Educate the patient on possible interactions of the herbal substance with his other medications. e. Instruct the patient not to take the herbal substance, as it is dangerous.: b. Encourage the patient to discuss the use of an herbal substance with his primary care provider. c. Explore with the patient which herbal substance he is planning on taking. d. Educate the patient on possible interactions of the herbal substance with his other medications. 73. An older patient is prescribed warfarin for stroke prevention. A nurse is providing patient education. Which of the following foods should the patient be taught to avoid? (Select all that apply.) a. Milk b. Whole grains c. Kale 32[Date] NURS 245 Comprehensive Final Exam Modules 1-7 d. Spinach e. Red meats: Kale and Spinach 74. You have four rooms to choose from for your older client to be admitted this afternoon. Which room would you choose? a. A brightly lit, blue room with cozy throw rugs b. An orange-carpeted room with soft lighting and yellow walls c. A brightly lit, blue room with an EZ-Glide wax floor d. A fluorescent-lighted room with green walls and a glossy, tiled floor: An orange-carpeted room with soft lighting and yellow walls 75. An older adult client shares with the nurse that, "I don't know what it is but it seems that I need more light for reading or even watching television as I get older." The nurse explains that aging may cause this change due to the: a. yellowing of the lens. b. impact arcus senilis has on visual acuity c. flattening and thinning of the cornea. d. retinal changes that begin to occur with aging.: yellowing of the lens 76. A 77-year-old client being treated for angle-closure glaucoma asks the nurse what caused his glaucoma. The nurse's response is: a. the angle of the iris causes obstruction of fluid in the eye. b. spasms of the orbicular muscle. 35[Date] NURS 245 Comprehensive Final Exam Modules 1-7 b. Avoid bending from the waist after the surgery. c. Take stool softeners as needed. d. Maintain strict control of your blood sugar and blood pressure. e. Maintain a dry sterile dressing over the eye for 10 days.: Avoid lifting heavy objects after the surgery. Avoid bending from the waist after the surgery. Take stool softeners as needed. 82. An older patient is diagnosed with diabetic retinopathy. The patient asks a nurse: "Is there anything that I can do to prevent progression of this disease and blindness?" The nurse includes which of the following into the response? (Select all that apply.) a. Strict control of blood glucose levels is important in slowing disease progression. b. Laser photocoagulation treatments can stop progression of the disease. c. Control of blood pressure and cholesterol levels are important steps slowing disease progression. d. Wearing sunglasses to protect the eyes from ultraviolet light can stop disease progression. e. Eating a diet high in beta-carotene can stop disease progression.: Strict control of blood glucose levels is important in slowing disease progression. Laser photocoagulation treatments can stop progression of the disease. Control of blood pressure and cholesterol levels are important steps slowing disease progression. 83. A nurse is conducting an assessment of an older patient's eyes. The nurse expects to see which of the following normal age-related changes of the external eye? a. The eyelids are less elastic and droopy. 36[Date] NURS 245 Comprehensive Final Exam Modules 1-7 b. The eyes are very dry. c. The eyelids may not close completely. d. There is a loss of eyelashes. e. The lower lid may be turned outward.: The eyelids are less elastic and droopy. The eyes are very dry. The eyelids may not close completely. The lower lid may be turned outward. 84. The nurse is most concerned by observing when assisting with an older client's bath: a. a firm, irregularly shaped, pink-colored nodule. b. a slightly raised multicolor lesion with an asymmetrical, irregular border. c. a pearly papule with prominent blood vessels. d. rough, scaly, sandpaper-like patches that are slightly tender.: a slightly raised multicolor lesion with an asymmetrical, irregular border 85. An older person is admitted to the hospital with an exacerbation of congestive heart failure. The nurse notes that the patient complains of severe itching at night and has a red rash on her torso. The patient is diagnosed with scabies. The patient asks the nurse, "How did I get something like this?" The best response by the nurse is: a. "Scabies is highly contagious and spreads easily through physical con-tact. b. Zostavax is recommended for all individuals over age 60 that have no contraindications to the vaccine. 37[Date] NURS 245 Comprehensive Final Exam Modules 1-7 b. "Scabies is commonly seen in older adults due to normal age-related changes in the skin." c. "Scabies is only seen in older adults who have multiple chronic illnesses." d. "Certain medications can make you more susceptible to contracting scabies.": "Scabies is highly contagious and spreads easily through physical contact." 86. A nurse is providing an educational session on vaccines to a group of older adults. The nurse is discussing the zoster vaccine (Zostavax). Which of the following information should the nurse include in the education? a. Zostavax should only be given to individuals who have never had an episode of herpes zoster (HZ). b. Zostavax is recommended for all individuals over age 60 that have no contraindications to the vaccine. c. Zostavax should not be given to anyone with a chronic cardiac or respira-tory condition. d. Zostavax will always prevent an individual from developing Herpes Zoster.-: Zostavax is recommended for all individuals over age 60 that have no contraindications to the vaccine. 87. A nurse is assessing an older patient and notes a cluster of fluid-filled vesicles on the right thoracic area. The nurse suspects HZ. The patient asks the nurse, "I really don't understand how I got shingles. I don't even know anyone who has this infection." The nurse includes which of the following in formulating a response to the patient? a. HZ is caused by a reactivation of dormant varicella zoster virus within the sensory neuron of the dorsal root ganglion. b. HZ is caused by the same virus as chickenpox and requires exposure to an individual with active chickenpox. c. HZ is caused by the same virus as chickenpox and requires direct contact with an individual with HZ. 40[Date] NURS 245 Comprehensive Final Exam Modules 1-7 Dress the resident in long sleeves and long pants to protect the extremities. 92. . Which of the following are subscales on the Braden Scale for predicting pressure ulcers? (Select all that apply.) a. Nutrition b. Moisture c. Mobility d. Age e. BMI: Nutrition Moisture Mobility 93. An older adult who is within a normal weight range asks a nurse, "I have heard that it is important to limit the amount of fats in my diet, but I don't know how much I should be taking in daily. Can you help me?" The best response by the nurse is: a. "Someone of your age needs to limit fats." b. "Less than 10% of calories per day should come from saturated fats." c. "Fat intake will depend on the presence of any cardiac issues." d. "Read food labels well and focus your diet on low-fat foods.": "Less than 10% of calories per day should come from saturated fats." 94. A nursing student asks the instructor, "Our textbook discussed the obesity paradox in older adults. I am not sure I understand; isn't obesity bad for everyone?" The best response by the instructor is: 41[Date] NURS 245 Comprehensive Final Exam Modules 1-7 a. "While there is evidence that obesity in younger people lessens life expectancy, overweight and obese adults do not have the same risk of morbidity and mortality. b. "Obesity is usually not a concern in older adults, as most older people tend to weigh less than they did when they were younger." c. "Obesity is a concern in all age groups; however, over the past decade obesity in older adults has decreased." d. "Obesity in older adults is less of a concern than we once thought; individ-uals over age 65 with a higher BMI have a lower mortality rate.": "While there is evidence that obesity in younger people lessens life expectancy, overweight and obese adults do not have the same risk of morbidity and mortality. 95. A nurse identifies that an older adult needs more education on nutritional needs when the older adult states the following: a. "Since I am an older person, I need more calories because my metabolic rate is slower." b. "Since I am an older person, I need fewer calories since my metabolic rate is slower." c. "Even though I am an older person, I still need the same amount of nutrients in order to be healthy." d. "Even though I am an older person, I still need to pay attention to my diet and activity levels.": "Since I am an older person, I need more calories because my metabolic rate is slower." 96. An older adult asks a nurse, "I hear a lot about getting enough fruits and vegetables in my diet and eating a balanced diet. It is confusing. Can you help me understand what a balanced diet for me would be?" The nurse bases a response on which of the following? a. Daily intake should consist of 25% fruits and vegetables; 25% grains; and 50% protein-rich foods. b. Daily intake should consist of 50% fruits and vegetables; 25% grains; and 25% protein-rich foods. c. Daily intake should consist of 33% fruits and vegetables; 33% grains; and 33% protein-rich foods. 42[Date] NURS 245 Comprehensive Final Exam Modules 1-7 d. Daily intake should consist of 40% fruits and vegetables; 30% grains; and 30% protein-rich foods.: Daily intake should consist of 50% fruits and vegetables; 25% grains; and 25% protein-rich foods. 97. A hospitalized older adult who recently had surgery and a wound infection postoperatively is noted to be losing weight despite consuming his meal trays and snacks. One reason that this might be occurring is: a. an injury may trigger inflammatory mediators that increase metabolic rate and impair nutrient utilization. b. an injury may cause malabsorption of nutrients. c. most hospitalized older patients do not consume adequate amounts of micro- and macronutrients. d. most hospitalized patients do not have accurate weights recorded upon admission.: an injury may trigger inflammatory mediators that increase metabolic rate and impair nutrient utilization 98. An older adult's nutritional status is screened by a nurse using the Mini Nutritional Assessment (MNA). The older adult scores a "7" (risk for malnutrition) on the screening portion of the tool. The best action by the nurse is to: a. offer high calorie meals. b. perform a comprehensive nutritional assessment. c. conduct a 72-hour calorie count. d. initiate nutritional supplements between meals.: perform a comprehensive nutritional assessment 99. A nurse is preparing to hand feed an older adult with a history of a right cerebrovascular accident (CVA) with facial weakness and dysphagia. Which techniques should the nurse utilize when feeding this patient? (Select all that apply.) a. Sit the patient upright in a chair at 90 degrees. 45[Date] NURS 245 Comprehensive Final Exam Modules 1-7 Assess the resident for ability to feed himself or herself. 103. An older woman asks a nurse, "You always seem to be telling me that I need to take in more fluids. How much fluid do I really need to drink?" The nurse bases her response on the knowledge that older adults should consume at least: a. 1000 mL of fluid per day. b. 1500 mL of fluid per day. c. 2000 mL of fluid per day. d. 2500 mL of fluid per day.: 1500 mL of fluid per day 104. A nurse administers hypodermoclysis (HDC) to an older nursing home resident. The purpose of hypodermoclysis is: a. to rehydrate an individual with severe dehydration. b. to quickly administer 4-5 L of fluid within a 24-hour period. c. to rehydrate an individual with mild to moderate dehydration. d. as a supplement to IV hydration to expedite rehydration.: to rehydrate an individual with mild to moderate dehydration 105. Which of the following statements describing oral care for the older population is correct? a. Regular dental examinations can prevent tooth loss and improve the ability to chew healthful foods. b. Losing one's teeth is considered a normal part of the aging process. c. Oral malignancies seldom occur in older adults so oral examinations are of low priority. 46[Date] NURS 245 Comprehensive Final Exam Modules 1-7 d. Preventative dental care is covered under Medicare.: Regular dental examinations can prevent tooth loss and improve the ability to chew healthful foods 106. In a long-term care facility, a nurse is having a discussion with the nurse aides about ways to deal with dementia clients who are uncooperative with mouth care. Appropriate methods to use include: a. speaking to the client sternly and instructing the client to open the mouth and cooperate immediately. b. having another nurse aide assist in holding the client's mouth open with a tongue depressor. c. initiating the action with the expectation that the client will take over. d. quickly performing oral hygiene without explanation since the client is uncooperative.: Initiating the action with the expectation that the client will take over 107. A nurse is observing a nurse aide perform denture care for a resident in the nursing home. The nurse recommends that the nurse aide receive additional education on denture care when the nurse observes which of the following? a. The nurse aide places a face cloth in the sink and fills the sink half full with water. b. The nurse aide uses toothpaste to clean the dentures. c. The nurse aide utilizes a specially designed denture brush to clean the dentures. d. The nurse aide stores the dentures in a denture cup filled with denture cleansing solution.: The nurse aide uses toothpaste to clean the dentures 108. Which of the following are age-related changes that affect hydration status? (Select all that apply.) a. Decrease in thirst sensation b. Decrease in total body water 47[Date] NURS 245 Comprehensive Final Exam Modules 1-7 c. Decrease in ability of kidneys to maximally concentrate urine d. Decrease in bone marrow mass e. Decrease in bladder capacity: decrease in thirst sensation decrease in total body water decrease in ability of kidneys to maximally concentrate urine 109. A nurse is performing an admission assessment on an older patient who presented with a high fever and cough, reduced oral intake for 3 days, and lower extremity weakness. The patient has sunken eyes, and the patient's skin turgor over the sternum is poor. The nurse suspects that the patient is dehydrated. Which of the following are indicators of dehydration in this patient? (Select all that apply.) a. Poor skin turgor over the sternum b. Lower extremity weakness c. High fever d. Sunken eyes e. Cough: Lower extremity weakness Sunken eyes 110. Which of the following nursing interventions should be implemented to prevent dehydration in hospitalized older adults? (Select all that apply.) a. Implementing intake and output recording for any patients with fever, diarrhea, vomiting, or an infection b. Limiting duration of NPO requirements for diagnostic tests and proce-dures c. Administering IV fluids to all hospitalized older adults 50[Date] NURS 245 Comprehensive Final Exam Modules 1-7 c. Bed rest d. Restricting fluids: Increasing fiber in the diet 116. Which of the following nursing actions would help minimize the psychosocial impact of bladder and/or bowel incontinence for individuals experiencing incontinence prior to going to a group dining room? a. Assess for soiled clothing and change, if necessary. b. Toilet the client and then promptly transport to the dining room. c. Provide pericare and fresh underclothing. d. Ask the client if toileting is needed and assist as necessary.: Assess for soiled clothing and change, if necessary. 117. An 89-year-old hospitalized female patient tells a nurse, "I go to the bathroom really often, but I manage this by not drinking too much before I go to bed so I can sleep for the night." The patient has no pain or discomfort with voiding. The nurse considers this finding to be: a: a. manifestation of urge incontinence. b. manifestation of a urinary tract infection. c. normal age-related change in an 89-year-old woman. d. manifestation of diabetes.: normal age-related change in an 89-year-old woman 118. The nurse interviewing an older adult for a nursing history recognizes that the client is experiencing symptomology inconsistent with normal aging of the urinary tract when the client reports: (Select all that apply.) a. finding it more difficult in the last few months to start voiding. 51[Date] NURS 245 Comprehensive Final Exam Modules 1-7 b. having two bladder infections in the last 4 years. c. getting up once or twice each night to urinate. d. occasionally experiencing pain when urinating. e. needing to urinate at least every 2 hours during the day.: finding it more difficult in the last few months to start voiding occasionally experiencing pain when urinating 119. An otherwise healthy older adult reports having begun to experience problems "holding my water." The nurse shows an understanding of interventions that may help minimize the problem of urinary incontinency when: (Select all that apply.) a. asking whether the client smokes tobacco. b. assessing the average amount of caffeine the client drinks daily. c. asking if the client has been evaluated for diabetes recently. d. suggesting the client keep a record of the amount of fluids ingested daily. e. reviewing the client's current medication list.: asking whether the client smokes tobacco. assessing the average amount of caffeine the client drinks daily. asking if the client has been evaluated for diabetes recently. reviewing the client's current medication list. 120. A nurse caring for a cognitively impaired older adult client shows an understanding of the unique clinical symptoms of constipation in this population when: (Select all that apply.) a. checking documentation to determine if the client has had a bowel move-ment in the last 24-36 hours. 52[Date] NURS 245 Comprehensive Final Exam Modules 1-7 b. questioning staff as to whether the client has any unexplained falls in the last few days. c. asking the client to name all of his or her children and grandchildren. d. requesting that the client's temperature be taken now and again in 4 hours. e. reviewing the client's food intake over the last 24-36 hours.: questioning staff as to whether the client has any unexplained falls in the last few days asking the client to name all of his or her children and grandchildren requesting that the client's temperature be taken now and again in 4 hours reviewing the client's food intake over the last 24-36 hours 121. A nurse is caring for an older adult in a hospital who has an indwelling catheter. The nurse assesses the patient based on the knowledge that which of the following are correct indications for an indwelling catheter? (Select all that apply.) a. To assist with incontinence management b. To manage acute urinary retention c. To assist in healing of open sacral or perineal wounds in incontinent patients d. To accurately measure urinary output in critically ill patients e. To prevent falls related to toileting in hospitalized older patients: To manage acute urinary retention To assist in healing of open sacral or perineal wounds in incontinent patients To accurately measure urinary output in critically ill patients 55[Date] NURS 245 Comprehensive Final Exam Modules 1-7 a. followed a vegetarian diet for last 28 years. b. male gender. c. a smoking history of 1 pack a day for 45 years. d. 30 pounds over ideal weight. e. history of Crohn's disease.: male gender a smoking history of 1 pack a day for 45 years 30 pounds over ideal weight 128. An older patient asks a nurse, "It seems like all of my friends and I have difficulty sleeping. Is it common among older people?" The nurse formulates a response based on the knowledge that normal age-related changes in sleep include: (Select all that apply.) a. total sleep time and sleep efficiency are reduced. b. rapid eye movement (REM) sleep is shorter, less intense, and more evenly distributed. c. sleep requirements for older adults are less than that of younger adults. d. daytime napping is common. e. sleep tends to be deeper in older adults than in younger adults.: total sleep time and sleep efficiency are reduced. rapid eye movement (REM) sleep is shorter, less intense, and more evenly distributed. daytime napping is common. 129. An older adult tells a nurse that he is experiencing difficulty falling asleep, he routinely gets into bed at 8:30 PM and watches his favorite television shows until 11:00 PM, and often lies awake for hours after. Which of the following suggestions are appropriate for the nurse to give to this patient? (Select all that apply.) 56[Date] NURS 245 Comprehensive Final Exam Modules 1-7 a. Go to bed only when sleepy. b. If unable to sleep within a reasonable time (15-20 minutes), get out of bed and pursue relaxing activities. c. Engage in moderate exercise to induce fatigue. d. Do not watch television or work in bed. e. If unable to sleep, engage in enjoyable activities on the computer.: Go to bed only when sleepy If unable to sleep within a reasonable time (15-20 minutes), get out of bed and pursue relaxing activities Do not watch television or work in bed. 130. An older patient is diagnosed with RLS/WEB. Which of the following nonpharmacologic interventions should the nurse include in the plan of care? (Select all that apply.) a. Engage in regular mild to moderate physical activity including stretching activities for the lower extremities. b. Avoid caffeine, alcohol, and tobacco. c. Avoid hot baths. d. Relaxation techniques may be helpful. e. A mild sleeping medication such as diphenhydramine (Benadryl) might be helpful.: Engage in regular mild to moderate physical activity including stretching activities for the lower extremities Avoid caffeine, alcohol, and tobacco Relaxation techniques may be helpful 57[Date] NURS 245 Comprehensive Final Exam Modules 1-7 131. A long-term care facility has selected sleep promotion as its quality improvement project. Which of the following interventions would be appropriate to implement on this unit? (Select all that apply.) a. Ensuring that all residents receive evening care and are in bed by 8:00 PM b. Taking as many residents as possible outside for 30 minutes daily c. Instituting quiet time (keep noise down, speak in hushed tones, no over-head paging) between 9:00 PM and 6:00 AM d. Avoiding waking residents for routine care during the night e. Limiting caffeine and fluids before bedtime: Taking as many residents as possible outside for 30 minutes daily Instituting quiet time (keep noise down, speak in hushed tones, no overhead paging) between 9:00 PM and 6:00 AM Avoiding waking residents for routine care during the night Limiting caffeine and fluids before bedtime 132. A 75-year-old female asks a nurse "I know I should be moving, but how much is the right amount of exercise for me?" The best response of the nurse is: a. "You need to engage in 30 minutes of moderate intensity exercise several days a week." b. "You need to engage in at least 30 minutes of moderate intensity exercise every day of the week." c. "Since you are 75, the recommendations are 30 minutes of moderate exercise three times a week." d. "There are no specific recommendations for someone of your age; just keep moving.": "You need to engage in 30 minutes of moderate intensity exercise several days a week." 133. A nurse is discussing the importance of exercise with a 78-year-old female who states: "I know I should be exercising, but I have arthritis in my knees and it is painful. Can you recommend a type of exercise that 60[Date] NURS 245 Comprehensive Final Exam Modules 1-7 Encouraging the patient to feed herself NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 . 138 A nurse is educating a group of older adults on the benefits of an exercise program. The nurse includes education on when not to exercise. Which of the following should the nurse include in the education? (Select all that apply.) a. Do not exercise if your resting heart rate is over 80. b. Do not exercise if your blood pressure is greater than 200 systolic and 100 diastolic. c. It is important to wait 30 minutes after a big meal before engaging in vigorous exercise. d. Do not exercise if a joint that you are using to exercise is red, warm, and painful. e. Do not exercise if you have a fever and muscle aches.: Do not exercise if your blood pressure is greater than 200 systolic and 100 diastolic. Do not exercise if a joint that you are using to exercise is red, warm, and painful. Do not exercise if you have a fever and muscle aches. 139. An older adult who has a balance disorder and has sustained repeated falls is recommended to start an exercise program. Which of the following exercises would be most beneficial in improving balance in this individual? (Select all that apply.) a. Yoga b. Tai Chi c. Swimming d. Pilates e. Weight lifting: Yoga 61 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 . Tai Chi 140. Which attempt by the family to prevent an older, frail adult from falling causes the home health nurse concern? a. Keeping several low wattage night-lights on in the evening b. Installing wooden railings on the stairway to the bathroom c. Keeping the side rails up on the client's bed at night d. Encouraging the client to use a cane when ambulating: Keeping the side rails up on the client's bed at night 141 An 88-year-old woman is admitted to the hospital with a diagnosis of pneumonia. She has a history of hypertension and congestive heart failure and is on a total of five different medications for these chronic conditions. The nurse caring for the woman develops a care plan that includes the diagnosis Risk for Falls. A priority nursing intervention for this client is to: a. perform a fall assessment. b. keep all of the side rails up on the client's bed at nighttime. c. place the client on bed rest so that she does not fall. d. assess the client's dietary intake for calcium adequacy.: perform a fall assessment 142. A nurse is assessing an older adult's risk for falls. One of the questions that she asks is whether the older adult has fallen in the past year. She asks this because individuals who have fallen: a. have a higher risk of falling again than persons who did not fall in the past year. b. are more likely to sustain injuries if they fall again than persons who did not fall in the past year. c. have most likely developed a fear of falling as compared to persons who did not fall in the past year. 62 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 . e. Grab bars in bathroom beside toilet: The absence of railings on the stairway 65 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 Clutter throughout the home A small throw rug outside of the shower stall 147. A group of older women in an assisted living facility are talking about one of the residents who fell and fractured her hip. The women ask a nurse the following: "It seems like so many of us fall and break our hips, and then it is downhill from there. Is this really true?" In formulating a response, the nurse considers which of the following? (Select all that apply.) a. Hip fractures are a leading cause of hospitalization for older people. b. The major cause of hip fractures is falls. c. Women have significantly higher mortality rates from hip fractures than do men. d. Nearly all older patients who sustain a hip fracture will regain prefracture mobility status within 1 year. e. Hip fractures are associated with very high morbidity and mortality.: Hip fractures are a leading cause of hospitalization for older people. The major cause of hip fractures is falls. Hip fractures are associated with very high morbidity and mortality. 148. A homecare nurse visits a client in the home to conduct a fall risk assessment. The nurse assesses the client and the home for extrinsic risk factors for falls. Which of the following are extrinsic risk factors? (Select all that apply.) a. The client has an unsteady gait. b.The client uses a cane, but the cane is not the appropriate size for the client. c. The client's home is cluttered. 66 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 d.The client is on two different medications that cause orthostatic hypoten-sion. e. There are no grab bars in the client's bathroom.: The client uses a cane, but the cane is not the appropriate size for the client. The client's home is cluttered. There are no grab bars in the client's bathroom. 149. A home health nurse is making a home visit to an older patient. A nurse conducts a home safety assessment and screens the environment for potential hazards for falls. The nurse recommends that the patient eliminate which of the following? (Select all that apply.) a. Night-lights b. Railings on the stairway c. Loose carpeting on the floors d. The use of a cane e. Excess clutter: Loose carpeting on the floors Excess clutter 150. The nurse is preparing educational material concerning fire safety in the home. What research data will be included in the material? a. Most fires occur during the daytime hours. b. Fire mortality is highest in adults older than 80 years of age. c. Most people who die in fires are killed by the flames. 67 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 Wear well-fitted clothing when cooking or when grilling outdoors Have a fire extinguisher readily available in the kitchen 156. Which precaution would be beneficial in minimizing an older adult's risk of being a victim of fraud? (Select all that apply.) a. Do not allow uninvited salespersons into your home. b. Never provide personal information to telephone sales solicitors. c. Rely on the advice of people who only friends have recommended. d. Contact the local Medicare or Medicaid service office for information when needed. e. Keep your bank account and credit card numbers with you at all times.: Do not allow uninvited salespersons into your home. Never provide personal information to telephone sales solicitors. Contact the local Medicare or Medicaid service office for information when needed. 157. The benefits of telehealth include that it: (Select all that apply.) a. promotes self-management of illness in rural and underserved areas. b. facilitates remote physical assessment and monitoring of chronic condi-tions. c. decreases costs by replacing the role of the nurse with technology. d. decreases costs by reducing hospital readmissions. e. is reimbursed by all health care insurances.: promotes self-management of illness in rural and underserved areas. facilitates remote physical assessment and monitoring of chronic conditions. decreases costs by reducing hospital readmissions. 70 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 158. A nurse is caring for a frail older adult in a long-term care facility and is concerned about preventing hypothermia. Which of the following interventions should the nurse implement? (Select all that apply.) a. Make sure that the temperature in the resident's room is at least 68° F. b. Cover residents well when in bed and while bathing. c. Provide a head covering for the resident. d. Maintain resident in bed covered with heavy blankets at all times. e. Provide hot, high-protein meals and bedtime snacks.: Make sure that the temperature in the resident's room is at least 68° F. Cover residents well when in bed and while bathing. Provide a head covering for the resident. Provide hot, high-protein meals and bedtime snacks. 159. The daughter of an older patient says to a nurse, "I am so concerned that my dad is still driving. He is dangerous! He has had a couple of accidents and I am worried that he is going to kill himself or, worse, somebody else. What can I do?" The nurse recommends which of the following involved type action strategies for driving cessation? (Select all that apply.) a. Report the person to the division of motor vehicles for license suspension. b. Hold a family meeting with the person to discuss the situation and come to a mutual agreement of the problem. c. Arrange for alternate transportation for the person. d. Confiscate the keys to the car. 71 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 e. Ask the patient's physician to write a prescription for the person to stop driving.: Hold a family meeting with the person to discuss the situation and come to a mutual agreement of the problem. Arrange for alternate transportation for the person. 160. The greatest risk for injury for a client with progressed Parkinson's disease is: a. falls. b. suicide. c. bleeding ulcers. d. respiratory arrest.: falls 161. An older adult with suspected Parkinson's disease has a "challenge test" performed in order to confirm the diagnosis. The nurse understands that a "challenge test" will demonstrate which of the following? a. Immediate reversal of all symptoms of Parkinson's disease after adminis-tration of levodopa b. Dramatic improvement of symptoms of Parkinson's disease after admin-istration of levodopa c. Dramatic improvement in gait only after administration of levodopa d. Dramatic improvement in tremor only after administration of levodopa: Dramatic improvement of symptoms of Parkinson's disease after administration of levodopa 162. A nurse is caring for an older adult with Parkinson's disease. The patient is receiving the medication levodopa-carbidopa. The nurse understands that in order to maximize effectiveness, the administration schedule for this medication should adhere to which of the following? a. Administer with meals only b. Administer first thing in the morning only 72 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 b. individuals with AD display impairments in judgment whereas individuals with LB do not. c. the use of traditional atypical medication is contraindicated for individuals with LB. d. LB usually occurs in individuals under age 60, and AD occurs in individu-als only over age 60. e. individuals with LB develop language symptoms, and individuals with AD do not.: individuals with LB develop motor symptoms, and individuals with AD do not. the use of traditional atypical medication is contraindicated for individuals with LB. 168. An older adult is referred to a geriatric nurse practitioner because of changes in memory and reports by family members that "there is something different about her." The nurse practitioner evaluates the older adult for potentially reversible causes for the changes, which include: (Select all that apply.) a. depression. b. delirium. c. osteoporosis. d. rheumatoid arthritis. e. medication side effects.: depression delirium medication side effects 169. A nurse understands that the pathophysiology of Parkinson's disease includes which of the following? (Select all that apply.) a. A deficiency of the neurotransmitter dopamine b. An inability of the neurons to absorb dopamine c. A reduction of dopamine receptors 75 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 d. An accumulation of Lewy Bodies, especially in the basal ganglia e. The presence of neurofibrillary tangles and amyloid plaques in the brain: A deficiency of the neurotransmitter dopamine A reduction of dopamine receptors An accumulation of Lewy Bodies, especially in the basal ganglia 170. When assessing an older client for indications of depression, the nurse bases the intervention on the knowledge that: a. the older client's symptoms may be atypical for the disorder. b. depression is a common mental disorder among the older population. c. the older client is generally willing to discuss his or her mental health symptoms. d. depression is not as commonly seen in this population as are anxiety disorders.: the older client's symptoms may be atypical for the disorder 171. The nurse preparing educational information on the most common mental health disorder among the older adult population should include: a. methods for reducing anxiety. b. a written depression screening tool. c. local schizophrenia support groups. d. signs and symptoms of alcoholism.: a written depression screening tool 172. An older adult client has been voluntarily admitted for treatment of alcohol dependency. In implementing care, the nurse plans which intervention based upon knowledge about alcohol and aging? 76 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 a. Assessing the client for both depression and anxiety b. Discussing the poor prognosis of this disorder with the client c. Explaining the need for proper nutrition to minimize the effects of al-coholism d. Identifying the effects of chronic alcoholism on the human body: Assessing the client for both depression and anxiety 173. In order to focus on the older population with the greatest risk for suicide, the nurse would conduct a depression screening that targets: a. African American men. b. white men. c. white women. d. African American women.: white men 174. An older adult says to the nurse, "I don't know why I can't handle booze like I used to when I was younger." The nurse's response is based on the knowledge that: a. older adults develop higher blood alcohol levels due to age-related changes in the neurological system. b. older adults develop higher blood alcohol levels due to age-related changes that alter absorption and distribution of alcohol. c. older adults develop higher blood alcohol levels due to slowed reaction times. d. older adults develop higher blood alcohol levels due to cognitive changes.: older adults develop higher blood alcohol levels due to age-related changes that alter absorption and distribution of alcohol. 175. How should the nurse reply when an older adult asks, "How much alcohol is good for you? a. "Alcohol isn't good for you so avoid it as a general rule." 77 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 "ECT is the most effective treatment for older adults with major depression." "ECT results in a more immediate reduction in depressive symptoms." 181. A nurse is assisting an older adult to cope with depression after the loss of a spouse. Which of the following actions should the nurse take? (Select all that apply.) a. Encourage the person to develop a daily activity schedule that includes pleasant activities. b. Validate depressed feelings as aiding recovery. c. Discourage angry outbursts. d. Suggest that the person not make any decisions until the depression has passed. e. Involve the family in teaching about depression.: Encourage the person to develop a daily activity schedule that includes pleasant activities Validate depressed feelings as aiding recovery Involve the family in teaching about depression 182. A nurse is conducting an assessment of an older adult in a geriatric clinic. The patient states that he drinks two to three alcoholic beverages daily. The patient has multiple chronic comorbid conditions and is on five different medications. Which of the following medications is the nurse concerned will interact with the alcohol? (Select all that apply.) a. Naproxen for pain b. Daily multivitamin c. Prozac for depression d. Celebrex for arthritis 80 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 e. Toprol XL for hypertensionANS: A, C, E: Naproxen for pain Prozac for depression Toprol XL for hypertension 183. A nurse in a long-term care facility is approached by an older resident who is crying and states: "You need to help me. The mean little men are in my room again. They are watching me from the corner and they are laughing at me. Make them go away." The nurse accompanies the resident to the room and there is no one in the corner of the room. What is the best response by the nurse? (Select all that apply.) a. "Yup, I see them. Let me call security to haul the men away." b. "Can you tell me what you are so frightened of?" c. "I will do my best to keep you safe." d. "I understand that you are very frightened and upset." e. "You know that there is no one there. Stop carrying on like this.": "Can you tell me what you are so frightened of?" "I will do my best to keep you safe." "I understand that you are very frightened and upset." 184. When an older adult reports experiencing several different stressors over the last 6 months, the nurse demonstrates an understanding of the physiological effects of stress on the body by: (Select all that apply). a. assessing the client using the Geriatric Depression Scale (GDS). b. testing the client's urine for red blood cells. c. screening the client for abnormally high serum glucose levels. 81 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 d. inquiring as to whether the client has experienced weight changes.: screening the client for abnormally high serum glucose levels. inquiring as to whether the client has experienced weight changes. 185. The nurse is caring for an older client who experienced a hip replacement surgery 10 hours ago. Which intervention will help minimize this client's risk of developing delirium? a. Requesting that staff offer fluids each time they interact with the client b. Medicating the client to best facilitate restorative sleep c. Encouraging the client to remain still and thus minimize pain d. Suggesting that visitors are limited to family members only: Requesting that staff offer fluids each time they interact with the client 186. . Which intervention best addresses the principle that is the basis for communicating with a client experiencing postsurgical delirium? a. Reminding the client that delirium is generally acute and reversible b. Assuming that the client's statements are an attempt to express needs c. Allowing the client sufficient time to formulate an answer to questions d. Using nonverbal communication techniques to communicate with the client: Assuming that the client's statements are an attempt to express needs 187. An older client admitted to the hospital after having sustained a fall at home is diagnosed with a right hip fracture and experienced a surgical reduction of the fracture. At 2:30 AM, she awakens from sleep insisting that her daughter is in the other room and wants to see her. Attempts to reorient her to the surroundings are unsuccessful. In reviewing the client's record, what data would be considered a primary risk factor for the delirium? a. History of dementia 82 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 192. A nurse is caring for a 92-year-old female patient who was admitted to the hospital 1 day after she had outpatient cataract surgery. The patient who lives in an assisted living facility became very confused and agitated and was found wandering in the lobby of the building in her nightgown. She refused to return to her room and stated that there were "bad men" in her room. The patient has a history of dementia, diabetes, heart failure, and is on seven different medications. She was widowed 1 year ago. The nurse suspects that she has delirium. What are the patient's risk factors for delirium? (Select all that apply.) a. Age of 92 b. Residing in an assisted living facility c. History of dementia d. Female gender e. Recent cataract surgery: Age of 92 History of dementia Recent cataract surgery 193. A nurse in a long-term care facility is concerned that a 94-year-old resident with dementia is losing weight. Upon assessment, the nurse notes that the resident, who is able to feed herself independently, consumes less than 50% of each of her meal trays. Which of the following strategies can the nurse utilize to improve this resident's intake? (Select all that apply.) a. Assign a nursing assistant to feed the resident. b. Assign a nursing assistant to sit with the resident as the resident eats. c. Serve the resident finger foods. d. Serve the resident one dish at a time. 85 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 e. Alter the dining ambience to reduce distractions.: Assign a nursing assistant to sit with the resident as the resident eats. Serve the resident finger foods. Serve the resident one dish at a time. Alter the dining ambience to reduce distractions. 194. A nurse is assessing an older patient with new onset confusion. The nurse understands that in order to have a diagnosis of delirium, the patient must exhibit which of the following? (Select all that apply.) a. Acute onset of symptoms or fluctuating course b. Inattention c. Disorganized thinking d. Altered level of consciousness e. Flat affect: Acute onset of symptoms or fluctuating course Inattention Disorganized thinking Altered level of consciousness 195. Which statement by the nurse is the strongest example of ageism by professional nurses? a. "It takes a special nurse to provide good care to the older population of clients. " b. "It's difficult for a nurse to develop an effective relationship with an older client because of the barriers their age creates." c. "It is so difficult to find nurses who are truly effective geriatric nurses." 86 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 d. "With the older population increasing so dramatically in numbers, nursing will have a difficult time meeting their needs.": "It is so difficult to find nurses who are truly effective geriatric nurses." 196. When conducting an admissions interview with an older client, the nurse observes that the client pauses for a period of time before responding to the questions. The nurse responds to this client based on the assumption that the client is: a. exhibiting signs of mild cognitive impairment. b. nervous and having difficulty concentrating on the questions. c. reluctant to share information with someone with whom he or she has norelationship. d. sorting through his or her vast life experiences in order to answer ap-propriately.: sorting through his or her vast life experiences in order to answer appropriately 197. Which technique is most effective when communicating with a client who is positioned in bed? a. Sitting in a chair at the foot of the bed b. Standing near the client's head on his or her dominant side c. Sitting in a chair at the bedside facing the client d. Standing at the foot of the bed: Sitting in a chair at the bedside facing the client 198. . Which nursing statement shows a true appreciation for an older client's willingness to tell his personal stories about "the war"? a. "It's so nice to see them excited and engaged as they tell the stories." b. "It helps their memory so much to retell their stories." c. "I learn so much about clients when they share their life story with me." 87 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 c. how well an individual communicates is a reflection on both his or her physical and emotional well- being. d. the need to communicate is a basic need of all individuals.: assessment, planning of care, and even the therapeutic relationship is based on effective communication. it is the social connection that all individuals base interpersonal relationships upon. the need to communicate is a basic need of all individuals. 203. The original intent of Social Security was to: a. provide a hospital insurance plan. b. minimize the dependency of older members on younger members of society. c. provide the blind, older adult, or disabled with adequate financial support. d. penalize women financially for numerous zero wage years while raising children.: minimize the dependency of older members of society 204. When an older adult is considering long-term care insurance (LTCI), what is important for the nurse to encourage the client to consider? a. The older one is when applying, the lower the rates will be. b. It is financially better to avoid purchasing LTCI through a group policy. c. It is wise to scrutinize all exclusions before enrolling. d. All policies cover care at home as well as in a long-term care facility.: It is wise to scrutinize all exclusions before enrolling 205. The cost of nursing home care is significant. The primary payer for nursing home care is: a. Medicare. 90 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 b. Medicaid. c. Long-term care insurance. d. Medigap insurance.: Medicaid 206. A Navy war veteran is seeking advice about getting treatment for a chronic respiratory problem at the local veterans' hospital. The nurse's initial response is to ask: a. "Why aren't you considering the local general hospital for the care that you need?" b. "Are you willing to travel to a veterans' hospital that offers respiratory diagnostic services?" c. "Have you ever been treated at a veterans' hospital before?" d. "Is the problem related to something that occurred while you were in the Navy?": "Is the problem related to something that occurred while you were in the Navy?" 207. An older adult is concerned that if her spouse, who recently suffered a stroke, is placed in a nursing home, "they will take everything in order to pay for his care." What response will the nurse make? a. "A spouse is allowed to keep a percentage of the family income and cash as well as the family home, car, and personal property" b. "You should consider transferring the assets to your son so that your husband will qualify for Medicaid" c. "Have you considered caring for your husband at home since Medicare will cover custodial care at home?" d. "Are you aware that your children have a legal obligation to provide financial support toward the care of disabled parents?": "A spouse is allowed to keep a percentage of the family income and cash as well as the family home, car, and personal property" 91 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 208. A 70-year-old diabetic patient has just received instruction from a nurse on glucose self-monitoring. He tells the nurse: "I hear that those test strips cost a lot. I am not sure that I can afford anything else. The only health insurance I have is Medicare Parts A and B." The best response by the nurse is: a. "I am sorry, but Medicaid is the only insurance that covers the cost of diabetic testing supplies." b. "Medicare Part A will cover the cost of the supplies to manage your diabetes." c. "Medicare Part B will cover the cost of the supplies to manage your diabetes." d. "I am sorry, but Medigap insurance is the only insurance that covers the cost of diabetic testing supplies.": "Medicare Part B will cover the cost of the supplies to manage your diabetes." 209. When educating an older adult about Medicare Part D, which information will be included? (Select all that apply.) a. It is an elective prescription drug plan with associated out-of-pocket premiums. b.All persons with either Medicare Part A or B can voluntarily purchase a Medicare Part D prescription drug plan. c. The plan covers all costs of drugs after a deductible is paid. d.The plan is not available for individuals who are receiving both Medicaid and Medicare. e. This prescription drug plan requires client co-payments.: It is an elective prescription drug plan with associated out-of-pocket premiums All persons with either Medicare Part A or B can voluntarily purchase a Medicare Part D description drug plan. This prescription drug plan requires client co-payments 210. A 70-year-old person who has Medicare Part A only is discussing the cost of health care with a nurse. The nurse understands that Medicare Part A covers the cost of which of the following? (Select all that apply.) 92 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 b. they have all levels of care in one location, allowing community members to easily transition between levels. c. they are paid for by Medicare. d. they allow the older adult's family to retain ownership of the property after the owner dies.: they have all levels of care in one location, allowing community members to easily transition between levels 216. An older adult is considering residential care/assisted living (RC/AL). The nurse knows that the older adult needs additional teaching when the older adult states which of the following? a. "I read a recent article that stated that more older adults would prefer to move to an assisted living community than a nursing home if they could no longer care for themselves." b. "I am happy that Medicare pays for the cost of living in an RC/AL." c. "I will have to check with my long-term care insurance company. I heard that it might pay for RC/AL." d. "RC/AL costs significantly less than nursing home care.": "I am happy that Medicare pays for the cost of living in an RC/AL" 217. Differences between subacute care and long-term care include which of the following? (Select all that apply.) a. Subacute care is more costly than long-term care. b. Higher levels of professional staffing are generally found in subacute settings. c. Medicare covers the costs of both subacute and long-term care. d. Subacute patients tend to be younger and more cognitively intact. e. Subacute care is usually delivered in a hospital setting and long-term care in a nursing home setting.: Subacute care is more costly than long-term care. Higher levels of professional staffing are generally found in subacute settings. 95 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 Subacute patients tend to be younger and more cognitively intact. 218. Factors that are influencing the decrease in nursing home beds in the United States include: (Select all that apply.) a. an increase in the use of residential care facilities. b. a shortage of certified nursing assistants (CNAs). c. increased Medicaid reimbursement for community-based care alterna-tives. d. a shortage of registered nurses who are certified in gerontology. e. the high cost of care in a nursing home.: an increase in the use of residential care facilities. increased Medicaid reimbursement for community-based care alternatives. 219. An older patient with dementia is referred for adult day services (ADS). The patient's daughter asks the nurse about the benefits of ADS. The nurse considers which of the following in formulating a response? (Select all that apply.) a. ADS are designed to provide social and some health services for older adults. b. ADS are covered under Medicare Part B. c. ADS offer respite services for caregivers from the responsibilities of caregiving. d. ADS often provide educational programs and support groups for care-givers. e. ADS are all staffed with registered nurses.: ADS are designed to provide social and some health services for older adults. ADS offer respite services for caregivers from the responsibilities of caregiving. ADS often provide educational programs and support groups for caregivers. 96 / 119 NURS 245 Comprehensive Final Exam Modules 1-7 Study online at https://quizlet.com/_8qb1f1 220. A nurse is discharging an older patient after a hospitalization for a hip fracture. The patient is a participant in a Program for All Inclusive Care for the Elderly (PACE). The nurse understands that a PACE program: (Select all that apply.) a. provides services to older people who would otherwise need a nursing home level of care. b. does not provide services to participants who reside in a nursing home. c. is only available to individuals who have both Medicare and Medicaid. d. provides medications, eyeglasses, and transportation to care. e. provides urgent and preventive care.: provides services to older people who would otherwise need a nursing home level of care. provides medications, eyeglasses, and transportation to care. provides urgent and preventive care. 221. Which nursing evaluation supports the fact that the goals of long-term client care have been achieved? Select all that apply. a. Resident has participated in bath with minimal assistance from the staff. b. Resident has experienced no falls since admission 3 months ago. c. Resident continues to show loss of strength in upper extremities. d. Resident is not required to dress or feed self since assistance is always available. e. Resident demonstrates improved weight bearing on affected leg; dis-charge to be considered.: Resident has participated in bath with minimal assistance from the staff. Resident has experienced no falls since admission 3 months ago. Resident demonstrates improved weight bearing on affected leg; discharge to be considered. 97 / 119