Caring for Older Adults Holistically 5th Edition, Mary Test Bank

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Test Bank For Caring for Older Adults Holistically 5th Edition, Mary. Note: This is not a text book. Description: ISBN-13: 978-0803625006, ISBN-10: 0803625006.

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Test Bank Caring Older Adults Holistically 5th Edition, Mary

Multiple Choice
Chapter 1: Holistic Caring
1. According to the 2002 U.S. Census, approximately how many Americans are older than age 65?
a. 5%
b. 20%
c. 12%
d. 2%
2. Today, the average life expectancy is
a. 70.2 years
b. 75 years
c. 79 years for women and 72.9 for men
d. longer for men than for women
3. All of the following would be good explanations of “holistic nursing” except
a. Holistic nursing focuses on the specific disease or disorder a person has in order to treat it effectively
b. Holistic nursing aims to treat the whole person, not just a specific disease or disorder the person may have
c. Holistic nursing focuses on the individual patient and uses many techniques such as empathetic listening, music, and imagery as well as specific clinical skills
d. Holistic nursing weaves the technical skills of nursing with the social science skills that enhance communication and rapport between the nurse and the person receiving care
4. The Science of Human Caring was developed by
a. Florence Nightingale
b. Clara Barton
c. Jean Watson
d. Savage and Money
5. The Science of Human Caring emphasizes all of the following except
a. Transpersonal caring
b. A focus on the person while you are with him or her
c. Ensuring that all nonessential tasks, such as bathing, are given according to a strict schedule
d. Reaching out to the patient, making eye contact, touching if appropriate, speaking softly
6. Basic concepts of holistic nursing include
a. Using your developed clinical expertise
b. Developing a close relationship with the patient’s family members and significant others
c. Remembering the personal intuition and creativity of patients in your nursing plan
d. All of the above
7. Most elderly people having a heart attack have
a. Pain diffused over the entire chest area
b. No pain
c. Crushing sternal pain
d. Pain on the left side of the chest and pain that radiates down the left arm
8. Compared with the doses of medication given to a young adult, the doses given to an old-old person are usually
a. Smaller
b. Larger because the old-old person is probably sicker
c. The same
d. Minimal because the person is very old and probably near death
9. What communication technique has been developed specifically for dealing with demented elderly persons?
a. Cognitive therapy
b. Validation therapy
c. Geriatric Depression Scale
d. MMSE (Mini-Mental Status Examination)
10. Mr. Leopold is an 82-year-old man in your care. He has been diagnosed with liver cancer and has long-standing cardiovascular problems. He begins to scream at you and pushes his meal tray away. What would be an appropriate response?
a. Take the meal tray and leave the room without saying anything
b. Tell him to stop screaming in a loud voice
c. Calmly ask him what he is upset about and listen carefully to him
d. Call your supervisor
Chapter 2: The Aging Experience
1. The fastest growing segment of the population in the United States is
a. Teenagers
b. Babies
c. People older than 85 years of age
d. None of the above
2. Mr. Smith, an 88-year-old retired school principal, lives alone in his home. His neighbors have never been in his home but believe it must be dark, dirty, smelly, and without modern conveniences. They instruct the children to stay away from the house and Mr. Smith because he is a “crazy old man.” This is an example of
a. Racism
b. Sexism
c. Ageism
d. Patriotism
3. Select the response that is not an example of ageism:
a. Getting old is a hopeless downward spiral to death
b. As people get older, they become very self-centered
c. Older people maintain unique and individual characteristics
d. Older people become very rigid and are unable to learn new things
4. Normal physiological aging is
a. A predictable and uniform process
b. Reflective of individual diversity
c. Accompanied by extreme mood swings and predictable depression
d. Primarily related to chronic disease processes
5. How individuals age does not depend on their
a. Life experiences
b. Financial resources
c. Stress management style
d. Social support system
6. The normal aging process is accompanied by
a. Potential problems in functional ability
b. Chronic disease processes
c. Regression from previous social activities
d. A characteristic depression related to multiple losses
7. The leading cause of death in older adults is
a. Stroke
b. Heart disorders
c. Cancer
d. Pneumonia
8. All of the following are psychological theories of aging except
a. Subcultural theory
b. Wear-and-tear theory
c. Developmental tasks theory
d. Continuity theory
9. According to Eric Erikson’s eight stages of life theory, the task of old age is
a. Industry vs. Inferiority
b. Identity vs. Role Confusion
c. Ego integrity vs. Despair
d. Generativist vs. Stagnation
10. Physiological theories of aging focus on all of the following except
a. Genetics
b. Nutrition
c. Wear and tear of the body
d. Personality
Chapter 3: Supporting Life Transitions and Spirituality in the Elderly
1. All of the following are true of life transitions except
a. Challenging experiences that accompany aging may require life transitions
b. A person usually experiences only one transition in a lifetime
c. Sometimes there is more than one transition occurring at the same time
d. Each loss or change requires transitional effort from the person experiencing it
2. Maria Hernandez, 76 years old, recently sustained a left hip fracture and dislocation while gardening in her yard. She underwent left total hip replacement surgery and is recovering on the orthopedic unit. Maria tells the nurse she is upset and does not feel at peace because she has been unable to attend church as a result of the injury. What is the best response by the nurse?
a. Encourage her to read a book, magazine, or newspaper
b. Suggest that she watch television to keep her mind distracted
c. Offer to call the hospital’s chaplain or clergyman to come pray with her
d. Tell her to sleep so that her body can heal and return to a state of peacefulness
3. Examples of transitional events include all of the following except
a. Marriage
b. Losing a job
c. Moving to a new home
d. Visiting an amusement park
4. Researchers have determined four common features to transitions. Which of the following is not one of the four features?
a. A stage of denial
b. An altered time perspective
c. Disturbances in bodily function
d. A phase of turmoil
5. Which developmental growth objective is essential in reaching gerotranscendence?
a. Formal operational stage
b. Integrity vs. Despair stage
c. Concrete operational stage
d. Initiative vs. Guilt stage
6. Mr. Smith, 79 years old, refuses to take any medications offered by the nurse. The nurse respects Mr. Smith’s decision and right to refuse treatment and returns at a later time to offer the medication. Which of the following factors influencing transitional outcomes applies to Mr. Smith’s situation?
a. Mr. Smith’s perception of change
b. Mr. Smith’s extent or degree of change
c. Mr. Smith’s degree of choice
d. Mr. Smith’s preparation for the change
7. The degree of change for an older person preparing to move can be minimized by all of the following considerations except
a. Ensuring the new home is located near a senior citizen’s center
b. Finding a home with a nearby grocery store within walking distance
c. Selecting a home that meets the physical needs of the person
d. Choosing a smaller apartment so the person has fewer items to move
8. Preparation is a key factor in managing future transitions. Which of the following is not an appropriate choice in helping patients prepare for transitions?
a. Avoid discussing difficult topics with patients
b. Talking to patients and residents about changes to be anticipated
c. Repeating all necessary information about the transition
d. Involving family members when discussing future transitions
9. The characteristics of an individual are important components to consider for transitions. Which of the following characteristics should be considered when a person is transitioning?
a. The person’s height and weight
b. The person’s past experiences
c. The sex of the person
d. The person’s vital signs
10. What aspects of the environment in a hospital room would most likely allow for smooth transitioning?
a. Cheerfulness and relaxation
b. Clean and colorful
c. Restrictive and demanding
d. Warm and dark
Chapter 4: Use of the Nursing Process and Nursing Diagnosis in the Care of Older Adults
1. Which of the following defines the nursing process?
a. A problem-solving approach
b. A structured and inflexible way to approach problems
c. A standardized care-planning method
d. An intuitive approach to planning nursing care
2. Which of the following is not a characteristic of the nursing process?
a. Patient centered
b. Organized according to medical diagnosis
c. Adaptable to change
d. Planned care
3. Which of the following is not a step in the nursing process?
a. Assessment
b. Nursing diagnosis
c. Physician orders
d. Planning
4. In which step of the nursing process does the nurse complete the Minimum Data Set (MDS)?
a. Assessment
b. Diagnosis
c. Physician orders
d. Planning
5. Which of the following is an example of assessment data?
a. Altered nutrition
b. Resident will walk 100 feet each afternoon
c. Resident complaining of difficulty swallowing
d. Monitor the resident’s oral intake
6. The Minimum Data Set (MDS)
a. Refers care providers to problem areas that must be addressed in the plan of care
b. Dictates the nursing care that should be provided to every nursing home resident
c. Focuses on care required for specific medical diagnoses
d. Refers care providers to standardized plans of care
7. Select the nursing diagnosis from the following
a. Congestive heart failure related to history of hypertension
b. Non–insulin-dependent diabetes mellitus related to obesity
c. Alteration in thought process related to Alzheimer’s disease
d. Osteoporosis related to menopause
8. The development of a nursing diagnosis depends on the
a. Medical diagnoses
b. Chronic disease processes
c. Data collected in the comprehensive assessment
d. Goals for the resident care
9. Which of the following describes the process of identifying a nursing diagnosis?
a. Selecting a nursing diagnosis from a list approved by the North American Nursing Diagnosis Association (NANDA)
b. Identifying the patient’s strengths and weaknesses
c. Setting goals for nursing care
d. Reviewing medical-surgical nursing texts for patterns of disease processes
10. Measurable goals in long-term care are measured
a. Every 30 or 90 days
b. Weekly
c. Bimonthly
d. Yearly
Chapter 5: Legal and Ethical Considerations Regarding Older Adults
1. Which of the following is an ethical dilemma?
a. Deciding whether to pass pills first or do a dressing change
b. Deciding whether to include the resident in on planning care
c. Allowing a resident to refuse care
d. Reporting a nursing assistant for physically abusing a resident
2. Which of the following is a situation that would be a legal dilemma for nurses caring for older adults?
a. The resident requests not to be bathed
b. The resident signs out of the nursing facility and does not tell the staff where he or she is going
c. The nurse passes the medications to all of the residents on time
d. The nurse gives the resident only half of the ordered dose of a medication because of side effects that the resident is experiencing
3. Ethics is the study of
a. Values and moral concepts
b. Right and wrong behaviors
c. Consequence evaluation
d. Legal aspects of health
4. Ethical decision making is
a. Beyond the legal scope of the practical nurse
b. The use of personal values and beliefs to solve problems
c. Unnecessary if there are comprehensive physician orders
d. Governed by the law
5. The Patient’s Bill of Rights is designed to
a. Protect the nurse from unfounded lawsuits
b. Identify the individual’s ability to make decisions
c. Protect the individual’s right to make informed choices relating to his or her health care
d. Support the choices of an individual who is able to read and write
6. Laws governing health care and health-care delivery are
a. Man-made and capable of being changed
b. Consistent with values systems
c. Fair and benefit most of the population
d. Developed with the rights of residents as the central theme
7. Janet, an LPN, is in charge of Unit 2A in Shady Grove Nursing Home. She finds Mrs. Smith in the bathroom barely breathing. Janet calls for help and instructs the staff to call 911 and bring emergency supplies. Janet sets up oxygen for Mrs. Smith. Janet is guilty of
a. Nothing: The Nurse Practice Act and facility procedures support this action
b. Negligence: She did not get a specific order
c. Omission: She did not chart the action
d. None of the above
8. Continuing with Mrs. Smith, Janet proceeds to start an IV with D5W so that the ambulance will have immediate venous access for medication. Janet is guilty of
a. Nothing: The Nurse Practice Act and facility procedures support this action
b. Negligence: She is not IV certified
c. Omission: She did not chart the action
d. None of the above
9. Mrs. Smith’s family sues the facility for allowing her to be up unassisted and in the process learns that the nurse was unauthorized to start an IV. In the court, the judge will ask others
a. Would another LPN do the same thing under these circumstances?
b. Why was there no one directly supervising Mrs. Smith at all times?
c. Where was the physician while all this was going on?
d. Did Mrs. Smith give express permission for the IV?
10. Failure to notify the physician or nursing supervisor when a resident’s heart rate decreases to less than 48 would be an example of
a. Negligence
b. Omission
c. Libel
d. Unprofessional behavior
Chapter 6: Promoting Wellness
1. The popular standard by which health is being defined for older people is
a. The absence of debilitating diseases
b. The ability to participate in aerobic exercises
c. The ability to pay for needed health service
d. The maintenance of independence
2. Wellness activities for the older adult must include
a. Relationships
b. Self-care
c. Exercise
d. All of the above
3. The treatment of chronic disease does not include
a. A focus on curing the disease process
b. Symptom management
c. Maximizing the individual’s strengths
d. Prevention of disabling side effects
4. Arthritis is a chronic disease process that affects the health of many older people. What is the best description of health promotion for individuals with arthritis?
a. Activity restrictions to minimize joint pain
b. Use of walkers and wheelchairs early in the disease process so that the older person is better able to use these aids when he or she is totally debilitated
c. Referral of the person to herbalists and massage therapists to seek potential disease cures
d. Pain management to enhance normal physical activity
5. “One does not have to be free of disease to experience the benefits of wellness and the positive side of living.” What does this statement mean in relationship to the health of older people?
a. A good attitude makes aging a positive learning experience
b. People’s needs are important, even if they are ill
c. Illness is not a good excuse for being inactive
d. Individuals do not have to limit their experience of health simply because they have an illness
6. Society is becoming very focused on health promotion. Which purpose statement would most likely appeal to older people selecting a health promotion program?
a. Focus on extension of life
b. Focus on enhancing the quality of life
c. Focus on prevention of chronic disease processes
d. Focus on prevention of aging
7. Select the best description of the role of the gerontological nurse in developing treatment strategies for people experiencing a chronic disease process
a. Assessing elderly clients and identifying treatable causes of pain and discomfort
b. Setting goals for elderly clients that consider the individual and the chronic disease process
c. Evaluating the impact of the disease process and treatment on individuals and their functional abilities
d. Administering ordered treatments to minimize debilitating symptoms
8. Compliance with a health promotion program for an elderly person depends on
a. The time of day that the activity takes place
b. The disabling characteristics of the older person’s disease process
c. The older person’s motivation
d. The older person’s recognition of a health problem
9. What percentage of people older than 65 years resides in nursing homes?
a. 5%
b. 3%
c. 10%
d. 15%
10. Which of the following is not an environmental factor that affects the nutritional habits of older people?
a. Food storage
b. Transportation
c. Lack of nutritional knowledge
d. Readability of food labels
Chapter 7: Nutrition for Older Adults
1. Food intake may change in an older adult because of
a. Adverse reactions to medications taken
b. Chronic diseases
c. Normal changes in the digestive tract
d. All of the above
2. A nutritional assessment in an older adult should include
a. Questions concerning how much weight has been gained or lost in the past 6 months
b. Questions about how many prescription and over-the-counter medications the older adult takes
c. Determination if the patient can shop and cook
d. All of the above
3. Assessment of nutritional status may include
a. Observation of the older adult while eating
b. Keeping a food journal of what and how much is eaten
c. Questions about the older adult’s food shopping and cooking practices
d. All of the above
4. An older adult may lose weight because of all of the following except
a. An infection and fever
b. Edema
c. Depression
d. Problems with dentition or swallowing or both
5. Which of the following statements about complex carbohydrates is not true?
a. They provide a quick source of energy
b. They replace the loss of stored reserves of glycogen
c. They are broken down slowly in the body
d. They provide a sustained source of energy
6. Functional proteins
a. Come from animals only
b. Make up the hair, muscles, tendons, and skin
c. Help the body carry out vital activities
d. Contain only essential amino acids
7. Which laboratory test is the primary test used to determine if excess body tissue is being broken down?
a. Hematocrit
b. BUN
c. Hemoglobin
d. Serum creatinine
8. Fat is necessary for the absorption and use of which of the following vitamins?
a. Vitamin A
b. Vitamin D
c. Vitamin C
d. Vitamins A and D
9. Which vitamin does the body produce naturally?
a. Vitamin C
b. Vitamin B6
c. Vitamin D
d. Vitamin A
10. You are caring for a homebound frail elderly woman. While helping her with toileting, you notice very dark stools. A possible nutrition-related reason for this may be
a. Lack of vitamin C
b. Lack of vitamin K
c. Lack of phosphorus in the diet
d. Lack of iron in the diet
Chapter 8: Culturally Specific Care
1. Culture includes all of the following except
a. Religion
b. Physical traits such as hair and eye color
c. Stories from grandparents
d. Nonphysical inherited traits
2. Based on census data and predictions about changes in the U.S. population, which of the following is a true statement?
a. The population of the United States will probably become younger and more assimilated
b. The population of the United States will become more diverse and older
c. The number of Asians living in the United States will decrease
d. The percentage of blacks living in the United States will increase more than any other ethnic group
3. You are treating a black Muslim man who has long-standing diabetes and recently had a mild stroke from which he is recuperating. Which of the following would be an example of culturally sensitive nursing care?
a. Inform him that while he is in the hospital, he must eat whatever is brought to him and take the insulin given him
b. Discuss his diet with him, asking him if he has any special needs
c. Request that the pharmacy send only nonpork insulin for him
d. Both B and C
4. In black men 15 to 34 years old, the leading cause of death is
b. Homicide
c. Stroke
d. Accidents
5. A 25-year-old black woman presents with fever and severe pain in her lower back and legs. She reports being upset and having flown a long distance yesterday. Tests reveal that she is anemic. Which is the first diagnosis you might consider?
a. Infection
b. Sickle cell anemia
c. TIA
d. None of the above
6. Which of the following are the two leading causes of death among Native Americans?
a. Alcoholism and diabetes mellitus
b. Suicide and homicide
d. Alcoholism and tuberculosis
7. Which of the following might you see when entering the hospital room of an ill Native American?
a. The patient and family facing east and praying to Allah
b. A shaman performing a healing “sing” with family members
c. Cups being applied to the patient’s back
d. The eldest member of the patient’s family asking questions and taking notes
8. Which ethnic group has the lowest cancer survival rate?
a. Hispanics
b. Europeans
c. Native Americans
d. Blacks
9. The incidence of diabetes mellitus differs among different ethnic groups. Among Native Americans, it is
a. 1 in 10
b. 1 in 20
c. 1 in 50
d. 1 in 5
10. The use of acupuncture has increased in the United States, but the practice of acupuncture and acupressure is most closely associated with which ethnic group?
a. Europeans
b. Asians
c. Hispanics
d. Blacks
Chapter 9: Activity, Rest, and Sleep as Criteria for Health
1. As adults become older, their sleep patterns change. Older adults tend to
a. Sleep later in the morning
b. Go to bed earlier
c. Wake earlier in the morning
d. Take several naps during the day
2. A 78-year-old woman with COPD and degenerative arthritis affecting her lower back and legs says she cannot exercise. She stays at home and has someone deliver her food and other necessities. What would be an appropriate intervention?
a. Suggest that she accept her limitations and live as best she can
b. Explain to her the importance of exercise—even for someone with her limitations. Suggest that she use a walker or wheelchair, pace herself slowly, and use oxygen if necessary, but to try to get out, go to the market, and interact with people
c. Suggest that she consider moving to an assisted living facility
d. Both B and C
3. Even minimal activity may help prevent or manage
a. Diabetes mellitus
b. Osteoporosis
c. Heart disease
d. All of the above
4. You are assigning tasks to nursing assistants in a nursing home. Which would be the most appropriate instruction to give to the assistant who will care for Mrs. Scott, a frail 80-year-old woman with arthritis?
a. Tell the NA to give her a bed bath, comb her hair, and brush her teeth
b. Tell the NA to help her use a bedpan
c. Tell the NA to “let her do as much as she can for herself,” such as brushing her teeth, combing her hair, and walking to the bathroom with assistance
d. Tell the NA to be sure to bring Mrs. Scott’s meal trays to her bed each day
5. All of the following are true about stress in an older adult’s life except
a. It should be eliminated from an older person’s life
b. It should be managed
c. It can have beneficial results
d. It increases with age
6. John Robinson, 74 years old, complains of insomnia and of always feeling tired. He has been diagnosed with gastroesophageal reflux disease (GERD) and congestive heart failure. What would you suggest to help him sleep better?
a. Take a long-lasting analgesic before bed
b. Take antacids before bed to relieve acid reflux
c. Raise the head of the bed so that the upper body is elevated
d. Tell him to lie only on his side
7. Mr. Anderson, who is 69 years old and obese, reports feeling tired all the time, even in the morning when he awakens. His wife reports that he snores loudly. What disorder should you suspect?
a. Nocturnal myoclonus
b. Dementia
d. Sleep apnea
8. All of the following contribute to disturbed or interrupted sleep except
a. Alcohol
b. Activity
c. Sedentary lifestyle
d. Tobacco
Chapter 10: End-of-Life Issues in the Older Adult
1. End-of-life care
a. Includes communication and education about choices
b. Requires the nurse to get in touch with his or her own beliefs
c. Is the same for all individuals
d. Both A and B
2. Examples of palliative care include all of the following except
a. Pain medication for relief of distress
b. Chemotherapy
c. IV lines for hydration
d. Flotation mattress
3. Terminal restlessness
a. Is involuntary thrashing or agitation
b. Is a common occurrence at the end of life
c. Occurs as a result of progressive shutdown of body systems
d. All of the above
4. Which of the following statements about hospice care is not true?
a. Hospice care serves the dying patient exclusively
b. Hospice care is responsive 24 hours a day 7 days a week
c. Hospice care has a small patient-to-worker ratio
d. Hospice care encourages the involvement of the patient’s personal physician
5. The stages of grief are present
a. When someone dies
b. After a mastectomy
c. During a divorce
d. All of the above
6. Mr. Alexander has been in the bedroom, venturing out only for brief minutes. His eyes are reddened and swollen, his appetite is decreased, and even the simplest task is too exhausting for him. Mr. Alexander is in the grief stage of
a. Bargaining
b. Denial
c. Depression
d. Acceptance
7. Tolerance can be defined as
a. Compassion and endurance
b. Impatience and open-mindedness
c. Closed-mindedness and impartiality
d. Impatience and impartiality
8. If you are empathetic with your patients, you are
a. Crying with the patients
b. Identifying with the patients
c. Understanding of the patients
d. Making choices for the patient
9. The benchmarks of a good listener include all of the following except
a. Taking time
b. Not interrupting
c. Asking appropriate questions
d. Assuming you know what the person is going to say
10. Advance directives are
a. Durable power of attorney
b. A will
c. A living will
d. Both A and C
Chapter 11: Environments of Care
1. George Baldwin, 72 years old, has been discharged from the hospital with the diagnosis of terminal cancer involving the pancreas and liver. His daughter is seeking care assistance for him in his home. What services would you recommend?
a. Hospice
b. Nursing home
c. Adult day care
d. Skilled nursing facility
2. Betty Daniels, 76 years old, has come to the physician’s office complaining of extreme exhaustion. Mrs. Daniels is the primary caregiver for her 80-year-old husband. She refuses to place her husband in a nursing facility. What referral would you make for Mrs. Daniels?
a. Hospitalization
b. Home health nursing
c. Respite care
d. Senior center
3. Byron Blazer, 78 years old, lives alone and is being discharged from the hospital after total hip replacement surgery. His sister is staying with him for 1 week. What care referral would you make for Mr. Blazer?
a. Home health services
b. Skilled nursing facility
c. Senior center
d. Hospice
4. A criterion for receiving hospice services is
a. A cancer diagnosis
b. Terminal disease process
c. Chronic disease with acute exacerbation
d. Lack of family support
5. Hospice services include all of the following except
a. Personal care services
b. Funeral arrangement services
c. Family counseling and support
d. Ongoing support for families after the person’s death
6. Lila Jacobs is 80 years old and lives at home with her husband. She has Alzheimer’s disease with increasing confusion and urinary incontinence. Mr. Jacobs has had a cerebrovascular accident and can no longer care for her in their home. What referral would you make for Mrs. Jacobs?
a. Retirement center
b. Intermediate nursing facility
c. Skilled nursing facility
d. Hospitalization
7. Freda LaRue, 78 years old, is distressed over the high maintenance costs of her large home. What would be a living alternative for Mrs. LaRue?
a. Retirement center
b. Intermediate nursing facility
c. Skilled nursing facility
d. Senior center
8. The goal of environmental assessment is to
a. Promote independent function
b. Detect reasons to admit an older adult to a long-term care facility
c. Establish an older adult’s housekeeping abilities
d. Assist the family with documenting reasons they should seek durable power of attorney
9. Environmental safety risk assessments include all of the following except
a. Noting electrical wiring, frayed cords, and hot extension cords
b. Sorting through older adults’ mail to see if they are paying their bills on time
c. Medication storage and date of medications
d. Noting clutter and throw rugs
10. Which of the following interventions increases the functionality of the environment?
a. Changing light bulbs to energy-saving, low-wattage bulbs
b. Installing grab bars in the bathroom
c. Inserting a Foley catheter so that the older adult does not have to get out of the chair to void
d. Padding the bed for an incontinent older adult
Chapter 12: The Management Role of the Licensed Practical/Vocational Nurse
1. The practice of the licensed practical nurse is
a. Determined by the needs of the nursing facility or hospital
b. Defined by shift-related responsibilities
c. Prescribed by the RN charge nurse, shift supervisor, or director of nursing service
d. Dictated by the State Nurse Practice Act
2. Which of the following is an example of an authoritarian style of leadership?
a. The practical nurse assigns the nursing assistants to specific times for their breaks and lunch
b. The practical nurse designs a rotating schedule for assigning breaks and lunch
c. Nursing assistants are not assigned to breaks and lunches
d. Nursing assistants sign up for the break and lunch that they prefer and negotiate if there are any conflicts
3. The best description of the work environment with a democratic leader would be
a. Individual accountability and responsibility
b. Structured time and task responsibilities
c. Teamwork
d. Following orders
4. Which of the following is not an appropriate strategy for communicating with older adults?
a. Sit so that you are at eye level with the older adult
b. Close the door to shut out background noises
c. Listen carefully and verify older adult’s statements
d. Shout loudly
5. Which of the following strategies would facilitate communication with families?
a. Being available to talk at the nurses’ station
b. Referring the family to a social worker
c. Meeting in a quiet room away from the care area
d. Asking the family to telephone to ask questions
6. Which of the following facilitates communication in interdisciplinary team (IDT) conferences?
a. Setting time limits on the discussion of each resident
b. Requiring that all members attend on time and are prepared
c. Writing the needed changes in the plan of care before the meeting
d. Inviting the family to meet with individual members of the team rather than coming to IDT meetings
7. “I feel” messages are part of the response format for
a. Active listening
b. Aggressive communication
c. Assertive communication
d. Passive communication
8. Which of the following is an assertive response to being embarrassed by another nurse in front of a family?
a. “I feel you are out of line”
b. “When you yell at me in front of family members, I feel very humiliated”
c. “You are so insensitive to my feelings”
d. “Could you just shut up?”
9. The major block to active listening with an angry resident is the
a. Amount of anger being expressed
b. Lack of time to listen
c. Unwillingness of the angry person to negotiate solutions
d. Tendency to prepare a defense
10. Crisis management is often caused by
a. Inappropriate workloads
b. Budget cuts
c. Lack of supplies
d. Poor planning
Chapter 13: Common Infectious Diseases
1. Improvement to the immune system of an older adult includes
a. Stress management, dehydration, decreased cigarette smoking
b. Adequate nutrition, decreased alcohol usage, fluid restriction
c. Exercise, adequate nutrition, decreased alcohol usage
d. Rest, fluid restriction, alcohol usage
2. Simple nursing and educational interventions that can aid in the prevention of urinary tract infection include
a. Catheterization
b. Adequate fluids
c. Incontinence pads
d. Exercise
3. Adequate hydration is a key to optimizing the health of many body systems, including
a. Genitourinary
b. Gastrointestinal
c. Respiratory
d. All of the above
4. Signs and symptoms of skin infections include
a. Fever, redness, pain
b. Fever, bleeding, discharge
c. Redness, pain, discoloration
d. Lesions, discoloration, fever
5. An example of a staphylococcal bacteria skin infection includes all of the following except
a. Impetigo
b. Herpes zoster
c. Boils
d. Cellulitis
6. Mr. Jones is a healthy, retired 68-year-old man. He has not been seen by his primary care physician since he was 55 years old. His immunization history is unavailable. At this time, he should be considered for
a. D/T (diphtheria-tetanus) vaccine, flu shot, pneumonia vaccine
b. Meningococcal vaccine, HepB (hepatitis B) series, flu shot
c. Flu shot, gamma shot, HepB series
d. MMR (measles-mumps-rubella) vaccine, flu shot, pneumonia shot
7. Mrs. Brown is a 72-year-old woman receiving chemotherapy treatments. Before her treatment, she became updated on all her vaccines. She and her husband are contemplating an African safari in 3 months to celebrate her anticipated remission. Mrs. Brown should consider receiving all of the following except
a. Meningococcal vaccine
b. MMR
c. Pneumonia vaccine
d. Hepatitis A vaccine
8. Mr. Arbor presents to the emergency department with a history of sudden-onset abdominal pain, fever, vomiting, and diarrhea. The LPN should consider (assuming orders)
a. Obtaining a stool culture
b. Interviewing carefully to determine recent food intake
c. Washing hands frequently
d. All of the above
9. Most food-borne diseases manifest with similar symptoms. In diagnosing the type of food-borne disease, factors that need to be considered include all of the following except
a. Number of days since exposure
b. Recent travel history
c. Types of chronic diseases present
d. Whether others became ill
10. The Richards family attended their family reunion on Saturday afternoon at the park. On Monday morning, the father, two children, and grandmother present to the emergency department with abdominal cramps, diarrhea, and fever for the last 12 hours. By history, they all ate shrimp salad, egg salad, and homemade custard, and the children drank milkshakes. A stool specimen reveals which food-borne disease?
a. Shigella
b. Cholera
c. Campylobacter
d. Salmonella
Chapter 14: Common Medical Diagnoses
1. Which of the following statements is true?
a. Chronic conditions develop rapidly and respond to prompt medical intervention
b. Chronic conditions often are not evident until they negatively affect an older person’s functional ability
c. Chronic conditions are often cured when they are detected
d. Chronic conditions are stable and unchangeable over time
2. What are the three most common chronic health conditions of older adults?
a. Diabetes mellitus, arthritis, influenza
b. Arthritis, heart disease, sensory changes
c. Arthritis, heart disease, diabetes mellitus
d. Diabetes mellitus, heart disease, pneumonia
3. Which of the following statements describes a goal for the review of systems?
a. Increase the speed and efficiency of the physical examination
b. Analyze older adults’ awareness of their body
c. Identify symptoms that affect the current health status of the older adult
d. Relax older adults so that they are less nervous for the actual examination
4. The underlying problem in myocardial infarction (MI) is that
a. The heart muscle is not receiving enough blood to operate properly
b. The heart stops pumping blood
c. The heart valves have become stiff and do not close properly
d. The major blood vessels bringing blood to the heart become occluded, causing peripheral edema and lung congestion
5. An older adult who has an MI may not have any chest pain and instead may complain of
a. Nausea and dyspnea
b. Severe constipation
c. Headache and intense hunger
d. Pain in the joints
6. Congestive heart failure is a common chronic disease of older people. Select the best description of this disease process.
a. Congested and overloaded cardiovascular system that requires the heart to work harder
b. Heart failure associated with the heart’s loss of muscle mass and efficiency in conduction of electrical impulses
c. Commonly associated with birth defects that do not manifest until old age
d. The major blood vessels bringing blood to the heart become occluded, causing peripheral edema and lung congestion
7. Which of the following is not a nursing responsibility in caring for an older adult with congestive heart failure?
a. Increase fluid intake to compensate for potential fluid depletion with the use of diuretics
b. Weigh the older adult daily at the same time
c. Assess the older adult for signs of pedal or other dependent edema
d. Provide a low-salt diet
8. Health promotion nursing interventions for older adults with hypertension include all of the following except
a. Tapering older adults off of the antihypertensive medications as soon as their blood pressure returns to normal range
b. Making diet changes to encourage weight loss, reduced salt intake, and lowered cholesterol intake
c. Monitoring blood pressure changes associated with positional hypotension
d. Encouraging a physician-ordered exercise plan
9. Leg ulcers in older adults with peripheral vascular disease (PVD) are caused by
a. Poor hygiene practices
b. Pressure from bed-bound status
c. Impaired circulation to lower extremities
d. Dryness of the older adult’s skin
10. Characteristics of a right hemisphere cerebrovascular accident (CVA) that are not usual features of a left hemisphere CVA are
a. Poor judgment and overestimation of abilities
b. Hemiparesis and hemiparalysis
c. Weakness and paralysis
d. Need for support for ambulation and activities of daily living
Chapter 15: Physiological Assessment
1. When the nurse is asking questions regarding an older person’s health history related to his or her nose and sinuses, which of the following is least appropriate?
a. History of allergies or hay fever
b. Discussion of appetite
c. History of nose trauma
d. History of colds and upper respiratory infections
2. Frank Palmer, 79 years old, has been having episodes of elevated blood pressure. Which of the following symptoms would make you concerned that his blood pressure is elevated?
a. Epistaxis
b. Neck stiffness
c. Excessive eye tearing
d. Gum tenderness and redness around the teeth
3. To examine the patency of each nostril, the nurse should
a. Examine the nasal mucosa to ensure that it is pink and moist
b. Check the older person’s sense of smell
c. Check for the presence of any nasal discharge
d. Ask the older person to inhale and exhale through each nostril while occluding the other nostril
4. Mary Jones, 85 years old, has had a cerebrovascular accident (CVA). Which of the following findings on physical examination would indicate a CVA?
a. Ptosis of both eyelids
b. Facial droop
c. Forward flexion of the neck
d. Facial edema
5. The yellowing of the lens in the aging eye may cause
a. Inaccurate color perception
b. Excessive eye dryness
c. Constricted pupils
d. Diminished visual accommodation
6. Treatment of dry eyes with saline drops is an important intervention to prevent
a. Decreased visual acuity
b. Development of cataracts
c. Double vision
d. Potential infection
7. George Handell, 78 years old, has a history of cerumen impaction. The best nursing intervention for Mr. Handell would be to
a. Instruct Mr. Handell to use cotton-tipped applicators to clean the cerumen out of his ears
b. Encourage Mr. Handell to have an audiological examination and to be fitted with hearing aids
c. Schedule appointments on a regular basis with Mr. Handell’s physician to have cerumen impaction removed
d. Refer Mr. Handell to a sign language class while he still has some of his hearing intact
8. An abnormal finding in the examination of an older person’s mouth would be
a. Pink, moist, and smooth gums
b. Varicose veins on the underside of the tongue
c. White patches along the gum line or under dentures
d. Decreased saliva production
9. Diabetic patients often have chronic arterial insufficiency. What findings during examination of the older person’s legs would indicate chronic arterial insufficiency?
a. Transparent, shiny, hairless skin
b. Varicose veins
c. Localized areas of inflammation and redness
d. Bilateral pedal edema
10. Taking blood pressure readings while the older person is lying, sitting, and standing
a. Is unnecessary, unless the older person complains of chest pain
b. Can assist in identifying orthostatic hypotension
c. Is usually done only with a physician’s order
d. Can identify the cause of increased heart rate when the older person changes positions
Chapter 16: Common Clinical Problems: Physiological
1. When an older adult reports problems with urinary incontinence, the primary goal should be to
a. Prevent urinary tract infections
b. Identify any reversible or treatable cause of the incontinence
c. Ensure that the older person is free from any skin breakdown
d. Select the type of incontinence pad that would allow the older person the most freedom and protection
2. The goal of a bladder retraining program is to
a. Increase the older person’s awareness of incontinent episodes
b. Have the older person void every 2 hours
c. Increase the period of time between voiding
d. Increase the older person’s awareness of the urge to void
3. The night nurse reports that, during the night, Mrs. Sherman fell on the floor at the foot of her bed. She was uninjured but was incontinent of urine and complained that she “could not get to the bathroom because of the side rails being up.” What is the most appropriate nursing intervention to prevent Mrs. Sherman from falling again?
a. Put the side rails down during the night
b. Place a commode next to Mrs. Sherman
c. Apply a soft waist restraint on Mrs. Sherman at night
d. Initiate a toileting program for Mrs. Sherman
4. The psychological and social impact of incontinence on an older person includes all of the following except
a. Withdrawal from social activities
b. Dementia
c. Depression
d. Diminished self-concept
5. One of the most common causes of urinary incontinence in an immobile older person is
a. Fecal impaction
b. Dietary indiscretions
c. Congestive heart failure
d. Lack of awareness of the urge to void
6. Diuretics can increase the incidence of urinary incontinence because of
a. Their chemical action on the kidneys that decreases the older person’s awareness of the urge to void
b. The increase in urine volume
c. The increased potential for older people to be dehydrated while taking these medications
d. Their ability to induce signs and symptoms of diabetes mellitus
7. Passive range of motion for an immobilized older adult
a. Replaces the need for ambulation
b. Decreases the risk of falls and skin breakdown
c. Maintains joint flexibility and delays muscle wasting
d. Increases the risk of deep vein thrombosis
8. Michael George, 78 years old, has left-sided hemiplegia related to a cerebrovascular accident (CVA) 1 month ago. He has been very depressed and noncompliant with the physical therapy regimen. Which of the following nursing interventions is important to initiate to prevent immobility for Mr. George?
a. Force him to participate in the activity program
b. Walk him to the bathroom before and after meals and before bedtime
c. Refer him to the facility social worker for counseling
d. Change his activity program to activities he can do in his wheelchair
9. Which of the following normal aging changes increase an older adult’s risk of falling?
a. Decreased cardiac output
b. Decreased aerobic reserve
c. Visual changes
d. Cognitive changes
10. Immobility is a concern for older adults who are a fall risk. Which of the following contributes to immobility?
a. Fear of falling
b. Restorative ambulation program
c. Release of safety restraints
d. Decreasing psychoactive medications
Chapter 17: Psychological Assessment
1. Which of the following is not a characteristic of mental wellness?
a. Coping creatively with life’s situations
b. Maintaining open relationships
c. Maintaining physical health despite being overwhelmed by stress
d. Having a clear purpose in life
2. Cognition is best measured by
a. Assessing mental function
b. Monitoring interpersonal communication
c. Evaluating choices
d. Reviewing educational level
3. Which of the following would be a symptom of short-term memory loss?
a. Inability to recall year of birth
b. Forgetting the names of one’s children
c. Inability to count backward from 100 by sevens
d. Always looking for glasses
4. The statement, “Where do I belong?” is an example of
a. Long-term memory loss
b. Short-term memory loss
c. Altered perception
d. Altered judgment
5. The statement, “The lady in the mirror took my dress,” is an example of
a. Long-term memory loss
b. Short-term memory loss
c. Altered perception
d. Altered problem solving
6. The statement, “High school years weren’t important to me,” may be an example of
a. Long-term memory loss
b. Short-term memory loss
c. Altered perception
d. Altered problem solving
7. The statement, “When you are old like me, what you had for breakfast isn’t important,” is an example of
a. Long-term memory loss
b. Short-term memory loss
c. Altered perception
d. Altered problem solving
8. Asking a resident to count backward from 100 by sevens is a test of
a. Perception
b. Short-term memory
c. Calculating ability
d. Problem-solving ability
9. Asking a resident to repeat three items after the nurse is a test of
a. Memory encoding
b. Memory recall
c. Short-term memory
d. Memory retention
10. Asking a resident the day, month, and year is a test of
a. Short-term memory
b. Long-term memory
c. Memory recall
d. Orientation
Chapter 19: Rehabilitation and Restorative Care
1. The goal of restorative care is
a. Maintenance of baseline function
b. Maximizing the abilities and functions of older adults
c. The same for all residents with a specific medical diagnosis
d. Based on the age of a long-term care resident
2. Which of the following statements best describes the practice role of the nurse in restorative care?
a. Provide care to support adjustment to the disease process
b. Provide care to avoid serious injury or disability
c. Provide care until the resident is discharged to home
d. Provide care to support the development of self-care abilities
3. Which of the following statements best describes the educator role of the nurse in restorative care?
a. Teaching the resident and family the importance of rehabilitation
b. Teaching the resident and family about the importance of activity after being disabled
c. Teaching the resident and family about the disease process, treatment options, and management strategies
d. Teaching the resident and family what they need to know to make choices and be involved in the restorative process
4. Which of the following statements best describes the counselor role of the nurse in restorative care?
a. Counseling residents and their families is not within the usual scope of practical nursing practice
b. Counseling residents and their families is aimed at assisting them with valuing the care they receive
c. Counseling residents and their families is aimed at assisting them with expressing their feelings and developing positive strategies to express their feelings
d. Counseling residents and their families is an important role for the interdisciplinary team
5. Which of the following statements best describes the advocate role of the nurse in restorative care?
a. As an advocate, the practical nurse uses his or her power and influence to promote an environment that supports the goals of restorative care
b. As an advocate, the practical nurse intervenes when family members do not support the plan of care
c. As an advocate, the practical nurse confronts the interdisciplinary team when their goals do not address their advocacy role
d. As an advocate, the practical nurse develops an adversarial role with the interdisciplinary team
6. Which of the following statements describes a strength of a resident for restorative care?
a. The resident cannot communicate verbally
b. The resident verbalizes complaints of pain
c. The resident has fallen when attempting to ambulate to the toilet
d. The resident coughs when eating
7. Alice Hoggan, 72 years old, is admitted to a long-term care facility after a serious myocardial infarction. After visiting with Mrs. Hoggan, the social worker is surprised that she is taking the loss of her independence and self-care ability so well. Which of the following statements addresses this assessment?
a. Mrs. Hoggan must be in the denial phase of grieving a loss
b. Mrs. Hoggan has probably withdrawn and is depressed
c. Mrs. Hoggan is probably just thankful to be alive
d. Mrs. Hoggan is demonstrating the concept that loss and its meaning vary with individuals
8. Jonas Roundy, 68 years old, had a cerebrovascular accident (CVA) 7 months ago. The physical and occupational therapy staff are very concerned regarding his slow progress. Which of the following rehabilitation principles should guide his rehabilitation?
a. Convalescence is a gradual process that can take a long time
b. The duration of rehabilitation depends on the psychological acceptance of the older adult of his or her condition
c. Loss and its meaning vary with every person
d. Values are examined and limitations are put in perspective over time
9. Oliver Jones, 71 years old, has been admitted to the long-term care facility with end-stage emphysema. He refuses to have physical therapy. He continues to smoke. He asks other residents to push his wheelchair down to the smoking room, leaves his oxygen tank in the hall, and goes into the room to smoke two to three cigarettes. When this behavior has been confronted, he responds that he enjoys smoking and that he knows that he will eventually die from emphysema. Which of the following rehabilitation principles should guide his rehabilitation?
a. Convalescence is a gradual process that can take a long time
b. The duration of rehabilitation depends on the psychological acceptance of the older adult of his or her condition
c. Loss and its meaning vary with every person
d. Values are examined and limitations are put into perspective over time
10. Donna Edelman, 79 years old, has been diagnosed with situational depression after she had to have her left leg amputated above the knee. Ms. Edelman has severe peripheral vascular disease related to diabetes mellitus. Which of the following rehabilitation principles should guide her rehabilitation?
a. Convalescence is a gradual process that can take a long time
b. The duration of rehabilitation depends on the psychological acceptance of the older adult of his or her condition
c. Loss and its meaning vary with every person
d. More severe emotional reactions are produced when disability is traumatic
Chapter 20: Pharmacology and Its Significance for Older Adults
1. Which of the following is an example of drug misuse?
a. Taking nonprescription medications without a physician’s order
b. Taking another person’s prescribed medications
c. Taking more than two prescription medications at one time
d. Taking medications out of their bottles and placing them into a medication box
2. An older adult who skips doses of medication so the medication lasts longer may be experiencing
a. Knowledge deficit related to proper dosing of medication
b. Increasing confusion
c. Financial difficulties
d. Inability to read the label for the correct dosing
3. Harold Dannon, 68 years old, had his blood pressure checked at the senior citizen center, and the nurse sent him to the physician because his blood pressure was 207/110 mm Hg. When you question Mr. Dannon about his dosage of Calan SR, he states that he quit taking it because he was too constipated. What is your best response?
a. “Mr. Dannon, you know that you have to take your blood pressure medicine no matter how you feel. You could have had a stroke in the middle of the senior center!”
b. “Constipation is a problem with that medication. What did you try to help relieve the constipation while you were taking Calan?”
c. “There are many different kinds of blood pressure medicines. You could have just called the office, and we would have called in a prescription for something else”
d. “I told you that you could get a little constipated. You can’t quit taking a blood pressure medication without first telling the doctor”
4. Slowed gastrointestinal motility and delayed gastric emptying time, coupled with a decrease in gastrointestinal blood flow in older adults, affect the
a. Absorption of medications
b. Distribution of ingested drugs through the body
c. General intolerance of oral medications experienced by older adults
d. Excretion of most drugs through the bowel
5. Protein-bound medications frequently cause side effects in older adults because
a. Older adults are more susceptible to adverse drug reactions
b. Older adults often have a decreased serum albumin level that increases the amount of free drug
c. Older adults take many drugs, and adverse drug reactions are primarily caused by polypharmacy
d. Older adults do not have adequate kidney function to excrete protein-bound drugs
6. Decreased renal excretion of drugs
a. Does not affect drug effect
b. Decreases the effect of drugs
c. Is not a concern for older adults
d. Potentially increases the effect of the drug
7. Mary Marcino, 78 years old, lives alone and has been active as a volunteer at the local children’s hospital. She was brought to the emergency department because she was confused at home and fell down a flight of stairs. After her initial physical examination, the health history revealed that she was taking a double dose of her diuretic and sleeping pills. Which of the following possibly caused Mrs. Marcino to make such a serious mistake in her medication regimen?
a. Decreased cognitive ability
b. Number of different medications and the complexity of the medication regimen
c. Generic labeling
d. Poor physical health
8. Melvin Wellington, 80 years old, is admitted with a severe exacerbation of congestive heart failure. He has 4+ pitting edema of both feet and ankles, moist crackles in the bases of both lungs, and marked shortness of breath. Which of the following could contribute to worsening of his congestive heart failure?
a. Cold remedies containing aspirin (acetylsalicylic acid [ASA])
b. Antacids
c. Alcohol
d. Laxatives
9. Which of the following is not a serious side effect related to excessive laxative use?
a. Inhibited absorption of nutrients
b. Fluid and electrolyte imbalance
c. Atonic bowel with chronic constipation
d. Daily bowel movements
10. Al Granger, 75 years old, has a history of chronic alcohol abuse. Which of the following statements would best describe his physical status?
a. Compromised dietary intake and nutritional status
b. Inappropriate weight gain
c. Inability to participate in any physical exercise program
d. Intact cognition and problem-solving ability