Test Bank Ebersole Hess Gerontological Nursing Healthy Aging 4th Edition, Touhy
Chapter 1: Introduction to Healthy Aging
1. Which option refers to the highest level of human functioning according to Maslow?
a. Biological and physical integrity
b. Safety and security
2. A man is terminally ill with end-stage prostate cancer. Which is the best statement about this man’s wellness?
a. Wellness is possible in the management of his medical care.
b. Wellness is unfortunately not a real option for this client.
c. Wellness is the same thing as faith healing, and if the client would be more receptive, then he could be back at work in a few weeks.
d. Nursing interventions can help empower a client to achieve a higher level of wellness.
3. In differentiating between health and wellness in health care, which of the following statements is true?
a. Health is a broad term encompassing attitudes and behaviors.
b. The concept of illness prevention was never considered by previous generations.
c. Wellness and self-actualization develop through learning and growth.
d. Wellness is impossible when one’s health is compromised.
4. Which cultural group is predicted to have the fastest growing older adult population in the United States between the years 2010 and 2050?
a. Native Americans
b. African Americans
c. Hispanic Americans
d. Asian/Pacific Island Americans
5. Historical influences that have shaped the lives of the majority of the middle-old population in the United States today include which of the following?
a. Influenza epidemic of 1918
b. Immigration from communist Europe
c. Child rearing in the Depression
d. World War II
6. The nurse prepares for the arrival of older adults evacuated from a hurricane to a shelter for short-term care. Which of the following is the priority nursing intervention?
a. Demonstrate that the staff is prepared to meet their needs.
b. Use individual medical records to develop a medication plan.
c. Help older adults display family photographs and memorabilia.
d. Help older adults teach one another a new skill in the shelter.
7. According to researchers, which characteristic will most centenarians share in the future?
d. Wheelchair bound
8. Which statement describes aging in developing countries?
a. Aged dependence is likely to improve from 1:4 to 1:2.
b. The biggest problem for older adults will be the lack of food.
c. Most older adults are likely to reside in these countries.
d. Similar to fertility, life expectancy is increasing, although at a different rate.
9. An older woman tells the nurse that she has experienced increasing fatigue and shortness of breath over the last 2 days. Which goal is the nurse’s priority?
a. Promote safety to prevent injury.
b. Complete nutritional assessment.
c. Balance exercise and rest periods.
d. Explore the woman’s complaints.
10. The nurse develops a community program to promote exercise for older adults. Which should the nurse include in the exercise program?
a. Reinforce the ease of exercising every day.
b. Use exercise to relax any dietary restrictions.
c. Describe ways to resume exercise after lapses.
d. Participate because exercise achieves wellness.
Chapter 2: Gerontological Nursing History, Education, and Roles
1. Identify the best statement about gerontological nursing.
a. Nurses have only recently become involved in the care of the older adult.
b. Gerontological care was the second specialty in which the American Nurses Association (ANA) offered a certification program.
c. Purposes of gerontological nursing include the promotion of health and support for maximal independence.
d. ANA certification is available only for gerontological nurses in research positions.
2. Which gerontological nursing organization welcomes nurses from all educational backgrounds?
a. The National Gerontological Nursing Association (NGNA)
b. The National Conference of Gerontological Nurse Practitioners (NCGNP)
c. The National Association of Directors of Nursing Administration in Long-Term Care (NADONA/LTC)
d. The American Society on Aging (ASA)
3. Which is an accurate statement regarding gerontological nursing education?
a. Gerontological nursing content has long been integrated into the curriculum of the typical school of nursing.
b. Undergraduate nursing programs extensively cover gerontological nursing in dedicated courses, comparable with the coverage of psychiatric nursing.
c. When content is integrated throughout a curriculum, less than 25% is devoted to geriatric care.
d. Accreditation of a nursing program guarantees that appropriate amounts of gerontological nursing content are included in the curriculum.
4. Based on current demographic data, which of the following statements identifies a predictive trend regarding the health care needs of society?
a. Most nurses will not need to care for older persons.
b. More nursing services will be required to serve the needs of the population older than 85 years of age.
c. Fewer nurses will be needed to care for older adults.
d. Older adults expect their quality of life to be less than that of earlier generations at their ages.
5. A case manager is likely to have how many years of nursing education?
a. 1 to 1.5 c. 4 to 6
b. 2 d. 8 or more
6. Which was the first formal action the ANA took in relation to gerontological nursing?
a. Established a national geriatric nursing group
b. Defined educational standards for gerontology
c. Created the ANA Division of Geriatric Nursing
d. Formed the Council of Long Term Care Nurses
7. A older man is transferred to a hospice facility with end-stage disease. Which is a suitable nursing intervention for this older adult and his family according to the goals of long-term care?
a. Decrease the analgesic dose to prevent sedation.
b. Provide a basin and towels for morning self-care.
c. Inform family members about strict visiting hours.
d. Facilitate family rituals related to death and dying.
8. A nursing home executive interviews RNs to fill a full-time position for direct patient care to maintain the standards of elder care. Which nurse should the nursing home hire?
a. Nurse from a certified college c. Nurse with 15 years of experience
b. Certified gerontological nurse d. Gerontological nurse practitioner
9. Mezey and Fulmer (2002) justify gerontological nursing research and the work of gerontological advanced practice nurses by concluding the following:
a. Other scientists devalue gerontological nursing research.
b. The research influences outcomes from nursing care in a positive way.
c. Gerontological care is expensive but required in long-term care.
d. Gerontological nursing research is well known to practicing nurses.
10. The gerontological nurse collaborates with the wound care team about an older patient who has an ulcer. How is this nurse demonstrating leadership in the care of older people?
a. Assessing older adults effectively
b. Facilitating access to elder care programs
c. Coordinating members of the health care team
d. Empowering older adults to manage chronic illness
Chapter 3: Care Across the Continuum
1. An older female resident in the residential facility keeps a large collection of personal items and photographs of her late husband on her bedside table, but the nursing assistant and resident frequently argue about this. Why should the nurse intervene between the resident and the nursing assistant?
a. Resident is attempting to maintain her sense of personal space.
b. Resident needs to accept the reality of her spouse’s death.
c. Resident’s argumentative nature can indicate early dementia.
d. Clutter from all the personal items is a safety and liability risk.
2. Which statement is true about living arrangements for older adults?
a. Older adults are more independent in their own homes than in a residential community.
b. The increase in real estate values makes home ownership essential to security.
c. Program for All-Inclusive Care for the Elderly (PACE) is a community alternative to nursing home care for frail older adults.
d. Florida is an example of a naturally occurring retirement community (NORC).
3. As the nurse admits an older woman to a long-term care facility from her home of 50 years, she mistakes the nurse for her daughter. Which diagnosis does the nurse use to plan care for this woman?
a. Hypoxia as a result of chronic disease
b. Relocation stress syndrome
c. Alzheimer disease (AD)
d. Attention-seeking behavior
4. Which statement is true about residential living for older adults?
a. A residential care facility is the new term for a nursing home.
b. An assisted living facility (ALF) must have an registered nurse (RN) on staff.
c. Administrators are realizing that their duty is to care for the residents as people.
d. A “granny flat” is an apartment in a high-rise building reserved for seniors.
5. A family that has three small children prepares to move an older female parent into their home knowing that she stays up all night. The nurse helps the family prepare for the change. Which part of planning should the nurse indicate is the family’s priority?
a. Sharing household responsibilities
b. Preparing the house for her arrival
c. Helping her use her skills and talents
d. Setting limits on nighttime activities
6. A resident of a long-term care facility has been asking to have the drain in the bathroom sink repaired for 2 months. The nurse responds by saying that when they move to the new building, the sinks will work very well. Which right of a resident of a long-term care facility has the nurse violated?
a. Right to be free of all forms of abuse
b. Right to be transferred for appropriate reasons
c. Right to voice grievances and have them remedied
d. Right to information about conditions and treatments
7. A nursing home is converting to a person-centered culture from an institution-centered culture. Which nursing intervention will be suitable in the new culture?
a. Maintain consistent resident assignments.
b. Provide structured activities for the residents.
c. Assign nursing assistants to perform bathing.
d. Determine mealtime on the basis of staffing levels.
8. The nurse prepares to transfer an older adult to a long-term care facility and calls the facility to give a report. Which nursing actions are the responsibilities of the transferring nurse and the receiving nurse?
a. Incorporating patient goals into the plan
b. Ensuring the patient is stable for transfer
c. Supplying patient documents for planning
d. Providing continuity of care during the transfer
9. The nurse assesses a resident who was transferred yesterday from an acute care hospital. Which should the nurse assess to determine whether this individual is under stress from the transfer?
a. Length of the resident’s stay in the acute care facility
b. Availability of disposition options before the transfer
c. Presence of familiar people throughout the transfer
d. Tour of the new facility shortly after transfer
10. Which is characteristic of relocation stress syndrome in a resident of a long-term care facility?
a. Agitation c. Caring family
b. Apprehension d. Hallucinations
Chapter 4: Culture and Aging
1. Which of the following is a true statement about gerontological nursing for patients of different races and ethnic backgrounds?
a. The fact that a nurse is white has no bearing on the nurse’s ability to care for minority patients or patients of color.
b. An encyclopedic accumulation of details of a particular culture is the best preparation for caring for persons from that culture.
c. A nurse who works in Illinois does not need to be as concerned about sensitivity to multiple cultures as the nurse who works in California.
d. Facial expressions, body language, posture, and touch are important elements of communication between a nurse and a patient from a different ethnicity.
2. Which of the following is a true statement about differing health belief systems?
a. Personalistic or magicoreligious beliefs have been superseded in Western minds by biomedical principles.
b. In most cultures, older adults are likely to treat themselves using traditional methods before turning to biomedical professionals.
c. Ayurvedic medicine is another name for traditional Chinese medicine.
d. The belief that health depends on maintaining a balance among opposite qualities is characteristic of a magicoreligious belief system.
3. Which of the following considerations is most likely to be true when working with an interpreter?
a. An interpreter is never needed if the nurse speaks the same language as the patient.
b. When working with interpreters, the nurse can use technical terms or metaphors.
c. A patient’s young granddaughter who speaks fluent English would make the best interpreter because she is familiar with and loves the patient.
d. The nurse should face the patient rather than the interpreter.
4. A resident in a nursing home insists that a priest hear his confession. The resident is very anxious, and the nursing home does not have a Roman Catholic chaplain. Which intervention should the nurse implement?
a. An Episcopal priest is coming to visit the home this evening. Arrange an appointment with her for the resident.
b. Report the resident’s change in behavior in detail so that the attending physician can appropriately prescribe medication.
c. Refer the resident to the staff psychologist to address the underlying cause of the patient’s anxiety.
d. Look in the local telephone book for a Roman Catholic Church, and ask the priest to visit the resident.
5. Which of the following is most likely to be true about caring for an older African-American patient?
a. The patient can expect to find support from his church after discharge.
b. During a physical assessment, an examination of the interior of the patient’s mouth with adequate light is important.
c. The patient may follow hot-cold beliefs.
d. African Americans may avoid eye contact when interacting with others.
6. An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg and refuses to remain in the bed. Which intervention should the nurse use to promote and maintain his health?
a. Have the health care provider speak to him.
b. Use principles of the holistic health system.
c. Ask about his perceptions and treatment ideas.
d. Consult with a practitioner of Chinese medicine.
7. Which action should the nurse take when addressing older adults?
a. Speak in an exaggerated pitch.
b. Use a lower quality of speech.
c. Use endearing terms such as “Honey.”
d. Speak clearly.
8. The nurse prepares an older woman, who is Polish, for discharge through an interpreter and notes that she becomes tense during the instructions about elimination. Which intervention should the nurse implement?
a. Move onto the discussion about medication.
b. Ask the older woman how she feels about this topic.
c. Instruct the interpreter to repeat the instructions.
d. Have the older woman repeat the instructions for clarity.
9. The nurse is aware that cultural competence means having the skills to put cultural knowledge to use in all of the following except:
a. Assessment c. Intervention
b. Communication d. Collaboration
10. The health care provider discusses the need for surgery with an older adult and her family. Which information about the older adult’s culture is important for the nurse to collect before this discussion to facilitate the process of informed consent?
a. Attitudes about caregiving c. Rituals for death and dying
b. Process of decision making d. Experience with discomfort
Chapter 5: Theories of Aging and Physical Changes
1. Name the theory of aging that suggests that the adverse physical effects of aging are the result of a gradual loss of control mechanisms in the pituitary and hypothalamus.
a. Free-radical theory c. Stochastic theory
b. Programmed theory d. Neuroendocrine theory
2. Decreased functioning of which physical structure is likely to result in decreased metabolism in older adults?
a. Kidney c. Brain
b. Thyroid gland d. Skeleton
3. An older female patient is reading a large-print magazine and states that reading is difficult for her in the evening. Which intervention should the nurse implement?
a. Put a high-intensity lamp at the head of her bed.
b. Explain to her that the gray-yellow ring around her cornea, arcus senilis, is interfering with visual acuity.
c. Put more powerful tubes in the fluorescent room lights.
d. Examine her retinas for signs of damage.
4. Aging ordinarily leads to decreases in which of the following?
a. Creatinine clearance and insulin secretion
b. Blood carbon dioxide and saliva production
c. Left ventricle-wall thickness and skin healing time
d. Serum triiodothyronine (T3) and gastric pepsin
5. Which change in the skin is abnormal in an older person?
a. Thinner and more fragile skin c. Greater number of freckles
b. Red, swollen 3-day-old wound d. Loss of hair on the extremities
6. The nurse designs a group exercise program at a senior center. Which room should the nurse choose for the program?
a. Room with a beautiful hardwood floor tastefully appointed with throw rugs
b. Spacious room with no windows but with fluorescent lighting and a natural stone floor
c. Room with a hardwood floor and large windows overlooking a garden area
d. End room with a linoleum floor and a fan for ventilation to compensate for the room’s broken air conditioner
7. The latest trends in medicine encourage health care providers to prescribe nutrient-dense foods and exercise to prevent or delay the shortening of telomeres. On which biological theory of aging are these practices based?
a. Genetic research c. Pacemaker theory
b. Caloric restriction d. Cross-link theory
8. During a nursing assessment, an older adult tells the nurse about increasing loss of balance. Further assessment indicates musculoskeletal changes. Which patient teaching should the nurse implement to address musculoskeletal reasons for the loss of balance?
a. Exercise with light weights.
b. Stand on one foot at a time while supported.
c. Train with the use of sit-ups.
d. Work out in a swimming pool.
9. The nurse cares for an older adult who has a prealbumin level of 10 mg/dl and an infection in a large wound. Which intervention is the nurse’s priority?
a. Monitor temperature and leukocytes.
b. Provide assistance with meal planning.
c. Provide high-quality protein in the diet.
d. Maintain oxygen saturation above 95%.
10. An older man who paints houses for a living has had a myocardial infarction (MI). Which intervention should the nurse implement to prevent adverse health effects from his occupational history?
a. Provide low-cholesterol diet meals.
b. Avoid substances that are hepatotoxic.
c. Promote coughing and deep breathing.
d. Analyze the electrocardiogram’s rhythm.
Chapter 6: Social, Psychological, Spiritual, and Cognitive Aspects of Aging
1. Which of the following is a true statement about the theories of aging?
a. Research data support the disengagement theory, activity theory, and continuity theory.
b. Everyone should be able to achieve the three tasks of Peck’s model of integrity.
c. The exercise of rights is not a task of aging in Kelly’s model.
d. A person may choose to avoid pursuing inner discovery in older age.
2. Which of the following is a true statement about neuropsychiatric function in older adults?
a. Overall cognitive abilities are progressively degraded by neuron loss in the cerebral cortex with aging.
b. Improving cognitive functions in an older person calls for sporadic mental activity around ideas the person finds significant and interesting.
c. Nerve cells regenerate in the hippocampus.
d. Mood does not influence an older person ability to remember verbal instructions.
3. Which of the following statements is true about social and emotional health of older adults?
a. Contemporary society has strong norms for the behavior of adults older than 80 years.
b. The transition to old age entails a declining level of contribution to others as one becomes increasingly dependent on them.
c. Computers and the Internet have little to contribute to older adults in their need for social support.
d. Nurses are often significant sources of social and emotional support for older adults.
4. Which role is most likely to have a significant effect on the type of aging process experienced by the older adult?
a. Grandparent c. Friend
b. Spouse d. Parent
5. The children in an African-American family attended college because their mother worked two jobs as they were growing up. She never finished high school, the children are grown, and she lives alone in retirement. Which noted weakness of sociological theories on aging explains why the social exchange theory is not applicable to this older adult?
a. Gender c. Ethnicity
b. Culture d. Opportunity
6. In which context are members of a cohort described when using the age-stratification theory to explain the effect of similar events, conditions, and circumstances?
a. Historical c. Sociological
b. Biological d. Chronological
7. An older patient who was just diagnosed with a terminal disease states, “All my life I attended church, but I am still worried about what will happen after death.” The nurse’s best response is which of the following?
a. “The unknown may be frightening. Do you want to talk about this?”
b. “Religious people know that God is a good God.”
c. “People that have had near death experiences say it is peaceful.”
d. “You must feel good about attending church most of your life.”
8. An older man with severe knee pain tells the nurse how he lost his job and his home after starting a new business when he was 48 years old. Now he lives alone and relies on Social Security. Using Jung’s theory, what in this individual’s life is the most pivotal in his personality development?
a. Living alone c. Severe knee pain
b. Meager income d. Job and home loss
9. The nurse plans care for older adults who are in good health but isolated from their families. If the nurse’s goal is to move the adults toward gerotranscendence, which intervention should the nurse use in the plan of care?
a. Give a daily tea party for the group.
b. Call each family to encourage visiting.
c. Assist them to resume midlife patterns.
d. Help each person with individual activities.
10. The nurse observes older female adults learning advanced knitting techniques. The nurse concludes that this learning activity is suitable for these women because it accomplishes which of the following?
a. Helps maintain joint flexibility
b. Improves the group’s cohesiveness
c. Provides a needed social opportunity
d. Adds to their existing knowledge base
Chapter 7: Assessment and Documentation for Optimal Care
1. Which option is not a primary reason that documentation is important?
a. Documentation enables the team to provide care to meet a resident’s individual needs.
b. Documentation helps defend the nurse in the event of a possible lawsuit.
c. Documentation enables a patient to receive consistent care from one shift to the next.
d. Documentation is the basis for reimbursement to the facility.
2. What is a SOAP note?
a. Record of supplies used in patient hygiene
b. Record of an event during a patient’s stay, formatted according to the Simple Object Access Protocol (SOAP), enabling it to be easily transmitted between computers
c. Form of bar code
d. Record of patient data listing the patient’s subjective complaint, objective data recorded by the nurse, the nurse’s assessment of the situation, and the nurse’s plan of action
3. Which of the following is a true statement about documentation?
a. Nurses should keep records of patients’ wishes.
b. Patients do not have access to their own medical records.
c. The Outcomes and Assessment Information Set (OASIS) is a complete record of the health status of a patient.
d. The nurse is responsible for completing all of the Minimum Data Set (MDS).
4. Which one of the following is connected with the nursing home reform mandated by a 1987 law?
a. Resident Assessment Instrument (RAI)
d. Fulmer SPICES
5. An older woman has diabetes mellitus and requires hemodialysis for renal failure. She is discharged to home to recover from a sternal wound infection and coronary artery bypass graft surgery (CABG). A home care nurse will provide wound care. Which of the following is the majorjustification for the complete and accurate documentation of this older adult’s care?
a. Requires complex health care
b. Has needs in multiple settings
c. Is at risk for iatrogenic problems
d. Has significant health care expenses
6. The nurse scans an older man’s identification band in preparation for medication administration. Which step should the nurse implement next?
a. Ask the patient to state his name.
b. Check for allergies to the medication.
c. Document the medication as given.
d. Administer the patient’s medication.
7. Which of the following does the nurse use to categorize the desired end result of nursing care delivered to a patient when using problem-oriented nurses’ notes?
a. North American Nursing Diagnosis Association (NANDA) nursing diagnosis
b. Nursing Goals Classification
c. Nursing Outcomes Classification (NOC)
d. Nursing Interventions Classification (NIC)
8. Which documentation tool does the nurse use to achieve optimal functional status for a nursing home resident?
a. Narrative patient progress notes
b. Problem-oriented documentation
c. Resource Utilization Group (RUG)
d. Resident Assessment Instrument (RAI)
9. Using the RAI, the nurse identifies a trigger for a male nursing home resident who requires an indwelling urinary catheter from the MDS. Which should the nurse do next?
a. Develop an individualized care plan.
b. Assign suitable nursing interventions.
c. Use the RAPs.
d. Institute agency-approved catheter care.
10. The federal government requires the use of a specific standardized documentation tool for home nursing care. Which information must a home nurse add to the approved documentation tool?
a. Activity c. Functional
b. Vital signs d. Demographic
Chapter 8: Safe Medication Use
1. Which pharmacokinetic parameter is affected most by decreased intestinal motility related to the aging process?
a. Absorption c. Metabolism
b. Distribution d. Excretion
2. Which process is increased in the early morning?
a. Fibrinolytic activity c. Asthma symptoms
b. Blood plasma d. Rheumatoid arthritis pain
3. Which interaction between each prescription and food or nutritional supplement is favorable?
a. Warfarin (Coumadin) and ginkgo biloba
b. Terazosin (Hytrin) and increased fluids
c. Lithium (Eskalith) and low-sodium diet
d. Warfarin (Coumadin) and leafy, green vegetables
4. Which medication is correctly matched to the condition given of an older adult patient according to current medical knowledge?
a. Methylphenidate (Ritalin) for depression at bedtime
b. Buspirone (BuSpar) for chronic anxiety states
c. Amitriptyline (Elavil) for depression in the morning
d. Haloperidol (Haldol) long-term for psychotic behavior
5. In questioning an older adult, which question is likely to elicit the most accurate information about the individual’s adherence to the medication plan?
a. “You take digoxin (Lanoxin) at the correct time, don’t you?”
b. “Why didn’t you take all of your digoxin (Lanoxin) last month?”
c. “How many doses of digoxin (Lanoxin) do you think you missed?”
d. “You have never missed a dose of digoxin (Lanoxin), have you?”
6. Which of the following is on the list of drugs considered suitable for the older adult?
a. Indomethacin (Indocin) c. Chlorpheniramine (Chlor-Trimeton)
b. Reserpine (Reserpine) d. Bupropion (Wellbutrin)
7. A patient receives heparin daily. The nurse should assess for which clinical response that indicates the need to discontinue heparin therapy?
a. International normalized ratio (INR) of 2.5
b. Platelet count of 150,000/mm3
8. A geriatric nurse practitioner prescribes an antidepressant for a patient. The patient asks, “How long will I have to be on this medication before I feel like my old self?” The nurse recalls that a therapeutic response to an antidepressant medication most often takes which one of the following?
a. 24 hours c. 2 weeks
b. 2 days d. 2 months
9. The nurse prepares to administer vancomycin (Vancocin) to an older adult. Which laboratory test should the nurse review before administering this medication?
a. Stool culture c. Creatinine clearance
b. Serum potassium d. Alkaline phosphatase
10. The nurse prepares to administer diltiazem (Cardizem LA) to an older adult with ischemic heart disease. When is the optimal time to administer this medication to help prevent complications of heart disease associated with rhythmical variations?
a. Midday c. At breakfast
b. At bedtime d. Every 4 hours
Chapter 9: Nutrition and Hydration
1. Which combination is suitable for the daily diet of older adults?
a. Vitamin B12, 2.4 mcg; and fiber, 15 g
b. Three 8-oz glasses of fluid; and 1600 calories
c. Vitamin B12, 1.1 mcg; and 40% of daily calories from fat
d. Calcium, 1200 mg; and vitamin D, 600 to 800 units
2. Which is a common age-related physical change that may affect digestion and food intake?
a. Loss of the majority of taste buds
b. Decreased motility in the esophagus
c. Decreased cholecystokinin secretion
d. Loss of smell
3. Which of the following is a true statement about nutrition for older adults?
a. The older person should be encouraged to practice strict controls on cholesterol intake to ensure protection against heart disease.
b. Transportation can be a critical factor in nutritional insufficiency in older adults.
c. Soul food is a concern primarily for the African-American culture.
d. No government programs promote congregate dining among older adults.
4. Which of the following is a true statement about dental health in older adults?
a. Most people can expect to lose most of their teeth by old age.
b. Excessive saliva production is a common problem among older adults.
c. Dentures should be cleaned once a day by brushing and soaking in a cleaning solution.
d. A little blood on the toothbrush is normal.
5. Which intervention should the nurse use to decrease the risk of burns during mealtime in patients with mental and physical impairments?
a. Wait until the drink has cooled.
b. Assist patients with warm drinks.
c. Use plastic mugs instead of ceramic.
d. Serve only cold beverages to patients at risk.
6. The nurse is trying to improve the nutritional status of residents in the nursing home. Which recommendations should the nurse implement?
a. Develop a seating chart for the main dining room based on the unit to facilitate a more organized and efficient meal delivery.
b. Replace the fluorescent lighting with candles at every table to create a cozy, restaurant-like atmosphere.
c. Provide nutritious food according to the residents’ expressed food preferences with a liberal use of seasonings that do not exceed any sodium restrictions.
d. Distribute “med-pass” nutritional supplements.
7. The nurse instructs the unlicensed assistive personnel to feed an older adult. If the nurse is unable to observe feeding directly, then which action should the nurse use to assess the older adult’s risk for aspiration immediately after feeding?
a. Note food volume eaten. c. Inspect for pocketing.
b. Observe skin color. d. Monitor for bradypnea.
8. An older adult with a gastrostomy tube has difficulty using the dominant hand. Which of the following should the nurse provide to prevent complications of the gastrostomy tube?
a. Use foam swabs to brush the teeth.
b. Provide oral care every 4 hours.
c. Supply a soft tooth brush and floss.
d. Position the patient at 90 degrees for tube feedings.
9. The nursing home staff needs assistance to feed properly the residents who need assistance with feeding. Which of the following should the nurse implement to ensure that the residents are properly fed?
a. Instruct the feeding assistants to feed four people at a time.
b. Draw on the availability of family members who are able to follow instructions.
c. Ask some residents to self-feed for part of the mealtime.
d. Assign a small group of nursing assistants to do the feeding.
10. The nurse is feeding an older adult patient with hemiparesis as a result of a stroke. Which intervention by the nurse is most important when feeding this patient?
a. Allow time to empty the mouth between bites.
b. Provide foods that require chewing.
c. Offer small sips of fluids with each bite.
d. Serve pureed foods only.
Chapter 10: Elimination
1. Which of the following is a true statement about elimination in older adults?
a. Defecation less than once each day is not necessarily constipation.
b. Mineral oil is recommended as a laxative for the older adult.
c. Excessive sleep can be a symptom of constipation.
d. Leaking liquid feces should be treated as diarrhea.
2. Which action should be included in all bladder-retraining programs?
a. Toileting at bedtime c. Toileting every hour
b. Using adult incontinence pads d. Providing 1000 ml of fluids daily
3. The nurse understands that stress incontinence occurs:
a. With a urinary tract infection (UTI)
b. Because of emotional strain
c. As a result of increased intraabdominal pressure
d. With a specific amount of urine in the bladder
4. What is the most important aspect of care for the nurse to maintain when assisting an older patient with urinary incontinence?
a. Availability of protective rubber garments
b. Using indwelling urinary catheters
c. Using smooth muscle relaxants
d. Maintaining an attitude that is respectful and positive about resolving the problem
5. Which option is part of a program that addresses bowel incontinence in an older adult patient?
a. Ensuring that a toilet or commode is readily accessible to the patient
b. Encouraging the intake of 1 liter of water each day
c. Expecting a rapid and full recovery
d. Toileting the patient 10 to 15 minutes after meals
6. An older adult who is on bed rest after surgery is prescribed morphine for pain. Which of the following is the nurse’s priority for preventive care?
a. Constipation c. Poor solid food intake
b. Diarrhea d. Poor liquid intake
7. The nurse is caring for a patient who has recently had an indwelling catheter placed. The nurse should assess the patient for:
a. An increase in oral fluid intake c. Upper back pain
b. A change in mental status d. A decrease in activity
8. The nurse assesses a male resident in a nursing home for urinary incontinence and determines that he is unaware of the problem. Which recommendation should the nurse implement?
a. Limit oral fluid intake. c. Apply absorbent undergarment.
b. Provide regular toileting. d. Encourage frequent rest periods.
9. A large residual urine volume characterizes what type of incontinence?
a. Urge c. Overflow
b. Stress d. Functional
10. An older adult is in the hospital because of heart failure and has become incontinent of urine. Which evidence-based resource should the nurse use to guide continence care for this patient?
a. Nursing Standard Practice Protocol
b. The Borun Center training modules
c. Toolkit from the American Geriatrics Society
d. The Centers for Medicare and Medicaid Services
Chapter 11: Rest, Sleep, and Activity
1. Which of the following is a true statement about sleep in older adults?
a. The time spent in bed increases, but the time spent asleep decreases.
b. The amount of leg movement during sleep remains steady throughout life.
c. Rapid-eye-movement (REM) sleep becomes more unevenly distributed with age.
d. The amount of stage III sleep increases steadily throughout life.
2. Which of the following is a true statement about sleeping in older adults?
a. Older adults tend to fall asleep quickly but are awakened throughout the night.
b. Sleep disturbances in the older adult can be caused by cardiovascular disease, arthritis, or diabetes.
c. Benzodiazepine agents are the medications of choice for sleep disorders.
d. Selective serotonin-reuptake inhibitors (SSRIs) can alleviate sleep disturbances caused by depression.
3. An older man has Alzheimer disease, and his wife says he is up and wandering around the house at night. Which intervention should the nurse implement to increase the man’s duration of sleep?
a. Instruct the wife to increase his daily physical activity.
b. Collaborate with the health care provider to administer a hypnotic medication.
c. Teach the wife how to apply a vest restraint during sleep.
d. Help the wife plan daily periods for napping and activity.
4. Exercises are prescribed for older adults as therapy to improve which one of the following qualities?
a. Relative intensity c. Muscle retraining
b. Muscle strength d. Body sculpting
5. Which of the following is important to include in the initial assessment for older adults who are frail and beginning an exercise program?
a. Exercise tolerance testing (ETT)
b. Financial ability to pay for training sessions
c. Medical history and physical examination
d. Pulmonary function tests (PFTs)
6. During the night, an older woman complains to the nurse that she has not slept more than 2 hours since admission to the hospital. Which intervention should the nurse implement to increase the duration of this woman’s sleep?
a. Inquire about her sleep habits used at home.
b. Suggest that she avoid napping during the day.
c. Tell her that sleep is fragmented in older people.
d. Offer a book to her or suggest watching a movie.
7. What is the difference between rest and sleep?
a. Sleep occurs with rest.
b. Rest is an extension of sleep.
c. Rest occurs only in brief periods.
d. Sleep is restorative and recuperative.
8. An older woman maintains an active lifestyle playing various games with friends. She reports to the nurse that she experiences wakefulness during the night and an inability to fall asleep after waking up at night. Which intervention should the nurse implement to improve the quality of this woman’s sleep?
a. Recommend preparation for sleep.
b. Suggest trying a cup of warm milk at bedtime.
c. Inquire about her nightly sleep rituals.
d. Propose volunteer work at a thrift shop.
9. The nurse completes an admission assessment on an older adult patient. The nurse identifies which factor that may contribute to sleep problems?
a. Exposure to sunlight c. Use of a sleep aid
b. Polypharmacy d. Decreased fluid intake
10. The nurse expresses concern about a female nursing home resident in the team meeting. Which resident information determines the team’s priority in planning her care?
a. Experiences several interruptions with sleep
b. Has had coronary bypass graft surgery during the last year
c. Needs increasing help with personal hygiene
d. Eats insufficient calories to maintain her weight
Chapter 12: Promoting Healthy Skin and Feet
1. Which of the following is an important consideration about the skin of an older adult person?
a. Generous amounts of soap should be used for cleansing.
b. Sweat gland activity increases.
c. Skin becomes more vulnerable to damage.
d. Skin becomes darker in unexposed areas.
2. A dermatologist should promptly evaluate which one of the following skin lesions?
a. Circumscribed, raised area resembling a blob of brown wax
b. Multicolored raised lesion with a fuzzy border
c. Bright red, glazed area with satellite lesions around it
d. Brown spot on the skin with no raised area
3. Which topical agent is safe to apply?
a. Cornstarch to absorb moisture in the groin area
b. Betadine to disinfect a healing pressure ulcer
c. An over-the-counter preparation to dissolve a corn
d. Light mineral oil to moisten skin after bathing
4. An older patient complains of dry skin and asks for advice. Which advice should the nurse offer for improving dry skin?
a. Add oil to the bath water to keep skin soft.
b. Use tepid bath water.
c. Move to a climate with lower humidity.
d. Vigorously dry skin with a rough towel after bathing.
5. Which of the following is a true statement about impaired skin integrity?
a. Stage III pressure ulcer cannot regress to stage II because the subcutaneous tissues regenerate.
b. Stasis ulcer is another term for pressure ulcer.
c. Muscle and fat cannot regenerate.
d. Weight reduction is recommended to help prevent pressure ulcers.
6. An older adult woman complains of foot pain from a corn. After assessing her feet, which intervention should the nurse implement to alleviate her discomfort safely?
a. Cut out an oval corn pad to make a U shape.
b. Use a corn pad slightly larger than the corn.
c. Gently remove the corn with a sterile razor blade.
d. Tape her toe with the corn to the other toes.
7. Which of the following is a true statement about skin care for older adults?
a. A licensed practical nurse is qualified to care for the feet of a patient with diabetes.
b. Onychomycosis is quickly eradicated with antifungal creams or powders.
c. A ram’s-horn nail should be cut to give a smooth, rounded edge.
d. Maintaining oral hydration may reduce the incidence of xerosis.
8. The nurse plans care to protect the skin covering an older adult’s greater trochanter. Which of the following interventions is the nurse’s priority when the older adult is positioned on the side?
a. Implement a turning schedule.
b. Place a cushion between the knees.
c. Keep the skin clean and dry.
d. Use the Sims’ position.
9. An older adult is vitamin deficient. Which of the following does the nurse offer to the older adult to provide the important missing vitamin for maintaining healthy skin and enhancing tissue repair?
a. Carrot sticks c. Orange slices
b. Nonfat milk d. Unsalted nuts
10. The nurse monitors for which clinical indicator when the older adult complains of pruritus?
a. Coarse skin c. Brownish skin
b. Brown macule d. Regional edema
Chapter 13: Promoting Safety
1. Which one of the following is a true statement about mobility and safety for older adults?
a. Use of restraints on older patients helps prevent injuries from falls.
b. Falls that do not cause physical injury are not significant.
c. The get-up-and-go test provides a measure of a patient’s energy and initiative.
d. Lowering the bed and fluorescent tapes are interventions to increase safety.
2. The nurse can place an older adult into one of four patient rooms. Which is the most suitable room for an older adult?
a. Brightly lit, blue room with cozy throw rugs
b. Room with orange carpeting and soft lighting
c. Brightly lit, blue room with waxed vinyl floors
d. Room for television and children’s playtime
3. Which of the following is a true statement about assistive devices to aid older adults with impaired mobility?
a. A walker can be used when climbing stairs.
b. Cane tips should be smooth.
c. Older adults save money by adapting assistive devices from their friends.
d. A cane is most useful for unilateral disabilities but not bilateral problems.
4. The overall temperature in your gerontological unit is 62° F during the evening shift. In documenting this concern to the administration, which factor is the most important for the health and well-being of older adults?
a. It is not fair for older adults to have to deal with an uncomfortable environment.
b. Some of the residents are wearing blankets around their shoulders to keep warm.
c. An ambient temperature of 62° F is unsuitable for older people because they have impaired thermoregulation.
d. It feels much warmer in the administration wing than out in the patient care areas.
5. Which of the following statements is true about a safe, effective care environment for older adults?
a. Cold beer with steak and potatoes is a good meal for an older adult on a hot day.
b. Older drivers are more likely to be in a fatal motor vehicle accident than younger drivers.
c. Barrier-free buses and low fares make public transit a safe transportation option.
d. A nurse’s perception of temperature is a useful guide for patient thermal needs.
6. The health care provider has not ordered the use of a restraint for an alert patient at high risk for falling. The nurse should implement which side rail use?
a. Two full-length rails
b. One -length rail
c. No side rails
d. Four -length rails
7. After assessing the older man in his bed, the nurse determines that he is at high risk for falls. The nurse leaves the room to get a fall risk sign and returns to find him on the floor pleading for help. Which of the following was the most important intervention the nurse should have implemented to prevent this event?
a. Call for someone to bring the sign.
b. Show the older man how to use the call bell.
c. Provide a urinal and drinking water.
d. Instruct the patient to call for help.
8. An older man was oriented and responded appropriately in the hospital, but he is now disoriented and confused in his home after discharge. Which of the following issues is the first that the home nurse should examine to determine whether an environmental issue is contributing to the patient’s condition at home?
a. Complaints of shivering
b. Temperature of household
c. Types of food preparation
d. Presence of radon
9. The nurse assesses the quality of which of the following patient characteristics when applying the Get-Up-and-Go test from the Hendrich II Fall Risk Model?
10. An older woman who receives intravenous (IV) fluids is making wide gesticulations with her arms and loudly insulting the nursing staff. Which intervention should the nurse implement to maintain safe, effective nursing care initially?
a. Apply bilateral upper extremity restraints.
b. Administer haloperidol (Haldol) for agitation.
c. Close the door to her room to reduce the noise.
d. Determine the patients needs.
Chapter 14: Living with Chronic Illness
1. An older female patient is diagnosed with a chronic illness. Which of the following principles should the nurse apply when answering her questions?
a. The most prevalent form of disease in the United States is acute illness.
b. Usually, chronic disease has a negligible impact on the family.
c. Chronic illness is unending, and coping can be influenced by the perception of uncertainty.
d. Older adults successfully cope with chronic disease by learning about the disease.
2. Which of the following is a true statement about Medicare for older adults?
a. Eighty percent of Medicare’s annual expenditures are for individuals with chronic illnesses.
b. Medicare enrollees spend under $1500 annually for out-of-pocket expenses related to chronic illnesses.
c. Complementary and alternative medicines (CAM) are not covered by Medicare.
d. Medicare covers care for those who have trouble with activities of daily living.
3. Which of the following describes the nurse’s role for an older patient with a chronic illness?
a. Implement an individualized therapeutic regimen that brings about a cure.
b. Provide caring to help the patient live at the optimal level of health and wellness.
c. Suggest that the patient accept eventual death to reduce the burdens on the patient’s family.
d. Encourage the patient to minimize the use of services to control costs.
4. Which of the following statements is true about rehabilitation and restorative care for older adults?
a. The purpose of rehabilitation and restorative care is to regain specific abilities lost because of a condition.
b. Rehabilitation consists primarily of regular physical therapy sessions.
c. A person can learn skills and gain abilities that enable functioning.
d. The patient’s capabilities are recognized at the time of admission.
5. Which of the following statements is the most suitable for establishing goals when teaching an older adult with a chronic illness about potential changes in the health maintenance regimen?
a. Management of the patient’s chronic disease rests on the patient and the caregiver; therefore the goals should be collaboratively set.
b. The patient will be able to make needed changes in his or her life if the nurse provides accurate, written instructions.
c. Psychological functioning is usually impaired only to a small extent in a patient with a chronic illness.
d. The patient’s values, culture, and beliefs will have little to do with the types of changes he or she will be able to make.
6. Acute illness is to chronic illness as to which of the following comparisons?
a. An emergency department is to a nursing home
b. A hospital staff nurse is to a nurse practitioner
c. Health insurance is to Medicare for older adults
d. Inpatient surgical care is to outpatient medical care
TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment
7. An older woman has severe osteoporosis in the long bones, impaired mobility, and chronic pain. Which acute illness or condition is this woman most likely to experience as a result of osteoporosis?
a. Peripheral neuropathy c. Intertrochanteric fracture
b. Chronic stable depression d. Opioid analgesic addiction
8. Over 50% of the population, aged 65 years and older, suffers from which one of the following chronic health conditions?
a. Hypertension c. Multiple sclerosis
b. Renal failure d. Cancer
9. An older man who is right-handed works as a carpenter, but he has been left with a flaccid right arm after a thrombus occluded a cerebral artery. Which is the most important goal for the plan of care to help this man achieve his optimal state of health and wellness?
a. Maintain skin integrity of right arm.
b. Collaborate with occupational therapy (OT).
c. Promote plaque-reversing strategies.
d. Support effective coping mechanisms.
10. An older woman has diabetes mellitus. Which patient assessment validates the nurse’s conclusion that she is in the foreground perspective of the shifting perspectives model of chronic illness?
a. Has an amputation of two toes.
b. Lives at home with her husband.
c. Frequently self-checks her blood sugar.
d. Changes the battery in her glucometer.
Chapter 15: Pain and Comfort
1. Compared with acute pain, which of the following statements is true of persistent pain?
a. Leads to significantly altered vital signs.
b. Is usually described as a burning pain.
c. Is generally gone within 4 months.
d. Can bring about long term changes in lifestyle.
2. The nurse admits an older man who had abdominal surgery. Admission vital signs are heart rate (pulse) (P), 73 beats per minute (bpm); respiration rate (R), 20 breaths per minute; blood pressure (BP), 136/84 mm Hg. He is receiving intravenous (IV) fluids but has not requested pain medication since surgery. Seven hours later, his vital signs are P, 98 bpm; R, 26 breaths per minute; and BP, 164/90 mm Hg; and he denies pain. Which intervention should the nurse implement?
a. Administer an opioid medication by IV route.
b. Check the surgical dressing for bleeding.
c. Report the vital signs to the health care provider.
d. Ask if he has about discomfort at the surgical site or any other location.
3. An older woman had hip replacement surgery 1 day ago, and the nurse thinks that the woman also has dementia. Which patient assessment does the nurse use to determine whether this woman is experiencing pain?
a. Holds abdomen tightly. c. Is not verbalizing.
b. Has stable vital signs. d. Moves during sleep.
4. The safest opioid analgesic choice for an older patient who has severe acute pain is which of the following?
a. Meperidine (Demerol) c. Morphine sulfate (Morphine)
b. Pentazocine (Talwin) d. Safe opioids do not exist.
5. Which of the following statements is true about analgesic medications for older adults?
a. Opioids are less effective in older patients than in younger patients.
b. Stool softeners and laxatives should be used with opioids.
c. Over-the-counter NSAIDs are generally harmless.
d. The dose limit for acetaminophen is difficult to reach for older adults.
6. Each of the following is a nonpharmacological intervention for pain except which one?
a. Acupuncture treatments c. Lidocaine patch
b. Adjuvant therapy d. Capsaicin
7. An older adult admitted for back surgery asks for opioid pain medication. The nurse knows the patient asks for pain medication 15 minutes before it is due. Which recommendation should the nurse implement?
a. Validate the pain with other assessment data.
b. Administer the pain medication as requested by the patient.
c. Tell the patient that it is too soon for pain medication.
d. Teach the patient alternative comfort measures.
8. The nurse administers an opioid analgesic to an older male postoperative patient in the surgical unit. Which is the most important intervention for the nurse to implement before leaving the patient’s room?
a. Place side rails up x 4.
b. Position the patient comfortably.
c. Offer toileting and a sip of water.
d. Instruct him to ask for help before getting up.
9. The older adult is at a higher risk for acute psychological pain than a younger adult because older adults:
a. Have many illnesses. c. Experience more loss.
b. Possess fewer assets. d. Live with impairments.
10. An older man who had a gastric resection states that he wants to ambulate but the osteoarthritis (OA) in his knees causes too much pain. Which intervention should the nurse implement to increase the amount of walking this man can perform?
a. Encourage the patient to keep his leg elevated.
b. Instruct him to rest until the pain disappears.
c. Suggest taking pain medication before walking.
d. Collaborate with the health care provider to make a walker available.
Chapter 16: Diseases Affecting Vision and Hearing
1. Which of the following diseases affects the eyesight of an older adult by damaging the central part of the retina?
d. Macular degeneration
2. Which of the following is used to treat the most common cause of impairment to an older person’s hearing?
a. Hearing aids
b. Cochlear implants
c. Ear canal irrigation
d. Sign language
3. A medical illustration shows a man with the blunt end of a tuning fork pressed to the center of his forehead. The man is being tested for which of the following?
a. Sensorineural hearing loss
d. Unilateral conductive hearing loss
4. Persons with normal age-related sensory changes are likely to have the most difficulty distinguishing which of the following?
a. Spoken pairs of phrases like “she’s praised” and “fees raised”
b. Orange towel hanging on a beige wall
c. “Go” and “to” in lowercase letters in fine print
d. Spoken word pairs like “cupful” and “capful”
5. Which of the following interventions should the nurse use when communicating with a hearing impaired older patient.
a. Stand beside the patient’s chair when speaking.
b. Always clearly identify yourself and others with you.
c. Exaggerate your voice, depending on the cause of the hearing loss.
d. Select colors for paint, furniture, and pictures with rich intensity.
6. The nurse plans the care of an older female resident of a nursing home who has experienced a sudden deterioration in visual acuity. Which intervention should the nurse complete first?
a. Prevent behavioral and social decline.
b. Tell her to hold onto the rails during ambulation.
c. Examine her mood and functional status.
d. Use problem solving involving the resident.
7. The most detrimental illness or condition that an older adult with deafness that occurred at birth can experience is which one of the following?
8. An older man who has tinnitus complains to the nurse that it is very annoying. Which should the nurse implement to alleviate the stress he is experiencing from tinnitus?
a. Irrigate the bilateral Eustachian tubes.
b. Assess for modifiable risk factors.
c. Propose a hearing aid and a masker.
d. Use white noise to override the tinnitus.
9. An older adult complains about experiencing dry eyes daily. Which of the following should the nurse assess to help determine the cause of the patient’s complaint?
a. Vitamin B deficiency
b. Use of humidifier at home
c. History of diabetes mellitus
d. Prescription antihistamine use
10. The nurse is teaching older adults about maintaining health and wellness. Which recommendation should the nurse include in the teaching to maintain optimal vision?
a. Take 50,000 units of vitamin A daily.
b. Wear sunglasses that block sun rays.
c. Read in good light to avoid eye strain.
d. Visit the ophthalmologist every 5 years.
Chapter 17: Metabolic Disorders
1. Which of the following statements is true about diabetes mellitus?
a. Type 2 diabetes is the result of the failure of the pancreas to produce insulin.
b. Diabetes is diagnosed after two fasting plasma glucose readings over 125 mg/dl.
c. Non–insulin-dependent diabetes mellitus is another name for type 1 diabetes.
d. The incidence of diabetes mellitus does not increase with age.
2. Which laboratory results are goals for reducing a person’s risk for diabetes and heart disease?
a. Triglycerides over 150 mg/dl
b. Cholesterol 250 mg/dl
c. High-density lipoprotein (HDL) over 40 mg/d
d. Fasting blood glucose under 150 mg/dl
3. When teaching a patient about foods that do not increase blood glucose, which should the nurse include?
a. White bread c. Broccoli
b. Baked beans d. Corn
4. Which of the following statements is true about medications taken by individuals with diabetes mellitus?
a. Sitagliptin (Januvia) is indicated to treat type 1 diabetes mellitus.
b. Nateglinide (Starlix) increases the secretion of insulin.
c. Metformin (Glucophage) increases the secretion of insulin.
d. Rosiglitazone (Avandia) decreases glucose absorption.
5. An older man with diabetes mellitus complains to the nurse that his feet feel like they are burning. Which of the following interventions should the nurse recommend to this older adult to reduce his discomfort?
a. Wear well-fitting, leather shoes
b. Wear knee-high nylon stockings
c. Soak the feet in warm water
d. Apply antifungal powder on the feet
6. An older woman who has diabetes mellitus takes glipizide (Glucotrol) and tells the nurse that her blood sugar levels have been higher than normal since she began using a vaginal cream for hot flashes. Which one of the following interventions is the best for the nurse to implement?
a. Ask the patient if she has had a fever or infection recently.
b. Verify the expiration date of the medication.
c. Review her diet for increased carbohydrates.
d. Ascertain whether the vaginal cream contains estrogen.
7. The older adult who has type 2 diabetes mellitus has a sensory impairment and unstable blood sugar levels. Which of the following alterations in sensory function does the nurse address in the plan of care for stabilizing the blood sugar?
a. Requires reading glasses at 2.0 strength.
b. Has difficulty hearing in crowded rooms.
c. Enjoys spicy food more than bland food.
d. Awakens with periodic left-foot numbness.
8. An older man comes to a primary care setting, and his reason for seeking health care is to get a prescription for sildenafil (Viagra). Which of the following laboratory reports can help explain why this individual needs sildenafil?
a. Serum potassium 4.5 mEq/L
b. Prothrombin time 13 seconds
c. Alanine transferase (ALT) 50 units/L
d. Glycosylated hemoglobin (Hgb A1c) over 8%
9. Which is the most important medication the nurse administers to a patient with diabetes mellitus to attenuate a metabolic disorder that is closely associated with diabetes mellitus and that accelerates the disease processes are associated with diabetes mellitus?
a. Atorvastatin (Lipitor) c. Calcium citrate (Citracal)
b. Colchicine (Colsalide) d. Aluminum hydroxide (Amphojel)
10. Which co-morbidity commonly associated with type 2 diabetes mellitus enhances the development of the microvascular complications of diabetes mellitus?
a. Hyperlipidemia c. Venous insufficiency
b. Hypothyroidism d. Chronic constipation
Chapter 18: Bone and Joint Problems
1. Which of the following is a true statement about osteoporosis (OA)?
a. OA is indicative of an underlying health problem.
b. The most common site for OA fractures is in long bones.
c. African-American women have the highest risk for OA.
d. A high risk of death follows an OA-related fracture.
2. Which is a healthy practice recommended for a person at risk for OA?
a. Milk and orange juice at breakfast; cheese pizza at lunch; spaghetti served with spinach covered with melted cheese for dinner; and ice cream for dessert
b. Long-term estrogen administration as adjunct therapy
c. Alendronate (Fosamax) taken with a snack just before bedtime
d. Coffee, raisin bran and milk, and sausage at breakfast; a can of cola and a hot dog on a high-fiber bun at lunch; cocktails before dinner; steak with brown rice, celery, and red wine for dinner
3. Which of the following is a true statement about joints in older adults?
a. OA is an inflammatory joint disorder.
b. Surgical joint replacement can cure OA.
c. Joint damage in OA is reversed with medication.
d. Very old patients should avoid joint replacement surgery.
4. Which of the following statements is true about RA?
a. Strikes unilaterally.
b. Affects more men than women.
c. Can affect body systems other than the joints.
d. Glucosamine can be helpful for patients in the first 2 years of RA.
5. Which of the following nursing interventions are suitable for a patient who has gout?
a. Nonsteroidal antiinflammatory drugs (NSAIDs)
b. Liquid paraffin hand baths
c. Colchicine (Colsalide) by mouth
d. Hyaluronic acid injections
6. An OA-related fall necessitated hip replacement surgery for an older woman who is entering a rehabilitation facility. Which of the following is the nurse’s priority goal during this woman’s rehabilitation?
a. Incorporate whole grains into her diet.
b. Recapture preoperative mobility status.
c. Keep the surgical wound clean and dry.
d. Tell her to take two steps into the walker.
7. An older woman seeks advice from the nurse about preventing further bone loss after being diagnosed with osteopenia. To achieve the woman’s goal, which of the following patient teachings should the nurse provide to enhance the activity of the osteoblasts?
a. Limit sodium intake. c. Eat high-fiber foods.
b. Refrain from alcohol use. d. Exercise with weights.
8. An older adult who has OA receives a prescription for alendronate (Fosamax). Which instruction should the nurse include in patient teaching?
a. Use with a bisphosphonate medication.
b. Is available for oral use.
c. Take this medication for up to 2 years.
d. Consume up to 600 mg of calcium daily.
9. After living with OA for 2 years, an older woman’s bone density scan shows no improvement, despite consistent bisphosphonate therapy. Which intervention should the nurse implement to reduce bone loss for this older adult?
a. Add tai chi or yoga exercises.
b. Instruct her to drink fortified milk.
c. Increase weight-bearing exercises.
d. Review her daily nutritional habits.
10. Which assessment is typical for a patient with OA?
a. Narrow joint spaces with crepitus
b. Effects in symmetrical joints
c. Morning stiffness for at least an hour
d. Swelling from excess synovial fluid
Chapter 19: Cardiovascular and Respiratory Disorders
1. Which of the following is a true statement about heart disease in older adults?
a. Myocardial infarction (MI) has many of the same symptoms in older patients as in middle-aged persons.
b. Both excessive urination at night and decreased urination can be signs of heart failure (HF).
c. Any exertion on the part of an older adult patient with heart disease can bring on another heart attack.
d. A person with HF is likely to have trouble breathing, except when lying down.
2. An older man in a cardiac rehabilitation exercise class refuses to participate in the cool-down phase of the activity; consequently, 2 minutes later, he passes out but quickly regains consciousness. Which instruction does the nurse include in patient teaching to reinforce the importance of cooling down after exercising to this man?
a. Cardiac output diminishes with age.
b. Mobility capacity decreases with age.
c. Baroreceptor function diminishes with age.
d. Sensory perception diminishes with age.
3. Which of the following is a true statement about heart disease in older men and women?
a. More women than men die from MIs.
b. Cardiac care for men and women is equally aggressive.
c. Cardiac medications have been tested on men and women equally.
d. Women generally receive less aggressive treatment than men do.
4. Which condition is a COPD?
a. Bronchial asthma c. Bacterial pneumonia
b. Histoplasmosis d. Mycobacterium tuberculosis
5. An older woman who has COPD wants to perform self-care activities. Which instruction should the nurse include in patient teaching to help her achieve this goal?
a. Bathe and eat slowly with periodic rest.
b. Walk short distances without oxygen.
c. Perform all activities of daily living (ADLs) and then rest.
d. Bathe right after eating, and then rest.
6. Which of the following statements is true about cardiopulmonary disease in older adults?
a. COPD can be reversed with proper treatment.
b. Chest radiographic studies are a reliable indicator of whether pneumonia is present in an older patient.
c. Persons older than 65 years should receive Pneumovax annually.
d. Mouth hygiene is essential to prevent and treat pneumonia.
7. Which of the following is a true statement about tuberculosis (TB) in older adults?
a. The principal threat from TB is its highly contagious nature.
b. The tuberculin purified protein derivative (PPD) is a conclusive test for TB.
c. Antimicrobial drugs have made TB an infection of the past.
d. Older persons, particularly those in nursing homes, are at risk for TB.
8. An African-American 58-year-old man in good health has a blood pressure at 120/73 mm Hg at his annual physical examination. Which of the following is the best goal for the nurse to use to assist him in maintaining his health and wellness into older age?
a. Alter modifiable risk factors.
b. Prevent cardiovascular disease.
c. Recognize disease in early stage.
d. Maintain tight glycemic control.
9. An older woman has severe ischemic heart disease, hypertension, and low cardiac output. Which medication does the nurse administer to counteract the neurohormonal activation of this patient’s cardiovascular status?
a. Loop diuretic c. Cardiac glycoside
b. Nitroglycerin d. Beta-adrenergic blocker
10. Which classic sign of an acute myocardial infarction (AMI) can be absent in an older man with an AMI?
a. Vague complaints c. Crushing chest pain
b. Epigastric burning d. Dyspnea and fatigue
Chapter 20: Neurological Disorders
1. Which of the following statements is true about Parkinson disease (PD)?
a. Drinking large amounts of alcohol can relieve symptoms of essential tremor.
b. Motor tremors and slow movement accompany severe cognitive impairment.
c. Lewy body dementia (LBD) is the most common form of dementia.
d. Older adults taking rasagiline (Azilect) must avoid eating foods containing tyramine.
2. An older man comes to the emergency department after falling at home, and he reports that he cannot walk without losing his balance. Which steps should the nurse implement for this patient?
a. Arrange to transfer him immediately to the radiology department.
b. Determine symptom onset or when he fell at home.
c. Organize the reperfusion tissue plasminogen activator (tPA) infusion.
d. Perform a comprehensive neurologic assessment.
3. Which of the following statements is true about dysarthria?
a. Does not affect intelligence.
b. Stems from severe rheumatoid arthritis.
c. Physical therapy can be beneficial.
d. Can affect the balance.
4. A new nurse in a long-term care facility is caring for a patient with PD. The nurse should note which one of the following actions related to PD that is observed during the assessment?
a. Tremors during sleep c. Frequent blinking
b. Cogwheel rigidity d. Fast movements
5. An older adult arrives at the emergency department with a probable diagnosis of a hemorrhagic stroke. The nurse understands, based on the patient’s age, that the most likely cause is which one of the following?
a. Intracranial hemorrhage c. Thrombosis
b. Decreased cardiac output d. Uncontrolled hypertension
6. After completing an admission assessment on a patient who recently suffered a stroke, the nurse should choose which of the following nursing diagnoses as a priority?
a. Risk for inury c. Altered cerebral perfusion
b. Altered thought process d. Decreased mobility
7. A home health nurse is completing an admission on a patient who recently experienced a transient ischemic attack (TIA). During the assessment, the patient begins to complain of a severe headache and numbness in his left arm. Which action should the nurse take next?
a. Instruct the patient to take Tylenol.
b. Ask whether patient suffers from migraine headaches.
c. Reschedule the visit.
d. Call 9-1-1.
8. The nurse in a rehabilitation center is caring for a patient who has new-onset stroke with right-side hemiparesis. Which intervention should the nurse implement when caring for this patient?
a. Orders a two-person assist with a transfer.
b. May need to incorporate repetition.
c. Gives the patient a dry erase board.
d. Raises all four side rails.
9. The nurse is caring for a patient who has had a stroke. The nurse is concerned the patient will develop contractures. Which intervention should the nurse implement?
a. Use tennis shoes while in bed.
b. Turn the patient onto the affected side, resting on the shoulder.
c. Use paraffin wax for hand soaks.
d. Conduct passive range-of-motion movements to the affected extremities.
10. The nurse is caring for a patient diagnosed with PD. Which tool should the nurse use to gather information from the patient’s perspective?
a. The Geriatric Depression Tool
b. The Sickness Impact Profile (SIP)
c. The Mini-Mental State Examination–2nd edition (MMSE-2)
d. The Montreal Cognitive Assessment Tool
AND MUCH MORE