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Geri Final Exam
Terms in this set (128)
Therapeutic/healing touch and Reiki both involve movement of a practitioner's hands over the patient's body to balance energy fields. Which of these two practices has been shown through large-scale controlled studies to be effective?
Therapeutic/healing touch is the only therapy to be researched in a large-scale controlled study.
The ________ pathway signals the endocrine system to release hormones, particularly thyroid and adrenal, which have a direct effect on the immune system.
Guided imagery is ________.
a directed deliberate daydream that uses all senses to create a focused state of relaxation and a sense of physical and emotional well being
Among the 10 most often used natural products, which of the following is the only one that does not have any contraindications or side effects listed?
Fish oils/omega fatty acids
NCAAM classifies complementary and alternative medicines into several categories. In which category would you find a diet such as Pritikin?
Potential side effects from megadoses of ________ can cause nausea, vomiting, headache, dizziness, blurred vision, and the possible risk of osteoporosis.
Energy medicine encompasses two basic types of energy fields. Which of the two uses energy fields that can be measured and can therefore be subjected to traditional scientific research methodology?
Mr. Armstrong is a 72-year-old patient who was put on warfarin following a stroke. It is about a year post-stroke and Mr. Armstrong has an appointment with the physician. During the assessment, the nurse should ask him ________.
whether he is taking any herbal supplements or natural products
The most-used mind-body therapy used by older adults is praying for one's own health (52.1%). The least-used therapy is ________ (0.5%)
A resident of the nursing home, Mrs. Green is an 83-year-old woman who is confined to a wheel chair due to advanced osteoporosis. Her daughter read in a magazine that massage can be helpful in promoting blood circulation and relieving pain. She asks the nurse to make an appointment with the massage therapist for Mrs. Green. What should the nurse do?
Advise Mrs. Green and her daughter that massage therapy is not recommended for people with advanced osteoporosis.
According to NCCAM's definition, ________ "is a group of diverse medical and health care systems, practices, and products that are not presently considered part of conventional medicine."
complementary and alternative medicine
Which popular diet excludes dairy, eggs, meat, fish, fowl, and other animal products?
Which of the following whole medical systems is based on the concept of "like cures like"?
Which common supplement is used for symptomatic relief of organic brain dysfunction and vertigo but is contraindicated in people who have bleeding disorders or high blood sugar?
Most elders who choose complementary and alternative medicine do so because of the belief system behind the modality, not because of dissatisfaction with conventional care. But it is important for nurses to recognize that some older people choose alternative therapies because they ________ traditional medical care or medications.
don't know the difference between nontraditional and
A deficiency in vitamin ________ may mimic signs of dementia, including memory loss, disorientation, hallucinations, and tingling in the arms and legs
Which of the following is NOT one of the important questions to ask in the algorithm for choosing the proper end-of-life care provider?
Does the hospice have a special wing to separate those who will recover from those who are dying?
To identify the causes of nausea and vomiting in a terminally ill patient, it is helpful to use the acronym VOMIT, in which the letter I stands for ________.
Infection / Inflammation
Who said, "When a person is born we rejoice, and when they're married we jubilate, but when they die we try to pretend nothing happened."?
A large percentage of dying patients experience ________ in the last hours or days of life, characterized by fluctuating cognitive disturbance and changes in mental status over a short period of time. This can be very distressing to family members and friends.
Which assessment instrument can help measure the caregiver's as well as the patient's adjustments to aspects of the dying experience, but also those of the caregivers?
Which study, conducted between 1989 and 1994, reported that nurses are often the first to recognize the impending death of a patient?
The pain of those in nursing homes is generally underappreciated, underreported, and undertreated. Research has shown that between ________ of nursing home residents have undertreated, substantial pain.
45% and 80%
The Patient Self-Determination Act (PSDA) is a federal law requiring healthcare providers to routinely make available information about advance directives to their patients. Which of the following advance directives is NOT a legally recognized document for indicating one's healthcare wishes?
Allow Natural Death (AND)
What medical intervention should be carefully considered before use with a terminally ill patient because the problems and side effects associated with it can be worse than the help it provides?
Artificial hydration and nutrition
Tolerance of opioids and physical dependence on opioids are not the same as addiction to opioids, but these three terms are often confused. Which of the following statements is TRUE of opioid addiction?
A pattern of compulsive drug use characterized by continued craving for an opioid and the need to use the opioid for effects other than pain relief
A valuable non-pharmacological technique used in helping a terminally ill patient with dyspnea would be ________.
An interdisciplinary group or team (IDG/IDT) provides or supervises the care and services offered by a hospice, including ongoing assessment of the needs of the patient, the caregiver, and the family. Which of the following would be considered a complementary therapy provider rather than a primary IDG/IDT team member?
In the past, Americans often lived in multigenerational households and frequently died at home, especially in rural areas. Since the end of _______, with the increased ability to cure illness and prolong life, dying increasingly happened in a hospital setting, away from the comforts of home and family.
World War II
The goal of grieving is NOT to ________, as much of society encourages, but to figure out how to go on living without the loved one actively present in one's life.
In the EPEC Project Module 2 six-step approach to communicating bad news, the first step is "Get started." What is the second step?
Find out what the patient knows
The goal of grieving is NOT to ________, as much of society encourages, but to figure out how to go on living without the loved one actively present in one's life.
get over it
Which of the following is NOT one of the four pillars of Care Transitions Intervention (CTI)?
Non-pharmacological interventions whenever possible
________ uses an interdisciplinary team with expertise in geriatric care and training in prevention of geriatric syndromes along with environmental adaptations to support the elderly.
The Acute Care of the Elderly (ACE) Unit
Assisted living facilities (ALFs) are residential facilities that provide assistance and monitoring of older adults who can no longer live independently but who do not need 24-hour skilled nursing home care. In the United States, ALFs are regulated and licensed at the ________ level.
For patients who are home-bound, Medicare may pay for ________ services to be provided in the home.
Which of the following is a benefit to older adults of the Intergenerational Care model, such as Grand Families House in Dorchester, Massachusetts, or Hope Meadows in Rantoul, Illinois?
Increases emotional support
The ________ nurse curriculum includes training in such areas as promoting self-management, motivational interviewing, and patient-centered care planning, and techniques for visiting patients, as well as working with physicians and community resources.
Mrs. Welk is moving into an independent handicap-accessible apartment with grab bars in the bathrooms and a wall-mounted emergency home response system. She will have access to personal services such as help with her activities of daily living, managing her medications, housekeeping services, and trained medical staff. She will join other residents for meals, encouraging socialization. Mrs. Welk is moving into a(n) ________.
assisted living facility
Which model uses APNs with experience caring for older adults to provide discharge planning and home interventions for older adults who have been hospitalized?
transitional care model
Which program provides much-needed transportation services to and from the day center as well as to medical appointments as needed?
________ is a program of the Hartford Institute for Geriatric Nursing at New York University College of Nursing whose mission is to create better care environments for hospitalized older adults by improving nursing care.
Which of the following is an electronic resource, providing materials through their website to help optimize the discharge process at any institution?
________ is a model of primary care that focuses on improving the quality of care for low-income seniors by the longitudinal integration of geriatric and primary care services across the continuity of care. It was developed by Dr. Steven Counsell and his colleagues in 2007.
The Eden Alternative is based on the principle of the "three plagues" facing older adults. Which of the following is NOT one of the "three plagues"?
The first premise of the Money Follows the Person (MFP) initiative is that older people living in long-term care facilities would prefer to return to the community. What is the second premise?
Transitioning these individuals back into the community would cost Medicare less than it currently pays for their institutional care.
Which member of the interdisciplinary AD-LIFE team conducts the initial assessment of the older adult prior to his or her discharge from acute care?
Adult daycare centers provide supervised daily care in a nonresidential facility for the elderly and disabled. Approximately how many adult daycare centers are currently operating in the United States?
According to the Centers for Disease Control and Prevention National Center for Health Statistics, the leading causes of death for all five of the United States' major ethnic groups are diseases of the heart and malignant neoplasms. Which ethnic group is most likely to die of diabetes mellitus?
By paying attention to and assessing the client from the perspectives of body, mind, and spirit, the nurse is addressing the client in a(n) ________ way.
Which of the following is NOT one of the three dimensions of spirituality?
Where once America was described with the metaphor of the "melting pot," where people from different cultures blended together to assimilate into the mainstream culture, what new metaphor describes today's immigrants, who maintain aspects of their original culture while also participating in mainstream culture?
In 1960, 32.6% of the foreign-born population in the United States was age 65 or older. As of 2010, that percentage is ________.
There are significant health-related differences among the five major ethnic groups in the United States. Members of which of the following ethnic groups are LEAST likely to turn to religion or spirituality as coping or problem-solving mechanisms?
Mrs. Chin, a 79-year-old woman of Chinese heritage, is a resident in a nursing home. She has no dietary restrictions but usually doesn't eat much when meals are served. The nurse sees that her family has come for a visit and has brought many containers of home-cooked food, which Mrs. Chin appears to be enjoying. Which of the following would be appropriate for the nurse to say about it?
"It looks like you're really enjoying these dishes. Which ones are your favorites?"
When a nurse obtains admission information on the status of the client's body, mind, and spirit, two important messages are relayed to the older client. First, that the human spirit is an important part of the client's health, and second, that ________.
the nurse is available and interested in helping the client work to improve his health status
Which of the following questions would NOT be appropriate to ask as part of a first-level spiritual screening?
When is the last time that you went to church?
The idea that all people need spirituality as a way to provide meaning in their lives, and the idea that spirituality must be tied to formal religious beliefs, are both described in the chapter as ________.
Which of the following ethnic groups has recently become the second largest population demographic in the U.S.?
A nurse is conducting a second-level spiritual screen with an older client. Which of the following questions would be part of a second-level spiritual screening?
"How are your energy reserves holding up when you consider your health status at the present time?"
What percentage of the older U.S. population will eventually need some level of assistance or health care?
Mr. Ebert is an older man who has been moved to a nursing home for rehabilitation following a stroke. The nurse conducts a spiritual assessment and determines that it would be a good idea to focus on the second dimension of spirituality to strengthen Mr. Ebert's energy levels. To that end, the nurse ________.
schedules visit from Mr. Ebert's family and friends
Healthcare organizations are required to provide translation services for patients with limited English proficiency, and failing to provide adequate interpretation is considered a form of ________.
Which of the following is not true about spirituality and the nursing profession?
Nurses are educated to share the personal faith and beliefs with all patients.
Most health promotion strategies can potentially make a positive impact on sexual relationships and sexual function. Which of the following is NOT a health promotion strategy?
The introduction of sildenafil in 1998, followed by vardenafil and tadalafil, changed the norms for sexual dysfunction. Sildenafil is the generic name for ________.
Urge or stress incontinence in women can lead to vaginal infections and painful intercourse, the term for which is ________.
Vaginal dryness is traditionally treated with lubricants or with the oral or cream form of ________.
Which of the following is a nursing strategy for older adults regarding HIV infection?
Target HIV prevention efforts to older adults.
Which of the following is NOT true regarding older adults and HIV?
Homosexual sex is the dominant mode of HIV transmission in older adults.
Both erectile dysfunction and vaginal dryness may be early signs of the following diseases EXCEPT ________.
amyotrophic lateral sclerosis
Healthcare professionals tend to ignore patient's concerns about sexuality and intimacy. One reason is that sexuality is not _______ for the patient.
seen as a priority
According to an AARP survey conducted in 2004, sexuality was identified as ________ part of life by respondents age 45 and older.
In a systematic review of the literature on the primary prevention of HIV/AIDS in people age 50+, which of the following was NOT found as a major challenge to education in this area?
The ________ model of human sexual response includes desire, excitement, and orgasm.
On occasion, a nurse may be confronted by an older adult who displays sexually inappropriate behavior. Which of the following is the correct response from the nurse in such a situation?
Confront the patient calmly and firmly, saying that the behavior is not appropriate.
Displaying sexually explicit materials in a public place or where others are likely to see them is considered ________.
Sexually inappropriate behavior on the part of an elderly resident of a long-term care facility may reflect a loss of inhibition due to cognitive impairments, ________, or a combination of factors.
a power issue
One way that older couples can overcome the problem of _______ is to plan sexual activity for the time of day when they are most energetic.
In a study of changes in sexual function associated with aging, ____ of men reported erectile dysfunctions (ED), which was the most common problem among men.
"A single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person" is the definition of elder abuse according to ________.
World Health Organization (WHO)
An 82-year-old sits in her bedroom in her son's house by herself all day. Her son works long hours and is rarely home; he brings her meals on a tray in the morning and evening but hurries away to attend to his work rather than sit with her. She does not go out and nobody visits her. In this state of psychological or emotional neglect, she is at risk for what condition?
Failure To Thrive
An elderly man who has always had a difficult temperament lives in a different state from either his daughter or son. He has a room in the home of a middle-age couple, who attend to his needs. His daughter checks in regularly by telephone and thinks well of the couple. After the elderly man's death, the daughter discovers that the couple has systematically taken all of the man's money. This is a case of ________.
Violation of personal rights
Persons who do not maintain adequate physical hygiene, have a poor diet, miss medical appointments, mismanage medication, and don't follow-up with prescribed medical care are considered to be ________.
a state of self-neglect
Which of the following people is most likely to be a victim of elder abuse?
An 80-year-old woman who has been recently widowed and has a long history of alcoholism. Her friends have stopped calling since she angrily refuses their offers to visit or take her out. She is insistent that she is independent and does not need company.
The elderly most at risk for abuse are those in a(n) ________ living situation.
Which of the following is not a general characteristic of perpetrators of elder abuse?
Which of the following is NOT a nursing intervention that can help prevent elder abuse?
Encourage the older person to trust no-one and to hide valuable papers and items.
Mrs. Keppler, an elderly woman with dementia, lives with her daughter, Linda, and Linda's husband and three children. Linda brings Mrs. Keppler to her medical appointment. The nurse notices that Mrs. Keppler appears clean, well fed, and well cared for. Linda has dark circles under eyes and speaks sharply to her mother when she makes a mistake answering a question. Which nursing intervention can help prevent a case of elder abuse from developing?
Encourage regular respite for the caregiver.
Which of the following is NOT a good way for older adults to reduce the potential for abuse?
Don't tell people that you are going to be traveling or where you are going.
If an elderly patient shows signs of depression, delusions, or poor health, and is socially isolated, the nurse should consider that person as likely to benefit from _________ to prevent elder abuse.
Which of the following is NOT a sign of possible mistreatment or abuse of an elderly person?
Person is brought for treatment by their usual caregiver
Which assessment includes three categories for a total of 15 questions, including "violation of personal rights or direct abuse," "characteristics of vulnerability," and "potentially abusive situation"?
Hwalek-Sengstock Elder Abuse Screening Test
Which of the following is a sign or symptom of neglect in an older person?
Dehydration and Malnurishment
The "Three Rs" in detecting and reporting elderly abuse are ________.
recognize, respond, report
Laws about reporting elder abuse ________.
vary from state to state
The delegation process has four steps. The first is Assessment. Which of the following is NOT one of the other three steps?
Which of the following is NOT one of the four types of leadership styles identified in behavior theory?
By creating satisfying work environments that help employees to feel valued, acknowledged, challenged, and engaged in unit decision making, the nurse manager is encouraging ________.
According to the Nurse Manager Leadership Partnership (NMLP) Learning Domain Framework, which of the following functions fall with the domain "The Art: Leading the People"?
When the nurse manager makes a point of responding quickly to questions from her staff and following up on their concerns, she is demonstrating and modeling ________.
professional communication standards
Nursing homes must comply with more than ________ federal regulations at all times
The hospital administrator, Dr. Boenz, must choose between two nurses in a department for the open position of nurse manager. While both are knowledgeable in their field, Dr. Boenz notices that only one of them consistently shows a positive attitude, a willingness to collaborate with others, and the assists others to develop their practice. Dr. Boenz will choose this nurse who is demonstrating ________.
the qualities of effective leaders
Workplace leaders must deal appropriately with people of different generations. The generation born between 1981 and 1999, who bring a mastery of technology to the workplace, are known as ________.
In Kotter's Change Management Model, which activity is associated with Phase 3-Implementing and sustaining the change?
Make it stick
You are the nurse manager of a hospital department that you think needs a new computerized record keeping system. One of your best nurses is excited and eager to learn the new system, but three average nurses are resistant to the change. This situation is creating conflict between the nurses in the department. What should you do?
Focus on mutual goals among the team and encourage collaborative decision making.
Nurse managers are encouraged to build a high-performance work team. To achieve that goal, high performers should be encouraged to ________.
bring concerns and solutions forward
Which of the following is indicative of a Leader rather than a Manager?
Which of the following competencies is associated with the role of Human Resource Developer?
Develops strategies to recruit and retain, coaches, assures quality education/training, and ensures meaningful work to maximize job satisfaction of the facility's human resources
________ seek to attain a collective goal for the organization, stimulating innovative thinking and transforming followers' beliefs.
Which NMLP Learning Domain includes "personal journey disciplines"?
The Leader Within: Creating the Leader in Yourself
Which of the following is NOT one of the components of a culture of compliance with regulations?
Maintain a reactive, rather than proactive, customer service response.
The term "nonmaleficence" means ________.
not doing harm
In an overview of the international literature on ethical considerations in the field of assistive technology (AT) related mainly to older adults (especially those with dementia) who live in the community, Zwijsen et al. found three major themes. Which of the following is NOT one of those themes?
the design of AT devices
Which of the following is NOT an ethical/moral principle related to nursing?
One of the measures taken by the National Quality Measures Clearinghouse (NQMC) relates to the effectiveness of healthcare facilities in saving patients from complications vs. preventing complications. Based on the number of deaths occurring out of those discharges with potential complications of care, this is known as ________.
Failure to Rescue
An elderly patient must be able to clearly understand the treatment or care choices being offered in order to provide ________.
Because elderly patients must put their trust in the healthcare system to carry out established agreements, commitments, and responsibilities, ________ is extremely important.
Jenny, a nurse in the emergency ward of a city hospital, answers a telephone call from a man who sounds distraught. He wants to know if his wife, who did not come home when she was expected, has been admitted to the hospital. It is a quiet night at the hospital, and Jenny is aware that nobody matching the wife's description has been admitted. What should she tell the man on the phone?
That she is not allowed to say whether a particular person is in the hospital's care.
According to the Institute of Medicine (2007) report, Informing the Future: Critical Issues in Health, "the average hospital patient can expect to be subjected to at least ________."
one medication error per day
Which term refers to the value of life and the right to live?
Sanctity of life
An elderly patient wishes to document in writing that she only wants her older daughter making decisions for her if she becomes incapacitated because her younger daughter has a substance abuse problem. What legal document does she need?
Durable power of attorney
Which feature of integrity is commonly known as the Golden Rule, to treat others the way one would like to be treated oneself?
When a nurse wants to do the right thing for a patient but is limited by hospital rules and is disturbed by this conflict, the nurse experiences ________.
Autonomy, one of the ethical/moral principles associated with nursing care for older adults, can be limited by ________.
cognitive deficits that impair clarity of thought and the ability of the patient to make decisions
Which publication outlines the ethical standards of the nursing profession?
The Guide to the Code of Ethics for Nurses: Interpretation and Application
Which of the following is NOT one of the criteria to be followed by a mentally competent adult to commit suicide under Oregon's Death with Dignity Act?
being diagnosed as chronically ill
According to the principle of informed consent, which of the following is a correct element to include in a discussion with a patient about a procedure or treatment?
Advocacy for the option of taking no action
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