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Terms in this set (324)

According to the 2010 U.S. Census, approximately how many Americans are older than age 65?
1) 2%
2) 5%
3) 13%
4) 20%

What is the average life expectancy today?
1) 70.2 years
2) 75 years
3) 81.1 years for women and 76.3 years for men
4) Longer for men than for women

3) 81.1 years for women and 76.3 years for men

Which statement is NOT true about holistic nursing?
1) Holistic nursing focuses on the specific disease or disorder a person has in order to treat it effectively.
2) Holistic nursing aims to treat the whole person, not just a specific disease or disorder the person may have.
3) Holistic nursing focuses on the individual patient and uses many techniques, such as empathetic listening, music, and imagery, as well as specific clinical skills.
4) Holistic nursing weaves the technical skills of nursing with the social science skills that enhance communication and rapport between the nurse and the person receiving care.

ANS 1). Holistic nursing focuses on the specific disease or disorder a person has in order to treat it effectively.

The Science of Human Caring theory was developed by
1) Florence Nightingale
2) Clara Barton
3) Jean Watson
4) Savage and Money

3) Jean Watson

Which is NOT emphasized in The Science of Human Caring?
1) Providing transpersonal caring
2) Focusing on the person while you are with him or her
3) Ensuring that all nonessential tasks, such as bathing, are given according to a strict schedule
4) Reaching out to the patient, making eye contact, touching if appropriate, speaking softly

3) Ensuring that all nonessential tasks, such as bathing, are given according to a strict schedule

Which of the following is included as a basic concept of holistic nursing?
1) Using your developed clinical expertise
2) Developing a close relationship with the patient's family members and significant others
3) Remembering the personal intuition and creativity of patients in your nursing plan
4) All of the above

4) All of the above

Most elderly people having a heart attack have
1) Pain diffused over the entire chest area
2) No pain
3) Crushing sternal pain
4) Pain on the left side of the chest and pain that radiates down the left arm

2) No pain

Compared with the doses of medication given to a young adult, the doses given to an old-old person are usually
1) Smaller
2) Larger, because the old-old person is probably sicker
3) The same
4) Minimal, because the person is very old and probably near death

1) Smaller

What communication technique has been developed specifically for dealing with demented elderly persons?
1) Cognitive therapy
2) Validation therapy
3) Geriatric Depression Scale
4) Mini-Mental Status Examination (MMSE)

2) Validation therapy

An 82-year-old patient is diagnosed with liver cancer and has long-standing cardiovascular problems. The patient begins screaming and pushes his meal tray away. What would be an appropriate response?
1) Take the meal tray and leave the room without saying anything.
2) Tell him to stop screaming in a loud voice.
3) Calmly ask him what he is upset about and listen carefully to him.
4) Call your supervisor.

3) Calmly ask him what he is upset about and listen carefully to him

The nurse is overhead addressing an 87-year-old patient as "honey." What is this an example of?
1) Beneficence
2) Paternalism
3) Caring
4) Malfeasance

2) Paternalism

The term "elite-old" is used for people
1) 65 to 74 years old
2) 75 to 84 years old
3) 85 to 100 years old
4) Older than 100 years

4) Older than 100 years

Which is a key concept in holistic nursing?
1) Following physician instructions and follow-up with the physician
2) Developing a relationship with family members of the patient
3) Using what you have learned—your clinical experience
4) All of the above

4) All of the above

How should the nursing instructor explain the term "gerontology" to a new class of students?
1) It means the use of older medications to treat illnesses.
2) It comes from a Greek word that means "related to old age."
3) It focuses on the housing needs of people who are underserved.
4) It is a way of explaining health problems of people over age 50.

2) It comes from a Greek word that means "related to old age."

During lunch a nursing colleague states that she never wants to be assigned to care for an older patient. What behavior is this nurse demonstrating?
1) Ageism
2) Stereotyping
3) Ethnocentricity
4) Personal preference

1) Ageism

How should a nursing instructor explain the term "baby boomers" to new students?
1) People who have large families
2) People who advocate for the care of infants
3) People who have decided not to have large families
4) People born between 1946 and 1965 after World War II

4) People born between 1946 and 1965 after World War II

What explains the decline in the elderly black population since 1980?
1) Diabetes
2) Homicides
3) Hypertension
4) Heart disease

2) Homicides

Why are older people more likely to participate in exercise programs?
1) They have more time to exercise.
2) They are trying to avoid boredom.
3) They initiated the fitness movement.
4) They want to spend time with their grandchildren.

3) They initiated the fitness movement.

What information would be helpful when explaining Social Security to a group of new nursing students?
1) It is a federal and state supported process that provides health care to financially disadvantaged people.
2) It is federal regulation providing health care for individuals older than age 65 or individuals who are permanently disabled.
3) It is a federal benefit check paid to persons older than age 65 or persons with disabilities who are unable to work.
4) It is a federal benefit check paid to retired workers of a specific age, disabled workers of any age, and spouses and minor children of deceased workers.

4) It is a federal benefit check paid to retired workers of a specific age, disabled workers of any age, and spouses and minor children of deceased workers.

What should be used to describe a nursing philosophy to a new nursing student?
1) It is a personal concept.
2) It defines goals and aspirations.
3) It outlines steps to a successful career.
4) It recognizes the importance of education.

1) It is a personal concept.

Which behavior demonstrates that a nurse is developing a healing relationship with a patient?
1) Answering a call light using the intercom system
2) Telling a patient that there is no time to try something new
3) Sitting down in the patient's room to discuss the plan of care
4) Reminding a patient that other patients are waiting for the nurse

3) Sitting down in the patient's room to discuss the plan of care

Which skill is essential to promote holistic nursing?
1) Critical thinking
2) Active listening
3) Time management
4) Care coordination

2) Active listening

Who should the nurse identify as being members of the holistic health-care team for an older patient?
1) The nurse, doctor, and pharmacist
2) The nurse, dietician, and discharge planner
3) Those who will help meet the patient's needs
4) The social worker, physical therapist, and nurse

3) Those who will help meet the patient's needs

Which action demonstrates a safe environment?
1) Telephoning a patient prior to arriving for a home visit
2) Mounting grab bars near the commode and in the shower
3) Ensuring that a patient receives a requested daily newspaper
4) Making sure that the television in the room has adequate volume

2) Mounting grab bars near the commode and in the shower

What action should a nurse take who desires to become a more caring nurse?
1) Become a caring person.
2) Ensure adequate daily rest.
3) Set aside time for personal activities.
4) Consume nutritious meals and exercise.

1) Become a caring person.

An older patient with heart failure refuses any diagnostic tests and does not want to take any medication because of having limited health insurance. Which action should the nurse take that demonstrates caring?
1) Recommend that the patient be discharged home as soon as possible.
2) Ask family members if they are willing to help pay for the patient's care.
3) Contact a social worker to talk with the patient about health insurance coverage.
4) Find out if the patient has any resources that can be liquidated to pay for the care.

3) Contact a social worker to talk with the patient about health insurance coverage.

During a home visit, an older patient is planning to have dinner with a close friend and then see a movie. What does this behavior indicate to the nurse?
1) Industry
2) Self-absorption
3) Identity diffusion
4) Gerotranscendence

4) Gerotranscendence

The home health nurse is completing an admission assessment of an older patient. Which health problems should the nurse identify as being leading chronic diseases of older adults? Select all that apply.
1) Cancer
2) Diabetes
3) Heart disease
4) Hypertension
5) Multiple sclerosis

2) Diabetes
3) Heart disease
4) Hypertension

What should be identified as reasons for the increased number of older adults in today's society? Select all that apply.
1) Better nutrition
2) Earlier retirement
3) Increased exercise
4) Improved health care
5) Consistent sanitation

1) Better nutrition
4) Improved health care
5) Consistent sanitation

What should the instructor emphasize as being essential elements of a nursing philosophy with beginning students? Select all that apply.
1) Simple
2) Popular
3) Specific
4) Meaningful
5) Inexpensive

1) Simple
3) Specific
4) Meaningful

The fastest growing segment of the population in the United States is
1) Teenagers
2) Babies
3) People older than 85 years of age
4) People between the ages of 20 and 40

ANS. 3) People older than 85 years of age

An 88-year-old retired school principal who lives alone has neighbors who believe his home is dark, dirty, smelly, and without modern conveniences. The neighborhood children think he is a "crazy old man." What does this describe?
1) Racism
2) Sexism
3) Ageism
4) Patriotism

ANS. 3) Ageism

Which statement reflects respect for people who are older?
1) Getting old is a hopeless downward spiral toward death.
2) As people get older, they become very self-centered.
3) Older people maintain unique and individual characteristics.
4) Older people become very rigid and are unable to learn new things.

ANS. 3) Older people maintain unique and individual characteristics

Normal physiological aging is
1) A predictable and uniform process
2) Reflective of individual diversity
3) Accompanied by extreme mood swings and predictable depression
4) Primarily related to chronic disease processes

ANS. 2) Reflective of individual diversity

What is LEAST likely to affect the aging process?
1) Life experiences
2) Financial resources
3) Stress management style
4) Social support system

ANS. 2) Financial resources

The normal aging process is accompanied by
1) Potential problems in functional ability
2) Chronic disease processes
3) Regression from previous social activities
4) A characteristic depression related to multiple losses

ANS. 1) Potential problems in functional ability

The leading cause of death in older adults is
1) Stroke
2) Heart disorders
3) Cancer
4) Pneumonia

ANS. 3) Cancer

. Which theory is NOT considered to be a psychological theory of aging?
1) Subcultural theory
2) Wear and tear theory
3) Developmental tasks theory
4) Continuity theory

ANS. 2) Wear and tear theory

According to Erik Erikson's eight stages of life theory, the task of old age is
1) Integrity vs. Despair
2) Industry vs. Inferiority
3) Identity vs. Role Confusion
4) Generativist vs. Stagnation

ANS. 1) Integrity vs. Despair

Which is NOT a characteristic of physiological theories of aging?
1) Genetics
2) Nutrition
3) Personality
4) Wear and tear of the body

ANS. 3) Personality

. What is considered normal aging of the cardiovascular system?
1) Strengthened heart contractions
2) Decreased cardiac output
3) Flaccid and thinned heart valves
4) Dilation of blood vessels

ANS. 2) Decreased cardiac output

What determines an older adult's ability to function?
1) Driving a car
2) Quality of life
3) Working, driving, shopping, and exercising as usual
4) Performance of activities of daily living (ADLs), instrumental ADLs, and quality of life

ANS. 4) Performance of activities of daily living (ADLs), instrumental ADLs, and quality of life

Which does NOT contribute to increased residual lung volume in an older patient?
1) Kyphosis
2) Decreased elastic recoil
3) Decreased number of functioning alveoli
4) Decreased efficiency of gas exchange in the alveoli

ANS. 4) Decreased efficiency of gas exchange in the alveoli

One of the best ways for the nurse to promote normal respiratory function with older adults is to
1) Encourage daily walks.
2) Encourage frequent naps and rest periods.
3) Discourage strenuous lifting and physical activity.
4) Teach the use of inhalers in case of respiratory emergencies.

ANS. 1) Encourage daily walks.

Which is NOT an expected age-related change affecting the respiratory status of an older patient?
1) Weakened abdominal muscles
2) Elongation of the thoracic spine
3) Increased rigidity of the rib cage
4) Increased thickness of the alveolus capillary membrane

ANS. 2) Elongation of the thoracic spine

Which is NOT considered a common complication of inactivity in an older adult?
1) Decreased energy
2) Decreased bone mass
3) Decreased muscle mass
4) Decreased joint range of motion

ANS. 1) Decreased energy

What effect do age-related changes of the skin have on an older patient?
1) Effects joint mobility
2) Alters temperature regulation
3) Impacts the ability to ambulate
4) Influences clothing style choices

ANS. 2) Alters temperature regulation

Which is one of the most effective ways to minimize the aging changes of the skin?
1) Wash the skin daily with soap.
2) Avoid excessive sun exposure.
3) Use a vitamin E-fortified lotion every day.
4) Use rose milk lotion on the skin every day.

ANS. 2) Avoid excessive sun exposure.

What can slow musculoskeletal changes in an older adult?
1) Exercising
2) Restricting calcium intake
3) Napping throughout the day
4) Eating a diet high in carbohydrates

ANS. 1) Exercising

What is the best advice for an older person who complains of never being hungry?
1) Try eating six small meals throughout the day.
2) Force yourself to eat at least three meals a day.
3) As people get older, they may need to eat only one meal a day.
4) Avoid eating roughage and drinking large amounts of fluid.

ANS. 1) Try eating six small meals throughout the day.

Which body system is most highly influenced by previous life patterns and environmental conditions?
1) Circulatory
2) Integumentary
3) Respiratory
4) Gastrointestinal

ANS. 2) Integumentary

Which statement is most true about enlargement of the prostate gland in older men?
1) It is a normal aging change.
2) It indicates the presence of cancer.
3) It is related to a high incidence of impotence for older men.
4) It decreases the incidence of urinary incontinence for older men.

ANS. 1) It is a normal aging change.

Incontinence is a problem for many older women. The normal aging change that contributes to stress incontinence for older women is
1) Decreased bladder capacity
2) Decreased renal blood flow
3) Reduced glomerular filtration rate
4) Loss of mass and strength of perineal muscles

ANS. 4) Loss of mass and strength of perineal muscles

Painful intercourse and vaginal infections can be associated with
1) Loss of pubic hair
2) Urinary incontinence
3) Decreased vaginal secretions
4) Decreased perineal muscle mass

ANS. 3) Decreased vaginal secretions

What sleep pattern change is most stressful to older adults?
1) Frequent wakening
2) Shorter sleeping time at night
3) Inability to nap during the day
4) Feeling of being less rested after sleeping all night

ANS. 4) Feeling of being less rested after sleeping all night

Which are the most common gastrointestinal problems for older adults?
1) Indigestion, diarrhea, and anorexia
2) Constipation, bulimia, and indigestion
3) Indigestion, constipation, and anorexia
4) Flatulence, diarrhea, and intestinal cramps

ANS. 3) Indigestion, constipation, and anorexia

How do older adults adapt to their slowed response time?
1) Giving up activities such as driving
2) Increasing accuracy of their responses
3) Avoiding situations that require quick responses
4) Using ambulation aids to decrease the chance of falling

ANS. 2) Increasing accuracy of their responses

Decreased tearing of the eyes increases the incidence of
1) Glaucoma
2) Eye infections
3) Corneal abrasions
4) Cataract formation

ANS. 2) Eye infections

Which is an age-related change in hearing for older adults?
1) Loss of low-frequency tones
2) Loss of high-frequency tones
3) Generalized loss of all frequencies
4) Loss of high-frequency and low-frequency tones

ANS. 2) Loss of high-frequency tones

What should the nurse do to help an older patient improve hearing?
1) Speak loudly.
2) Speak slowly in a normal tone.
3) Speak slowly with an increased pitch.
4) Mouth words slowly so that the older adult can read lips.

ANS. 2) Speak slowly in a normal tone.

Which are the preferred colors to use for signs, curb markings, and stair edgings for older adults?
1) Red and green
2) Blue and green
3) Yellow and red
4) Blue and yellow

ANS, 3) Yellow and red

Which change in the aging eye increases risk of falling?
1) Decreased tearing
2) Yellowing of the lens
3) Increased sensitivity to glare
4) Decreased dark and light accommodation

ANS. 4) Decreased dark and light accommodation

A 78-year-old patient has both ears impacted with cerumen. Why is the incidence of cerumen impaction increased for older adults?
1) Increased keratin in cerumen
2) Increased production of cerumen
3) Decreased bathing because of skin dryness, so ears do not get cleaned as often
4) Older adults are less likely to be in the habit of using cotton-tipped applicators to clean out their ears

ANS. 1) Increased keratin in cerumen

An 84-year-old patient is experiencing decreased reaction time while driving and some dizziness when getting out of his car. What should the nurse realize about this patient's symptoms?
1) Secondary to diet
2) Indicative of senile dementia
3) Part of the normal aging process
4) Indicative of decreased mental capabilities

ANS. 3) Part of the normal aging process

Which is NOT included during the assessment of ADLs?
1) Eating
2) Moving
3) Cooking
4) Dressing

ANS. 3) Cooking

Which would NOT be included when assessing instrumental activities of daily living (IADLs)?
1) Toileting
2) Cleaning
3) Managing finances
4) Taking medications

ADL. 1) Toileting

Which are NOT considered to be signs of wear and tear on the body as the result of aging?
1) Slow gait
2) Replaced knees
3) Use of a walker
4) Chronic diseases

ANS. 4) Chronic diseases

What information does NOT need to be collected when first interviewing an elderly patient?
1) Nutrition
2) Family history
3) Chronic diseases
4) Number of friends

ANS. 4) Number of friends

Why is it common for an older adult to feel colder and have decreased diaphoresis, even with an elevated body temperature?
1) Increased body fluid
2) Alterations in appetite
3) Decreased subcutaneous fat
4) Difficulty with bowel elimination

ANS. 3) Decreased subcutaneous fat

An older patient is experiencing skin breakdown. What should the nurse identify as the reason for this health problem?
1) Clustering of melanocytes
2) Decreased sweat production
3) Decreased subcutaneous fat
4) Dryness and reduced skin elasticity

ANS. 4) Dryness and reduced skin elasticity

What should the nurse realize is the reason for an older patient to have an increase in blood pressure?
1) Reduced blood volume
2) Increased rigidity of heart valves
3) Increased rigidity of vascular walls
4) Diminished strength of cardiac muscle

ANS. 3) Increased rigidity of vascular walls

An older patient is experiencing a drop in blood volume. What should the nurse realize is the age-related reason for this?
1) Decreased physical activity
2) Increased daily urine output
3) Reduced oral intake of fluids
4) Decreased amount of total body water

ANS. 4) Decreased amount of total body water

What should the nurse identify as the reason for an older patient to have a decrease in hematocrit and hemoglobin levels?
1) Increased oral fluid intake
2) Decreased rigidity of heart valves
3) Increased rigidity of blood vessels
4) Reduced bone marrow production

ANS. 4) Reduced bone marrow production

The nurse is preparing to assess the respiratory status of an older patient. What should the nurse realize about this status in relation to cardiovascular functioning?
1) The degree of changes within both systems will be minimal.
2) The changes within both systems appear suddenly, causing acute health problems.
3) Changes in the respiratory system are gradual and the older patient will compensate.
4) Changes in the cardiovascular system are gradual and the older patient will compensate.

ANS. 3) Changes in the respiratory system are gradual and the older patient will compensate.

An older patient has osteoporosis. What effect should the nurse expect this health problem to have on the patient's respiratory status?
1) Improved cough reflex
2) Improved lung capacity
3) Reduced lung space and air flow
4) No change to the respiratory status

ANS. 3) Reduced lung space and air flow

What impact do good nutrition, exercise, and stress control have on longevity according to the genetic theory of aging?
1) Experiencing an early death
2) Adding 15 years to life expectancy
3) Reducing risk factors for chronic disease
4) Prolonging or improving the quality of life

ANS. 4) Prolonging or improving the quality of life

What concept is used to describe today's nursing homes?
1) Hospice care
2) Palliative care
3) Custodial care
4) Rehabilitative care

ANS. 4) Rehabilitative care

Which nursing statement takes the concept of ageism into consideration when caring for an 85-year-old patient with renal failure?
1) "Mr. Martin, how are you doing this morning?"
2) "Now, you know you shouldn't do that, baby doll."
3) "Hon, how would you like your eggs in the morning?"
4) "You are doing such a good job with dialysis, sweetie."

ANS. 1) "Mr. Martin, how are you doing this morning?"

The nurse is caring for an 80-year-old patient with lung disease. Which action indicates that the nurse understands the wear and tear theory of aging when caring for this patient?
1) Reviews the importance of a daily intake of adequate calcium
2) Asks the patient at what age the patient's mother and father passed away
3) Stops and rests for a few seconds when walking with the patient down the hall
4) Suggests that the patient use a wheelchair to reduce the time needed to get to physical therapy

ANS. 3) Stops and rests for a few seconds when walking with the patient down the hall

An older patient used to be a teacher but after being diagnosed with a health problem the patient began to write educational materials. Which theory explains this patient's actions?
1) Continuity
2) Subculture
3) Wear and tear
4) Developmental tasks

ANS. 1) Continuity

Which statement can be used to define health for an older adult?
1) Expecting to enjoy perfect health until death
2) Realizing that no one leaves this life alive and death occurs to us all
3) Understanding that the body wears out and nothing can be done about it
4) Functioning at the highest potential in the presence of age-related changes

ANS. 4) Functioning at the highest potential in the presence of age-related changes

The nurse suspects that an older patient is having difficulty with the developmental task of integrity vs. despair. Which behaviors caused the nurse to make this clinical determination? Select all that apply.
1) Anger
2) Depression
3) Reading the newspaper
4) Feelings of inadequacy
5) Laughing with grandchildren

1) Anger
2) Depression
4) Feelings of inadequacy

What should the nurse realize about the normal aging process? Select all that apply.
1) Normal aging does not indicate decline.
2) People become more diverse as they age.
3) Age-related changes are the same in everyone.
4) Normal aging and disease cannot be separated.
5) Adapting to the aging process is accomplished by many adults.

1) Normal aging does not indicate decline.
2) People become more diverse as they age.
5) Adapting to the aging process is accomplished by many adults.

An older patient is experiencing shortness of breath with household activities. Which respiratory changes with aging could explain this patient's symptoms? Select all that apply.
1) Loss of lung elastic recoil
2) Larger and thinner alveoli
3) Increased surface area for gas exchange
4) Thickening of the alveolar-capillary membrane
5) Reduction in the number of functioning alveoli

1) Loss of lung elastic recoil
2) Larger and thinner alveoli
4) Thickening of the alveolar-capillary membrane
5) Reduction in the number of functioning alveoli

The nurse is concerned that an older patient is experiencing age-related changes to the gastrointestinal system. What findings caused the nurse to have this concern? Select all that apply.
1) Loose teeth
2) Poor appetite
3) Feeling thirsty
4) Weak gag reflex
5) Feeling of fullness

1) Loose teeth
2) Poor appetite
4) Weak gag reflex
5) Feeling of fullness

An older patient is experiencing functional changes caused by decreased bladder capacity. What should the nurse assess for in this patient? Select all that apply.
1) Nocturia
2) Frequency
3) Incontinence
4) Renal calculi
5) Urinary retention

1) Nocturia
2) Frequency
3) Incontinence

Which statement is LEAST true about life transitions?
1) A person usually experiences only one transition in a lifetime.
2) Sometimes there is more than one transition occurring at the same time in a person's life.
3) Challenging experiences that accompany aging may require life transitions.
4) Each loss or change requires transitional effort from the person experiencing it.

1) A person usually experiences only one transition in a lifetime.

A 76-year-old patient recovering from hip replacement surgery is upset and does not feel at peace because of her inability to attend church as a result of the injury. What is the best response by the nurse?
1) Encourage her to read a book, magazine, or newspaper.
2) Suggest that she watch television to keep her mind distracted.
3) Offer to call the hospital's chaplain or clergyman to come pray with her.
4) Tell her to sleep so that her body can heal and return to a state of peacefulness.

3) Offer to call the hospital's chaplain or clergyman to come pray with her.

Which would NOT be considered a transitional event?
1) Marriage
2) Losing a job
3) Moving to a new home
4) Visiting an amusement park

4) Visiting an amusement park

Which is NOT an identified feature of a transition?
1) A stage of denial
2) A phase of turmoil
3) An altered time perspective
4) A disturbance in body function

1) A stage of denial

The nurse respects an older patient's decision and right to refuse treatment and returns at a later time to offer previously refused medication. Which factor influencing transitional outcomes applies to this patient's situation?
1) Degree of choice
2) Perception of change
3) Preparation for the change
4) Extent or degree of change

1) Degree of choice

Which action would LEAST likely support the degree of change that an older person has to make when preparing to move?
1) Selecting a home that meets the physical needs of the person
2) Ensuring the new home is located near a senior citizen's center
3) Choosing a smaller apartment so the person has fewer items to move
4) Finding a home with a grocery store within walking distance

3) Choosing a smaller apartment so the person has fewer items to move

Which approach is LEAST appropriate when helping patients prepare for transitions?
1) Avoid discussing difficult topics with patients.
2) Repeat all necessary information about the transition.
3) Involve family members when discussing future transitions.
4) Talk to patients and residents about changes to be anticipated.

1) Avoid discussing difficult topics with patients.

Which characteristics should be considered when a person is transitioning?
1) Gender
2) Vital signs
3) Past experiences
4) Height and weight

3) Past experiences

What aspects of the environment in a hospital room would most likely allow for smooth transitioning?
1) Warm and dark
2) Clean and colorful
3) Restrictive and demanding
4) Cheerful and relaxing

4) Cheerful and relaxing

. Which is NOT a common transition for an older adult?
1) Marriage
2) Health changes
3) Family role changes
4) Job changes and retirement

1) Marriage

A 68-year-old patient has just been admitted to the oncology unit with a new diagnosis of lung cancer. This is the patient's first hospital admission and she knows very little about the diagnosis. Which action should the nurse take to make this patient's transition easier?
1) Administer an antianxiety agent to keep her calm.
2) Leave a printout about lung cancer at her bedside.
3) Talk with her about her fears, questions, or concerns.
4) Tell her a physician will be in to explain what is going on.

3) Talk with her about her fears, questions, or concerns.

Spirituality is defined as
1) The service and worship of God or the supernatural
2) The organized practice of one's belief in a higher power
3) Formal worship involving prescribed actions or practices
4) A feeling from within that communicates a higher power at work

4) A feeling from within that communicates a higher power at work

Which is the LEAST likely way to assess a patient's spiritual needs?
1) Looking for any religious books in the patient's room
2) Identifying the patient's religious preference from the chart
3) Asking the patient's neighbor if he or she has heard the patient praying
4) Looking for identifying jewelry or artifacts in the patient's personal belongings

3) Asking the patient's neighbor if he or she has heard the patient praying

A 73-year-old patient recovering from coronary artery bypass surgery is depressed and is continuously asking, "Why is God doing this to me?" The best response by the nurse is to
1) Ask the patient if he has any specific spiritual needs to be addressed.
2) Call for a psychiatric consultation to screen the patient for depression.
3) Reassure the patient that he did nothing wrong and everything is okay.
4) Tell the patient that sadness usually occurs after undergoing heart surgery.

1) Ask the patient if he has any specific spiritual needs to be addressed.

A patient asks the nurse to pray with her, however, the nurse does not usually pray. Which approach would be the LEAST supportive of the patient's needs?
1) Hold the patient's hands while she prays.
2) Sit near the patient and be reverent during the prayer.
3) Tell the patient to find someone else who will pray with her.
4) Find a coworker who would be willing to pray with the patient.

3) Tell the patient to find someone else who will pray with her.

Achieving gerotranscendence allows for an older person to
1) Live life without regret and die well.
2) Withdraw and disengage from life's many hardships.
3) Become more involved with the self rather than others.
4) Reach a state of wealth and superfluous social interaction.

1) Live life without regret and die well.

Which is the LEAST likely reason to perform a life review?
1) To reflect on all the great accomplishments of one's life
2) To identify strengths that can assist with current transitions
3) To assist older people to review their lives and appreciate them
4) To help older people prepare for life insurance and funeral expenses

4) To help older people prepare for life insurance and funeral expenses

One of the purposes of a creating a life story is to
1) Ensure the patient's memory is intact.
2) Publish it as a book and sell it for profit.
3) Keep the patient busy for long periods of time.
4) Share the life story with children and grandchildren.

4) Share the life story with children and grandchildren.

When working with older people it is important for the nurse to employ holistic nursing care by embracing the body, mind, and spirit of the patient. Which action does NOT represent embracing the body, mind, or spirit?
1) Meeting spiritual needs
2) Following the medical plan of care
3) Addressing transitional stress needs
4) Delivering a mechanistic form of care

4) Delivering a mechanistic form of care

What role does spirituality have with transitions?
1) Estimates the number of transitions to expect in the future
2) Summarizes approaches to speed up the transition process
3) Helps explain how long the transition will take to complete
4) Provides a method to understand the losses being experienced

4) Provides a method to understand the losses being experienced

Which phrase best describes a transitional moment?
1) Stress provoked by the change
2) Letting go of previous practices
3) Realizing that a change has to occur
4) Accepting new ways of doing things

1) Stress provoked by the change

A nursing instructor has spinal fusion surgery and learns afterward that performing cardiopulmonary resuscitation and walking for long periods of time will be contraindicated in the future after recovery. What is the transitional moment for this instructor?
1) Having surgery
2) Recovering from surgery
3) Teaching nursing students
4) Learning that certain activities are not permitted to be performed

4) Learning that certain activities are not permitted to be performed

What is interconnected with a transition?
1) Cost
2) Growth
3) Relocation
4) Change in vocation

2) Growth

A middle-aged adult is having difficulty with losing one parent and then the other 5 months later. What should the nurse do to help this adult with the transition of losing both parents in a short period of time?
1) Remind the person that the parents had long lives.
2) Assure the person that the parents are in a better place now.
3) Encourage the person to move forward and resume routine activities.
4) Ask how the transition of losing a spouse a few years ago was handled.

4) Ask how the transition of losing a spouse a few years ago was handled.

What is the average length of a transitional period?
1) Decades
2) A few days
3) A few hours
4) Weeks to months

4) Weeks to months

One member of an older couple is unable to walk independently and needs hemodialysis treatments three times a week. The couple is discussing the need for an extended care facility. What should be done to facilitate the ill spouse's free choice with a transition?
1) Identify the facilities with hemodialysis treatment centers.
2) Explain how it is safer for an extended care facility admission to occur.
3) Remind the couple that as they age they should expect health problems
4) Review the importance of receiving quality care to improve physical status.

1) Identify the facilities with hemodialysis treatment centers.

What strategy should be used to learn how an older person perceives a transition?
1) Listen to the person talk.
2) Observe how the person lives.
3) Plan to share a meal with the person.
4) Analyze the person's living situation and clothing.

1) Listen to the person talk.

What is the major premise of the progressively lowered stress threshold?
1) Identify the cause of stress.
2) Strategize approaches to limit distractions.
3) Reduce the number of decisions a person has to make.
4) Provide the individual with as much control as possible.

4) Provide the individual with as much control as possible.

The aging parents of a middle-aged adult have both recently passed away. What transition will the middle-aged adult be facing?
1) Role crisis
2) Loss of identity
3) Change in employment
4) Unpreparedness for the future

1) Role crisis

An older adult is having difficulty adjusting to needing a cane to safely ambulate. With which transitions is the person having difficulty?
1) Role crisis
2) Body image
3) Loss of identity
4) Lack of social interaction

2) Body image

During a home visit, the adult daughter of an aging couple asks her father to not tell the story about "the time you were in the war and had to use sheets to cover a wound" again. What should the nurse realize that the older parent is demonstrating?
1) Delirium
2) Dementia
3) Confusion
4) Life review

4) Life review

An older married couple spent a few weeks going through all photos and placing them in albums to present to their adult children. What behavior did the older couple demonstrate?
1) Creativity
2) Motivation
3) Life review
4) Storytelling

3) Life review

During a community picnic, the nurse observes a middle-aged adult sitting alone on a bench. This adult is reflecting on the times spent with parents and friends and does not want to forget the memories. What should the nurse suggest to this person?
1) Write a life story.
2) Learn a new hobby.
3) Spend less time alone.
4) Share the memories with children.

1) Write a life story.

What characteristics should be considered when assisting an older person with a transition? Select all that apply.
1) Finances
2) Nutrition
3) Personality
4) Coping skills
5) Past experiences

2) Nutrition
3) Personality
4) Coping skills
5) Past experiences

What behaviors indicate that an older person is experiencing unresolved stress? Select all that apply.
1) Punching an orderly
2) Criticizing the meals
3) Sitting in a dark room
4) Arguing with the staff
5) Yelling at a family member

1) Punching an orderly
2) Criticizing the meals
4) Arguing with the staff
5) Yelling at a family member

What should be identified as potentially causing stress in an older patient? Select all that apply.
1) Waiting over an hour for a pain pill
2) Watching a horror movie on television
3) Having a different nurse scheduled for the day shift
4) Hearing a jackhammer breaking up concrete on the street
5) Being awakened every 2 hours during the night for blood work

1) Waiting over an hour for a pain pill
3) Having a different nurse scheduled for the day shift
4) Hearing a jackhammer breaking up concrete on the street
5) Being awakened every 2 hours during the night for blood work

Which observation indicates that a recently retired older person is having difficulty with the transition? Select all that apply.
1) Losing weight
2) Meeting with friends
3) Downloading ebooks
4) Babysitting grandchildren
5) Skipping medication doses

1) Losing weight
5) Skipping medication doses

Which situation could cause an ethical/legal issue?
1) Allowing a resident to refuse care
2) Deciding whether to pass pills first or do a dressing change
3) Deciding whether to include the resident in planning care
4) Reporting a nursing assistant for not answering a resident's call light

1) Allowing a resident to refuse care

Which situation could be a legal dilemma for nurses caring for older adults?
1) The resident requests not to be bathed.
2) The nurse passes the medications to all of the residents on time.
3) The resident signs out of the nursing facility and does not tell the staff where he or she is going.
4) The nurse gives the resident only half of the ordered dose of a medication because of side effects that the resident is experiencing.

4) The nurse gives the resident only half of the ordered dose of a medication because of side effects that the resident is experiencing.

Which best describes ethics?
1) Legal aspects of health
2) Consequence evaluation
3) Values and moral concepts
4) Right and wrong behaviors

3) Values and moral concepts

Which is true about ethical decision making?
1) It is governed by the law.
2) It is beyond the legal scope of the practical nurse.
3) It is the use of personal values and beliefs to solve problems.
4) It is unnecessary if there are comprehensive physician orders.

3) It is the use of personal values and beliefs to solve problems.

What is the Patient Care Partnership designed to do?
1) Protect the nurse from unfounded lawsuits.
2) Identify the individual's ability to make decisions.
3) Support the choices of an individual who is able to read and write.
4) Protect the individual's right to make informed choices relating to his or her health care.

4) Protect the individual's right to make informed choices relating to his or her health care.

Which is true regarding laws governing health care and health-care delivery?
1) They are consistent with values systems.
2) They are fair and benefit most of the population.
3) They are man-made and capable of being changed.
4) They are developed with the rights of residents as the central theme.

3) They are man-made and capable of being changed.

A licensed practical nurse (LPN) finds a resident unresponsive, calls for help, and instructs the staff to call 911 and bring emergency supplies while she sets up oxygen for the resident. What is this nurse guilty of doing?
1) The LPN should have called 911.
2) The LPN did not document the event.
3) The LPN functioned within the scope of practice.
4) The LPN should have requested a physician's order for the oxygen.

3) The LPN functioned within the scope of practice.

A non-intravenous (IV) certified LPN starts an IV infusion in a resident during an emergency situation. What is this nurse guilty of doing?
1) Doing someone else's job
2) Adhering to the Nurse Practice Act
3) Being negligent because of not being IV-certified
4) Skipping resident consent for the IV insertion

3) Being negligent because of not being IV-certified

If a non-IV certified LPN starts an IV infusion what should the judge determine if this situation is reviewed in court?
1) Was the physician in attendance?
2) Who was responsible for the resident's care?
3) Did the resident give permission for the IV?
4) Would another LPN do the same thing?

4) Would another LPN do the same thing?

What does the failure to notify the physician or nursing supervisor when a resident's heart rate decreases to less than 48 describe?
1) Libel
2) Omission
3) Negligence
4) Unprofessional behavior

2) Omission

An 84-year-old patient experiencing severe cancer pain is restless and refuses pain medication. Which is an ethical approach to this problem?
1) Discuss with the patient feelings about the pain and the medication.
2) Call the family to ensure that the resident's choice is in the living will.
3) Withhold the medication, because all residents have the right to refuse care.
4) Give the medication, because the resident's decision may be related to delirium.

1) Discuss with the patient feelings about the pain and the medication.

What is a positive result of a restraint-free environment?
1) Use of more medications
2) Fewer incidents of resident falls
3) Increased nursing assistant staffing
4) Development of more creative care strategies

4) Development of more creative care strategies

What may an LPN be required to do when providing ethical nursing care?
1) Examine personal beliefs and values.
2) Practice outside of the facility's policies and procedures.
3) Practice outside of the legal scope of practical nursing practice.
4) Compromise the rights of residents as outlined in the Patient Care Partnership.

1) Examine personal beliefs and values.

What does NOT legally define the practice of the LPN?
1) Facility procedure outlines
2) The State Nurse Practice Act
3) Facility nursing care policies
4) Experience in providing nursing care

4) Experience in providing nursing care

Which is an example of omission?
1) Forgetting to unclamp a catheter
2) Changing a resident's diet to increase fiber
3) Refusing to sign off on a medication that was not given
4) Adjusting a dosage schedule of an antibiotic that the pharmacy delivered late

1) Forgetting to unclamp a catheter

Why are other nurses often used as expert witnesses in lawsuits involving nurses?
1) They can review the usual job description of nurses.
2) They can learn about the Nurse Practice Act standards.
3) They can establish the definition of safe and prudent care.
4) They can validate the credentials of the nurse being charged.

3) They can establish the definition of safe and prudent care.

What is the most important factor in successfully initiating a restraint-free environment?
1) Discussing safer methods of restraining residents
2) Educating the residents and families regarding restraint-free principles
3) Providing in-service training of nursing staff about restraint policies and procedures
4) Reviewing the Patient Care Partnership with the whole staff so that they understand the right of the resident to choose to be unrestrained

4) Reviewing the Patient Care Partnership with the whole staff so that they understand the right of the resident to choose to be unrestrained

What does informed consent mean?
1) The resident has the right to refuse treatment.
2) The resident must sign a release statement before all treatments.
3) The care personnel are exempt from any lawsuit if something goes wrong during a procedure.
4) The resident has the right to know all of the information regarding procedures before consenting to treatment.

4) The resident has the right to know all of the information regarding procedures before consenting to treatment.

What is the role of the LPN when elder abuse is suspected?
1) Review the care of other residents.
2) Document and investigate the incident.
3) Report the incident to the local, county, or state authorities.
4) Discuss suspicions at the next interdisciplinary team meeting.

3) Report the incident to the local, county, or state authorities.

Who are the abusers in most cases of elder abuse?
1) Privately paid caregivers
2) Long-term care facility employees
3) Anyone who cares for an older adult
4) Family members who are living with the older adult

3) Anyone who cares for an older adult

What is a major barrier to reporting of elder abuse?
1) Reporting involves too much paperwork.
2) It is not a felony to abuse a competent adult.
3) Elders are reluctant to report incidents of abuse.
4) Families of elderly abuse victims seldom believe that they are abusing the elder.

3) Elders are reluctant to report incidents of abuse.

The wife of a married couple in a facility requests to be moved into a different room. How should the nurse respond to this request?
1) "Don't you think your husband will miss you?"
2) "This must have been a difficult decision for you to make."
3) "We will have to get your husband's permission for you to move."
4) "This is against the facility policy, which encourages couples to be in the same room."

2) "This must have been a difficult decision for you to make."

What statement best describes a resident's rights for sexual expression?
1) The right to use touch to express sexual feelings.
2) The right to have access to opportunities for sexual expression.
3) The right to engage in sexual relationships with other residents.
4) The right to express sexual feelings in socially appropriate ways.

4) The right to express sexual feelings in socially appropriate ways.

Which statement is NOT true about physical restraints?
1) They may include bed rails.
2) They restrict access to one's body.
3) They can be removed by the resident.
4) They include anything attached to the individual that cannot be removed easily.

3) They can be removed by the resident.

A certified nursing assistant (CNA) uses soft restraints to protect a resident from falling out of bed even though there was no order for their usage. On rounds several hours later, the resident is found not breathing, tangled, with her restraints around her neck. What is the responsibility of the LPN?
1) Guilty of omission
2) Guilty of negligence
3) Not at fault because of being unaware of the restraints being used
4) Not concerned because the resident has a do not resuscitate (DNR) order

2) Guilty of negligence

A primary care provider orders short-term restraints for an elderly patient. Which is NOT a responsibility of the nurse regarding these restraints?
1) Remove the restraints periodically.
2) Assist with range-of-motion exercises.
3) Observe and care for the skin periodically.
4) Delay following the physician's instructions and contact the interdisciplinary team (IDT).

4) Delay following the physician's instructions and contact the interdisciplinary team (IDT).

Which law was specifically designed to protect and regulate patient privacy?
1) Patient Care Partnership
2) Patient Self-Determination Act
3) Omnibus Budget Reconciliation Act (OBRA)
4) Health Insurance Portability and Accountability Act (HIPAA)

4) Health Insurance Portability and Accountability Act (HIPAA)

What has research been unable to prove regarding the use of restraints?
1) Care based on the patient's individual needs
2) A reduction in the person's functional capacity
3) Injuries to the patient who tries to get free from the restraints
4) Problems with many body systems often resulting from immobility

1) Care based on the patient's individual needs

. The nurse lives in Erie, Pennsylvania, but sees home care patients in New York, Pennsylvania, and Ohio. Which state licensure requirements should the nurse follow?
1) Ohio
2) New York
3) Pennsylvania
4) All of the states

4) All of the states

The nurse is concerned about an unsafe situation with a resident. With whom should the nurse discuss this situation first?
1) The CNAs
2) The physician
3) The charge nurse
4) The administrator

3) The charge nurse

While making afternoon rounds the charge nurse sees a resident sitting in a geriatric chair with a tray. What should the nurse do?
1) Do nothing.
2) Remove the tray.
3) Assist with ambulation.
4) Transfer to another chair.

4) Transfer to another chair.

A resident of a nursing facility demonstrates occasional delirium. From whom should the nurse obtain consent for an invasive procedure?
1) The resident
2) The physician
3) Family attorney
4) Medical power of attorney

4) Medical power of attorney

What is the primary objective of an advance directive?
1) Reduce the cost of care.
2) Restrict the utilization of resources.
3) Follow the resident's wishes for care.
4) Calm the family's fears and concerns.

3) Follow the resident's wishes for care.

What is the most extreme expression of ageism?
1) Negligence
2) Malpractice
3) Elder abuse
4) False imprisonment

3) Elder abuse

During morning care an older male resident begins to masturbate. What should the CNA do?
1) Ignore the action and complete the bath.
2) Ask the resident to stop until the bath is over.
3) Leave the resident to complete the action in private.
4) Stand and wait for the resident to complete the action.

3) Leave the resident to complete the action in private.

The nurse overhears several CNAs discussing a resident's health problems in the lunch room. What should the nurse do?
1) Do nothing.
2) Participate in the discussion.
3) Listen to what they have to say.
4) Remind them that the information is confidential.

4) Remind them that the information is confidential.

What information should the nurse expect to find within the Patient Care Partnership? Select all that apply.
1) Billing and collection policies
2) Access to health care and coverage
3) Acceptable nurse-resident staffing ratios
4) Intolerance of racial and ethnic disparities
5) Partnership with health-care decisions and delivery

1) Billing and collection policies
2) Access to health care and coverage
4) Intolerance of racial and ethnic disparities
5) Partnership with health-care decisions and delivery

Which actions should the nurse take when enforcing the Patient Self-Determination Act of 1990 with a newly admitted resident of a nursing facility? Select all that apply.
1) Ask if the resident has a living will.
2) Ask if the resident has advance directives.
3) Ask if the executor of the will has been identified.
4) Ask if the resident has a durable power of attorney.
5) Ask if the resident will sign the consent to treatment form.

1) Ask if the resident has a living will.
2) Ask if the resident has advance directives.
4) Ask if the resident has a durable power of attorney.

The Director of Nursing is concerned that one staff nurse is at risk for liability issues when providing resident care. What did the director observe to make this decision? Select all that apply.
1) The nurse changed a medication dosage.
2) The nurse worked 32 hours over the last 2 days.
3) The nurse documented the status of a resident's pressure ulcer.
4) The nurse did not have supplies to change a wound-vac draining system.
5) The nurse did not obtain consent before sending a resident for a surgical procedure.

1) The nurse changed a medication dosage.
2) The nurse worked 32 hours over the last 2 days.
4) The nurse did not have supplies to change a wound-vac draining system.
5) The nurse did not obtain consent before sending a resident for a surgical procedure.

The nurse is identifying tasks to delegate to CNAs. What should the nurse use as a guide when making these decisions? Select all that apply.
1) Age of the CNAs
2) Skill level of the CNAs
3) Experience of the CNAs
4) Certification of the CNAs
5) Shift the CNAs are working

2) Skill level of the CNAs
3) Experience of the CNAs
4) Certification of the CNAs

What are the characteristics of a prudent, responsible nurse? Select all that apply.
1) Attends seminars
2) Thinks through actions
3) Applies for re-licensure
4) Reads nursing magazines
5) Carefully considers options

1) Attends seminars
2) Thinks through actions
4) Reads nursing magazines
5) Carefully considers options

What can be used in place of restraints to monitor residents who have a tendency to wander? Select all that apply.
1) Sitters hired to stay with the resident
2) Alarm doors
3) Bed alarm pads
4) Room door locks
5) Wristband alarms

2) Alarm doors
3) Bed alarm pads
5) Wristband alarms

A resident is having a health-care proxy created. What should be included in this document? Select all that apply.
1) Use of feeding tubes
2) Types of medications
3) Plans for resuscitation
4) Location of will in the home
5) Desire for mechanical ventilation

1) Use of feeding tubes
2) Types of medications
3) Plans for resuscitation
5) Desire for mechanical ventilation

Which parts of Medicare are associated with monthly premiums? Select all that apply.
1) A
2) B
3) C
4) D
5) E

2) B
3) C
4) D

What should the nurse explain to a resident of a nursing facility about Medicaid? Select all that apply.
1) It includes acute care.
2) It includes long-term care.
3) It has a monthly premium.
4) It has substantial co-payments.
5) It is the largest payer for skilled care.

1) It includes acute care.
2) It includes long-term care.
5) It is the largest payer for skilled care.

How did the Affordable Care Act (ACA) impact Medicare? Select all that apply.
1) Increased co-payments
2) Added deductibles for office visits
3) Included more preventive services
4) Reduced the cost of prescription drugs
5) Limited the number of skilled care days

3) Included more preventive services
4) Reduced the cost of prescription drugs

Which is true about an older adult's sleep pattern?
1) Go to bed earlier
2) Sleep later in the morning
3) Wake earlier in the morning
4) Take several naps during the day

3) Wake earlier in the morning

The nurse is assigning tasks to nursing assistants in a nursing home. Which would be the most appropriate instruction to give to the assistant who will care for a frail 80-year-old woman with arthritis?
1) Help her to use a bedpan.
2) Bring her meal trays to the bed.
3) Give her a bed bath, comb her hair, and brush her teeth.
4) Let the patient do as much as she can for mouth and personal care and toileting.

4) Let the patient do as much as she can for mouth and personal care and toileting.

Which is NOT a realistic expectation about stress in an older person's life?
1) It increases with age.
2) It should be managed.
3) It should be eliminated.
4) It can have beneficial results.

3) It should be eliminated.

An older patient with gastroesophageal reflux disease (GERD) and heart failure complains of insomnia and of always feeling tired. What should the nurse suggest to help the patient sleep better?
1) Lie on the left side.
2) Take a long-lasting analgesic before bed.
3) Take antacids before bed to relieve gastric reflux.
4) Raise the head of the bed so that the upper body is elevated.

4) Raise the head of the bed so that the upper body is elevated.

An older male patient with obesity reports feeling tired all of the time, even in the morning. The patient's spouse says he snores loudly. What disorder should the nurse suspect?
1) GERD
2) Dementia
3) Sleep apnea
4) Nocturnal myoclonus
E

3) Sleep apnea

Which is not identified as contributing to disturbed or interrupted sleep?
1) Activity
2) Alcohol
3) Tobacco
4) Sedentary lifestyle

1) Activity

An older patient states that the most activity he wants to get is walking from the couch to the kitchen table to eat every day. What might be this patient's philosophy of activity and exercise?
1) Exercise is a luxury.
2) Exercise is not necessary.
3) Exercise is a waste of time.
4) Exercise is for younger people.

2) Exercise is not necessary.

The nurse notes that an older patient who had been on bedrest for a deep venous thrombosis is reluctant to ambulate and expresses fatigue and disinterest in recovery. How should the nurse respond to this patient?
1) "It is wise to limit ambulation with your health problems."
2) "That is just a normal part of aging. You will get used to less activity."
3) "Exercising will help you regain your strength and motivation to get better."
4) "There are other things that you can do to take your mind off of your health problems."

3) "Exercising will help you regain your strength and motivation to get better."

The nurse is guiding a group of older patients with limited mobility on an exercise to improve strength in the lower legs. What goal is this nurse supporting?
1) Increase the number of older adults with physical mobility issues to walk independently.
2) Increase the number of older adults who are wheelchair-bound to maintain muscle tone and function.
3) Increase the number of older adults with arthritis to experience less pain and improve their quality of life.
4) Increase the proportion of older adults with reduced physical or cognitive function who engage in light, moderate, or vigorous leisure-time physical activities

4) Increase the proportion of older adults with reduced physical or cognitive function who engage in light, moderate, or vigorous leisure-time physical activities

The nurse is aware of an older patient having difficulty with upper arm mobility. Which activity should the nurse encourage to help this patient?
1) Tie shoes.
2) Comb hair.
3) Put on socks.
4) Flex the ankles.

2) Comb hair

A group of older community members are taking a walk through the neighborhood arboretum. Which type of activity are these individuals engaging in?
1) Endurance
2) Balance training
3) Muscle lengthening
4) Flexibility exercises

1) Endurance

An older person attends yoga three times a week. Which type of activity is this person participating in?
1) Flexibility
2) Endurance
3) Circuit training
4) Muscle building

1) Flexibility

An older person notices that after working in the garden she has to sit and rest for a few minutes. What should the nurse say in response to this patient?
1) "This means that you are not eating enough."
2) "It might be that the gardening will need to be given up if it is too tiring for you."
3) "That's an abnormal behavior that should be investigated by your health-care provider."
4) "This means you are moderating activity with rest to stay energized throughout the day."

4) "This means you are moderating activity with rest to stay energized throughout the day."

An older patient is observed napping at 10:00 a.m., 1:00 p.m., 3:00 p.m., and again at 7:00 p.m. What action should the nurse take?
1) Nothing, since this is normal behavior.
2) Discuss the need for frequent napping with the patient.
3) Hang a "do not disturb" sign on the patient's room door.
4) Recommend that the patient stay in bed for most of the day.

2) Discuss the need for frequent napping with the patient.

The nurse observes that an older patient is increasingly irritable, does not want to participate in routine activities, and is frequently napping. What should the nurse do to help this patient?
1) Encourage more napping.
2) Restrict interaction with other people.
3) Reduce the amount of daytime activities.
4) Provide uninterrupted sleep during the night.

4) Provide uninterrupted sleep during the night.

The nurse notes that an older patient who usually awakens in the morning at 5:00 a.m. is watching television at 1:00 a.m.. What should the nurse consider is occurring with the patient?
1) Off-balance circadian rhythm
2) Mechanism to relieve boredom
3) Not sleepy because of napping throughout the day
4) Attempting to stay awake longer to sleep longer in the morning

4) Attempting to stay awake longer to sleep longer in the morning

An older patient tells the nurse that sleep is optional because moving in bed is painful. What should the nurse do first to help this patient?
1) Assess pain level.
2) Provide pain medication.
3) Review the causes of the pain.
4) Discuss pain management strategies.

1) Assess pain level.

The nursing assistant reports that a newly admitted older patient is confused. What should the nurse find out during morning report about this patient?
1) What is the patient's routine diet?
2) What time was the patient admitted?
3) Did the patient sleep through the night?
4) What activities does the patient like to perform?

3) Did the patient sleep through the night?

An older patient is experiencing a new onset of ankle edema. What should the nurse include when assessing this patient?
1) Routine oral intake
2) Ability to perform ADLs
3) Feelings after sleeping throughout the night
4) Amount of physical activity performed during the day

3) Feelings after sleeping throughout the night

An older patient desires to increase tolerance for walking but becomes fatigued with short distances. What should the nurse suggest to this patient?
1) Walk in a mall, stopping when necessary to sit.
2) Walk 10 feet to the mailbox several times a day.
3) Walk in the park and stop periodically to sit on a bench.
4) Walk in the grocery store using a cart for stability and support.

2) Walk 10 feet to the mailbox several times a day.

An older patient reports engaging in physical activity 15 minutes every day. What should the nurse say in response to this patient's activity level?
1) "That's all you need!"
2) "You need to increase that to 30 minutes every day."
3) "Why so much? Fifteen minutes every other day would be better."
4) "Just 7 more minutes a day and then you will be right on target."

4) "Just 7 more minutes a day and then you will be right on target."

The spouse of an older patient asks the nurse why the patient is shaking the cans of soup so much every day. How should the nurse respond to the spouse?
1) "That's to keep her arms limber."
2) "That's being done to increase elbow flexibility."
3) "That's an exercise using a can of soup as a weight."
4) "That's to make sure the contents that have settled are dispersed throughout the soup."

3) "That's an exercise using a can of soup as a weight."

An older patient with chronic obstructive pulmonary disease and degenerative arthritis affecting her lower back and legs is unable to exercise and has someone deliver food and other necessities. Which interventions are appropriate to help improve this patient's physical status? Select all that apply.
1) Consider moving to an assisted living facility.
2) Discuss family members who can move in to help her.
3) Explain activities such as using a walker for shopping.
4) Encourage getting out of the house to interact with others.
5) Suggest that she accept her limitations and live as best she can.

1) Consider moving to an assisted living facility.
3) Explain activities such as using a walker for shopping.
4) Encourage getting out of the house to interact with others.

Which health problems are managed or prevented by activity? Select all that apply.
1) Arthritis
2) Diabetes
3) Osteoporosis
4) Diverticulitis
5) Heart disease

1) Arthritis
2) Diabetes
3) Osteoporosis
5) Heart disease

During a home visit, the nurse suspects that an older person is participating in routine physical activity. What did the nurse observe to have this conclusion? Select all that apply.
1) Asks a grandson to help him stand up
2) Weight loss of 2 lb over the last month
3) Rests on a walker after moving a few feet
4) Able to bend down to pick up the newspaper
5) Recalls when the next health-care appointment is scheduled

2) Weight loss of 2 lb over the last month
4) Able to bend down to pick up the newspaper
5) Recalls when the next health-care appointment is scheduled

The nurse is preparing a community program focusing on the importance of physical activity for older people with chronic health problems. Which health problems should the nurse highlight as being the most common in this age group? Select all that apply.
1) Arthritis
2) Diabetes
3) Hypertension
4) Prostate cancer
5) Urinary incontinence

1) Arthritis
2) Diabetes
3) Hypertension

What is the goal of an environmental assessment?
1) Promote independent function.
2) Establish an older adult's housekeeping abilities.
3) Detect reasons to admit an older adult to a long-term care facility.
4) Assist the family with documenting reasons they should seek durable power of attorney.

1) Promote independent function.

After admitting an 86-year-old resident to a retirement community, the nurse assisted with transitioning to the new home, arranged Meals on Wheels, provided a list of local physicians, and made arrangements for the community Welcome Wagon to make a visit. What type of care did the nurse perform?
1) Hospice
2) Transpersonal caring
3) Micromanaging the client
4) Environmental management

2) Transpersonal caring

When entering an older patient's home the nurse notices that the room is very warm. What patient behavior should the nurse attribute to the environment?
1) Hunger
2) Lethargy
3) Talkativeness
4) Being motivated

2) Lethargy

The nurse is visiting an assisted living facility to help an older person decide if she wants to relocate to this environment. Which observation should the nurse question as being desirable for this person?
1) Lack of community lounge
2) Garden with benches and chairs
3) Recreation room with a television and magazines
4) Residents visiting in the common areas on each floor

1) Lack of community lounge

The nurse determines that one apartment in an assisted living facility would not be appropriate for a person who relies on a wheelchair. What did the nurse observe to make this determination?
1) Bath tub with shower
2) Absence of throw rugs
3) Oversized door openings
4) Handicapped-accessible commode

1) Bath tub with shower

Which would NOT be included in an environmental safety risk assessment?
1) Noting clutter and throw rugs
2) Medication storage and date of medications
3) Noting electrical wiring, frayed cords, and hot extension cords
4) Sorting through older adults' mail to see if they are paying their bills on time

4) Sorting through older adults' mail to see if they are paying their bills on time

Which intervention increases the functionality of the environment?
1) Installing grab bars in the bathroom
2) Padding the bed for an incontinent older adult
3) Changing light bulbs to energy-saving, low-wattage bulbs
4) Inserting an indwelling catheter so that the older adult does not have to get out of the chair to void

1) Installing grab bars in the bathroom

If the nurse is evaluating the home of an elderly person who has had a total hip replacement, what areas should be considered as being the most important?
1) Friendliness of the neighbors
2) The safety of the neighborhood and the internal safety of the home
3) If emergency medical services are available in the event that the patient falls
4) The accessibility of a grocery store and drug store and the availability of a working telephone

2) The safety of the neighborhood and the internal safety of the home

While conducting a home assessment the nurse identifies safety issues in the patient's bathroom. What did the nurse assess to make this determination?
1) Grab bars in the shower
2) Grab bars around the commode
3) Throw rug absent from the floor
4) Cord for electric shaver crossing over the sink

4) Cord for electric shaver crossing over the sink

The nurse notes that an older patient smokes. What would be imperative for this patient to have in the home?
1) Functioning smoke alarms
2) Electric cooking appliances
3) Water in every room of the house
4) Telephone number for the fire department

1) Functioning smoke alarms

An older patient is hospitalized with a broken hip after falling in the home. What should the nurse discuss as a priority when making a home visit?
1) The time the patient goes to sleep at night
2) The location of the pharmacy that the patient uses
3) Asking someone to take the patient's toy poodle
4) When the patient expects the mail to be delivered each day

3) Asking someone to take the patient's toy poodle

What does the respect for personal space and privacy help develop?
1) A climate of caring
2) Nursing assessments
3) A comprehensive care plan
4) Customer satisfaction with nursing care

1) A climate of caring

Which is NOT a component of a caring climate?
1) Privacy
2) Dependence
3) Personal space
4) Activity and involvement

2) Dependence

An older person who used to work until midnight doesn't go to sleep until 3:00 a.m. and likes to stay in bed until 11:00 a.m. The facility that the patient lives in provides breakfast at 8:00 a.m. What should the nurse do to ensure that this patient's nutritional needs are being met?
1) Wake the patient up for breakfast at 8:00 a.m.
2) Stop the delivery of a breakfast tray for this patient.
3) Have the breakfast tray delivered with the lunch tray.
4) Place the breakfast tray aside to be warmed up when the patient wakes up.

4) Place the breakfast tray aside to be warmed up when the patient wakes up.

An older patient is being admitted to an extended care facility for several weeks for extensive wound care and hemodialysis. What should be done to personalize this patient's living area during this time?
1) Dress the patient in personal clothing.
2) Place the patient's toilet articles in the bathroom.
3) Keep the patient's slippers on the floor next to the bed.
4) Ask family to bring in a favorite picture to place on the bedside table.

4) Ask family to bring in a favorite picture to place on the bedside table.

An older patient with terminal cancer is being discharged back to his home. What service should be recommended to this patient's family for care?
1) Hospice
2) Nursing home
3) Adult day services
4) Skilled nursing facility

1) Hospice

A spouse is the primary caregiver for an 80-year-old ill patient. The spouse does not want to place the patient in a nursing facility but is experiencing extreme exhaustion. What should the nurse recommend to the spouse?
1) Respite care
2) Senior center
3) Hospitalization
4) Home health nursing

1) Respite care

An older patient who lives alone is recovering from total hip replacement surgery with the plan to return home. The patient's sister will be staying for 1 week after discharge. Which referral is appropriate for this patient?
1) Hospice
2) Senior center
3) Home health services
4) Skilled nursing facility

3) Home health services

Which is a criterion for hospice services?
1) A cancer diagnosis
2) Lack of family support
3) Terminal disease process
4) Chronic disease with acute exacerbation

3) Terminal disease process

Which is NOT a part of hospice care?
1) Personal care services
2) Funeral arrangement services
3) Family counseling and support
4) Ongoing support for families after the person's death

2) Funeral arrangement services

An older person is increasingly confused from Alzheimer's disease and the spouse is unable to continue to care for the patient at home. What referral should be made for the patient?
1) Hospitalization
2) Retirement center
3) Skilled nursing facility
4) Intermediate nursing facility

3) Skilled nursing facility

A 78-year-old patient is distressed over the high maintenance costs of a large home. What should be recommended as a living alternative for the patient?
1) Senior center
2) Retirement center
3) Skilled nursing facility
4) Intermediate nursing facility

2) Retirement center

Who directs the care and instruction for an LPN providing home care services?
1) The physician
2) The family and patient
3) The registered nurse (RN) case manager
4) The secretary at the agency who makes the assignments

3) The registered nurse (RN) case manager

What would be the LPN's primary responsibilities in an adult day services center?
1) Medications and meals
2) Activities and teaching
3) Assessments and medications
4) Meal preparation and activity planning

3) Assessments and medications

In which environment does the nurse require some level of creativity because of a limitation of equipment and supplies?
1) Hospice
2) Home care
3) Adult day services
4) Retirement communities

2) Home care

A patient is interested in adult day services. What should the nurse remind the patient about the financing of these services?
1) Medicare pays for these services.
2) Medicare does not pay for these services.
3) Medicaid does not pay for these services.
4) Personal insurance pays for these services.

2) Medicare does not pay for these services.

The nurse is preparing to make a visit to the home of an older patient newly diagnosed with heart failure. How much time should the nurse plan to spend with the patient?
1) Less than an hour
2) A complete 8-hour day
3) Between 4 and 6 hours
4) As much time as needed to provide treatments

4) As much time as needed to provide treatments

The nurse is hired to staff a community care clinic. Which type of care should the nurse expect to provide to older community members?
1) Vaccinations
2) Routine physicals
3) Wellness activities
4) Available resources

4) Available resources

For which person would an assisted living community be an appropriate choice?
1) A non-ambulatory terminally ill patient
2) A completely independent and ambulatory older adult
3) A non-ambulatory, very frail person with a serious chronic illness
4) An ambulatory patient who has a chronic condition that requires medication

4) An ambulatory patient who has a chronic condition that requires medication

What type of care would the nurse provide in an assisted living community?
1) Preparing meals
2) Helping with laundry
3) Assisting with daily grooming
4) Assessing medication responses

4) Assessing medication responses

A participant in an adult day services program tells the nurse that she needs to start on insulin every day to help manage her diabetes. What should the nurse make a priority for this patient?
1) Ability to self-inject the medication
2) Importance of having the eyes checked every year
3) Need to see the primary care physician every 3 months
4) Frequency of checking capillary blood glucose levels at home

1) Ability to self-inject the medication

Which observation should the nurse question in a person who is a participant in an adult services program?
1) Laughing while watching a comedy movie
2) Walking slowly to the bathroom with a walker
3) Helping clean up materials used to make posters
4) Changing from actively participating in an activity to sleeping in a chair

4) Changing from actively participating in an activity to sleeping in a chair

The nurse notices that an older participant in adult day services asks for leftover food to take home every day. What should the nurse suggest as assistance for this participant?
1) Meals on Wheels
2) Menus of restaurants that deliver
3) Telephone numbers of grocery stores that deliver
4) Names of caregivers willing to come into the home and cook for the person

1) Meals on Wheels

An 86-year-old patient is diagnosed with relocation-related stress. Which is a symptom of this disorder?
1) Attending all available activities in the facility
2) Watching television and visiting with other residents in the day room
3) Exhibiting increased confusion and wandering behavior at night
4) Refusing to take a tub bath and washing himself at the sink in his room

3) Exhibiting increased confusion and wandering behavior at night

What intervention would help decrease stress related to relocation?
1) Having residents eat their meals in the dining room
2) Taking residents on a tour of the facility and introducing them to all of the caregivers
3) Spending an afternoon reviewing all of the facility policies and procedures that relate to resident care
4) Encouraging residents to discuss bringing some of their furniture and personal belongings with their families

4) Encouraging residents to discuss bringing some of their furniture and personal belongings with their families

. What should be a part of the environment for a confused resident of a nursing facility?
1) A standardized appearance
2) A stark and unstimulating atmosphere
3) Sensory stimulation through colors, furniture, and wall coverings
4) A home-like, familiar atmosphere with the resident's own belongings

4) A home-like, familiar atmosphere with the resident's own belongings

What should be done on the first day that a new resident is in a nursing facility?
1) Introduce the new resident to all of the staff in the unit.
2) Encourage the resident to go to the afternoon bingo game.
3) Help the resident make the environment cozy and home-like.
4) Accompany the resident to the dining room at lunch to meet all the residents of the floor.

3) Help the resident make the environment cozy and home-like.

An older person is argumentative and refuses to sit with family members during dinner because the discussion will be about the patient's upcoming relocation to an assisted living facility. What is this older person demonstrating?
1) Conflict
2) Rigidity
3) Noncompliance
4) Transitional stress

4) Transitional stress

An older patient needing hemodialysis three times a week and extensive wound care is unable to be cared for at home by family members. The patient agrees to be admitted to a skilled nursing facility but refuses to talk with any of the staff or family members who come to visit. What should be done to assist this patient?
1) Transport the patient to the recreation room.
2) Nothing. The patient will adjust in time.
3) Have the staff introduce themselves one at a time.
4) Encourage placement of personal items to be easily viewed.

4) Encourage placement of personal items to be easily viewed.

While visiting the home of an older patient who recently became widowed the nurse determines that the patient has a strong support system. What occurred that caused the nurse to make this determination? Select all that apply.
1) Delivery person rang the doorbell
2) Paid caregiver was doing the laundry
3) Daughter was visiting with her mother
4) Neighbor came over to bring a pot of soup
5) Friend telephoned to ask for the best time to visit

2) Paid caregiver was doing the laundry
3) Daughter was visiting with her mother
4) Neighbor came over to bring a pot of soup
5) Friend telephoned to ask for the best time to visit

Which behaviors indicate that a new resident of a nursing facility is experiencing relocation trauma? Select all that apply.
1) Agitation
2) Acting out
3) Poor appetite
4) Hallucinations
5) Disorientation

1) Agitation
2) Acting out
4) Hallucinations
5) Disorientation

An older patient recovering from a stroke has been very depressed and noncompliant with the physical therapy regimen. Which nursing intervention is important to initiate to prevent immobility in this patient?
1) Force the patient to participate in the activity program.
2) Refer the patient to the facility social worker for counseling.
3) Walk the patient to the bathroom before and after meals and before bedtime.
4) Change the patient's activity program to activities that can be done in a wheelchair.

3) Walk the patient to the bathroom before and after meals and before bedtime.

What is LEAST likely to occur to the body physiologically with immobility?
1) Bone dissolution
2) Parkinson's disease
3) Joint stiffness and decreased range of motion
4) A decrease in muscle strength equal to 20% to 30% over 7 to 9 days

2) Parkinson's disease

How does physical exercise affect the cardiovascular system?
1) Increasing cardiac output
2) Decreasing cardiac efficiency
3) Decreasing cardiac response to activity
4) Maintaining pulse rate in response to activity

1) Increasing cardiac output

What is the most significant and overlooked nursing intervention to promote functional ability for an older adult?
1) Ensure safety.
2) Promote fluids.
3) Decrease stressors.
4) Maintain and improve mobility.

4) Maintain and improve mobility

During the night, an older patient fell, was incontinent of urine, and complained of not being able to get to the bathroom because the side rails on the bed were raised. What is the most appropriate nursing intervention to prevent this patient from falling again?
1) Initiate a toileting program.
2) Place a commode next to the bed.
3) Apply a soft waist restraint at night.
4) Put the side rails down during the night.

1) Initiate a toileting program.

Which normal aging change increases an older adult's risk of falling?
1) Vision changes
2) Cognitive changes
3) Decreased cardiac output
4) Decreased aerobic reserve

1) Vision changes

What contributes to an older person developing immobility?
1) Fear of falling
2) Release of safety restraints
3) Restorative ambulation program
4) Decreasing psychoactive medications

1) Fear of falling

Patients with Parkinson's disease frequently have a shuffling gait and use assistive devices for ambulation. What is the reason for these people to have a high risk of falling?
1) Gait and balance
2) Posture and mental status
3) Posture and ability to use a walker
4) Ability to use a walker and mental status

1) Gait and balance

Which situation would NOT increase an older adult's risk of falling?
1) Mood lighting
2) Small bathroom with toilet, sink, and tub
3) Large sunroom with clear path to bedroom and bathroom
4) Having children's toys and books scattered around the room

3) Large sunroom with clear path to bedroom and bathroom

Which is NOT a psychological or social effect of incontinence on an older person?
1) Dementia
2) Depression
3) Diminished self-concept
4) Withdrawal from social activities

1) Dementia

What is one of the most common causes of urinary incontinence in an immobile older person?
1) Fecal impaction
2) Dietary indiscretions
3) Congestive heart failure (CHF)
4) Lack of awareness of the urge to void

1) Fecal impaction

Why can diuretics increase the incidence of urinary incontinence?
1) They increase urine volume.
2) They induce signs and symptoms of diabetes mellitus.
3) The potential for older people to be dehydrated increases while taking these medications.
4) The chemical action they have on the kidneys decreases the older person's awareness of the urge to void.

1) They increase urine volume.

Which is true about stress incontinence?
1) It is more common in men.
2) It is caused by bladder obstruction.
3) It is most common in long-term care facilities.
4) It is a sudden loss of small amounts of urine when coughing, laughing, or lifting.

4) It is a sudden loss of small amounts of urine when coughing, laughing, or lifting.

A 79-year-old man is complaining of leaking urine and constipation. Which health problem is this patient most likely experiencing?
1) Diabetes
2) Heart failure
3) Alzheimer's disease
4) A fecal impaction, causing overflow incontinence

4) A fecal impaction, causing overflow incontinence

The mnemonic DRIP is used to help remember the possible causes of acute incontinence. Which does not represent a letter within this mnemonic?
1) Delirium
2) Infection
3) Renal stones
4) Pharmaceutical and psychological

3) Renal stones

An older patient who is incontinent has bacteria in the urine. What should the nurse expect to be prescribed for this patient?
1) Bedrest
2) Antibiotics
3) Fluid restriction
4) Oxygen therapy

2) Antibiotics

A newly admitted resident of a skilled facility has to void, however, a wheelchair and stretcher are blocking the entrance to the bathroom. Which type of incontinence is this patient most likely going to experience?
1) Urge
2) Stress
3) Overflow
4) Functional

4) Functional

When an older adult reports problems with urinary incontinence what should be the primary goal?
1) Prevent urinary tract infections.
2) Ensure that the older person is free from any skin breakdown.
3) Identify any reversible or treatable cause of the incontinence.
4) Select the type of incontinence pad that would allow the older person the most freedom and protection.

3) Identify any reversible or treatable cause of the incontinence.

What is the goal of a bladder retraining program?
1) Have the older person void every 2 hours.
2) Increase the period of time between voiding.
3) Increase the older person's awareness of the urge to void.
4) Increase the older person's awareness of incontinence episodes.

2) Increase the period of time between voiding.

Which is NOT considered as being a cause of constipation in an older adult?
1) Diuretics
2) Sedatives
3) Antibiotics
4) Aluminum-containing antacids

3) Antibiotics

Which is a characteristic of a bladder retraining program?
1) Empty the bladder every 2 hours.
2) Ingest 240 mL of fluid every 2 hours.
3) Ambulate to the bathroom every 6 hours.
4) Use the toilet every 4 hours around the clock.

1) Empty the bladder every 2 hours.

What is the purpose of passive range of motion (ROM) for an immobilized older adult?
1) Replaces the need for ambulation
2) Increases the risk of deep vein thrombosis
3) Decreases the risk of falls and skin breakdown
4) Maintains joint flexibility and delays muscle wasting

4) Maintains joint flexibility and delays muscle wasting

What is a characteristic of a stage III pressure ulcer?
1) A non-blanchable erythema
2) Partial-thickness skin loss involving the epidermis or dermis
3) Full-thickness skin loss with extensive destruction; tissue necrosis; or damage to muscle, bone, or supporting tissue
4) Full-thickness skin loss involving damage to or necrosis of subcutaneous tissue down to, but not involving, the fascia

4) Full-thickness skin loss involving damage to or necrosis of subcutaneous tissue down to, but not involving, the fascia

What is NOT included in the care of pressure ulcers?
1) Daily bath
2) Adequate nutrition
3) Use of gel-filled mattresses
4) Frequent change of position

1) Daily bath

An older patient is sitting in a wheelchair for 3 hours. When changing position the nurse notes an area of redness over the coccyx. Which risk factor caused this patient's area of erythema?
1) Friction
2) Pressure
3) Shearing
4) Moisture

2) Pressure

Which statement is false?
1) Meat is the most expensive source of protein and iron.
2) Pastas, grains, and breads are examples of carbohydrates.
3) Vitamin-rich foods are necessary but not necessarily expensive.
4) Carbohydrates and fats are filling, less expensive, and as equally nutritious as proteins.

4) Carbohydrates and fats are filling, less expensive, and as equally nutritious as proteins.

An older patient who is losing weight refuses to come to meals and when he does he cannot sit down long enough to eat. What should the nurse do to improve this patient's nutritional status?
1) Increase food choices.
2) Use body restraints for meals.
3) Call the physician for medication to alter his behavior.
4) Provide him with sandwiches, small pieces of fruit and cheese, and spill-proof drink containers.

4) Provide him with sandwiches, small pieces of fruit and cheese, and spill-proof drink containers.

An older person who uses the bathroom three times a night is experiencing eye problems, extreme fatigue, weakness, unsteadiness, and depression. What should the nurse say in response to this patient's symptoms?
1) "As people get older, they need less sleep."
2) "You may be having symptoms of sleep deprivation."
3) "Depression usually changes a person's sleep patterns."
4) "Changes in sleep patterns are a normal aging change."

2) "You may be having symptoms of sleep deprivation."

The nurse notes that an older patient has a behavior change during the evening hours. What should the nurse suspect is occurring with this patient?
1) Dehydration
2) Relocation trauma
3) Sundown syndrome
4) Reaction to medications

3) Sundown syndrome

Which action should the nurse suggest to an older person to promote sleep?
1) Take a sleeping aid.
2) Avoid bedtime snacks.
3) Go to bed early in the evening.
4) Get more physical activity during the day.

4) Get more physical activity during the day.

Which is an example of an iatrogenic disorder?
1) Stroke
2) Sensory loss
3) Pressure ulcers
4) Diabetes mellitus

3) Pressure ulcers

Alterations in mobility result primarily from problems with which body systems? Select all that apply.
1) Sensory system
2) Respiratory system
3) Genitourinary system
4) Cardiovascular system
5) Musculoskeletal system

1) Sensory system
2) Respiratory system
4) Cardiovascular system
5) Musculoskeletal system

Which potential respiratory problems is the nurse helping to prevent by encouraging an older person to increase activity? Select all that apply.
1) Influenza
2) Atelectasis
3) Pneumonia
4) Tuberculosis
5) Chronic bronchitis

2) Atelectasis
3) Pneumonia

How can the nurse instruct the older patient who is prescribed bedrest to improve mobility? Select all that apply.
1) Guided imagery
2) Aerobic exercises
3) Isometric exercises
4) Anaerobic exercises
5) Active ROM exercises

3) Isometric exercises
5) Active ROM exercises

What contributes to the development of postural sway with ambulation? Select all that apply.
1) Medications
2) Environment
3) Aging changes
4) Chronic diseases
5) Prolonged bedrest

1) Medications
3) Aging changes
4) Chronic diseases

After an assessment, the nurse determines that an older patient is at risk for falling. What assessment findings did the nurse use to make this clinical decision? Select all that apply.
1) Has sleep apnea
2) Is hard of hearing
3) Drinks caffeinated coffee
4) Has osteoarthritis in both hips
5) Takes acetaminophen for pain

1) Has sleep apnea
2) Is hard of hearing
4) Has osteoarthritis in both hips

For which type of incontinence would a prompted bladder retraining program be the most beneficial? Select all that apply.
1) Urge
2) Stress
3) Surgical
4) Overflow
5) Functional

1) Urge
2) Stress

What physiological factors increase an older person's risk of developing pressure ulcers? Select all that apply.
1) Age
2) Friction
3) Moisture
4) Immobility
5) Nutritional status

1) Age
4) Immobility
5) Nutritional status

Which nutrients are often lacking in an older person's diet? Select all that apply.
1) Fats
2) Iron
3) Calcium
4) Vitamin C
5) Riboflavin

2) Iron
3) Calcium
4) Vitamin C
5) Riboflavin

What should the nurse recognize as causes for an older person to experience anorexia? Select all that apply.
1) Depression
2) Poor dentition
3) Social isolation
4) Vitamin deficiency
5) Quality of institutional food

1) Depression
2) Poor dentition
3) Social isolation
5) Quality of institutional food

The nurse is concerned that an older patient is at risk for aspirating. What information did the nurse use to make this clinical determination? Select all that apply.
1) Prefers to eat alone
2) Poor appetite for breakfast
3) Difficulty swallowing liquids
4) Serum albumin level 2.8 g/dL
5) Frequent episodes of heartburn

3) Difficulty swallowing liquids
5) Frequent episodes of heartburn

Which observations indicate that an older person may be experiencing sleep apnea? Select all that apply.
1) Talking during sleep
2) Moaning while turning in bed
3) Changing positions throughout the night
4) Cessation of breathing for 10 seconds or more
5) Loud choking or snoring when breathing resumes

4) Cessation of breathing for 10 seconds or more
5) Loud choking or snoring when breathing resumes

What health conditions are associated with untreated sleep apnea? Select all that apply.
1) Stroke
2) Osteoarthritis
3) Cardiac disease
4) Cognitive decline
5) Decreased quality of life

1) Stroke
3) Cardiac disease
4) Cognitive decline
5) Decreased quality of life

What contributes to iatrogenesis in hospitals? Select all that apply.
1) Dehydration
2) Malnutrition
3) Constipation
4) Overuse of drugs
5) Prolonged immobilization

1) Dehydration
2) Malnutrition
4) Overuse of drugs
5) Prolonged immobilization

What are common iatrogenic disorders seen in a nursing facility? Select all that apply.
1) Stroke
2) Pressure ulcers
3) Immobilization
4) Nosocomial infections
5) Adverse drug reactions

2) Pressure ulcers
3) Immobilization
4) Nosocomial infections
5) Adverse drug reactions

Which is NOT a characteristic of mental wellness?
1) Having a clear purpose in life
2) Maintaining open relationships
3) Coping creatively with life's situations
4) Maintaining physical health despite being overwhelmed by stress

4) Maintaining physical health despite being overwhelmed by stress

Which characteristic indicates a lack of mental health wellness?
1) A strong reality orientation
2) A feeling of impending doom
3) A clear meaning and purpose in life
4) A capability for open and creative relationships

2) A feeling of impending doom

What is the best way to measure cognition?
1) Evaluating choices
2) Assessing mental function
3) Reviewing educational level
4) Monitoring interpersonal communication

2) Assessing mental function

Which would be a symptom of short-term memory loss?
1) Always looking for glasses
2) Inability to recall year of birth
3) Forgetting the names of one's children
4) Inability to count backward from 100 by sevens

1) Always looking for glasses

Where do I belong?" is an example of what type of statement?
1) Altered judgment
2) Altered perception
3) Short-term memory loss
4) Long-term memory loss

3) Short-term memory loss

High school years weren't important to me" is an example of what type of statement?
1) Altered perception
2) Long-term memory loss
3) Short-term memory loss
4) Altered problem solving

2) Long-term memory loss

When you are old like me, what you had for breakfast isn't important" is an example of what type of statement?
1) Altered perception
2) Long-term memory loss
3) Short-term memory loss
4) Altered problem solving

3) Short-term memory loss

What is the first symptom of Alzheimer's disease?
1) Depression
2) Behavior changes
3) Long-term memory loss
4) Short-term memory loss

4) Short-term memory loss

The lady in the mirror took my dress" is an example of what type of statement?
1) Altered perception
2) Long-term memory loss
3) Short-term memory loss
4) Altered problem solving

1) Altered perception

Which is NOT considered to be a higher level of thought?
1) Managing finances
2) Knowing how to do laundry
3) Remembering to order heating oil in the winter
4) Knowing how to turn off the stove after cooking

2) Knowing how to do laundry

What is being tested when a person is asked to count backward from 100 by sevens?
1) Perception
2) Calculating ability
3) Short-term memory
4) Problem-solving ability

2) Calculating ability

Which statement is true about mental health?
1) Gerotranscendence is psychological well-being.
2) Healthy mental health depends on enmeshment.
3) Having good mental health depends on positive nurturing.
4) Healthy mental health is the result of positive life experiences.

1) Gerotranscendence is psychological well-being.

Family members sit with an older patient and listen while he tells about a period of time when he was in the Army and lived with extended family in another state. What should the nurse identify as a characteristic of this patient's memories?
1) They are fiction.
2) They are based on facts.
3) They are evidence of cognitive decline.
4) They are based on the patient's belief system.

4) They are based on the patient's belief system

Which describes the first phase of developing a perception?
1) Form an opinion.
2) Collect data through the five senses.
3) Question the validity of observations.
4) Compare data with previous experiences.

2) Collect data through the five senses.

Which statement indicates that an older patient with dementia has an alteration in perception?
1) "The bingo game starts at 3:00 pm and I can't be late."
2) "My family is expected to arrive later this afternoon."
3) "The best breakfast here is scrambled eggs and toast."
4) "The people here are all prisoners and you are the guards."

4) "The people here are all prisoners and you are the guards."

The nurse is concerned that an older patient is becoming disoriented. What information caused the nurse to have this concern?
1) Patient cannot find reading glasses
2) Patient identifies the year as being 1945
3) Patient is expecting family to visit later in the day
4) Patient thinks the dining hall is where the recreation room is located

2) Patient identifies the year as being 1945

The nurse is preparing to conduct a short test of mental functioning with an older person. Which aspect of this test may be omitted?
1) Memory
2) Thinking
3) Perception
4) Orientation

2) Thinking

What is the nurse testing when asking a resident to repeat three items after the nurse?
1) Memory recall
2) Memory retention
3) Memory encoding
4) Short-term memory

3) Memory encoding

What is the nurse testing when asking a resident the day, month, and year?
1) Orientation
2) Memory recall
3) Long-term memory
4) Short-term memory

1) Orientation

Which is NOT a correct assumption about mental status tools?
1) Most tools are short.
2) They assess level of impairment.
3) They take into consideration education and race.
4) They can be used with medical and psychiatric patients.

3) They take into consideration education and race.

Which would NOT be a reason for an older adult becoming uncooperative during a mental competency assessment?
1) Feeling defensive
2) Feeling forced to cooperate
3) Having a poor attention span
4) Having the nurse focus entirely on the adult

4) Having the nurse focus entirely on the adult

When administering the Mini-Cog mental status examination, the older patient refuses to draw the face of a clock. How should the nurse score this finding?
1) Delirium
2) Confusion
3) Correct response
4) Abnormal response

4) Abnormal response

What technique should the nurse use to ensure that a mental status examination tool is valid and reliable?
1) Seek evidence-based information about the tool.
2) Ask the charge nurse which tool meets the criteria.
3) Read an article about testing performed on the tool.
4) Have two nurses use it and score the patient at the same time.

4) Have two nurses use it and score the patient at the same time.

What should the nurse do to gain an older patient's cooperation when conducting a mental status examination?
1) Ask the patient to select the time.
2) Schedule the examination after morning care.
3) Plan to complete the examination before bedtime.
4) Fit the examination in while providing medications.

1) Ask the patient to select the time.

Which are aids for memory and mental function that an older adult might use?
1) List making and environmental cues
2) Changing routine to avoid getting into repetitive patterns
3) A wide variation of daily experiences to trigger memory
4) Attempting to meet new people to keep social skills intact

1) List making and environmental cues

Which is true about confused older adults who retain social skills?
1) They are often ignored in social situations.
2) They are often more confused in social situations.
3) They are often encouraged not to interact with others.
4) They are often assessed as being able to function at a higher level.

4) They are often assessed as being able to function at a higher level.

During an annual assessment, an older patient has decreases in memory recall and orientation. What might cause this type of change in mental status?
1) Dementia
2) Normal aging
3) Severe depression
4) Elevated blood pressure

1) Dementia

What should be done with information learned during a mental health assessment?
1) The information must be used on the patient's behalf.
2) The information could be used as case studies in textbooks.
3) The information should be used to further nursing research.
4) The information should be shared with family and friends of the patient in an open forum.

1) The information must be used on the patient's behalf.

What should the nurse do with a completed mental status examination?
1) Give it to the family.
2) Send it to the physician.
3) Place it on the medical record.
4) Fax it to the insurance company.

3) Place it on the medical record.

An older patient's mental functioning is lower than the score of a mental status examination indicates. What should this information suggest to the nurse?
1) The patient has dementia.
2) The patient has a mental illness.
3) The examination needs to be repeated.
4) The examination was performed incorrectly.

2) The patient has a mental illness.

An older person is demonstrating a significant change in personality. What should the nurse suspect is occurring with this patient?
1) Pick's disease
2) Parkinson's disease
3) Alzheimer's disease
4) Cardiovascular disease

1) Pick's disease

An older patient is demonstrating signs of dementia. What should the nurse plan for this patient?
1) Reassess mental status frequently.
2) Transfer to a facility that specializes in dementia.
3) Reassess using a different mental status examination tool.
4) Schedule a conference to share the findings with the family.

1) Reassess mental status frequently.

An older patient who is recovering from a spinal cord injury refuses to participate in any facility activities and refuses to leave his room when his family visits. The occupational therapist is having difficulty getting him to participate in feeding and other upper extremity activities. What might be the cause of this type of behavior?
1) Delirium
2) Depression
3) Relocation trauma
4) Undiagnosed head injury

2) Depression

What is severe depression in an older person LEAST likely to effect?
1) Nursing home placement
2) Memory and cognitive function
3) Treatment of chronic disease processes
4) Personal hygiene and activities of daily living

3) Treatment of chronic disease processes

An older patient who lives alone has dried feces on his legs and under the fingernails. Additional observations include oily hair, unkempt beard, and a weight loss of 15 lb over the last 2 months. For what is this patient at risk?
1) Diabetes
2) Tuberculosis
3) Adult day care
4) Nursing home placement

4) Nursing home placement

The nurse notes that an older community member who has been sad since the death of her spouse has experienced pneumonia and exacerbation of heart failure over the last 3 months. What should the nurse suspect is occurring with this patient?
1) Depression is causing the illnesses.
2) The patient's home needs a thorough cleaning.
3) The patient is not taking medications as prescribed.
4) Family members are ignoring the patient's feelings.

1) Depression is causing the illnesses.

The nurse overhears nursing assistants talk about how an older newly admitted patient is mean and argues with everyone who comes into the room. What should the nurse suspect is occurring with this patient?
1) Depression
2) Poor oxygenation
3) Body fluid imbalance
4) Inadequate nutritional intake

1) Depression

The nurse suspects that an older patient is depressed. What should the nurse expect to be most affected when completing a mental status examination with this patient?
1) Memory
2) Thinking
3) Judgment
4) Calculation

1) Memory

An older patient being treated for depression claims that she recalls certain aspects of her life differently than what her family state occurred. What should the nurse identify as being the reason for the discrepancy between the patient's memory and the family's statements?
1) The patient is confused.
2) The patient's memories are biased.
3) The family is misunderstanding the events.
4) The family wants the patient to stay institutionalized.

2) The patient's memories are biased.

When should mental status assessments be completed? Select all that apply.
1) Every day
2) At least once a week
3) At the time of admission
4) After the patient has been settled for a few months
5) Any time there is a decline in activities of daily living or change in behavior

3) At the time of admission
5) Any time there is a decline in activities of daily living or change in behavior

Which criteria are tested with the Mini Cog mental status examination? Select all that apply.
1) Calculating
2) Remembering
3) Communicating
4) Problem-solving
5) Corrects for education and culture

2) Remembering
3) Communicating
4) Problem-solving
5) Corrects for education and culture

What is the purpose of a psychological assessment? Select all that apply.
1) Care planning
2) Determining placement in a facility
3) Identifying strengths and weaknesses
4) Determining the cost of nursing care
5) Pointing out the need for psychiatric evaluation

1) Care planning
2) Determining placement in a facility
3) Identifying strengths and weaknesses

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