Gerontological Nursing Final Exam Test Bank Questions

The nurse explains that in the late 1960s, health care focus was aimed at the older adult because:

a. disability was viewed as unavoidable.

b. complications from disease increased mortality.

c. older adults needs are similar to those of all adults.

d. preventive health care practices increased longevity.

ANS: D

The nurse clarifies that in the terminology defining specific age groups, the term aged refers to persons who are:

a. 55 to 64 years of age.

b. 65 to 74 years of age.

c. 75 to 84 years of age.

d. 85 and older.

ANS: C

The nurse cautions that ageism is a mindset that influences persons to:

a. discriminate against persons solely on the basis of age.

b. fear aging.

c. be culturally sensitive to concerns of aging.

d. focus on resources for the older adult.

ANS: A

The nurse points out that the most beneficial legislation that has influenced health care for the older adult is:

a. Medicare and Medicaid.

b. elimination of the mandatory retirement age.

c. the Americans with Disabilities Act.

d. the Drug Benefit Program.

ANS: A

The nurse clarifies that a housing option for the older adult that offers the privacy of an apartment with restaurant-style meals and some medical and personal care services is the:

a. government-subsidized housing.

b. long-term care facility.

c. assisted-living center.

d. group housing plan.

ANS: C

The 75-year-old man who has been hospitalized following a severe case of pneumonia is concerned about his mounting hospital bill and asks if his Medicare coverage will pay for his

care. The nurses most helpful response is Yes. Medicare:

a. pays 100% of all medical costs for persons older than 65.

b. Part B pays hospital costs and physician fees.

c. Part A pays for inpatient hospital costs.

d. Part D pays 80% of the charges made by physicians.

ANS: C

The daughter of a patient who has been diagnosed with terminal cancer asks which documents are required to allow her to make health care decisions for her parent. The nurses most informative response is:

a. Advance directives indicate the degree of intervention desired by the patient.

b. A Do Not Resuscitate document signed by the patient transfers authority to the next of kin.

c. A durable power of attorney for health care transfers decision-making authority for health care to a designated person.

d. A living will transfers authority to the physician.

ANS: C

The daughter of a resident in a long-term care facility is frustrated with her 80-year-old mothers refusal to eat. The nurse explains that the refusal to eat is a behavior that is an:

a. effort to maintain a portion of independence and self direction.

b. indication of approaching Alzheimer disease.

c. effort to gain attention.

d. indication of the dislike of the institutional food.

ANS: A

The nurse clarifies that the conditions of a living will go into effect when:

a. the patient declares that desire in writing.

b. a family member indicates the desire for curative therapy to cease.

c. two physicians agree in writing that the criteria in the living will have been met.

d. the physician and a family member agree that the criteria in the living will have

been met

ANS: C

In the 1980s, Medicare initiated a program of diagnosis-related groups (DRGs) to reduce hospital costs by:

a. classifying various diagnoses as ineligible for hospitalization.

b. allotting a set amount of hospital days and prospective payment on the basis of the admitting diagnosis.

c. specifying particular physicians to treat specified diagnoses.

d. using frequency of a particular diagnosis to set a payment schedule.

ANS: B

When discussing extended care with a patient who has had a hip replacement and needs physical therapy, the nurse would recommend a(n):

a. basic care facility.

b. skilled care facility.

c. subacute care facility.

d. assisted-living residence.

ANS: B

The 80-year-old woman who is recovering from a stroke is being sent to an extended-care facility. She is concerned about the expense. The nurse can allay anxiety by explaining that Medicare will cover extended-care facility costs:

a. for a period of 30 days.

b. for a period of 45 days for physical therapy.

c. for a period of 100 days for needed skilled care.

d. until she is able to be discharged home.

ANS: C

The senior citizen political action group that uses volunteers and lobbyists to advance the interests of older adults is the:

a. American Association of Retired Persons (AARP).

b. National Council of Senior Citizens (NCSC).

c. National Alliance of Senior Citizens (NASC).

d. Gray Panthers.

ANS: A

The nurse gives an example of the caregiver who is guilty of elder abuse as the:

a. daughter who uses her mothers Social Security money to purchase her mothers

medication.

b. son who puts an alarm on the front door to prevent his mother from wandering out

of the house.

c. wife who allows her mentally competent husband to refuse to take a bath for a

week.

d. frail spouse who is unable to bathe or change the clothes of her physically

dependent husband.

ANS: D

The nurse cautions that the most frequent response to elder abuse by the abused older adult is:

a. anger.

b. physical retaliation.

c. notification of authorities.

d. nothing at all.

ANS: D

Many nurses today do not seek careers in gerontology because:

a. the physical work is too difficult.

b. their technological skills are not used.

c. there is not enough challenge.

d. there are limited options for employment.

ANS: B

The nurse clarifies that the term baby boomers refers to persons who:

a. entered school in 1945.

b. served in the military in World War II.

c. were born between 1946 and 1964.

d. were eligible for Social Security benefits in 2000.

ANS: C

Restraining an older adult in a recliner to prevent wandering is an example of:

a. physical abuse.

b. neglect.

c. emotional abuse.

d. self-neglect.

ANS: A

Nonprovision of medical care because of lack of finances is an example of:

a. physical abuse.

b. neglect.

c. emotional abuse.

d. self-neglect.

ANS: B

Health care workers eating a residents candy without permission is an example of:

a. physical abuse.

b. neglect.

c. emotional abuse.

d. self-neglect.

ANS: C

The nurse is aware that a persons attitude about aging is influenced mainly by his or her. (Select all that apply.)

a. life experiences

b. income level

c. level of education

d. current age

e. occupation

Gerontology encompasses application to . (Select all that apply.)

a. appropriate housing

b. health care

c. public education

d. business ventures

e. government-sponsored pensions

Medicare Part C allows eligible persons to receive Medicare benefits via the services of private insurance companies through the services of a . (Select all that apply.)

a. health maintenance organization (HMO)

b. preferred provider organization (PPO)

c. provider-sponsored organization (PSO)

d. private fee for service organization (PFFS) medical service organization

The nurse is aware that a familys emotional response to an aging loved ones attempts to cope with diminishing abilities and increased care needs would include

apply.)

a. grief

b. anger

c. frustration

d. loss

e. resentment

The nurse outlines the characteristics of the typical caregiver for an aging family member as. (Select all that apply.)

a. 32 years of age

b. female

c. having full-time employment

d. having a care recipient older than 70

e. giving care for an average of 18 years

The nurse reminds a family that indicators of self-neglect in the aging person include. (Select all that apply.)

a. misbalanced check book

b. reduced personal hygienec. increased alcohol consumption

d. irritability

e. loss of weight

The nurse reminds a group of prospective caregivers that elder abuse may take the form of

. (Select all that apply.)

a. causing physical harm

b. misappropriation of finances

c. psychological intimidation

d. emotional depersonalization

e. abandonment

The nurse explains that research done by the National Institute on Aging found that. (Select all that apply.)a. older patients receive less information regarding health management than younger

patients

b. information on lifestyle changes were directed at younger people

c. older patients were denied timely appointments for evaluation of acute illnesses

d. rehabilitation programs offered limited services to the older adult

e. older patients receive less evaluation and fewer treatment options for acute illnesses

The Nursing Competence in Aging initiative advocates enhancing nurses . (Select all that apply.)

a. knowledge in gerontics

b. skills in geriatrics

c. opportunities for employment

d. political sensitivity for the older adult

e. attitudes related to the older adult

The nurse keeps the environment warmer for older adults because they are more sensitive to

cold because of the age-related changes in their:

a. metabolism rate.

b. subcutaneous tissue.

c. musculoskeletal system.

d. peripheral vascular system.

ANS: B

The nurse reassures the distressed 75-year-old male that the wartlike dark macules with distinct borders are not melanomas, but the skin lesions of:a. senile lentigo.

b. cutaneous papillomas.

c. seborrheic keratoses.

d. xerosis.

ANS: C

The nurse is accompanying a group of older adults on a July 4th outing to monitor heat prostration. Older adults are intolerant of heat because of an age-related reduction of:

a. melanin.

b. perspiration.

c. body temperature.

d. capillary fragility.

ANS: B

The nurse cautions the CNAs to use care when transferring or handling older adults because their vascular fragility will cause:

a. altered blood pressure.

b. pressure ulcers.

c. pruritus.

d. senile purpura.

ANS: D

The nurse assesses a stage I pressure ulcer on an older adults coccyx by the appearance of a:

a. clear blister.

b. nonblanchable area of erythema.

c. scaly abraded area.

d. painful reddened area.

ANS: B

The CNA caring for an older adult asks if the yellow, waxy, crusty lesions on the patients axilla and groin are contagious. The nurses most helpful response is:

a. Yes. It is cellulitis caused by bacteria.

b. No. It is seborrheic dermatitis caused by excessive sebum.

c. Yes. It is an indication of scabies.d. No. It is the lesion seen with basal cell carcinoma.

ANS: B

The nurse leads a group of postmenopausal older women on a daily 15-minute walking tour

through the long-term care facility to:

a. improve bone strength.

b. orient them to their surroundings.

c. improve their socialization.

d. increase their appetite.

ANS: A

When the perplexed 70-year-old woman asks, How in the world can my bones be brittle when I eat all the right foods? the nurses most informative reply is:

a. Calcium loss is expected in the older adult.

b. Calcium is continuously withdrawn from bone for nerve and muscle function.

c. Smoking and alcohol consumption speed calcium loss from the bones.

d. Walking and standing increase calcium loss from the bone.

ANS: B

When the 70-year-old woman complains, I weigh exactly the same as I did when I wore a size 10 and now I can barely squeeze into a size 16, the nurse explains:

a. Metabolism in the older adult creates increased adipose tissue.

b. Postmenopausal women gain adipose tissue related to loss of calcium.

c. Decrease in muscle mass is replaced with adipose tissue.

d. Kyphosis causes a redistribution of weight.

ANS: C

When the 70-year-old postmenopausal woman asks whether her hormone replacement therapy (HRT) will prevent bone loss, the nurses most helpful response is:

a. No. HRT is not helpful after the age of 60.

b. Yes. HRT will prevent bone loss but can cause a stroke, heart attack, or breast

cancer.

c. No. HRT is reliant on some natural estrogen production from the ovaries.

d. Yes. HRT is a widely accepted therapy for prevention of bone loss.

ANS: B

An 80-year-old-woman who has osteoarthritis complains of how ugly her hands have become since she has developed Heberden nodes, which are:

a. yellow longitudinal lines in the nails.

b. thickened discolored fingernails.

c. darkened areas under the fingernail.

d. bony enlargements of distal joints of the fingers.

ANS: D

The nurse modifies the nursing care plan for a 62-year-old woman in an extended-care facility who is suffering a flare in her rheumatoid arthritis to include interventions to:

a. increase fluid intake.

b. schedule several rest periods to balance activity.

c. reduce salt in the diet.

d. assist with rigorous finger extension exercises.

ANS: B

The nurse explains that emphysema is a chronic obstructive pulmonary disease characterized by the pathophysiology of:

a. constriction of the bronchial tree, excessive mucus, and nonproductive cough.

b. calcification of the alveoli and a dry cough.

c. overinflation of the alveoli, making them ineffective for gas exchange.

d. inflammation of the trachea and bronchioles, excessive mucus, and productive

cough.

ANS: C

The nurse explains that the pathophysiology of a myocardial infarct is that:

a. a portion of the myocardium necroses and scars over.

b. the coronary vessels are narrowed during the attack.

c. the ischemic myocardium causes pain during the attack but is able to regenerate.

d. there is damage to the myocardium but no serious alteration of cardiac output.

ANS: A

The nurse is aware that the cardinal signs and symptoms of congestive heart failure are:

a. dyspnea and edema.

b. myocardial pain and hypotension.

c. ventricular arrhythmias and cyanosis.

d. atrial arrhythmias and polycythemia.

ANS: A

The nurse explains that pernicious anemia is caused by:

a. an iron deficiency.

b. a deficiency of vitamin B12.

c. inadequate nutrition.

d. blood loss.

ANS: B

The nurse alters the nursing care plan for a patient with a hiatal hernia and resultant

gastrointestinal reflux to include interventions for:

a. encouraging the patient to lie down after meals.

b. drinking two full glasses of liquid after the evening meal.

c. eating smaller, more frequent meals.

d. using caffeine drinks to assist with digestion.

ANS: C

The nurse suspects that the pale, edematous, listless diabetic patient who has a blood urea nitrogen (BUN) level of 35 mg/dL and a creatinine level of 4 mg/dL has:

a. diverticulitis.

b. congestive heart failure.

c. chronic renal failure.

d. benign prostatic hypertrophy.

ANS: C

The most appropriate intervention added to the nursing care plan for a person with Parkinson disease with a nursing diagnosis of Nutrition, less than body requirements related to difficulty

swallowing, would be to:

a. feed the patient at each meal.

b. place the patient in a semi-Fowler position for mealtime.

c. offer a thick, high-nutrition shake as a snack.

d. encourage the patient to drink a sip of water after each bite of solid food.

ANS: C

The nurse would anticipate that a person with a hemorrhagic CVA to the left hemisphere would exhibit:

a. language disturbances.

b. poor impulse control.

c. inappropriate affect.

d. confabulation.

ANS: A

When giving written discharge instructions to a person with macular degeneration, the nurse should:

a. write the instructions in bold print.

b. adjust the table and light to assist the patient to use peripheral vision to read.

c. place written document directly in front of the patient to read.

d. read the document to the patient.

ANS: B

The nurse becomes aware of inadequate insulin coverage in a patient with diabetes mellitus type 1 when the patient exhibits:

a. diminished urine output.

b. ketones in the urine.

c. shallow and slow respirations.

d. extreme diaphoresis.

ANS: B

An 80-year-old extended-care resident comes to the nurse asking for a bandage for a bleeding, dark pigmented mole with irregular shape and border. The nurse documents this assessment and reports it as a suspected:

a. melanoma.

b. basal cell carcinoma.

c. cutaneous papilloma.

d. senile lentigo.

ANS: A

The nurse takes into consideration that the factors influencing the timing and extent of age- related changes include . (Select all that apply.)

a. health maintenance

b. ethnicity

c. heredity

d. attitude

e. environment

The nurse reminds an 82-year-old man with rosacea that he should avoid . (Select

all that apply.)

a. stress

b. dairy products

c. sun exposure

d. spicy foods

e. alcohol consumption

The nurse is aware that in order for a person to support ossification, he or she must have an

adequate intake of vitamin(s) . (Select all that apply.)

a. A

b. B6

c. C

d. D

e. E

The nurse uses a chart to outline the risk factors for osteoporosis, which include .

(Select all that apply.)

a. menopause

b. smoking

c. white female

d. excessive high-impact exercise

e. long-term use of phenytoin (Dilantin)

The nurse outlines age-related changes in the respiratory system that put the older adult at risk for infection, which include . (Select all that apply.)

a. reduced ciliary movement

b. decrease in alveolar elasticity

c. pooling of secretions

d. flattened diaphragm

e. calcification of costal cartilage

The nurse explains that the lowest recommended daily caloric intake to meet nutritional needs

of the older adult safely is calories.

a. 1000

b. 1200c. 1400

d. 1800

ANS: B

The 65-year-old woman brags that by using the MyPyramid guidelines for nutrition, she has

lost 15 lb. The nurse reminds her that in order to maintain the weight loss, she must be physically

active for minutes a day.

a. 15 to 20

b. 20 to 30

c. 30 to 40

d. 40 to 60

ANS: D

The nurse recommends that the older man eat chicken and fish because these are complete

proteins, which have:

a. some molecules of carbohydrate.

b. all the essential amino acids.

c. high fat content.

d. soluble fiber.

ANS: B

The nurse explains that high-density lipoproteins (HDLs), the so-called healthy fats, are made

up of:

a. mainly proteins.

b. mostly triglycerides.

c. mainly cholesterol.

d. a variety of minerals.

ANS: A

The nurse points out that the nonhealing pressure ulcers and decreasing visual acuity in a

patient on a fat-restricted diet may be related to the patients impaired ability to metabolize

vitamin:

a. A.

b. B6.

c. B12.

d. C.

ANS: A

The home health nurse does an ongoing assessment of the patient who has had a subtotal

gastrectomy for evidence of a deficiency in vitamin:

a. A.

b. B6.

c. B12.

d. C.

ANS: C

The nurse giving an iron preparation in capsule form will improve its absorption by giving the

patient extra:

a. orange juice.

b. milk products.

c. water.

d. caffeine drinks.

ANS: A

The nurse caring for the older adult patient who is taking a diuretic for control of hypertension

should monitor the patient closely for signs of:

a. hypokalemia.

b. hypocalcemia.

c. hyponatremia.

d. hyperkalemia.

ANS: A

The older adult patient in an extended-care facility has a pressure ulcer. The nurse would

encourage wound healing by increasing the patients intake of zinc from food sources such as:

a. meat.

b. citrus fruit.

c. green leafy vegetables.

d. complex carbohydrates.

ANS: A

The nurse is aware that older adults need a minimum daily fluid intake of mL.

a. 1000

b. 2000

c. 3000

d. 4000

ANS: B

Older adults who consume excessive amounts of alcohol put themselves at risk for nutritional

deficits because alcohol:a. decreases blood glucose levels.

b. alters the function of some minerals.

c. interferes with the absorption of nutrients.

d. increases the metabolism.

ANS: C

The nurse in a retirement center who is selecting a main dish from the residents menu for an

Orthodox Jewish man would select:

a. crab cakes with white sauce.

b. lamb chops with mint jelly.

c. ham steak with red gravy.

d. pork chops with cranberries.

ANS: B

The nurse takes into consideration that the patient who would need higher caloric intake

would be the patient with a condition such as:

a. bacterial pneumonia.

b. osteoporosis.

c. arthritis.

d. stroke.

ANS: A

The nurse explains that most older adults need only about 50 g of protein daily, which is equivalent to approximately lb.

a. 1

b.

c.

d.

ANS: D

The nurse instructing the older man in the use of MyPyramid points out that he should eat

cup(s) of fruit a day.

a.

b. 1

c.

d. 2

ANS: D

While instructing the patient who is to take oral iron supplements, the nurse indicates that:

a. supplements should be taken between meals on an empty stomach.

b. medication should be drunk from a nonmetal glass.

c. the color of the stool will change to dark green or black.

d. constipation is likely to occur.

ANS: C

When the nurse weighs an edematous patient with congestive heart failure, the weight

increase from yesterday is 2.2 lb. The nurse assesses that this patient has retained of fluid.

a. 500 mL

b. 1 L

c. 1500 mL

d. 2 L

ANS: B

The nurse encourages a group of extended care residents to sit out on the sunny patio for an

hour a day during the afternoon in order to help them with the synthesis of vitamin:

a. A.

b. B12.

c. D.

d. K.

ANS: C

What is the caloric value (in calories per gram [cal/g]) of protein?

a. 9 cal/g

b. 4 cal/g

c. 0 cal/g

d. 7 cal/g

ANS: B

What is the caloric value of alcohol?

a. 9 cal/g

b. 4 cal/g

c. 0 cal/g

d. 7 cal/g

ANS: D

What is the caloric value of vitamins?

a. 9 cal/g

b. 4 cal/g

c. 0 cal/g

d. 7 cal/g

ANS: C

What is the caloric value of fat?

a. 9 cal/g

b. 4 cal/g

c. 0 cal/g

d. 7 cal/g

ANS: A

The nurse takes into consideration the factors that influence nutritional needs, which include

. (Select all that apply.)

a. bone density

b. gender

c. climate

d. presence of illness

e. body temperature

The nurse uses a chart to show the vital nutrients required by all persons, which are

. (Select all that apply.)

a. carbohydrates

b. proteins

c. vitamins and minerals

d. fats

e. electrolytes

The nurse encourages older adults to include complex carbohydrates such as vegetables and

fruits in their diet because complex carbohydrates contain . (Select all that apply.)

a. minerals

b. fats

c. vitamins

d. soluble fiber

e. polysaccharides

The nurse is aware that older adults who do not take in adequate fluids are at risk for. (Select all that apply.)

a. altered absorption of drugs

b. digestive disorders

c. constipation

d. bleeding disorders

e. reduced appetite

Older adults plagued with chronic health problems may become undernourished because they. (Select all that apply.)

a. are too fatigued to prepare meals

b. become frustrated when attempting to open packaging

c. may be unable to carry groceries any distance

d. have no interest in eating out due to health issues

e. lack stamina to shop for groceries

Older adults plagued with chronic health problems may become undernourished because they. (Select all that apply.)

a. are too fatigued to prepare meals

b. become frustrated when attempting to open packaging

c. may be unable to carry groceries any distance

d. have no interest in eating out due to health issues

e. lack stamina to shop for groceries

n older adult who is a resident in an extended-care facility is at risk for nutritional deficits

related to . (Select all that apply.)

a. repetitive nature of meals

b. lack of culturally significant food

c. environmental odorsd. reaction to being fed by others

e. non-nutritious food choices

The nurse suggests to the older adult that sources of protein that are less expensive than meat

include . (Select all that apply.)

a. corn

b. beans

c. whole-grain foods

d. cheese

e. nuts

The nurse cautions the older adult against taking excess vitamin supplements because some

vitamins can be retained in fatty tissue and cause liver damage, including vitamin(s)

. (Select all that apply.)

a. Ab. B6

c. C

d. D

e. E

The nurse is aware that the initial entry to deep sleep is:

a. stage 1 nonrapid eye movement (NREM).

b. stage 3 NREM.

c. stage 5 NREM.

d. rapid eye movement (REM) sleep.

ANS: B

The phenomenon of sleep walking is most likely to occur in the sleep stage of:

a. stage 1 NREM.

b. stage 2 NREM.

c. stage 4 NREM.d. REM sleep.

ANS: C

The nurse explains that older adults often experience a disturbed sleep-wake cycle because of hormonal changes, which include a(n) level.

a. increase in angiotensin

b. decrease in insulin

c. increase in growth hormone

d. decrease in melatonin

ANS: D

The older man in a long-term care facility consistently wakes at 3 AM and does not return to sleep. The nurse records this behavior as insomnia.

a. sleep initiation

b. sleep maintenance

c. terminal

d. undifferentiated

ANS: C

The newly admitted older adult who cannot fall asleep and asks for a sedative every night is most probably experiencing a difficulty with sleep:

a. initiation related to anxiety of relocation.

b. maintenance related to unfamiliar environment.

c. initiation related to depression associated with relocation.

d. maintenance related to episodes of nocturnal movement disorders.

ANS: A

The home health nurse assesses that the patient is probably experiencing myoclonus when his wife says:

a. His loud snoring and jerking awake wakes me up, too.

b. I am black and blue from his kicking me every night.

c. He wakes up at 2 AM every morning and walks around the house.

d. His constant leg movements tear up the covers and keep me awake.

ANS: B

The nurse would question the order for lorazepam (Ativan), 5 mg at bedtime, for a patient with:

a. chronic obstructive pulmonary disease (COPD).

b. any form of dementia.

c. hypertension.

d. sleep apnea.

ANS: D

In order to assist a 75-year-old male resident in a long-term care facility to decrease his problems with sleep initiation, the nurse would:

a. provide a heavy snack at bedtime.

b. reschedule the 8 PM albuterol inhalation treatment to 4 PM.

c. coach the resident in 10 minutes of exercise before bedtime.

d. provide a cola drink, strong tea, or cocoa at bedtime.

ANS: B

The nurse cautions the patient who has just started on the antidepressant trazodone

hydrochloride to help relieve insomnia to:

a. increase fluids.

b. avoid aged cheese and red wine.

c. decrease sodium intake.

d. avoid excessive exposure to the sun.

ANS: D

The 80-year-old man complains that when he goes to bed and cannot fall asleep, he tosses and turns and gets so frustrated that he gets up and drinks coffee all night. The nurse suggests

that when he has not fallen asleep after 30 minutes, he should:

a. take two tablets of a sedative medication.

b. get up and do a mild stretching exercise for 15 minutes.

c. remain in bed with his eyes closed.

d. get up and read until he feels sleepy and then return to bed.

ANS: D

The nurse clarifies that the continuous positive airway pressure (CPAP) machine decreases the incidence of episodes of sleep apnea by:

a. stimulating inspiration to be deeper.

b. taking over respiratory activity when the patient ceases to breathe.

c. sounding an alarm if respirations have ceased.

d. keeping alveoli from collapsing.

ANS: D

When the patient tells the home health nurse that he has flung himself out of bed three times in the course of a violent nightmare, the nurse recognizes the cardinal indicator of:

a. myoclonus.

b. restless legs syndrome.

c. rapid eye movement (REM) sleep disorder.

d. epilepsy.

ANS: C