Care
To minimize the effect of ageism, what is an initial action for the nurse caring for an older adult?
a. Recognize that nurses must act as advocates for aging clients
b. Accept that this population represents a substantial portion of those requiring nursing care
c. Self-reflect and formulate one’s personal view of aging and the older clients
d. Recognize ageism as a form of bigotry shared by many Americans
c. Self-reflect and formulate one’s personal view of aging and the older clients
A client residing in a long-term care facility has been experiencing restlessness and has often been found by nursing staff wandering in and out of other clients’ rooms during the night. The nurse views the client’s PRN antipsychotic medication order as which of the following?
a. An appropriate intervention to help assure the resident’s safety.
b. An option to be used only when all other nondrug interventions prove ineffective.
c. Inappropriate unless the physician is notified and approves its use.
d. Not an option because it should not be used to manage behaviors of this type.
d. Not an option because it should not be used to manage behaviors of this type.
While performing an assessment of a 75-year-old client in the emergency department, a nurse notes many bruises in various stages of healing on the client’s body. Which action should the nurse perform first?
a. Notify the nursing supervisor immediately
b. Notify the physician
c. Try to obtain more information from the client as to when and how these bruises occurred
d. Document the findings
c. Try to obtain more information from the client as to when and how these bruises occurred
According to Maslow, a fully actualized person displays which traits? Select all that apply.
a. Spontaneity
b. Self-direction
c. Creativity
d. Ethical conduct
e. Acceptance of self
A, B, C, E
The nurse is educating an 80-year-old client regarding a newly prescribed medication. The nurse’s teaching strategies include which of the following? Select all that apply.
a. Use pictures to show how the medication should be stored.
b. Ask the client to use his own words to describe the medication’s possible side effects.
c. Avoid written instruction in favor of verbal, face-to-face communication.
d. Deliver the information using a slow, deliberate manner of speech.
e. Repeat the information at least three times during the conversation.
A, B, E
In order to best respect an older client’s autonomy when assisting him finding appropriate, affordable housing, the nurse:
a. Provides examples of various options that include assistive services
b. Locates housing near senior citizen community center to minimize social isolation
c. Identifies housing close to the services he will need
d. Asks the client to provide examples of where he would like to live
d. Asks the client to provide examples of where he would like to live
The gerontologic nurse recognizes that which client is at highest risk for a decline in functional ability?
a. 79-year-old, moderate Alzheimer’s disease, requires assistance with all activities of daily living (ADLs).
b. 73-year-old, history of chronic bronchitis, lives with family.
c. 86-year-old, lost a spouse recently, is moving into an assisted living facility.
d. 69-year-old, peripheral vascular disease, visited by home health care weekly.
c. 86-year-old, lost a spouse recently, is moving into an assisted living facility.
Which of the following statements made by a nurse preparing to complete a health assessment and history of an older client reflects an understanding of the general health status of this population?
a. “I’ll need to document well regarding the medications the client is currently prescribed.”
b. “I am particularly interested in knowing how supportive the client’s family members are.”
c. “Older clients are being treated for a variety of chronic health care issues.”
d. “It will be interesting to see whether this client sees herself as being healthy.”
d. “It will be interesting to see whether this client sees herself as being healthy.”
The nurse using the SPICES model to assess older clients collects data on which topics? (Select all that apply.)
a. Sleep disorders
b. Problems with eating
c. Incontinence
d. Falls
e. Social situations
A, B, C, D
The daughter of an 80-year-old client brings her mother to the clinic and tearfully shares with the nurse “mom is too frail to live alone.” What is the nurse’s priority intervention?
a. Help the client express the importance of living independently to the family members
b. Assess the client’s functional abilities related to being able to safely live independently
c. Have the family provide examples that cause concern about client’s ability to live independently
d. Identify ways the family can help assure the client’s safety while living independently
b. Assess the client’s functional abilities related to being able to safely live independently
How can the nurse best respond to advocate for an older adult that is approached to participate in a research study?
a. Evaluating the client’s cognitive ability to understand the consequence of the study
b. Determining what risks to the client are involved
c. Discussing the importance of the study with the client and his family
d. Encouraging the client to discuss decision with a trusted family member or friend
a. Evaluating the client’s cognitive ability to understand the consequence of the study
The nurse working with older clients understands what fact about a health care proxy?
a. It states that no resuscitation should occur if breathing or heartbeat cease.
b. It can specify what treatment measures are or are not acceptable to the client.
c. It explains client’s wishes regarding treatment if the client cannot communicate.
d. It designates a surrogate health care decision maker if the client is incapacitated.
d. It designates a surrogate health care decision maker if the client is incapacitated.
An 80-year-old client is being admitted to a long term facility. What is the primary purpose of the initial geriatric assessment?
a. Identify the client’s physiologic baselines
b. Ultimately create a plan of care that prevents disability and dependence
c. Initiate the therapeutic nurse-client relationship
d. Document self-care deficiencies that the client exhibits
b. Ultimately create a plan of care that prevents disability and dependence
The nurse is assessing a family caregiver for signs of role stress. Which assessment findings are consistent with this condition? Select all that apply.
a. Denial
b. Anger
c. Social withdrawal
d. Irritability
e. Restfulness
A, B, C, D
The nurse is about to discuss the possible ways to meet the physical needs of an older adult client with the client’s adult children. The nurse guides the discussion based on which of the following American societal realities? Select all that apply.
a. Most dependent older adults prefer to live with family members whenever possible.
b. Family members are generally the care providers for dependent older adult family members.
c. Nursing facilities are generally a family’s last resort for the care of an older dependent adult.
d. A family generally doesn’t discuss financial issues until a crisis occurs.
e. Older dependent adults expect their adult family members to provide for care.
B, C, D
To establish a mutually respectful relationship with an older adult client being admitted to a skilled nursing unit, the nurse first introduces himself and then asks:
a. How the client would like to be addressed
b. If the client has any specific requests to make of the staff
c. The client to share a little about his or her personal likes and dislikes
d. The client to read the orientation materials that the facility provides
a. How the client would like to be addressed
The nurse is caring for a terminally ill older client who has a living will that excludes pulmonary and cardiac resuscitation. The family expresses a concern that the client may “change her mind.” The nurse best reassures the family by stating
a. “The nursing staff will watch her very closely for any indication she has changed her mind.”
b. “We will discuss her wishes with her regularly.”
c. “She can change her mind about any provision in the document at any time.”
d. “Your mother was very clear about her wishes when she signed the document.”
a. “The nursing staff will watch her very closely for any indication she has changed her mind.”
Which of the following statements accurately reflects data that the nurse should use in planning care to meet the needs of the older adult?
a. 50% of older adults have two chronic health problems.
b. Cancer is the most common cause of death among older adults.
c. Nutritional needs for both younger and older adults are essentially the same.
d. Adults older than 65 years of age are the greatest users of prescription medications.
d. Adults older than 65 years of age are the greatest users of prescription medications.
The nurse who volunteers at a community center for older people refers which people to the Supplemental Security Income office? Select all that apply.
a. Disabled persons
b. Those who are visually impaired
c. Deaf persons
d. Those with minimal income
e. Those who are cognitively impaired
A, B, D
A 76-year-old Hispanic client explains that she has not been taking her prescribed medication because her culture believes that dietary management would be just as effective in managing her problems. Which action by the nurse illustrates cultural accommodation?
a. Asking the client to give more details regarding this belief
b. Discussing with the client about possibly adding her dietary preferences into her treatment plan
c. Offering to have a registered nutritionist discuss the situation with the client
d. Researching the client’s proposed dietary beliefs
c. Offering to have a registered nutritionist discuss the situation with the client
An 87-year-old client is unsure of the purpose of a living will. The nurse describes its purpose best when stating:
a. “It’s a legal document that social services can help you create.”
b. “It designates a family member to make decisions if you become incompetent.”
c. “It provides a written description of your wishes in the event you become terminally ill.”
d. “It assures you won’t be subjected to treatments you don’t want.”
c. “It provides a written description of your wishes in the event you become terminally ill.”
A 69-year-old client who has both Medicare and long-term supplemental health care insurance shares with the nurse that he needs a visual examination as a follow-up after his cataract surgery. The nurse suggests that such treatment is most likely covered by
a. Medicare Part A.
b. Medicare Part B.
c. Medicare Part D.
d. Supplemental policy.
b. Medicare Part B.
What statement if made by a 70-year-old client would alert the nurse that teaching has been effective regarding normal physiological changes?
a. I have more sebaceous gland activity
b. I have lost some of my social support systems
c. I have an increased need for sleep
d. I have less joint cartilage that I used to
d. I have less joint cartilage that I used to
The director of nursing at a certified long-term care facility overhauls the nursing assistant training program to include which features? Select all that apply.
a. Training by the Activities Director on arts and crafts
b. Training in infection control measures
c. Instruction on resident rights
d. Inservice on physical therapy sessions
e. Education on safety measures
B, C, E
To best address the client’s right to self-determination, which of the following questions does the nurse ask at the time the client is admitted to a nursing facility? Select all that apply.
a. “Do you understand what a living will, and durable power of attorney are?”
b. “If you have already prepared an advance care directive, can you provide it now?”
c. “Are you prepared to discuss your end-of-life choices with the nursing staff?”
d. “Have you discussed your end-of-life choices with your family or designated surrogate?”
e. “Would you like help with preparing a living will or a durable power of attorney?”
A, B, D, E