CH 8
CH 9
CH 16
CH 10
CH 11/CH 12
100
Which of the following is a true statement about documentation?
A. Nurses should keep records of clients’ wishes.
B. Clients do not have access to their own medical records.
C. The Outcomes and Assessment Information Set (OASIS) is a complete record of the health status of a client.
D. The nurse is responsible for completing all of the Minimum Data Set (MDS).
A. Nurses should keep records of clients' wishes.
100
A nurse is caring for an older adult resident in a long-term care facility who has a history of dementia and is becoming
agitated. What is the best initial response by the nurse to the client’s agitation?
A. Call the prescriber and request an order for a psychotropic medication.
B. Ignore the behavior since psychoactive medications have potentially dangerous side effects in older clients.
C. Utilize only nonpharamacologic interventions to manage the client’s behavior.
D. Conduct a thorough nursing assessment of the client related to the client’s behavior.
D. Conduct a thorough nursing assessment of the client related to the client’s behavior.
100
The overall temperature in the gerontological unit is 62°F during the evening shift. In documenting this concern to the
administration, which factor is the most important for the health and well-being of older adults?
A. It is not fair for older adults to have to deal with an uncomfortable environment.
B. Some of the residents are wearing blankets around their shoulders to keep warm.
C. An ambient temperature of 62°F is unsuitable for older people because they have impaired thermoregulation.
D. It feels much warmer in the administration wing than out in the client care areas.
C. An ambient temperature of 62°F is unsuitable for older people because they have impaired thermoregulation.
100
Which is a common age-related physical change that may affect digestion and food intake?
A. Loss of the majority of taste buds
B. Decreased motility in the esophagus
C. Decreased cholecystokinin secretion
D. Loss of smell
B. Decreased motility in the esophagus
100
Which factor increases the risk for chronic dehydration in older adults?
A. Overuse of diuretic agents
B. Poor cognitive function
C. Dry mucous membranes
D. Fluid loss from vomiting
B. Poor cognitive function
200
An older adult client has diabetes mellitus and requires hemodialysis for renal failure. The client is discharged to home to
recover from a sternal wound infection and coronary artery bypass graft surgery (CABG). A home care nurse will provide
wound care. Which of the following is the major justification for the complete and accurate documentation of this client’s
care?
A. Requires complex health care
B. Has needs in multiple settings
C. Is at risk for iatrogenic problems
D. Has significant health care expenses
A. Requires complex health care
200
An older client who is receiving haloperidol is noted to have a change in mental status (increasing confusion). Upon
assessment the nurse notes that the client has a fever, 102°F, 92/60, 118, 24. The client is noted to have rigidity of the
upper and lower extremities. The first action of the nurse is to do what?
A. Administer acetaminophen for the elevated temperature.
B. Place the client on fall precautions due to the rigidity of the lower extremities.
C. Contact the medical provider immediately.
D. Force fluids to treat the low blood pressure.
C. Contact the medical provider immediately.
200
An older adult client was oriented and responded appropriately in the hospital, but he is now disoriented and confused in his
home after discharge. Which of the following issues is the first that the home nurse should examine to determine whether an
environmental issue is contributing to the client’s condition at home?
A. Complaints of shivering
B. Temperature of household
C. Types of food preparation
D. Presence of radon
B. Temperature of household
200
The nurse is trying to improve the nutritional status of residents in the nursing home. Which recommendations should the
nurse implement?
A. Develop a seating chart for the main dining room based on the unit to facilitate a more organized and efficient
meal delivery.
B. Replace the fluorescent lighting with candles at every table to create a cozy, restaurant-like atmosphere.
C. Provide nutritious food according to the residents’ expressed food preferences.
D. Distribute “med-pass” nutritional supplements.
C. Provide nutritious food according to the residents’ expressed food preferences.
200
An older woman asks a nurse, “You always seem to be telling me that I need to drink more water. How much water do I
really need to drink?” The nurse bases her response on the knowledge that
A. older adults should consume at least 1000 mL of fluid per day.
B. older adults should consume at least 1500 mL of fluid per day.
C. older adults should consume at least 2000 mL of fluid per day.
D. older adults should consume at least 2500 mL of fluid per day.
B. older adults should consume at least 1500 mL of fluid per day.
300
Using the Resident Assessment Instrument (RAI), the nurse identifies a trigger for a male nursing home resident who
requires an indwelling urinary catheter from the Minimum Data Set (MDS). Which should the nurse do next?
A. Develop an individualized care plan.
B. Assign suitable nursing interventions.
C. Refer to the appropriate quality measures.
D. Institute agency-approved catheter care.
C. Refer to the appropriate quality measures.
300
Which herbal supplement(s) when taken with an anticoagulant increases the effectiveness of the medication and should be
avoided during anticoagulant therapy? (Select all that apply.)
A. Garlic
B. Ginkgo
C. Hawthorn
D. Ginseng
E. Green tea
A. Garlic
B. Ginkgo
E. Green tea
300
A 79-year-old client resides independently in the community. The visiting home health nurse finds that despite it being 90°F
outside, the windows are closed and the client is wearing a sweater. The nurse initially recognizes that this behavior may be
related to what?
A. Cognitive changes that diminish the individual’s awareness of temperature changes
B. Age-related neurosensory changes that diminish awareness of temperature changes
C. Delirium-related to an acute illness that is affecting body heat production
D. Age-related motor deficiencies that result in self-neglect
B. Age-related neurosensory changes that diminish awareness of temperature changes
300
If the nurse is unable to observe feeding directly, then which action should the nurse use to assess the older adult’s risk for
aspiration immediately after feeding?
A. Note food volume eaten.
B. Observe skin color.
C. Inspect for pocketing.
D. Monitor for bradypnea
C. Inspect for pocketing.
300
Which of the following are age related changes that affect hydration status? (Select all that apply.)
A. Decrease in thirst sensation
B. Decrease in total body water
C. Decrease in ability of kidneys to maximally concentrate urine
D. Decrease in bone marrow mass
E. Decrease in bladder capacity
A. Decrease in thirst sensation
B. Decrease in total body water
C. Decrease in ability of kidneys to maximally concentrate urine
400
A nurse conducts a comprehensive assessment of an older adult client. The nurse utilizes the Mini-Cog, a valid and reliable
assessment tool to assess the individual’s mental status. The nurse understands that the benefit of utilizing a standard
assessment tool is what?
A. A standard assessment tool is required by Medicare and Medicaid.
B. A standard assessment tool will increase likelihood of obtaining accurate data.
C. A standard assessment tool will increase reimbursement by Medicare and Medicaid.
D. A standard assessment tool will increase the client’s confidence in the nurse.
B. A standard assessment tool will increase likelihood of obtaining accurate data.
400
A nurse is administering medications to an older client who has renal insufficiency. The nurse understands which of the
following? (Select all that apply.)
A. Certain drugs may need to be avoided in this client.
B. Certain drug dosages may need to be adjusted based on this client’s creatinine clearance.
C. Larger doses of most drugs frequently need to be administered in this client.
D. This client should never be administered acetaminophen (Tylenol).
E. Drug effects would in general be diminished in this client.
A. Certain drugs may need to be avoided in this client.
B. Certain drug dosages may need to be adjusted based on this client’s creatinine clearance.
400
A homecare nurse visits an older client who lives in a Smart medical home community environment. What should the nurse
understand about Smart Homes?
A. An emerging technology to enhance safety of older adults by using environmental control systems
B. An assistive technology that keeps data on vital signs, gait, behavior, and sleep without providing an interactive
medical-advising system
C. An emerging technology to aid in the prevention and later detection of disease through the use of sensors and
monitors
D. Elder-friendly communities where residents participate in the design and operation of the home
A. An emerging technology to enhance safety of older adults by using environmental control systems
400
What is the recommended daily intake of fiber for older adults?
A. 10 g
B. 25 g
C. 30 g
D. 50 g
B. 25 g
400
An older adult reports symptoms of xerostomia. Which of the following intervention should the nurse implement for this
patient? (Select all that apply.)
A. Encourage the patient to brush and floss teeth regularly.
B. Encourage the patient to have regular dental screenings.
C. Provide antiseptic mouth wash (such as Listerine) for the patient.
D. Encourage adequate intake of water.
E. Provide saliva substitutes.
A. Encourage the patient to brush and floss teeth regularly.
B. Encourage the patient to have regular dental screenings.
D. Encourage adequate intake of water.
E. Provide saliva substitutes.
500
A nurse utilizes the FANCAPES to assess an older adult. Which of the following are accurate statements about this
assessment? (Select all that apply.)
A. The FANCAPES is utilized as guide for the comprehensive assessment of medically complex older adults.
B. The FANCAPES includes a fall risk assessment of the older adult.
C. The FANCAPES assesses an older adult’s activity abilities.
D. The FANCAPES includes the Mini-Cog assessment to assess cognitive abilities.
E. The FANCAPES assesses the older person’s current state of hydration.
A. The FANCAPES is utilized as guide for the comprehensive assessment of medically complex older adults.
C. The FANCAPES assesses an older adult’s activity abilities.
E. The FANCAPES assesses the older person’s current state of hydration.
500
A nurse is reviewing an older resident’s medication list in a long-term care facility. The nurse notices that two of the
medications are on the Beer’s Criteria. The nurse understands what about the Beer’s Criteria: (Select all that apply.)
A. It lists medications that are not permitted to be administered in a long-term care facility.
B. It lists medications that should be used in caution in older adults.
C. It lists specific drug-drug interactions that are known to cause harm in older adults.
D. It lists medications that need to be dose adjusted in older adults with impaired kidney function.
E. It lists medications that are not reimbursed by Medicare and Medicaid.
B. It lists medications that should be used in caution in older adults.
C. It lists specific drug-drug interactions that are known to cause harm in older adults.
D. It lists medications that need to be dose adjusted in older adults with impaired kidney function.
500
The nurse plans care to prevent a dangerous thermal environment for an older adult client who lives in a northern climate of
the United States. Which client assessment data does the nurse recognize that can contribute to the risk of
hypothermia? (Select all that apply.)
A. Has a history of a cerebrovascular accident (CVA)
B. Has a history of diabetes mellitus
C. Is prescribed antidepressant
D. Bathes three to four times a week
E. Has a history of alcohol abuse
F. Becomes diaphoretic on warm days
A. Has a history of a cerebrovascular accident (CVA)
B. Has a history of diabetes mellitus
C. Is prescribed antidepressant
E. Has a history of alcohol abuse
500
A nurse assesses an older adult woman in an outpatient setting. The client’s height is measured at 5'1" and her weight is
recorded as 100 lb. The patient is surprised by her weight and asks the nurse: “I think I lost some weight since last month.”
The nurse checks the medical record and 1 month ago the patient’s weight was 106 lb. The next action by the nurse is:
A. Continue to monitor the patient’s weight on a monthly basis.
B. Do a thorough assessment of the patient; this is a significant weight loss and of concern.
C. Suggest that the patient begin to take in between meal supplements.
D. Recommend that the patient have several small meals instead of three large meals daily.
B. Do a thorough assessment of the patient; this is a significant weight loss and of concern.
500
Which of the following is a true statement about elimination in older adults?
A. Defecation less than once each day is not necessarily constipation.
B. Mineral oil is recommended as a laxative for the older adult.
C. Excessive sleep can be a symptom of constipation.
D. Leaking liquid feces should be treated as diarrhea.
A. Defecation less than once each day is not necessarily constipation.
600
The nurse assesses an older adult’s cognitive status using a standard assessment instrument. Which of the following are
cognitive assessment tools? (Select all that apply.)
A. Mini-Cog
B. Mini Mental State Exam (MMSE)
C. The Barthel Index
D. The Global Deterioration Scale
E. Older American’s Resources and Services (OARS)
A. Mini-Cog
B. Mini Mental State Exam (MMSE)
D. The Global Deterioration Scale
600
What are common side effects of selective serotonin reuptake inhibitors (SSRIs)? (Select all that apply.)
A. Decreased appetite
B. Dry mouth
C. Nausea
D. Sexual dysfunction
E. Dizziness
B. Dry mouth
C. Nausea
D. Sexual dysfunction
E. Dizziness
600
What are the benefits associated with telehealth technology? (Select all that apply.)
A. Promotes self-management of illness in rural and underserved areas
B. Facilitates remote physical assessment and monitoring of chronic conditions
C. Decreases costs by replacing the role of the nurse with technology
D. Decreases costs by reducing hospital readmissions
E. Reimbursed by all health care insurances
A. Promotes self-management of illness in rural and underserved areas
B. Facilitates remote physical assessment and monitoring of chronic conditions
D. Decreases costs by reducing hospital readmissions
600
A nurse is assessing an older adult’s nutritional status. The nurse understands that which of the following is the most
important indicator for a potential nutritional deficit?
A. Decreased serum albumin levels
B. Decreased vitamin D levels
C. Unintentional weight loss
D. Anorexia lasting more than 24 hours
C. Unintentional weight loss
600
An older adult who is on bed rest after surgery is prescribed morphine for pain. Which of the following is the nurse’s priority
for preventive care?
A. Constipation
B. Diarrhea
C. Poor solid food intake
D. Poor liquid intake
A. Constipation
700
A nurse assesses an older person’s instrumental activities of daily living (IADL) utilizing the Lawton instrument. Which of the
following are IADLs? (Select all that apply.)
A. Shopping
B. Cleaning
C. Bathing
D. Eating
E. Money management
A. Shopping
B. Cleaning
E. Money management
700
Common anticholinergic side effects include which of the following? (Select all that apply.)
A. Ataxia
B. Blurred vision
C. Confusion
D. Urinary retention
E. Hallucinations
B. Blurred vision
C. Confusion
D. Urinary retention
E. Hallucinations
700
The daughter of an older adult client states the following to a nurse: “I am so concerned that my dad is still driving. He is
dangerous! He has had a couple of accidents and I am worried that he is going to kill himself, or worse, somebody else.
What can I do?” The nurse recommends which of the following interventions to help deal with this situation? (Select all that
apply.)
A. Report the person to the division of motor vehicles for license suspension.
B. Hold a family meeting with the person to discuss the situation and come to a mutual agreement of the problem.
C. Arrange for alternate transportation for the person.
D. Confiscate the keys to the car.
E. Ask the client’s physician to write a prescription for the person to stop driving.
B. Hold a family meeting with the person to discuss the situation and come to a mutual agreement of the problem.
C. Arrange for alternate transportation for the person.
700
A resident’s family member is concerned that the resident is not eating adequately and is at risk for malnutrition. The family
member says to a nurse, “I heard that there are drugs that can make my mother eat better. Do you think she should be on
one?” What is the best response by the nurse?
A. “Yes, there are some very effective drugs out there. Your mother should be on one of them.”
B. “Use of drugs results in minimal improvement in appetite and weight gain and can have some serious side effects.”
C. “There are no drugs that impact appetite or weight gain.”
D. “These drugs are not permitted to be used in a long-term care facility.”
B. “Use of drugs results in minimal improvement in appetite and weight gain and can have some serious side effects.”
700
A nurse is conducting education on urinary incontinence at a senior center. The nurse is discussing lifestyle changes that
are associated with an improvement in urinary incontinence. The nurse includes which of the following interventions?
(Select all that apply.)
A. Weight reduction
B. Smoking cessation
C. Increase in physical activity
D. Fluid restriction
E. Blood sugar control
A. Weight reduction
B. Smoking cessation
C. Increase in physical activity
800
An older client is visited by a nurse in the community. The nurse is from a Certified Home Health Agency and completes the
OASIS assessment. The client is 89 years old, has a history of hypertension, and had a stroke 2 years ago. The client was
referred to the home health agency because she fell and sustained a large laceration on her forehead which required
sutures. She has been seen in the emergency department of the local hospital three times over the past 2 months. Based
on the OASIS assessment, the nurse notes which of the following risks for hospitalization for this client? (Select all that
apply.)
A. Age over 85
B. A fall with injury
C. History of a stroke
D. Multiple emergency department visits (2 or more in previous 6 months)
E. Diagnosis of hypertension
B. A fall with injury
D. Multiple emergency department visits (2 or more in previous 6 months)
800
Common causes of polypharmacy in older clients include which of the following? (Select all that apply.)
A. Use of multiple different health care providers
B. Presence of multiple chronic conditions
C. Use of multiple pharmacies to obtain medications
D. High cost of medications
E. Lack of adequate education on medications
A. Use of multiple different health care providers
B. Presence of multiple chronic conditions
C. Use of multiple pharmacies to obtain medications
E. Lack of adequate education on medications
800
A nurse is caring for a frail older adult in a long-term care facility and is concerned about preventing hypothermia. Which of the following interventions should the nurse implement? (Select all that apply.)
A. Make sure that the temperature in the resident’s room is at least 65°F.
B. Cover residents well when in bed and while bathing.
C. Provide a head covering for the resident.
D. Maintain resident in bed covered with heavy blankets at all times.
E. Provide hot, high-protein meals and bedtime snacks.
A. Make sure that the temperature in the resident’s room is at least 65°F.
B. Cover residents well when in bed and while bathing.
C. Provide a head covering for the resident.
E. Provide hot, high-protein meals and bedtime snacks.
800
Which recommendations for daily food intake is correct for older adults according to the MyPlate for Older Adults? (Select all
that apply.)
A. Three 8-ounce glasses of water
B. Two servings of deep-colored fruit
C. Four or more servings of high-quality protein
D. One or two servings of brightly colored vegetables
E. Three or more servings of low-fat or nonfat dairy products
F. Six or more servings of fortified, enriched, or whole grain foods
B. Two servings of deep-colored fruit
E. Three or more servings of low-fat or nonfat dairy products
F. Six or more servings of fortified, enriched, or whole grain foods
800
An older adult diagnosed with moderate dementia is seen in the geriatric clinic. As the nurse is evaluating the client, the client’s wife states that her husband has developed an increasing number of episodes of incontinence. She does not know what is precipitating the episodes, and states “maybe he just doesn’t remember that he needs to urinate or maybe it’s me, it takes me a while to walk him to the bathroom.” The nurse develops a plan of care for this client and includes which of the following interventions to manage the incontinence? (Select all that apply.)
A. Use of adult incontinence briefs
B. Use of an external catheter
C. Development of a toileting schedule
D. Use of a commode close by to where the client spends most of his time
E. Bladder diary to be completed by the client’s wife
C. Development of a toileting schedule
D. Use of a commode close by to where the client spends most of his time
E. Bladder diary to be completed by the client’s wife