Geriatrics Test

Geriatrics Test 1 1. What fact explains the shift of health care focus toward the older adult in the late 1960s? 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. Preventive health care practices increased longevity. To what age group does the term "aged" apply? a. 55-64 years of age b. 65-74 years of age c. 75-84 years of age d. 85 and older - ANS c. 75-84 years of age Which is true of ageism? a. It is discrimination against persons solely on the basis of age. b. It causes a person to fear aging. c. It involves the use of cultural sensitivity to address concerns of aging. d. It focuses on resources for the older adult. - ANS a. It is discrimination against persons solely on the basis of age. What is the most beneficial legislation that has influenced health care for the older adult? a. Medicare and Medicaid b. Elimination of the mandatory retirement age c. The Americans with Disabilities Act d. The Drug Benefit Program - ANS a. Medicare and Medicaid What housing option for the older adult offers the privacy of an apartment with restaurant-style meals and some medical and personal care services? a. Government-subsidized housing b. Long-term care facility c. Assisted-living center d. Group housing plan - ANS c. Assisted-living center 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. What would be the most helpful response by the nurse? a. Medicare Part C pays 50% of all medical costs for persons older than 65. b. Medicare Part B pays hospital costs and physician fees. c. Medicare Part A pays for inpatient hospital costs. d. Medicare Part D pays 80% of the charges made by physicians. - ANS c. Medicare Part A pays for inpatient hospital costs. 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. Which response would provide the most accurate information to the daughter? 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. A durable power of attorney for health care transfers decision-making authority for health care to a designated person. The daughter of a resident in a long-term care facility is frustrated with her 80-year-old mother's refusal to eat. Which response would be the most appropriate? a. The refusal to eat is an effort to maintain a portion of independence and self-direction. b. The refusal to eat is an indication of approaching Alzheimer disease. c. The refusal to eat is an effort to gain attention. d. The refusal to eat is an indication of the dislike of the institutional food. - ANS a. The refusal to eat is an effort to maintain a portion of independence and self-direction. When do the conditions of a living will go into effect? a. When the patient declares that desire in writing b. When a family member indicates the desire for curative therapy to cease c. When two physicians agree in writing that the criteria in the living will have been met d. When the physician and a family member agree that the criteria in the living will have been met - ANS c. When two physicians agree in writing that the criteria in the living will have been met In the 1980s, Medicare initiated a program of diagnosis-related groups (DRGs) to reduce hospital costs. How did the DRGs reduce hospital costs? a. By classifying various diagnoses as ineligible for hospitalization b. By allotting a set amount of hospital days and prospective payment on the basis of the admitting diagnosis c. By specifying particular physicians to treat specified diagnoses d. By using frequency of a particular diagnosis to set a payment schedule - ANS b. By allotting a set amount of hospital days and prospective payment on the basis of the admitting diagnosis Which facility would be recommended for a patient who has had a hip replacement and needs physical therapy? a. Basic care facility b. Skilled care facility c. Subacute care facility d. Assisted-living residence - ANS b. Skilled care facility The 80-year-old woman who is recovering from a stroke is being sent to a skilled care facility. She is concerned about the expense. The nurse can decrease anxiety by explaining that Medicare will cover extended-care facility costs for what period of time? a. A period of 30 days b. A period of 45 days for physical therapy c. A period of 100 days for needed skilled care d. Until she is able to be discharged home - ANS c. A period of 100 days for needed skilled care Which senior citizen political action group uses volunteers and lobbyists to advance the interests of older adults? 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. American Association of Retired Persons (AARP) Which caregiver could be found guilty of elder abuse? a. A daughter who uses her mother's Social Security money to purchase her mother's medication b. A son who puts an alarm on the front door to prevent his mother from wandering out of the house c. A wife who allows her mentally competent husband to refuse to take a bath for a week d. A son who uses his mother's checking account funds to purchase alcohol for himself - ANS d. A son who uses his mother's checking account funds to purchase alcohol for himself What is the most frequent response to elder abuse by the abused older adult? a. Anger b. Physical retaliation c. Notification of authorities d. Nothing at all - ANS d. Nothing at all What reason is often stated by nurses today for not seeking careers in gerontology? a. The physical work is too difficult. b. Their technical skills are not used. c. There is too much challenge. d. There are limited options for employment. - ANS b. Their technical skills are not used "Baby boomers" is a term used to classify which of the following persons? a. Those who entered school in 1945 b. Those who served in the military in World War II c. Those who were born between 1946 and 1964 d. Those who were eligible for Social Security benefits in 2000 - ANS c. Those who were born between 1946 and 1964 What type of abuse is demonstrated by restraining an older adult in a recliner? a. Physical abuse b. Neglect c. Emotional abuse d. Self-neglect - ANS a. Physical abuse Which type of elder abuse is demonstrated by the nonprovision of medical care? a. Physical abuse b. Neglect c. Emotional abuse d. Self-neglect - ANS b. Neglect Which type of elder abuse is demonstrated by a health care worker telling a nursing homeresident she will be left without a call light if she continues to use it excessively. a. Physical abuse b. Neglect c. Emotional abuse d. Self-neglect - ANS c. Emotional abuse The nurse is aware that a person's 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 - ANS a. life experiences d. current age Gerontology encompasses application to __________. (Select all that apply.) a. appropriate housing b. health care c. public education d. business ventures - ANS 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 which of the following? (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) e. Medical service organization (MSO) - ANS a. Health maintenance organization (HMO) b. Preferred provider organization (PPO) c. Provider-sponsored organization (PSO) d. Private fee for service organization (PFFS) Which emotional response would be expected from a family who is coping with an aging loved one's diminishing abilities and increased care needs? (Select all that apply.) a. Grief b. Anger c. Frustration d. Loss e. Resentment - ANS a. Grief b. Anger c. Frustration d. Loss What characteristics are typical for a caregiver of an aging family member? (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 4 years - ANS b. Female c. Having full-time employment d. Having a care recipient older than 70 e. Giving care for an average of 4 years Which are indicators of self-neglect in the aging person? (Select all that apply.) a. Misbalanced checkbook b. Reduced personal hygiene c. Increased alcohol consumption d. Irritability e. Loss of weight - ANS a. Misbalanced checkbook b. Reduced personal hygiene c. Increased alcohol consumption 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. caring for physical needs b. misappropriation of finances c. psychological intimidation d. emotional depersonalization e. abandonment - ANS b. misappropriation of finances c. psychological intimidation d. emotional depersonalization e. abandonment Research by the National Institute on Aging found which of the following to be correct? (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. - ANS a. Older patients receive less information regarding health management than younger patients. b. Information on lifestyle changes were directed at younger people. 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 - ANS a. knowledge in gerontics b. skills in geriatrics e. attitudes related to the older adult The nurse clarifies that the term that refers to the promotion of high-level functioning and supportive care to older adults is __________. - ANS gerontics The nurse reminds a patient who was born in 1965 that eligibility for full Social Security benefits for persons of this age is now the age of __________. - ANS 67 The nurse clarifies that the point at which a person on Medicaid Part D must assume full cost of medication is called the ___________________. - ANS donut hole How does a theory differ from a fact? a. A theory proves how different influences affect a particular phenomenon. b. A theory attempts to explain and give some logical order to observations. c. A theory is a collection of facts about a particular phenomenon. d. A theory shows a relationship among facts about a particular phenomenon. - ANS b. A theory attempts to explain and give some logical order to observations. The biological theory of aging uses a genetic perspective and suggests that aging is a programmed process in which _____________. a. each person will age exactly like those in the previous generation b. a biological timeline predetermines number of cell divisions c. genetic traits can overcome environmental influences d. age-related physical changes are controlled only by genetic factors - ANS b. a biological timeline predetermines number of cell divisions The Gene Theory of aging suggests which of the following ? a. The presence of a "master gene" prolongs youth. b. Genes interact with each other to resist aging. c. Specific genes target specific body systems to initiate system deterioration. d. The activation of harmful genes initiates the aging process. - ANS d. The activation of harmful genes initiates the aging process. The theory that identifies an unstable molecule as the causative factor in aging is the _____theory. a. free radical b. molecular c. neuroendocrine d. crosslink - ANS a. free radical A patient uses good health maintenance practices. What aging theory most accurately relates to the patient's practices? a. Wear-and-tear b. Free radical c. Neuroendocrine d. Molecular - ANS a. Wear-and-tear The patient asks the nurse to describe the neuroendocrine theory of aging. What would be an appropriate response by the nurse? a. It relates thyroid function to age-related changes. b. Adrenal corticosteroids inhibit the aging process. c. The stimulation and/or inhibition of the hypothalamus causes age-related changes. d. The adrenal medulla inhibits epinephrine, causing age-related changes. - ANS c. The stimulation and/or inhibition of the hypothalamus causes age-related changes. What is true of the psychosocial theories of aging? a. They focus on methods to delay the aging process. b. They are directed at decreasing depression in the older adult. c. They are organized to enhance the perception of aging. d. They attempt to explain responses to the aging process. - ANS d. They attempt to explain responses to the aging process. What is the major objection to the disengagement theory? a. The theory justifies ageism. b. The theory addresses the diversity of older adults. c. The theory does not clarify the aging process. d. The theory diminishes the self-esteem of the older adult. - ANS a. The theory justifies ageism. An 80-year-old teaches Sunday school each week and delivers food for Meals on Wheels. What theory of aging would apply? a. Newman's developmental b. The life course c. The activity d. The disengagement - ANS c. The activity The nurse would recognize successful aging according to Jung's theory when a long-term care facility resident demonstrates which of the following behaviors? a. The resident takes special care to dress for dinner in a manner that pleases his tablemates. b. The resident asks permission to sit on the patio with other residents. c. The resident asks persons in his hall if his television is bothering them. d. The resident wears a large cowboy hat at all times because he likes it. - ANS d. The resident wears a large cowboy hat at all times because he likes it. How would an elderly female be most likely to reduce the amount of the free radical lipofuscin? a. Avoid animal fat b. Take antioxidants daily c. Build muscle mass d. Perform outdoor exercise three times weekly - ANS b. Take antioxidants daily A recently widowed woman moved to an assisted living community because of her hypertension and joined a group to learn how to do water color painting with other women her age. Which theory of aging does the nurse assess the patient to be following? a. Jung b. Havighurst c. Erikson d. Newman - ANS b. Havighurst What age-related illnesses are thought to cause the accumulation of free radicals? (Select all that apply.) a. Arthritis b. Colon cancer c. Osteoporosis d. Diabetes e. Atherosclerosis - ANS a. Arthritis d. Diabetes e. Atherosclerosis The nurse emphasizes that the relatively new theory that correlates restricted caloric intake to slowing of the aging process would probably extend the life span of the person, provided that the person __________. (Select all that apply.) a. consistently eats high-nutrient, low-calorie foods b. maintains a regular exercise program c. consumes mL of fluid a day d. supports the diet with adequate fat-soluble vitamins e. eats only organically grown foods - ANS a. consistently eats high-nutrient, low-calorie foods b. maintains a regular exercise program Which would be considered positive outcomes of Erikson's "life review"? (Select all that apply.) a. Wisdom and integrated self-image b. Comparing self with others c. Understanding self and relationships d. Seeking another's opinion of his or her achievement e. Acceptance of self - ANS a. Wisdom and integrated self-image c. Understanding self and relationships e. Acceptance of self Which of the following would be selected for a diet high in antioxidants? (Select all that apply.) a. Fruits b. Vegetables c. Organ meat d. Folic acid e. Vitamin D - ANS a. Fruits b. Vegetables d. Folic acid The theory that proposes that defects in ribonucleic acid (RNA) protein production cause a progressive decline in the function of all cells is the __________ theory. - ANS error The nurse clarifies that the biologic theory that proposes that aging is based on the using up of a finite number of breaths or heartbeats is the ______ of ______ theory. - ANS rate living Why does the nurse modify the environment to keep it warmer for the older adult? a. A change in the metabolic rate b. Decreased subcutaneous tissue c. Changes in the musculoskeletal system d. A weakened peripheral vascular system - ANS b. Decreased subcutaneous tissue A 75-year-old male is worried that his wartlike dark macules with distinct borders are melanomas. What would be the most likely cause for the macules? a. Senile lentigo b. Cutaneous papillomas c. Seborrheic keratoses d. Xerosis - ANS c. Seborrheic keratoses The nurse is accompanying a group of older adults on a July 4th outing to monitor heat prostration. What factor is related to heat intolerance in the older adult? a. An increase in melanin b. A reduction of perspiration c. A reduction in body temperature d. Increased capillary fragility - ANS b. A reduction of perspiration The nurse cautions the Certified Nursing Assistants (CNAs) to use care when transferring or handling older adults. The nurse understands that the vascular fragility of the older adult can result in which condition? a. Altered blood pressure b. Pressure ulcers c. Pruritus d. Senile purpura - ANS d. Senile purpura The Certified Nursing Assistant (CNA) caring for an older adult asks if the yellow, waxy, crusty lesions on the patient s axilla and groin are contagious. Which response shows the nurse's understanding for the cause of the lesions? 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. No. It is seborrheic dermatitis caused by excessive sebum. Why would a nurse lead a group of postmenopausal women on a daily 15-minute walking tour through the long-term care facility? a. To improve bone strength b. To orient them to their surroundings c. To improve their socialization d. To increase their appetite - ANS a. To improve bone strength A 70-year-old woman asks, How in the world can my bones be brittle when I eat all the right foods? Which response by the nurse would be the most informative? 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. Calcium is continuously withdrawn from bone for nerve and muscle function. A 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. Which statement by the nurse would most correctly explain the size change to the woman? 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. Decrease in muscle mass is replaced with adipose tissue. What would be the most helpful response to a 70-year-old postmenopausal woman who asks whether her hormone replacement therapy (HRT) will prevent bone loss? 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. Yes. HRT will prevent bone loss but can cause a stroke, heart attack, or breast cancer. What are Heberden nodes? 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. Bony enlargements of distal joints of the fingers Which care plan modification would be the most beneficial for a 62-year-old woman who is suffering from a flare in her rheumatoid arthritis? 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. Schedule several rest periods to balance activity What is the pathophysiology of emphysema? 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. Overinflation of the alveoli, making them ineffective for gas exchange What is the pathophysiology of a myocardial infarct? 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. A portion of the myocardium necroses and scars over. Which assessment finding is the cardinal signs and symptoms of congestive heart failure? a. Dyspnea and edema b. Myocardial pain and hypotension c. Ventricular arrhythmias and cyanosis d. Atrial arrhythmias and polycythemia - ANS a. Dyspnea and edema What is a cause of pernicious anemia? a. An iron deficiency b. A deficiency of vitamin B12 c. Low serum potassium level d. Blood loss - ANS b. A deficiency of vitamin B12 What would be an acceptable alteration in the plan of care for a patient with a hiatal hernia who is experiencing gastrointestinal reflux? 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. Eating smaller, more frequent meals The nurse assesses a patient with diabetes and finds the patient to be pale, edematous, and listless with a blood urea nitrogen (BUN) level of 35 mg/dL and a creatinine level of 4 mg/dL. What would the results of the nursing assessment indicate? a. Diverticulitis b. Congestive heart failure c. Chronic kidney disease d. Benign prostatic hypertrophy - ANS c. Chronic kidney disease A person with Parkinsons disease has a nursing diagnosis of nutrition, less than body requirements related to difficulty swallowing. What change would the nurse make in the nursing care plan? 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. Offer a thick, high-nutrition shake as a snack. A person who experienced a hemorrhagic cardiac vascular accident (CVA) to the left hemisphere would demonstrate which type of symptoms? a. Language disturbances b. Poor impulse control c. Inappropriate affect d. Confabulation - ANS a. Language disturbances How should the nurse provide written discharge instructions for a patient with maculardegeneration? 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. Adjust the table and light to assist the patient to use peripheral vision to read. What is a symptom of inadequate insulin coverage in a patient with diabetes mellitus type I? a. Diminished urine output b. Ketones in the urine c. Shallow and slow respirations d. Extreme diaphoresis - ANS b. Ketones in the urine 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. What does the nurse suspect? a. Melanoma b. Basal cell carcinoma c. Cutaneous papilloma d. Senile lentigo - ANS a. Melanoma What factors influence the timing and extent of age-related changes? (Select all that apply.) a. Health maintenance b. Ethnicity c. Heredity d. Attitude e. Environment - ANS a. Health maintenance c. Heredity e. Environment What should be avoided by an 82-year-old man with rosacea? (Select all that apply.) a. Stress b. Dairy products c. Sun exposure d. Spicy foods e. Alcohol consumption - ANS a. Stress c. Sun exposure d. Spicy foods e. Alcohol consumption What vitamins are necessary to support ossification? (Select all that apply.) a. A b. B6 c. C d. D e. E - ANS a. A c. C d. D What are risk factors for osteoporosis? (Select all that apply.) a. Menopause b. Smoking c. White female d. Excessive high-impact exercise e. Long-term use of phenytoin - ANS a. Menopause b. Smoking c. White female e. Long-term use of phenytoin What age-related changes in the respiratory system explain why the older adult is at risk for infection? (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 - ANS a. Reduced ciliary movement b. Decrease in alveolar elasticity c. Pooling of secretions The nurse is aware that children with __________ have the treatment and care needs of persons of advanced age. - ANS ANS: progeria The 75-year-old resident in a long-term care facility complains of muscle pain while riding astationary bicycle. The nurse explains that the discomfort is related to the buildup of ____________ in the muscle. - ANS ANS: lactic acid When a 75-year-old male resident in an extended-care facility tells the nurse he wants to build up the muscles in his arms, the nurse recommends a(n) __________ exercise program. - ANS ANS: isotonic Arrange these common diseases of the older adult in order of their mortality rate. a. Cancer b. Pneumonia c. Stroke d. Chronic obstructive pulmonary disease (COPD) e. Heart disease - ANS E, A, C, B, D