NURSING CARE OF THE OLDER ADULT Exam Questions and Answers Latest Updated 2024/2025 Scored A+

NURSING CARE OF THE OLDER ADULT Exam Questions and Answers Latest Updated 2024/2025 Scored A+. One reason why many “baby boomers” have multiple chronic conditions such as heart disease, diabetes, and arthritis is that: a. they have less access to medication and other treatment regimens. b. there was a lack of importance placed on healthy living as they were growing up. c. they did not have access to immunizations against communicable disease when they were children. d. they grew up in an era of rampant poverty and malnutrition. 3. A nursing student is preparing a presentation on the Wellness-Based Model for Healthy Aging. Which of the following concepts should the student include in the presentation? (Select all that apply.) a. Healthy aging is defined by the absence of physical illness alone b. Healthy aging is individually defined and can change over time c. There are many strategies to promote healthy aging that are believed to be helpful but do not have empirical evidence to support them d. Healthy aging cannot be achieved by only focusing on later life. It is a lifelong process e. According to this model, an individual with a chronic disease would not be considered healthy 4. When asked by new parents what the life expectancy is for their African American newborn, the nurse replies that, “2010 statistics indicate that your son: a. can realistically expect to live into his late 80s.” b. has a good chance of celebrating his 75th birthday. c. is likely to live into his late 90s.” 5. A nurse is caring for an 85-year-old male client with diabetes in a community setting. The nurse promotes functional wellness by which of the following activities? a. Encouraging the client maintains current levels of physical activities b. Assisting the client to receive all the recommended preventive screenings that are appropriate for his age group c. Teaching the patient how to use a rolling walker so that he can ambulate for longer distances 6. A nurse organizes a health fair for older adults. The nurse’s goal is to focus on the six priority areas identified by the National Prevention Council**. Which of the following activities should the nurse include? (SATA) a. Smoking cessation b. Depression screening c. Recognizing elder abuse d. Cholesterol screening e. Fitness training 7. A nurse is planning an education program on wellness in a local senior citizen center. The nurse plans to provide education on the importance of immunizations, annual physical examinations, screening for diabetes, and vision and hearing screening. It is important for the nurse to understand which of the following? a. Approximately 40% of older adults (ages 65 and older) utilize available preventive services b. Preventive strategies are more widely used in the 40-64 age group than in the 65 and over age group c. The research on health promotion strategies in older adults demonstrates that they have low efficacy d. There is an abundance of research specific to health promotion and aging 8. The “in-between” generation (individuals born between 1915 and 1945) were subject to which of the following health challenges during their childhood? (Select all that apply.) a. Polio b. Lack of fluoride in the water causing teeth to be soft and cavity prone NURSING CARE OF THE OLDER ADULT Exam Questions and Answers Latest Updated 2024/2025 | Scored A+ 2 c. “Pigeon Chest,” a malformation of the rib cage due to a lack of vitamin D 9. A nurse is planning care for a group of super-centenarians in an assisted living facility. The nurse considers which of the following? a. Most super-centenarians are functionally independent or require minimal assistance with activities of daily living b. The majority of super-centenarians have cognitive impairment c. The number of super-centenarians is expected to decrease in coming years as a result of heart disease and stroke d. It is theorized that super-centenarians survived as long as they have due to genetic mutations that made them less susceptible to common diseases 10. Based on the census reports of 2010, the typical profile of a centenarian in the United States includes which of the following characteristics? a. A Caucasian woman who lives in an urban area of a Southern state b. An African American woman who lives in a rural area of a Southern state c. A Hispanic man who lives in an urban area of a Midwestern state d. A Caucasian man who lives in a rural area of a Midwestern state Chapter 4 1. A paper on culture and illness would be likely to include the statement that: a. culture is the same as ethnicity. b. ethnic groups always share common geographic origin and religion. c. ethnicity involves recognized traditions, symbols, and literature. d. most members of an ethnic group exhibit identical cultural traits. 2. Ethnocentrism is defined as: a. a belief that one's ethnic group is superior to that of another 3. Regarding health care disparities, it is true that older adults of color have: a. equal risk factors for vulnerability as do all older adults. b. equal risk factors for vulnerability as do the young adults of color. c. increased risk factors for vulnerability if they are female. d. an increase in risk factors for vulnerability if care is provided by public facilities. 4. An older female patient tells a nurse the following: "In my culture, women are the silent partner in the family. Men make all of the decisions. However, when we came to the United States, all that changed. I became an American. I am in charge of my family just like my husband." This is an example of: a. Acculturation 5. A home care nurse is caring for an older patient from a different culture who is bed-bound and high risk for development of a pressure ulcer. The nurse discusses the plan of care with the patient's daughter, emphasizing the importance of turning every 2 hours and posts a turning clock on the wall. When the nurse returns later in the week, the turning clock has been removed, and the patient's daughter reports that she turns her mother occasionally. She states, "I am taking very good care of my mother. You just don't understand; our ways do not involve doing things on schedules." The best response by the nurse is: a. d. "How can we best work together to provide the best care for your mother?" 6. An older patient learns that he has metastatic cancer. The patient states: "I must have angered God." This is an example of which type of belief? a. Biomedical b. Magico-religious c. Naturalistic d. Ayurvedic 7. A female nurse is caring for an older woman from the Hasidic Jewish community. The woman's son is at the patient's bedside. The nurse notes that when she communicates with the patient and her son, the son does not maintain eye contact with her and also notes that he withdraws when she attempts to shake his hand. The best response by the nurse is to: a. continue conversing with both the patient and the son. 3 8. The nurse in a clinic setting that provides care for an ethnically diverse population of older clients shows an understanding of the LEARN Model** to direct the assessment process when: (Select all that apply.) a. recognizing that the client's hands are clenched as she answers the assessment questions. b. asking the client to describe what he thinks will help him feel better. c. explaining to the client that herbal remedies may not be sufficient treatment for his chest congestion. d. acknowledging that the client has a different view of the appropriate treatment. 9. A nurse completes a cultural assessment of an older adult who is being admitted to an assisted living facility. Reasons for completing a cultural assessment include: (Select all that apply.) a. culture guides decision-making about health, illness, and preventive care. b. culture provides direction for individuals on how to interact during health care encounters. c. culture impacts attitudes toward aging. d. all members of a culture react in the same way in similar situations. e. knowledge of culture eliminates health care disparities 10. A nurse in the ambulatory care setting is preparing to do an interview with a non-English-speaking client. The nurse secures an interpreter. In order to have the most effective interview, the nurse should do which of the following? (Select all that apply.) a. Look and speak to the interpreter b. Use technical terminology to ensure accuracy c. Allow more time for the interview d. Watch the client's nonverbal communication e. Have the interpreter check whether the client understands the communication Chapter 5 1. An older resident in a senior community tells a nurse: “I am really worried. I joined an exercise class, and I just learned everyone’s name yesterday, and I cannot remember them all today. Am I developing Alzheimer’s disease?” The best response by the nurse is: a. “You should be concerned. It is very unusual to forget something that you just learned.” b. “There is no reason to be concerned. Short-term memory decreases with age.” c. “Don’t worry, a decline in both short- and long-term memory is a normal part of getting older.” d. “Although it is normal to have some changes in memory, forgetting names is very unusual.” 2. A nurse is planning a fall prevention education refresher session for the residents of a long- term care facility. The individuals are all cognitively intact and range in age from 80 to 100. The previous education on fall prevention was presented 2 months ago. What special considerations should the nurse take in relation to teaching this group of older adults? (Select all that apply.) a. Make sure that all pamphlets are in large readable font (14-16 points) and include upper and lower case lettering b. Start education on falls from the beginning. It is unlikely that anyone remembers previous material c. Present all the information at once in one long session d. Ensure that there is adequate lighting in the room and that the temperature is comfortable e. Provide ongoing positive feedback during the session 3. A nurse hears a colleague state the following: “Can you believe that Mr. Jones’ daughter just bought him a tablet computer? He is 90 years old. It is ridiculous to think that he can learn to use it.” The nurse formulates a response based on research that shows: (Select all that apply.) a. older adults comprise the fastest growing population using computers and the Internet. b. Internet use is less prevalent in individuals over age 75 than those ages 65-74. c. older American men are the fastest growing group of social networking site users. d. older adults use the Internet only for social networking and recreational uses. e. technology has the potential to improve quality of life for older adults. 4 4. An older female resident of an assisted living facility says the following to a nurse: “I am very frightened about getting dementia. I have read a lot about brain exercises, but I am not sure what I should be doing.” The nurse formulates a response based on knowledge of which of the following? (Select all that apply.) a. Individuals should engage in some type of brain fitness activity a couple of times a week for at least 25 minutes b. Brain fitness activities are only effective if an individual has not experienced any memory problems at all c. Brain fitness activities may include computer-based games, memory training, board games, reading, and engaging in conversation d. Physical activity is important for wellness but is unrelated to brain fitness e. Individuals should choose brain exercise activities that are unfamiliar, challenging, and fun 5. The daughter of an older hospitalized patient tells a nurse: “I am worried about my father. His memory is sharper when he is at home. He is forgetful but is functional. Since he has been hospitalized his memory problems are much worse.” The best response by the nurse is: a. “It is common for long-term memory to be more impacted by age-related changes than short-term memory.” b. “Memory changes are often worse when an individual is in an unfamiliar or stressful situation.” c. “Perhaps you are just noticing your father’s memory loss now that he is hospitalized.” d. “There is a lot of new information for your father to process here in the hospital; he is overloaded.” 6. Health literacy is defined as: a. the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions. 7. A nurse is developing an educational session for a group of older adults at a senior center. Which of the following would the nurse include in the education? (Select all that apply.) a. Attention span, language, and communication skills typically remain stable with increasing age b. Older brains slow down and take longer to process constantly increasing amounts of information c. In order to preserve brain function, it is important to engage in challenging cognitive activities d. Older adults are not able to develop new cognitive abilities e. Individuals over age 100 have a higher prevalence of dementia than younger individuals Chapter 7 1. A nurse completes a functional status assessment of an older person using the Lawton IADL instrument, a selfreported instrument. The nurse knows that limitations of self-reported measures include that: (SATA) a. individuals tend to overestimate their functional ability. b. self-reports often differ from that of proxy reports. c. older adults are not able to complete self-reported measurements. 2. A limitation of the Katz Index of activities of daily living (ADLs) is that: a. all ADLs are weighted equally. 3. A 78-year-old man is being evaluated in the geriatric clinic. His daughter reports that he has been very forgetful lately, and she is concerned that he might be “senile.” The advanced practice nurse administers the clockdrawing test and the patient draws a distorted circular shape and places the numbers all on one side of the shape. Based on his performance, the nurse concludes that the patient: a. needs further evaluation. b. needs a functional status assessment 4. A nurse utilizes the SPICES tool (Sleep disorders, Problems with eating, Incontinence, Confusion, Evidence of falls, and Skin breakdown) to assess an older female patient in the hospital. The nurse notes that the patient has new onset urinary incontinence. The first action by the nurse is to: a. conduct a more in-depth focused assessment of the urinary incontinence. 5. When comparing the Older American’s Resources and Services (OARS**) with the Katz Index of ADLs, what is true? a. The Katz Index and the OARS both measure only ADL performance 5 b. The OARS is a comprehensive assessment tool that measures ability in five areas; the Katz Index measures only ADL performance 6. A resident of a long-term care facility is assessed by a nurse upon admission to the facility. The assessment includes a comprehensive health, social, and functional profile. The tool that the nurse utilizes is: a. Outcomes and Assessment Information Set (OASIS). **homecare setting** b. Resident Assessment Instrument (RAI). **long-term** c. Older Americans Resources and Services (OARS). **functional status test** d. .Comprehensive Geriatric Assessment (CGS). **approach to assessment** e. Mini Mental Status Examination (MMSE). **mental status tool* 7. Factors that complicate assessment of older adults include: (Select all that apply.) a. presence of multiple comorbid conditions. b. atypical presentation of illness. c. difficulty in differentiating symptoms of disease from normal age-related changes. d. increase in iatrogenic illness. e. lack of assessment instruments specific for the older adult population. 8. The FANCAPES assessment tool focuses on the older adult’s: a. ability to meet personal needs to identify the amount of assistance needed. b. ability to perform instrumental activities of daily living (IADLs). c. cognitive abilities. d. level of dementia present. 9. A nurse is assessing a patient’s activities of daily living. The nurse will assess which of the following? (Select all that apply.) a. Eating b. Continence c. Toileting d. Self-medication administration e. Bathing 10. A nurse identifies a need to assess a patient’s cognitive status. The nurse chooses to use the MMSE. The nurse knows that the patient must have which of the following abilities? (Select all that apply.) a. Number fluency b. Familiarity with analog clocks c. Ability to hear and see d. Ability to sit up for 10 minutes e. Ability to speak English Chapter 8 1. The nurse is reviewing the postsurgical laboratory values of an older adult client. The client's erythrocyte sedimentation rate (ESR) is 20 mm/hr. The nurse initially responds to this data by: a. asking the client if he or she has been diagnosed with any chronic inflammatory diseases. b. recognizing that the value is normal for older adults. **normal value is: 10-20** c. notifying the client's health care provider immediately. d. requesting that the laboratory rerun the test. 2. An older client in a long-term care facility is receiving an annual physical examination and is ordered laboratory tests that include a complete blood count, serum electrolytes, and thyroid tests. When the client's son questions why these tests are being ordered by saying, "Dad is 85 why are you bothering him?" the nurse's response is based on an understanding that: a. when conducted annually, all of the tests are helpful in promoting maximum health for older adults in the long-term care setting. 3. When asked by an older adult client, "What is the difference between my normal laboratory values and the ones for a 55-year-old?" The nurse responds based on the understanding that there are: a. age-adjusted ranges for older adults for all of the common laboratory findings, similar to those for infants and children. 6 b. no age-adjusted ranges for older adults due to the large variations within the age group and the increasing number of factors that influence the results. 4. An older resident of a long-term care facility diagnosed with dementia has in the last 48 hours become more confused than usual and while usually requiring help with toileting has been incontinent of urine. The client's health care provider orders a complete blood count and serum electrolytes. When the laboratory tests are all within normal limits, the nurse initially: a. attributes the changes in the resident's functioning to advancing dementia. b. speaks with the health care provider regarding the changes in the client's function and the possibility of obtaining a urine culture. 5. An older woman with breast cancer has completed a course of external radiation and is receiving chemotherapy. After her recent chemotherapy treatment, she complains of severe weakness, dizziness, and lethargy and is admitted to the hospital. Her platelet count is 45,000. Based on this scenario, what nursing intervention is of the highest priority? a. Preventing falls 6. A 69-year-old patient in the geriatric clinic has an annual physical examination and a complete blood count and serum electrolytes are drawn. While the physical examination was uneventful, the laboratory results show an elevated blood urea nitrogen (BUN). The nurse will then: a. ask that the test be rerun since the client showed no physical signs of renal failure. b. review the client's medication list since BUN can be affected by many specific medications. c. instruct the client on collecting a 24-hour urine specimen for a more detailed analysis. 7. A 78-year-old female patient was recently diagnosed with atrial fibrillation and started on Coumadin (warfarin) for stroke prophylaxis. A nurse provides extensive education on warfarin including the need for routine blood testing. The woman states the following to a nurse: "I understand all that you have taught me, but I do not know what a good number for the INR test is." The nurse bases her response on the knowledge that the recommended INR is: a. 1.0-2.0. b. 2.0-3.0. **normal for ppl on warfarin** c. 3.0-4.0. d. 4.0-5.0. 8. An older woman asks a nurse in the cardiology practice, "What is the ideal number that my cholesterol levels should be? I am confused by all of the different numbers." The nurse formulates her response on the knowledge that: a. recent guidelines from the American Heart Association state that there is no "one size fits all" recommendation and that recommendations must be individualized to each patient. 9. When a client asks, "What could be causing my triglycerides to be so low; I'm really careful about my diet?" the nurse responds by asking the client: (Select all that apply.) a. "Is your type 2 diabetes well managed?" **elevated** b. "Have you ever been diagnosed with renal failure?" ** elevated levels** c. "Do you have a history of pancreatitis?" **elevated** d. "Are you on medication for hyperthyroidism?" e. "Could you tell me how you are careful about your diet?" 10. An elderly man is brought to the geriatrics clinic by his wife because of his increasing confusion. As part of his medical workup, the nurse practitioner orders which of the following laboratory tests? (Select all that apply.) a. Basic metabolic panel b. Vitamin D level c. Thyroid stimulating panel d. Vitamin B12 e. Serum albumin level **not part of dementia workup** Chapter 9 1. The nurse’s first response when told by a client during an assessment interview that he “can’t take furosemide (Lasix)” is to ask: 7 a. “Is your health care provider aware that you are allergic to Lasix?” b. “Can you describe what happened when you took Lasix?” c. “When was the last time you took Lasix?” d. “Have you any questions regarding your reaction to Lasix?” 2. When performing the initial assessment on a new client in a geriatric outpatients practice, the most effective method the nurse can implement to elicit an accurate medication assessment is to ask that the client: a. bring in all of the medications that she is currently taking. 3. An older patient is prescribed warfarin for stroke prevention. A nurse is providing patient education. Which of the following foods should the patient be taught to avoid? (Select all that apply.) a. Milk b. Whole grains c. Kale d. Spinach e. Red meats 4. The area in which nurses have the greatest effect on the safe, effective medication therapy of an older client is: a. educating the client to all aspects of the medication. b. assessing for adverse reactions to the medication. c. monitoring overall health of the client as it is affected by the medication. d. evaluating the outcomes resulting from the medication. 5. An 81-year-old patient is being discharged from the hospital to home. She is on seven different medications, which are to be taken at four different times during the day. What would be most useful in helping this patient manage her medications? a. The package inserts from all of the medications for the client to read b. A pillbox with compartments for each day and each of the doses c. A written list of all the client’s medications and administration routine d. A suggestion that the client’s daughter administers the medications 6. The nurse suspects that a client is experiencing tardive dyskinesia when observing that: a. the client can’t seem to stop moving. b. the client’s facial muscles are twisting involuntarily. c. the client not able to get up out of a chair. d. the client’s hand tremors so much that drinking from a cup is difficult. 7. An older client prescribed a transdermal morphine patch for severe chronic pain is being educated on the appropriate administration of the medication. The nurse shows an understanding of essential information regarding this route of drug administration when stating: (Select all that apply.) a. “This is an effective route for delivering small doses of medication over long periods of time.” b. “Since you have problems with digestion, this is a good way to take your medication.” c. “Please show me how you would apply your patch.” d. “Be careful to put the patch only on your chest but change locations with each application.” e. “Be sure to avoid placing the patch on injured skin.” 8. What factor is an important contribution to polypharmacy in older adults? a. Inadequate communication among medical care providers b. Implementation of Medicare Part D prescription drug benefit c. Use of generic medications d. Increasing popularity of dietary and herbal supplements 9. The Beers Criteria is an effective tool for health care professionals prescribing and/or managing the medication therapy of older adults since it identifies medications that for this population: a. are not typically covered by drug benefit plans. b. have a higher than usual risk for injury. c. are likely to be abused. d. generally, cause allergic reactions 10. When discussing pharmacological considerations, a 68-year-old client asks, “Why do medications seem to act differently than they did when I was younger?” The nurse bases the response on the concept that: 8 a. age-related changes affect the way drugs are metabolized by older adults. 11. When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse best ensures an understanding of oral hypoglycemic medications when providing: a. the package insert and assessing the client’s reading skills. b. the client with the website address for the American Diabetes Association. c. oral explanations and sending the client home with a written copy. d. the information in paragraph form as opposed to numbered line fashion. 12. Which pharmacokinetic/pharmacodynamic parameter does the aging process least affect? a. Absorption b. Distribution c. Metabolism d. Excretion 13. An antihypertensive medication has been prescribed for an older patient with hypertension. The patient tells a clinic nurse that he would like to take an herbal substance to help lower his blood pressure instead of the prescription medication. Which of the following should the nurse do? (Select all that apply.) a. Tell the patient that herbal substances are less effective than prescription medications b. Encourage the patient to discuss the use of an herbal substance with his primary care provider c. Explore with the patient which herbal substance he is planning on taking d. Educate the patient on possible interactions of the herbal substance with his other medications e. Instruct the patient not to take the herbal substance, as it is dangerous 14. Factors that affect the pharmacokinetics of lipophilic medications in older adults include: a. greater adipose tissue ratio to body mass b. decreased total body water. c. increased glomerular filtration rate. d. increased creatinine clearance. Chapter 10 1. The nurse preparing an educational program focused on herbal supplement targets as a likely interested group: a. Inner-city females who live below the poverty level b. White females who own their own successful businesses c. Male Hispanic Americans who are single, divorced, or widowed