Gerntological Nursing Questions & Answers (100% Correct & Verified Answers)

1. Identify the best statement about gerontological nursing. a. Nurses have only recently become involved in the care of the older adult. b. Gerontological care was the second specialty in which the American Nurses Association (ANA) offered a certification program. c. Purposes of gerontological nursing include the promotion of health and support for maximal independence. d. ANA certification is available only for gerontological nurses in research positions. ANS: C. 2. Which gerontological nursing organization welcomes nurses from all educational backgrounds? a. The National Gerontological Nursing Association (NGNA) b. The National Conference of Gerontological Nurse Practitioners (NCGNP) c. The National Association of Directors of Nursing Administration in Long-Term Care (NADONA/LTC) d. The American Society on Aging (ASA) ANS: A 3. Which is an accurate statement regarding gerontological nursing education? a. Gerontological nursing content has long been integrated into the curriculum of the typical school of nursing. b. Undergraduate nursing programs extensively cover gerontological nursing in dedicated courses, comparable with the coverage of psychiatric nursing. c. When content is integrated throughout a curriculum, less than 25% is devoted to geriatric care. d. Accreditation of a nursing program guarantees that appropriate amounts of gerontological nursing content are included in the curriculum. ANS: C 4. Based on current demographic data, which of the following statements identifies a predictive trend regarding the health care needs of society? a. Most nurses will not need to care for older persons. b. More nursing services will be required to serve the needs of the population older than 85 years of age. c. Fewer nurses will be needed to care for older adults. d. Older adults expect their quality of life to be less than that of earlier generations at their ages. ANS: B 5. A case manager is likely to have how many years of nursing education? a. 1 to 1.5 b. 2 c. 4 to 6 d. 8 or more ANS: C6. Which was the first formal action the ANA took in relation to gerontological nursing? a. Established a national geriatric nursing group b. Defined educational standards for gerontology c. Created the ANA Division of Geriatric Nursing d. Formed the Council of Long Term Care Nurses ANS: A 7. A older man is transferred to a hospice facility with end-stage disease. Which is a suitable nursing intervention for this older adult and his family according to the goals of long-term care? a. Decrease the analgesic dose to prevent sedation. b. Provide a basin and towels for morning self-care. c. Inform family members about strict visiting hours. d. Facilitate family rituals related to death and dying. ANS: D 8. A nursing home executive interviews RNs to fill a full-time position for direct patient care to maintain the standards of elder care. Which nurse should the nursing home hire? a. Nurse from a certified college c. Nurse with 15 years of experience b. Certified gerontological nurse d. Gerontological nurse practitioner ANS: B . 9. Mezey and Fulmer (2002) justify gerontological nursing research and the work of gerontological advanced practice nurses by concluding the following: a. Other scientists devalue gerontological nursing research. b. The research influences outcomes from nursing care in a positive way. c. Gerontological care is expensive but required in long-term care. d. Gerontological nursing research is well known to practicing nurses. ANS: B 10. The gerontological nurse collaborates with the wound care team about an older patient who has an ulcer. How is this nurse demonstrating leadership in the care of older people? a. Assessing older adults effectively b. Facilitating access to elder care programs c. Coordinating members of the health care team d. Empowering older adults to manage chronic illness ANS: C 11. Several organizations collaborated in 2001 to publish Scope and Standards of Gerontological Nursing Practice by the ANA. What is the significance of the collaborative effort to gerontological nurses? a. Changes the health care delivery to increasing numbers of older adultsb. Mandates gerontological certification for nurses who care for older adults c. Standardizes gerontological nursing practice among various organizations d. Ensures minimum gerontological competencies for all graduating students ANS: C 12. Which had a major influence in shifting the care of older adults away from almshouses and public institutions and stimulated the growth of commercial nursing homes? a. Medicare b. Social Security Act c. Hartford Institute for Geriatric Nursing d. Health maintenance organizations (HMOs) ANS: B 13. Which gerontological organization had a significant influence on the care of older adults? a. American Association of Retired Persons (AARP) b. John Hartford Foundation c. Medicare d. Mutual of Omaha Insurance ANS: B MULTIPLE RESPONSE 1. In which areas have advanced practice nurses demonstrated their skill in improving? (Select all that apply.) a. Health outcomes b. Length of stay c. Cost effectiveness d. Reimbursement measures e. Interprofessional communication ANS: A, C 2. Identify future directions for gerontological nursing research as suggested by Wykle and Tappen. (Select all that apply.) a. Interdisciplinary practice models b. Intergenerational caregiving c. Health disparities d. Influence of culture on aging e. Long-term care initiatives ANS: A, B, C, D 1. Mr. Jones is a 90 year old male who resides in a nursing home, he has a cholesterol level of 245mg/dl. Which nursing intervention is most likely to assist Mr. Jones in achieving his highest level of wellness? a. Review a menu with Mr. Jones to choose suitable foods2. The gerontological nurse collaborates with the wound care team about an older patient who has a leg ulcer. Which statement best demonstrates the gerontological nurse's leadership in the care of the older patient? a. Coordinate care among members of the health care team 3. Mrs. Smith, a 90 year old widow who is recently married to her high school sweetheart (also residing in the same independent living retirement community). She comments she has no regrets, looking back at her life, she feels satisfied with the way she has lived. Which theory best describes her aging experience a. Erickson's ego integrity stage 4. In differentiating between health and wellness in health care which of the following is true? a. Health is a broad term encompassing attitudes and behaviors. 5. Which factor associated with aging contributes to the high incidence of type 2 diabetes in older adults? a. Decr insulin sensitivity 6. Which of the following statement about malnutrition in older adults is true? a. Between 16-30% of older adults are malnourished or at high risk 7. Decreased functioning of which physical structure is likely to result in decreased metabolism in older adults? a. Thyroid gland 8. Mr. Jones an 85 year old retired author spends time in his room reading or writing. Nancy, the nursing assistant is worried and reports to the RN that Mr. Jones should be encouraged to play Bingo and other group activities. The RN's most appropriate answer to Nancy is: a. He prefers reading and writing 9. The nurse is assessing an older adult from a culture different than the nurse's by asking questions from the Explanatory Model for Culturally Sensitive Assessment. Which question should the nurse ask to follow this model? a. What do you think started this problem? 10. Which statement is true about geronotlogical nursing for patients of different races and ethnic backgrounds? a. Facial expressions, body language, posture and touch are important elements of communication between a nurse and a patient form different ethnicities 11. Which of the following is a TRUE description of the need in clinical preventive services among older adults a. 51% Hispanic adults need pneumococcal vaccination12. Which of the following description regarding chronic illness is FALSE? a. Chronic illness is reversible 13. Which one of the following is UNTRUE about the goals and objectives of Healthy People 2020 a. Reduce heath care cost of chronic illness for older adults 14. Which statement about nutrition for older adults is true? a. Transportation can be critical factor in nutritional insufficiency in elders 15. Mr. Chan is an 89 year old Chinese man, he has a blood pressure of 80/45 mmHg and refuses to remain in bed. Which intervention should the nurse use to promote and maintain his health? a. Ask Mr. Chan about his perceptions and treatment ideas 16. Which change in the skin is abnormal in an older person a. Red, swollen 3 day old wound 17. Which one is a true statement a. In 2009 African American men were 30% ore likely than non-Hispanic white men to die of heart disease 18. Which age-related change contributes to anorexia and weight loss in older adults? a. Fewer taste buds 19. Which is a true statement regarding fluid balance and aging? a. Multiple physiological changes of aging place elders at greater risk of dehydration than middle aged adults 20. Which is a true statement about social and emotional health of older adults? a. Nurses are often important confidants and providers of social support for older adults 21. The nurse prepares Mrs. Z an 85 year old Polish American for discharge through an interpreter and notes Mrs. Z becomes tense during the topic of incontinence. Which is the correct action the nurse should take? a. Ask Mrs. Z how she feels about the topic 22. Based on current demographic data, which statement accurately identifies health care needs of the elderly? a. More nursing services will be required to serve the needs of the population older than 85 years 23. Mrs. Assaf is an 85 year old woman who immigrated from Saudi-Arabia and is receiving home health for follow up and management of diabetes. Which intervention is a culturally competent approach to Mrs. A? a. Assign female nurses to her home visits24. Acute illness is to chronic illness as which of the following comparisons? a. An emergency department to a nursing home 25. Name the theory of aging that suggests the adverse physical effects of aging result from gradual loss of control mechanisms in the hormones and immune cells. a. Neuroendocrine theory 26. Which of the following refers to the highest level of human functioning according to Maslow? a. Self-actualization 27. A man is terminally ill with end-stage prostate cancer. Which is the best statement about this man's wellness? a. Nursing interventions can help empower a client to achieve a higher level of wellness 28. Which describes the nurse's role for an older patient with chronic illness? a. Provide caring to help the patient live at optimal level of health and wellness 29. Which of the following is false? a. A client's 5 year old granddaughter who speaks English would make the best interpreter because she is familiar with and loves the client. 1. The nurse has to teach a male patient, who is 85 years old, and his family about a new medication. Which of the following interventions should the nurse implement to enhance patient teaching? a. Face the patient directly and speak clearly in a quiet place 2. The nurses asks an older female adult, tell me more about countries that were your favorite travel destinations. Which strategy is most important for the nurse to incorporate into communicating with this elder? a. Allocate more time for answering 3. The nurse is trying to improve the nutritional status of residents in the nursing home. Which recommendation should the nurse implement? a. Provide nutritious food according to the residents expressed food preferences with liberal use of seasonings 4. Which statement is true about sleeping older adults a. Time spent in bed increases, time spent asleep decreases 5. An older man with Alzheimer's disease, and his wife says he is up and wandering around the house at night. Which intervention should the nurse implement to increase the man's duration of sleep? a. Instruct the wife to increase his daily physical activity6. Which process is NOT increased in the early morning a. RA pain 7. Which medication is matched Correctly to the condition given of an older adult patient according to current medical knowledge (on safety in medication) a. Buspirone (Buspar) for chronic anxiety states 8. The nurse provides instruction about medication safety to older adults. Which instruction should the nurse provide? a. Older adults should ask the health care provider for the purpose of the medication 9. Compared with acute pain, which of the following is true of persistent pain? a. It can bring about changes in lifestyle 10. Mr. Hernandez is a 75 year old Spanish speaking (Hispanic) man. He states he is not having pain, but he had knee replacement surgery 2 days ago. Which is the best pain assessment tool for the nurse to use for this man? a. FACES pain scale -revised 11. Which condition is NOT likely to cause an older adult chronic pain? a. Migraine headache 12. The nursing home staff needs assistance to feed properly the residents who need assistance with feeding. Which of the following should the nurse implement to ensure that the residents are properly fed? a. Draw on the availability of family members who are able to follow instructions 13. Which of the following is a true statement regarding fluid intake for older adults a. Daily total volume should be mL 14. In questioning an older adult, which question is likely to elicit the most accurate information about the individual's adherence to the medication plan? a. How many doses of digoxin do you think you missed 15. Which is a common age-related physical change that may affect digestion and food intake? a. Decreased motility of the esophagus 16. An older man comes to the emergency department after falling at home, and he reports that he cannot walk without losing his balance. Which step should the nurse implement first in this patient? a. Determine the symptom onset or when he fell at home 17. Which of the following is true about dysarthria? a. Does not affect intelligence18. A nurse in a long-term care facility for a patient with Parkinson's disease. The nurse should note which one of the following movements related to PD that is observed during the assessment of the patient? a. Cogwheel rigidity 19. The nurse is caring for a patient diagnosed with PD. Which tool should the nurse use to gather information from the patient's perspective? a. The Sickness Impact Profile (SIP) 20. Which of the following statement is false about aphasia? a. Global aphasia is the result of right hemisphere lesions and affects the cognitive areas of the brain 21. Which one of the following pathways is not where drugs and metabolites are eliminated? a. Spleen 22. Which pharmacokinetic parameter is affected most by decr intestinal motility related to the aging process? a. Absorption 23. An older man dislikes the daily meal he receives from his family because it is always cold. He is underweight and has a hgb of 11.2g/1000mL. Which recommendation should the nurse case manager implement? a. Meet with the man and his family to solve the problem 24. A nurse is educating a patient who has been recently diagnosed with osteoporosis on foods high in calcium. The nurse should include which food choice? a. Plain yogurt 25. Which of the following is untrue? a. Urine specific gravity and skin turgor can be used to diagnose dehydration in old adults and in younger people 26. Which cultural group is predicted to have the fastest growing elder population in the United States between the years ? a. Hispanic Americans 27. Identify the best statement about gerontological nursing. a. Purposes of gerontological nursing include promotion of health and support for maximal independence. 1. An older adult complaints about experiencing dry eyes daily. Which of the following should the nurses assess to help determine the cause of the patient's complaint? a. Prescription antihistamine use 2. The nurse is teaching older adults about maintaining health and wellness. Which recommendation should the nurse include in the teaching to maintain optimal vision?a. Wear sunglasses daily to block sun rays 3. An older male who has tinnitus complains to the nurse that it is very annoying. Which should be the first nursing action to address the stress he is experiencing from tinnitus? a. Assess patient for risk factors that can be modified 4. The nurse plans care for an older female resident of a nursing home who has experienced a sudden deterioration in visual acuity. Which intervention should the nurse complete first? a. Examine her mood and functional status 5. The nurse at a nursing home wants to help decrease the risk of Alzheimer's disease in residents. Which of the following should the nurse do to implement this goal? a. Assist residents with ambulation to meals 6. The nurse observes older female adults learning advanced knitting techniques. The nurse concludes that this is a suitable learning activity for these women because it accomplishes which of the following? a. Adds to their existing knowledge base 7. Which is NOT a true statement about neuropsychiatric function in older adults? a. Overall cognitive abilities are progressively degraded by neuron loss in the central cortex with aging 8. Which is NOT a disease that can affect an older adults eyesight? a. Presbyopia 9. A definitive diagnosis of Alzheimer's disease can be made by detecting or utilizing which of the following? a. Neurofibrillary tangles and beta amyloid plaques 10. A family that has three small children prepares to move Mrs. Dee, who is a 90 year old mother into their house knowing she stays up all night. The nurse helps this family prepare for the change. Which part of the planning should the nurse point is the family's first priority? a. Prepare the house for Mrs. Dee's arrival 11. As the nurse admits Mrs. Love an 85 year old to the nursing home from her home of 50 years, Mrs. Love mistakes the nurse for her daughter. Which diagnosis does the nurse use to plan care for Mrs. Love? a. Relocation stress syndrome 12. Mrs. Johnson, a 91 year old female resident in the residential facility keeps a large collection of personal items and photos of her late husband on her bedside table, but the nursing assistant argues with Mrs. Johnson about this frequently. Why should the RN intervene between Mrs. J and the nursing assistant? a. Mrs. J is attempting to maintain her sense of personal space 13. Which characteristics of Mr. Mason would the nurse report to social services as an indicator of potential elder abuse? a. Mr. Mason is overly demanding on assistive care personnel 14. Mrs. Jones brings her husband to primary care. Mr. Jones is 85 years old and has DM, he has severe bilateral infections forming black rings around each ankle. He told the nurse it is caused by tight shoes. Which intervention should the nurse implement first to investigate Mr. Jones health care regiment? a. Check his glycostaed hgb level (Hgb a1c)15. The nurse provides opportunities for nursing home residents to read aloud to others. Which cognitive skill is this nursing intervention most likely to improve? a. Verbal fluency 16. At 10 pm an older male resident is attempting to climb over the bed rails. Which intervention should the nurse implement first? a. Talk to the resident about his behavior 17. Which is not true about cognitive impairments in older adults? a. Confusion is a normal and unavoidable consequence of aging for older adults 18. Which statement is true about residential living for older adults? a. Administrators are realizing that residents and families are central focus of the facility 19. Mr. McGarret is an older white male forced to retire from law enforcement; he has multiple physical complaints, but the primary care provider finds nothing abnormal. Mr. McGarret tells the nurse that his girlfriend just left him, which is the priority nursing intervention to complete before Mr. McG leaves the clinic? a. Use direct questions about firearm access 20. Which older adult is most likely to have a normal mental health? a. The older adults who grieved over the loss of a spouse for 2 years but is traveling again 21. The older adult wants to appoint an attorney-in-fact with durable power of attorney (DPA) for a specific period around forthcoming surgery. Which should the nurse implement? a. Help the patient in finding a qualified attorney 22. Which assessment findings of an older adult living in an assisted living facility indicate the highest risk for suicide? a. Declines company, preoccupied with lethal weapons 23. Which is at rue statement about suicide among older adults? a. A therapist's hopelessness or desire to drop a patient from therapy can contribute to the risk of suicide 24. The nurse prepares to transfer an older adult to a long term care facility and calls the facility to give report. Which of the following nursing action are the responsibilities of the transferring and receiving nurse? a. Providing continuity of care during transfers 25. Which chronic condition is the third most prevalent among elders in the US? a. Hearing loss 28. Which type of question should the nurse AVOID when communicating with an elder who has aphasia? a. Those that have open-ended answers 29. The nurse observes that a male patient is snoring every night. The nurse assesses the following to diagnose the patient: a. Changes in appetite 30. An older female adult has a glass of wine a few days after being discharged from the hospital with atrial fibrillation. Which should the nurse tell her first? a. Avoid alcoholic beverages on an anticoagulant 31. The nurse uses comfort measures to enhance an older adult's pharm pain management. Which should the nurse use to identify between the relationships of comfort measures, pharmacotherapy, and the older adults pain level?a. Older adult's pain diary 26. Mrs. Henriksen is a 89 year old woman with dementia who exhibits new behaviors including cursing and repeatedly verbalizing the same phrase; further, the behavior has increased over 2 days. Which intervention should the nurse implement in response to this behavior? a. Check the medication administration record for missed doses 27. Which of the following diseases affects the eyesight of an older adult by damaging the central part of the retina? a. Macular degeneration 28. Person's with normal age-related sensory changes are likely to have the most difficulty distinguishing which of the following? a. Spoken pairs of phrases like she's praised and fees raised 1. Nurse determines that Mr. Smith, an older adult with chronic bronchitis is at high risk for falls but Mr. Smith repeatedly tries to ambulate without assistance. Which is an alternative measure to restraints is contraindicated? a. Place a concave mattress on the bed 2. Osteoporosis related fall necessitated hip replacement surgery for an older female adult who is entering a rehab facility. Which is the nurse's priority goal during rehab? a. Recapture pre op mobility status 3. Mrs. Love an older female seeks advice from the nurse about preventing further bone loss after being diagnosed with osteopenia. To achieve Mrs. L's goals which teaching should the nurse provide to enhance activity of osteoblasts? a. Exercise with weights 4. Which assessment is typical for a patient with OA? a. Narrow joint spaces with crepitus 5. Which are characteristics of RA unlike OA? a. Systemic and symmetrical 6. Older adult is considering long term care insurance (LTCI) which is an important consideration? a. Scrutinize all exclusions carefully before enrolling 7. Mrs. Jones an older patient who has end-stage pulmonary disease decides to accept care from the palliative care nurse. Mrs. Jones is most likely to benefit from the palliative care nurse in which patient needs of Weisman's six needs for the dying? a. Control 8. What makes nursing support of caregivers so important for health care in the US? a. Informal caregiving saves the health care system enormous sums of money 9. Which is a true statement about mobility and safety for older adults a. Lowering the bed and using fluorescent tapes to mark path from bed to toilet are interventions to increase safety 10. Which is NOT a true statement about assistive devices to aid older adults with impaired mobility? a. Older adults should save money by adapting assistive devices from their friends11. Mrs. Jones an 85 year old female patient receives IV fluid is making wide gesticulations with her arms and insulting staff. Which intervention should the nurse implement first to maintain safe, effective nursing care? a. Pad the arm to prevent elbow and wrist flexion 12. Which is a healthy practice recommended for a person at risk for osteoporosis? a. Milk and OJ for breakfast, cheese pizza for lunch, spaghetti with spinach and cheese for dinner, ice cream for dessert 13. Not true about RA? a. Glucosamine can be helpful for the first 2 years with RA 14. Managed care systems are most effective for an older adult who does which of the following? a. Seeks regularly primary care and preventive strategies to maintain health 15. Which intervention is not recommended for an older adult in the final stages of dying? a. Applying an electric blanket to keep the patient warm 16. Son of an older adult couple ends his life suddenly and violently. Husband proceeds with living as usual. After 1 year the wife remains in seclusion and hospitalized for dehydration. Which is an important step the nurse should implement first to help improve the wife's mental health and wellness? a. Establish a trusting, caring relationship with the wife 17. Mrs. Smith loses her husband because of sudden MI and blames herself for not recognizing the warning signs. Which patient outcome associated with her loss should the nurse use to plan care? a. Mrs. Smith is able to express feelings of guilt, fear, anger or sadness 18. A client who is having trouble sleeping at night do all of the following except: administer a sedative 20. Older adult client complains of itching and pain and several days later shows you a rash: herpes zoster 22. To find out info about a patients fall ask about circumstances behind the falls, frequency of falls and evaluate the gait and balance 23. TBI risk Takes ASA, throw rugs, poor lighting, vasculitis, arthritis 24. Physical restraints can causeasphyxiation, pressure ulcers, nosocomial infections, agitation 25. DEXA scan is a diagnostic tool that measures mineral density in the bones 26. Older adult client has been married for 60 years: women over 65 are 3x more likely to become widowed, marital status is positively related to good health, families provide the majority of care, once again many grandparents assume parental roles 27. Widowhood: death of a partner is loss of self, core part of oneself dies with the partner, still miss their other half even years later, mourning is also for oneself In assessing the aging client, it is importnat for the nurse to recognize: a) The client's ability to perform ADLs b) The financial status of the client c) The job that the client held prior to aging d) All components of well-being, including biological function, psychological function, and social function D Medications, slower mobility, lack of proper fluid intake, and poor diet can contribute to what common symptom in the elder population? a) Urinary incontinence b) Skin changes c) Mental changes d) Depression A The nurse assessing the older population needs to have a basic understanding of which of the following? a) The economic status of the area b) The difference between normal and abnormal for the older age group c) The signs of sexual dysfunction d) The signs of cardiac disease B Which statement would be most appropriate to ask when assessing an aging adult for cognitive function? a) What is today's date? b) Can you count to 10 for me? c) Have you noticed anything different about your memory or thinking in the past few months? d) Who is the president of the United States? C Which disease or ailment is often under diagnosed and undertreated in the aging population? a) Schizpphreniab) Depression c) Associative disorders d) Attention deficit disorder B Which statement demonstrates normal cognitive function for an aging adult? a) Occasional memory lapses b) Unable to recall the names of their children or siblings c) Unable to recall current address or phone number d) Unable to count to 10 or repeat a series of consecutive numbers A Denmentia and depression are strongly related to: a) Clients over the age of 60 b) Clients over the age of 65 c) A decreased quality of life and functional deficits d) Past economic status and job performance C Which statement reflects the state of drug absorption in the geriatric patient? a) The rate of absorption is slowed b) The rate of absorption is faster due to thinning of the mucosa c) The percentage of the medication that is absorbed is decreased d) There is a decrease in gastric pH as we age A The absorption of medication in the geriatric client is most often affected by: a) A decrease in body fat b) An increase in serun albumin c) A decrease in body water and lean body weight d) An increase in body water C Which organ is responsible for drug metabolism and must be considered when prescribing medicaiton for an older adult? a) Kidneys b) Pancreas c) Intestines d) Liver D An older adult on digoxin and furosemide is showing signs of toxicity. The gerontology nurse understands that: a) Digoxin and furosemide are excreted by the kidneys, and the doses may need to be decreased due to impaired kidney function b) Digoxin and furosemide are excreted through the intestinal tract, and dose changes would be ineffective c) An increase in fluid intake will fix the symptoms, and no change in dose is needed d) How a drug is excreted is not a consideration when dosing an older adult A Which statement is true regarding adverse drug reactions (ADRs) in older adults? a) The rate of ADRs in geriatric clients is seven times that of younger adults and posesserious health problems b) Older adults rarely have adverse reactions to prescribed medications becuase they are monitored c) Adverse reactions are minimal in older adults and require no intervention d) Only about 1% of older adults require hospitalization for ADRs A Upgrade to remove ads Only CA$44.99/year Which substance(s) show changes through aging by becoming less pliable and stiffer? a) Lipofuscin b) Collagen and elastin c) Epithelial tissue d) Cytoplasm B Which factor is NOT a normal part of aging and needs to be addressed to promote nutrition in the older adult client? a) Loss of teeth b) Increase in gastric pH c) Xerostoma or dry mouth d) Decline in basal metabolic rate C An 80-year-old female asks the nurse about over-the-counter vitamin supplements. The most appropriate advice would include: a) No vitamin supplements are needed with a balanced diet b) Any multivitamin will do c) Take only a calcium supplement d) Take a multivitamin for those over the age of 50, which should include the recommended vitamins for the aging adult D Which theories on aging were introduced in the early 1900s? a) Wear-and-tear theory and autointoxication theory b) Evolution theory c) Molecular theory d) Cellular theory A Systems theory includes which components about aging? a) Gene regulation ideas b) Nutation accumulation on aging c) Neuroendocrine and immunological ideas d) Free radical ideas C What is the most noticeable change in tissue as it ages? a) Decrease in lipids b) Increase in subcutaneous tissue c) Decrease in wrinkles d) Accumulation of pigmented material called lipofuscinD What is the most significant change in vital organs in the aging client? a) No change in organ tissue is noted b) The outer appearance of an organ changes, but the functional component does not change c) Organs show signs of decrease in function during the aging process d) The aging process speeds up the functional capacity of major organs C What benefit does evidnce-based practice offer clients over the age of 60? a) No actual benefits have been noted when evidence-based practice is the model for geriatric care b) Evidence-based practice offers the client improved health care in all settings c) Evidence-based pracrice is only used as a model in acute care settings d) Minimal changes in geriatric care have arisen from the use of evidnece-baseed practice models B What is the purpose of Rogers' diffusion of innovation model in relation to evidnecebased practice (EBP)? a) There is no relation to EBP b) It offers an explanation of aging c) It is used to open communication around issues of implementing changes in practice when EBP research has shown that change would improve outcomes d) It is the model that contradicts the EBP theory C Which of the following statements defines who is appropriate for gerontological nursing care as stated by Orem (1991)? a) Orem (1991) refers to advanced epdistric nursing care b) Any aged client whose self-care demands exceed their ability to meet those demands is appropriate c) Orem (1991) refers to young adult nursing care in preparation for a healthyolder adult life stage d) Any client who needs nursing care for whatever reason at any age is appropriate B Upgrade to remove ads Only CA$44.99/year Describe the order for the nursing process as practiced by the gerontological nurse: a) Diagnose, implement, evaluate b) Assess, identify expected outcomes, implement, evaluate c) Assess, dignose along with the team, identify outcomes, plan, implement, evaluate d) Assess, evaluate, plan, implement, and look at outcomes C Which choice best explains the practice setting for the gerontological nurse? a) In the home of the client b) Only in acute care settings c) Clinics and long-term care facilitiesd) Home of the client, acute care facilities, long-term care settings, and clinics or anywhere clients over the age of 65 seek health care and health education D A 70-year-old presents to the clinic stating that his family things he is losing his mind and they want to put him in a home. What would be the intial role of the gerontological nurse? a) Begin the process of finding a qualified nursing home b) Do a complete history,physical, and assessment c) Speak with the family about their concerns d) Make light of the subject until the nurse can evaluate the situation B Which item would not be a focus of a cognitive-perceptual pattern assessment for the older client? a) Cognition--Have you experienced any changes in your memory? b) Communication--Have you had any difficulty speaking or forming ideas? c) FInancial--Have you had any financial hardships over the past several months? d) Orientation--Do you know what day, month, and year it is? C Which topic should NOT be omitted when assessign the aging client? a) Sexual history b) Caridac history c) History of abuse d) All of the above D For an individual with age-related hearing loss, which sound is most difficult to hear: a) A recording of a march played softly b) A young child talking in a cafeteria line c) Hammering during construction of a house next door d) The voice of a man speaking in an elevator 2 Pain of gastrointestinal origin is best differentiated from pain of cardiac origin by the presence of: 1. chest pain lasting longer than five minutes. 2. chest pain of rapid onset. 3. left flank pain. 4. substernal chest discomfort. 4 The progression of intermittent claudication is measured by the: 1. distance walked before leg pain starts. 2. pedal edema after dangling the legs for 20 minutes. 3. peripheral pulses in the affected leg. 4. skin temperature and color of the feet. 1 An early sign of alcohol withdrawal is: 1. auditory hallucinations. 2. decreased blood pressure.3. depression. 4. diaphoresis. 4 A stage III pressure ulcer is characterized by: 1. blisters, abrasions, or shallow craters. 2. deep craters with or without undermining and full-thickness skin loss involving subcutaneous tissue. 3. full-thickness skin loss with tissue necrosis or damage to muscle or bone. 4. partial-thickness skin loss involving the dermis or epidermis. 2 Upgrade to remove ads Only CA$44.99/year The primary risk factor for the development of pressure ulcers in older adult patients is: 1. immobility. 2. impaired circulation. 3. incontinence. 4. malnutrition. 1 An 80-year-old resident of a retirement center states that something is wrong with the lighting in the room because colored rings appear around the light bulbs. The resident most likely has: 1. cataracts. 2. delusions. 3. glaucoma. 4. increased intracranial pressure. 3 The most common cause of chronic pain in older adults is: 1. arthritis. 2. fractures. 3. headaches. 4. neuropathy. 1 A 72-year-old man with asthma, chronic obstructive pulmonary disease, and chronic anxiety is admitted to a nursing home. Care plan objectives for this man include: 1. adherence to his medication regimen, inhalation therapy, and instruction about methods of conserving energy. 2. an exercise program to increase the vital capacity of his lungs. 3. instruction in respiratory exercises with emphasis on forced inhalation. 4. oxygen therapy at 3 L/min as needed and deep-breathing exercises for relaxation. 1 A 65-year-old man with a 45-year history of smoking complains of a change in his cough pattern, a nonproductive cough, and an ache in his chest. The man's chest x-ray reveals an infiltrate. The gerontological nurse suspects: 1. a lung tumor. 2. chronic obstructive pulmonary disease.3. pulmonary edema. 4. tuberculosis. 1 Which symptom in older adults is most indicative of a urinary tract infection? 1. Confusion 2. Dysuria 3. Fever 4. Frequency 1 Which is a risk factor for vaginitis in older adult women? 1. Anticoagulation therapy 2. Increased sexual activity 3. Poor nutrition 4. Prolonged antibiotic therapy 4 Which condition might be indicated by an increase in hemoglobin values? 1. Dehydration 2. Infection 3. Malnutrition 4. Opiate use 1 An 83-year-old female patient underwent a total hip replacement three days ago. She should not cross her legs because: 1. abduction of the hip can cause dislocation of the prosthesis. 2. adduction of the hip can cause dislocation of the prosthesis. 3. blood clots often result from pressure on arteries in the legs. 4. contracture can be prevented by avoiding acute flexion of the hip. 2 A 76-year-old patient with osteoarthritis complains of pain, stiffness, and deformities of the fingers. The gerontological nurse recommends: 1. cold packs. 2. exercise. 3. meditation therapy. 4. vitamin therapy. 2 A factor that contributes to hypothermia in older adults is: 1. decreased activity. 2. decreased vulnerability to cold. 3. increased perception of cold. 4. increased subcutaneous fat. 1 Heat stroke is a serious form of hyperthermia that is characterized by: 1. absence of sweating. 2. decrease in body temperature. 3. increase in sweating. 4. nausea and vomiting.1 A gerontological nurse is teaching dressing techniques to a patient with right hemiplegia and a severe speech impairment. An appropriate first step in the nurse's teaching would be to: 1. ask the patient to put on a shirt. 2. demonstrate the proper way to put on a shirt. 3. explain the difficulties in putting on a shirt. 4. give verbal instructions on dressing procedures. 2 Older adults with Parkinson disease exhibit: 1. confusion and depression. 2. dementia and hyperkinesia. 3. rigidity and tremor at rest. 4. weakness and tremor with movement. 3 To prevent injury, a gerontological nurse advises an older adult who is taking tricyclic antidepressants to: 1. eat a diet high in roughage. 2. get an additional night light. 3. provide lubrication for the oral mucosa. 4. stand up slowly from sitting or lying positions. 4 Persons who are taking anticholinergic drugs are at high risk for: 1. cardiac arrhythmias. 2. dry mouth. 3. orthostatic hypotension. 4. slurred speech. 2 Age-related changes in which two organs most affect an older adult's reaction to medication? 1. Heart and lungs 2. Intestines and spleen 3. Liver and kidneys 4. Pancreas and gall bladder 3 Sildenafil citrate (Viagra) is hazardous for patients with: 1. a history of coronary artery bypass graft. 2. a history of shingles. 3. heart failure and borderline hypotension. 4. Paget disease and hypertension. 3 A 78-year-old patient calls a telephone triage nurse and reports several falls after taking over-the-counter medication for a recent cold. Which medication contributed to the falls? 1. Diphenhydramine (Benadryl) 2. Ferrous sulfate3. Guaifenesin (Robitussin) 4. Loratadine (Claritin) 1 Older adults who take the herbal supplement cascara sagrada are monitored for the presence of: 1. fever. 2. hypokalemia. 3. jaundice. 4. vertigo. 2 Upgrade to remove ads Only CA$44.99/year A nursing home conducts a survey to evaluate nursing care. However, some residents did not express their concerns due to fear of reprisal by the staff. Which aspect of the evaluation is most affected? 1. Generalizability 2. Reliability 3. Statistical significance 4. Validity 4 A common side effect of angiotensin-converting enzyme inhibitors that frequently results in discontinuation of therapy is: 1. a dry, persistent cough. 2. exacerbation of heart failure. 3. sedation. 4. urinary incontinence. 1 A patient with Stage 2 Alzheimer disease visits the mental health clinic. During the interview, the patient becomes hostile and refuses to answer further questions. The gerontological nurse's best action is to: 1. ask if the questions upset the patient in any way. 2. discontinue the interview. 3. explain that the information is needed to plan the patient's care. 4. ignore the patient's reaction and proceed. 2 A gerontological nurse at a nursing home conducts a reminiscence therapy group for residents with confusion. A member of the group stands up and says, "I just heard my cow. I have to go and milk her now." The nurse's most therapeutic response is: 1. "All right, you may leave the group now." 2. "Please tell us about your cow." 3. "That wasn't a cow; maybe you heard a vacuum cleaner." 4. "You live here at the nursing home now, not on the farm." 2 Reminiscence therapy promotes an older adult's sense of security by: 1. increasing socialization skills. 2. meshing the past with the future.3. providing praise and recognition. 4. reviewing comforting memories. 4 A physician has just informed an older adult patient that test results indicate that the patient has cancer and will require extensive surgery. The patient says, "I know the tests are wrong. I feel fine." The gerontological nurse's most appropriate response is to: 1. acknowledge that the patient looks healthy and encourage seeking a second opinion. 2. advise the patient to join a support group. 3. convey availability to talk to the patient. 4. tell the patient that the tests are reliable and accurate. 3 A 75-year-old patient who sustained a stroke has residual left-sided weakness. From the first day of hospitalization, the patient has been combative and demanding, and has refused to swallow any medication. The most constructive nursing action is to: 1. continue to attempt to follow the physician's orders. 2. determine the patient's premorbid personality. 3. restrain the patient and request a change in the route of medication. 4. wait for the patient to become more cooperative. 2 A healthy 80-year-old female patient complains that her skin feels dry and sometimes itchy. The gerontological nurse advises her to: 1. avoid scratching since breaks in the skin increase the risk of infection. 2. drink more liquids and take showers instead of baths. 3. take fewer baths, use soap sparingly, and apply skin cream afterward. 4. wear cotton clothing and try a different brand of soap. 3 A 90-year-old patient with multiple medical problems is admitted to the hospital's geriatric care unit. The nursing assessment reveals lethargy, poor capillary perfusion, and urinary incontinence. These findings alert the gerontological nurse to the potential for: 1. aspiration. 2. contractures. 3. dehydration. 4. skin breakdown. 4 An 80-year-old patient complains of sleeping less despite spending more time in bed. The patient does not use alcohol, caffeine, or any medications other than acetaminophen for arthritis pain. The patient goes to bed at 11:00 pm, falls asleep in 15 minutes, awakens several times during the night, and promptly goes back to sleep. The patient feels refreshed in the morning and works five days a week as a volunteer. The gerontological nurse's most appropriate response is to: 1. recommend that the patient eliminate fluid intake after 6:00 pm. 2. recommend that the patient go to bed one hour earlier. 3. suggest that the patient enroll in a sleep study. 4. tell the patient that the sleeping pattern is a normal age-related change.4 Which signs are characteristic of deep vein thrombosis? 1. A cool, non-tender limb 2. Limb numbness with diaphoresis 3. Rapid onset of unilateral leg swelling with dependent edema 4. Vertigo with an abrupt onset of blurred vision 3 Unusual symptoms of pneumonia often found in long-term care residents include: 1. anorexia and new behavioral problems. 2. headache and difficulty breathing. 3. muscle aches and fever. 4. nonproductive cough and chest pain. 1 Which symptom is exhibited first by an older adult with a urinary tract infection? 1. Anorexia 2. Confusion 3. Fever 4. Restlessness 2 Which assessment tool measures economic resources, mental health, and activities of daily living? 1. Lawton's Physical Self-Maintenance Scale 2. Older Americans Resources and Services Assessment 3. Problem Oriented Medical Record 4. Short Portable Mental Status Questionnaire 2 All care plans for older adult patients include: 1. a bowel and bladder program. 2. a fall prevention program. 3. discharge planning. 4. reminiscence therapy. 3 An older adult patient, who is recovering from surgery, has a sodium level of 128 mEq/L and is confused. The physician diagnoses syndrome of inappropriate secretion of antidiuretic hormone. The gerontological nurse's primary goal for this patient is to: 1. decrease edema by restricting free water intake. 2. prevent complications of hyponatremia. 3. reorient the patient to his or her surroundings. 4. restore the patient's fluid and electrolyte balance. 4 The adult children of an aging couple ask a gerontological nurse about alternative therapies or nontraditional services to improve their parents' health. The nurse's most appropriate response is to: 1. discuss the benefits, risks, and limitations of various therapies. 2. distinguish between folk and traditional medicine.3. give a firm warning about alternative therapies. 4. recommend a reputable holistic health therapist. 1 A 73-year-old patient is admitted to a rehabilitation facility after sustaining a mild stroke. After three nights in the facility, the patient begins to sleep only four to five hours a night and to awaken frequently during the night. The patient then complains of not feeling rested and begins to nap during the day. Which is the most appropriate nursing action? 1. Completing an assessment of the patient's sleep-wake cycle to determine necessary interventions 2. Doing nothing since this type of sleep pattern is associated with normal aging 3. Inquiring if the patient takes a medication at bedtime and requesting that the physician order it 4. Moving the patient further away from the nurse's station to minimize disturbances 1 A 68-year-old man calls his daughter every night to talk about his beloved wife who died four weeks ago. During the day, he is sad and goes out frequently to get away from the empty house. The man's most probable state is: 1. depression. 2. mourning. 3. neurosis. 4. prolonged grief. 2 The main reason that older adults with a chronic illness tolerate functional impairments is that they: 1. are afraid to seek medical advice for fear of what they may find. 2. associate their symptoms with aging rather than an illness. 3. believe in home remedies and parental traditions. 4. relate their symptoms to conditions that resolved in the past without treatment. 2 An 87-year-old man, who has been living independently, is entering a nursing home. To help him adjust, the most effective action is to: 1. involve him in as many activities as possible so he can meet other residents. 2. move him as quickly as possible so that he does not have time to think. 3. restrict family visits for the first two weeks to give him time to adjust. 4. suggest that he bring his favorite things from home to make his room seem familiar. 4 An 80-year-old patient is in the terminal stage of Alzheimer disease. The treatment team meets with the patient's who are angry and complain about a recent incident in which their parent's dentures were misplaced. The team members realize that: 1. anger at staff is a symptom of grief and needs to be addressed. 2. anxiety about the meeting may have interfered with the children's affect. 3. material items are the focus for the children at this time. 4. the focus of control should shift to the parent. 1When relocating from a family home to a continuing care community, the most crucial factor in an older person's adjustment is his or her: 1. level of economic independence. 2. perceived control of the move. 3. physical proximity to remaining family. 4. risk-taking ability. 2 A 78-year-old male resident at a long-term care facility, who is a former business executive, has been smoking and extinguishing cigarettes in a paper cup in areas where smoking is prohibited. He has been informed repeatedly of the designated smoking areas. The resident's behavior indicates an attempt to: 1. express self-transcendence. 2. maintain autonomy by exercising control. 3. maintain his previous professional role. 4. react against the facility's ageism. 2 A gerontological nurse is caring for an older adult who has been confined to home for the last 10 weeks due to illness. The patient is anxious, has multiple somatic complaints, and has become unable to follow instructions. The nurse knows that this phenomenon commonly occurs with: 1. environmental overload. 2. protective isolation. 3. selective inattention. 4. sensory deprivation. 4 The gerontological nurse facilitates the benefits of life review by: 1. assisting the older adult to accept death as the inevitable last stage. 2. changing the topic when a patient talks about his or her morbid past. 3. encouraging reminiscence, oral histories, and storytelling. 4. helping the older adult explore how spiritual involvement assists with stress relief. 3 The holiday season is approaching and a woman is admitted to a psychiatric unit. She reports that her husband of 45 years passed away four weeks ago. She frequently cries, eats poorly, periodically complains of back and stomach aches, and has begun isolating herself. What type of grief is this woman exhibiting? 1. Acute 2. Anticipatory 3. Disenfranchising 4. Dysfunctional 1 A 92-year old patient, who recently underwent a below-the-knee leg amputation, is resisting attempts at rehabilitation. The most likely reason for the resistance is that the patient: 1. has goals that differ from the rehabilitation care plan. 2. has too many disabilities to realistically plan for rehabilitation.3. is too old to undergo rehabilitation. 4. requires a psychiatrist's assistance to deal with the loss. 1 When the gerontological nurse in a clinic asks a 70-year-old man about his sexual activity, he begins to cry and says, "I feel so bad for my wife; she is only 60, and I can't seem to satisfy her as often as I used to." Which is the nurse's most appropriate response? 1. "At your age, sexual activity diminishes because of changes in your circulation. I will explain this to your wife." 2. "Certain body functions, such as erections, slow down with age. Could you tell me more about your sexual relations? For instance, how often do you have intercourse?" 3. "Your problem is probably an emotional one. If you could relax, you would be as sexually active as you were 10 years ago." 4. "Your problem is probably due to a decrease in your sexual hormones. This occurs naturally as people age." 2 An alert and oriented 82-year-old woman, who lives with her daughter, has been admitted to the hospital with bruises about the face and head. The daughter reports that her mother fell. Which behavior by the daughter raises the greatest suspicion of elder abuse? 1. Becoming defensive when questions are asked 2. Complaining about care delivered by hospital staff 3. Giving an illogical account of her mother's fall 4. Refusing to leave her mother alone to answer questions 4 In teaching an older adult client, the gerontological nurse's most appropriate initial strategy is to: 1. assess the client and individualize the teaching methods. 2. set a slow learning pace and begin teaching simple concepts. 3. teach slowly and use repetition. 4. use demonstration and provide ample opportunity for practice. 1 In preparing a presentation for older adults, a gerontological nurse keeps in mind that: 1. older adults are unlikely to participate in educational programs due to lack of interest. 2. older adult learners are heterogeneous due to diverse educational experiences and learning strategies. 3. the ability to acquire knowledge from a verbal presentation decreases with age more than the ability to acquire knowledge through reasoning. 4. the age-related decline in intellectual performance creates obstacles for acquiring new information. 2 Members of a family are caring for their father at home. Which statement by a family member indicates a need for teaching and caregiver instruction? 1. "Dad has gotten lazy about his bathroom habits. He blames his arthritismedication for his toileting accidents." 2. "Dad's room is close to the bathroom and we keep a light on for him at night." 3. "It's inconvenient, but we stop other activities to remind Dad to go to the bathroom on a regular schedule." 4. "We try to avoid coffee and tea at night, but Dad really likes a cup of coffee for breakfast." 1 When hospital quality assurance indicators are assigned, the nursing staff strives to: 1. avoid emphasizing performance deficits. 2. decrease patient falls. 3. focus on achieving 100% compliance. 4. identify high-risk, high-volume, or problem-prone areas. 4 The most appropriate environment for a person with chronic dementia is one that: 1. changes often to decrease boredom. 2. contains familiar objects. 3. is limited in color and sound. 4. is stimulating so as to challenge thought. 2 In assessing the lighting for a patient with glaucoma, the gerontological nurse knows that: 1. ceiling lights are best. 2. drapes should be left open during the daylight hours. 3. higher levels of light are needed. 4. lower levels of light are needed. 4 A 63-year-old patient is returning home after being hospitalized for injuries received during a robbery and home invasion. Although neighborhood robberies are rampant, the patient has lived in the same house for 50 years and does not want to move. The patient receives a monthly social security check. The gerontological nurse's most appropriate step is to: 1. advise the patient to arrange for someone to visit regularly or move into the home. 2. advise the patient to have the social security check deposited directly to the bank and to get a dog. 3. assume that the patient is incompetent and initiate commitment proceedings. 4. take no action since the patient has a right to autonomy. 2 A gerontological nurse in a daycare program for older adults observes that the participants have long toenails, corns, calluses, and other problems indicating a need for better foot care. What is the nurse's best action? 1. Developing an educational program on foot health and arranging for podiatry services at the site 2. Establishing a regular foot care plan whereby the participants' toenails would be cut and corns and calluses shaved 3. Instructing competent family members in the proper methods of cutting toenailsand using commercial foot care products. 4. Recommending that the participants soak their feet for 10 minutes before cutting their toenails using safe toenail clippers 1 The occurrence of tuberculosis in the older adult is significantly increased among individuals who: 1. are physically inactive. 2. are cigarette smokers. 3. have received the Bacile Calmette Guérin (BCG) vaccine. 4. reside in institutions. 4 Which type of fracture has the highest morbidity and mortality in the older adult? 1. Ankle 2. Hip 3. Shoulder 4. Vertebral 2 The primary reason for establishing quality improvement committees at long-term care facilities is to: 1. facilitate staff participation. 2. initiate changes based on interdisciplinary exchange. 3. monitor and record incidents, accidents, and injuries. 4. provide quality care based on measurable data. 4 An accrediting body evaluates a nursing home by monitoring the number of residents who developed pressure ulcers and urinary tract infections. What type of audit is being conducted? 1. Outcomes 2. Process 3. Prospective 4. Structure 1 A gerontological nurse is creating a staff development program for a unit. To assess the staff's learning needs, the nurse's best approach is to ask staff members: 1. "How do you want to learn new material?" 2. "What do you need to know to do your job better?" 3. "What do you think others need to learn?" 4. "What do you think others want you to learn?" 2 A comprehensive staff development program in a long-term care facility is based on the: 1. availability of educational resources. 2. nursing director's perceptions of staff learning needs. 3. philosophy, goals, and objectives of the organization. 4. recommendations of the ombudsman. 3A gerontological charge nurse delegates the administration of a nasogastric tube feeding to a licensed practical nurse (LPN). Which statement about this situation is most accurate? 1. The charge nurse is responsible for delegated care. 2. The charge nurse should implement the care and not delegate the task. 3. The LPN is accountable for his or her own actions. 4. The LPN should respectfully refuse to initiate this care. 1 Which profession first developed standards of gerontological care and provided a certification mechanism to ensure expertise? 1. Medicine 2. Nursing 3. Physical therapy 4. Social work 2 The gerontological nurses in a teaching nursing home are informed of a research project to obtain voiding cystometrograms on all residents. The gerontological nurses' responsibility is to ensure that the: 1. non-English speaking residents receive a complete explanation of the study in their native languages. 2. nursing home administration know that the nurses do not support such invasive studies on the residents. 3. research team is well staffed so that the nursing home staff can provide care as usual. 4. residents will be properly medicated in the examining room where the tests will be conducted. 1 Which is an accurate statement about Medicare? 1. Medicare is a health insurance program with carefully described benefits that may restrict the length of hospital stays. 2. Medicare patients can expect to receive routine household and attendant care under Part A of their Medicare insurance. 3. Medicare pays for the majority of nursing home care for persons who are 65 years of age or older. 4. Persons covered by Medicare must pay once-in-a-lifetime deductibles on both the physician and hospital portions of the program. 1 Nursing facilities that receive federal funds must complete for all residents a: 1. minimum data set and care plan within seven days. 2. resident assessment instrument and care plan on admission. 3. resident assessment instrument and care plan within 14 days. 4. resident assessment instrument within 14 days and a care plan within 21 days. 4 The primary function of an ombudsman is to: 1. act as a clearinghouse for complaints and problems. 2. initiate complaints about the facility's operations.3. question the facility administrator and the director of nursing. 4. welcome and interview patients and their families. 1 A 73-year-old patient reports "dizzy spells" for the past several weeks. The patient describes three similar episodes during which the patient experienced "a swimming in my head," loss of balance without falling, and numbness in the left arm. These episodes lasted 10 to 30 minutes. This patient is experiencing: a) carotid artery stenosis b) Meniere's disease c) postural hypotension d) transient ischemic attacks D Which is the main principal age-related change that causes alteration in drug distribution in older adults? a) A decrease in absorption b) A decrease in total body weight c) An increase in body water d) An increase in the ratio of body fat to lean body mass D An 85-year-old patient has an intestinal viral infection with severe diarrhea. Laboratory studies are ordered. Which result confirms a diagnosis of dehydration? a) Hyperchloremia and hypernatremia b) Hyperglycemia and hyponatremia c) Hyperkelemia and hypercapnia d) Hypermagnesemia and hyponatremia A In older women, the onset of physical discomfort and bleeding associated with intercourse often indicates: a) a friable cervix with possible cellular abnormalities b) decreased distensibility and mucosal changes of the vaginal vault c) infrequent sexual activity d) thickening of the vaginal mucosa with decreased lubrication B A gerontological clinical nurse specialist is administering a mental status examination to an 80-year-old patient. The patient answers the more complicated questions by saying "I don't know." Which test is included in a further assessment? a) Barthel Index b) Functional Independence Measure c) Geriatric Depression Scale d) Lawton Life Satisfaction Scale C The most reliable measure for assessing hydration in an older adult is: a) Mucous membrane condition b) Skin texture c) Skin turgor d) Urinary frequencyA Differences between the IQ scores of a group of 20-year-old individuals and a group of 80-year-old individuals suggest: a) Cortical atrophy b) An accumulation of lipofuscin c) Cohort differences d) Vascular changes C Which group of older adults has the highest risk for suicide? a) African-American men b) African-American women c) White men d) White women C In a quality review of pressure ulcers amoung nursing home residents, appropriate outcome criteria include the: a) Availability of supplies for wound care b) Incidence of pressure ulcers correlated with staffing levels c) Percentage of pressure ulcers that demonstrate healing each month d) Rate of nurse compliance with the protocol for treating pressure ulcers C Ever since the death of her husband a year ago, an older woman's ability to care for herself has significantly diminished. The older woman expresses increased feelings of inadequacy and decreased satisfaction with life. The daughter had become the primary caregiver for the woman and has become increasingly resentful of this role. The mother and daughter's feelings are best explained in terms of: a) Ego integrity versus despair b) Role theory c) Social exchange theory d) Unresolved grieving C Persons who have chronic open-angle glaucoma are advised to wear medical alert bracelets because they have the potential for