Test Bank for Gerontological Nursing:
Competencies for Care, 4th Edition by
Kristen L. Mauk
The nurse explains that older adults often experience a disturbed sleep-wake cycle because of
hormonal changes, which include a(n) level.
a. increase in angiotensin
b. decrease in insulin
c. increase in growth hormone
d. decrease in melatonin
ANS: D
The older man in a long-term care facility consistently wakes at 3 AM and does not return to
sleep. The nurse records this behavior as insomnia.
a. sleep initiation
b. sleep maintenance
c. terminal
d. undifferentiated
ANS: C
The newly admitted older adult who cannot fall asleep and asks for a sedative every night is
most probably experiencing a difficulty with sleep:
a. initiation related to anxiety of relocation.
b. maintenance related to unfamiliar environment.
c. initiation related to depression associated with relocation.
d. maintenance related to episodes of nocturnal movement disorders.
ANS: A
The home health nurse assesses that the patient is probably experiencing myoclonus when
his wife says:
a. His loud snoring and jerking awake wakes me up, too.
,b. I am black and blue from his kicking me every night.
c. He wakes up at 2 AM every morning and walks around the house.
d. His constant leg movements tear up the covers and keep me awake.
ANS: B
The nurse would question the order for lorazepam (Ativan), 5 mg at bedtime, for a patient
with:
a. chronic obstructive pulmonary disease (COPD).
b. any form of dementia.
c. hypertension.
d. sleep apnea.
ANS: D
In order to assist a 75-year-old male resident in a long-term care facility to decrease his
problems with sleep initiation, the nurse would:
a. provide a heavy snack at bedtime.
b. reschedule the 8 PM albuterol inhalation treatment to 4 PM.
c. coach the resident in 10 minutes of exercise before bedtime.
d. provide a cola drink, strong tea, or cocoa at bedtime.
ANS: B
The nurse cautions the patient who has just started on the antidepressant trazodone
hydrochloride to help relieve insomnia to:
a. increase fluids.
b. avoid aged cheese and red wine.
c. decrease sodium intake.
d. avoid excessive exposure to the sun.
ANS: D
The 80-year-old man complains that when he goes to bed and cannot fall asleep, he tosses
and turns and gets so frustrated that he gets up and drinks coffee all night. The nurse suggests
that when he has not fallen asleep after 30 minutes, he should:
a. take two tablets of a sedative medication.
b. get up and do a mild stretching exercise for 15 minutes.
c. remain in bed with his eyes closed.
d. get up and read until he feels sleepy and then return to bed.
ANS: D
,The nurse clarifies that the continuous positive airway pressure (CPAP) machine decreases the
incidence of episodes of sleep apnea by:
a. stimulating inspiration to be deeper.
b. taking over respiratory activity when the patient ceases to breathe.
c. sounding an alarm if respirations have ceased.
d. keeping alveoli from collapsing.
ANS: D
When the patient tells the home health nurse that he has flung himself out of bed three times
in the course of a violent nightmare, the nurse recognizes the cardinal indicator of:
a. myoclonus.
b. restless legs syndrome.
c. rapid eye movement (REM) sleep disorder.
d. epilepsy.
ANS: C
The nurse cautions that although activity and exercise during the day are an effective sleep
aid, activity and exercise should be avoided within before bedtime.
a. 30 minutes
b. 1 hour
c. 2 hours
d. 3 hours
ANS: C
The patient is encouraged to decrease fluid intake in the late evening to prevent interruption
of sleep from:
a. increased digestive processes in the bowel.
b. episodes of nocturia.
c. gastroesophageal reflux.
d. changes in body temperature.
ANS: B
The nurse makes arrangements to promote normal circadian rhythm in a long-term care
facility by ensuring that all rooms have:
a. bright lights during the daytime.
b. dim lights to promote relaxation.
c. appropriate environmental temperature.
d. curtains for privacy.
, ANS: A
When discussing extended care with a patient who has had a hip replacement and needs
physical therapy, the nurse would recommend a(n):
a. basic care facility.
b. skilled care facility.
c. subacute care facility.
d. assisted-living residence.
ANS: B
The 80-year-old woman who is recovering from a stroke is being sent to an extended-care
facility. She is concerned about the expense. The nurse can allay anxiety by explaining that
Medicare will cover extended-care facility costs:
a. for a period of 30 days.
b. for a period of 45 days for physical therapy.
c. for a period of 100 days for needed skilled care.
d. until she is able to be discharged home.
ANS: C
The senior citizen political action group that uses volunteers and lobbyists to advance the
interests of older adults is the:
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
The nurse gives an example of the caregiver who is guilty of elder abuse as the:
a. daughter who uses her mothers Social Security money to purchase her mothers
medication.
b. son who puts an alarm on the front door to prevent his mother from wandering out
of the house.
c. wife who allows her mentally competent husband to refuse to take a bath for a
week.
d. frail spouse who is unable to bathe or change the clothes of her physically
dependent husband.
ANS: D
Competencies for Care, 4th Edition by
Kristen L. Mauk
The nurse explains that older adults often experience a disturbed sleep-wake cycle because of
hormonal changes, which include a(n) level.
a. increase in angiotensin
b. decrease in insulin
c. increase in growth hormone
d. decrease in melatonin
ANS: D
The older man in a long-term care facility consistently wakes at 3 AM and does not return to
sleep. The nurse records this behavior as insomnia.
a. sleep initiation
b. sleep maintenance
c. terminal
d. undifferentiated
ANS: C
The newly admitted older adult who cannot fall asleep and asks for a sedative every night is
most probably experiencing a difficulty with sleep:
a. initiation related to anxiety of relocation.
b. maintenance related to unfamiliar environment.
c. initiation related to depression associated with relocation.
d. maintenance related to episodes of nocturnal movement disorders.
ANS: A
The home health nurse assesses that the patient is probably experiencing myoclonus when
his wife says:
a. His loud snoring and jerking awake wakes me up, too.
,b. I am black and blue from his kicking me every night.
c. He wakes up at 2 AM every morning and walks around the house.
d. His constant leg movements tear up the covers and keep me awake.
ANS: B
The nurse would question the order for lorazepam (Ativan), 5 mg at bedtime, for a patient
with:
a. chronic obstructive pulmonary disease (COPD).
b. any form of dementia.
c. hypertension.
d. sleep apnea.
ANS: D
In order to assist a 75-year-old male resident in a long-term care facility to decrease his
problems with sleep initiation, the nurse would:
a. provide a heavy snack at bedtime.
b. reschedule the 8 PM albuterol inhalation treatment to 4 PM.
c. coach the resident in 10 minutes of exercise before bedtime.
d. provide a cola drink, strong tea, or cocoa at bedtime.
ANS: B
The nurse cautions the patient who has just started on the antidepressant trazodone
hydrochloride to help relieve insomnia to:
a. increase fluids.
b. avoid aged cheese and red wine.
c. decrease sodium intake.
d. avoid excessive exposure to the sun.
ANS: D
The 80-year-old man complains that when he goes to bed and cannot fall asleep, he tosses
and turns and gets so frustrated that he gets up and drinks coffee all night. The nurse suggests
that when he has not fallen asleep after 30 minutes, he should:
a. take two tablets of a sedative medication.
b. get up and do a mild stretching exercise for 15 minutes.
c. remain in bed with his eyes closed.
d. get up and read until he feels sleepy and then return to bed.
ANS: D
,The nurse clarifies that the continuous positive airway pressure (CPAP) machine decreases the
incidence of episodes of sleep apnea by:
a. stimulating inspiration to be deeper.
b. taking over respiratory activity when the patient ceases to breathe.
c. sounding an alarm if respirations have ceased.
d. keeping alveoli from collapsing.
ANS: D
When the patient tells the home health nurse that he has flung himself out of bed three times
in the course of a violent nightmare, the nurse recognizes the cardinal indicator of:
a. myoclonus.
b. restless legs syndrome.
c. rapid eye movement (REM) sleep disorder.
d. epilepsy.
ANS: C
The nurse cautions that although activity and exercise during the day are an effective sleep
aid, activity and exercise should be avoided within before bedtime.
a. 30 minutes
b. 1 hour
c. 2 hours
d. 3 hours
ANS: C
The patient is encouraged to decrease fluid intake in the late evening to prevent interruption
of sleep from:
a. increased digestive processes in the bowel.
b. episodes of nocturia.
c. gastroesophageal reflux.
d. changes in body temperature.
ANS: B
The nurse makes arrangements to promote normal circadian rhythm in a long-term care
facility by ensuring that all rooms have:
a. bright lights during the daytime.
b. dim lights to promote relaxation.
c. appropriate environmental temperature.
d. curtains for privacy.
, ANS: A
When discussing extended care with a patient who has had a hip replacement and needs
physical therapy, the nurse would recommend a(n):
a. basic care facility.
b. skilled care facility.
c. subacute care facility.
d. assisted-living residence.
ANS: B
The 80-year-old woman who is recovering from a stroke is being sent to an extended-care
facility. She is concerned about the expense. The nurse can allay anxiety by explaining that
Medicare will cover extended-care facility costs:
a. for a period of 30 days.
b. for a period of 45 days for physical therapy.
c. for a period of 100 days for needed skilled care.
d. until she is able to be discharged home.
ANS: C
The senior citizen political action group that uses volunteers and lobbyists to advance the
interests of older adults is the:
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
The nurse gives an example of the caregiver who is guilty of elder abuse as the:
a. daughter who uses her mothers Social Security money to purchase her mothers
medication.
b. son who puts an alarm on the front door to prevent his mother from wandering out
of the house.
c. wife who allows her mentally competent husband to refuse to take a bath for a
week.
d. frail spouse who is unable to bathe or change the clothes of her physically
dependent husband.
ANS: D
