Geriatric Nursing Exam 1 questions and verified answers

Geriatric Nursing Exam 1 What is aging determined by? - Correct answer Society and Culture" "In 1935 social security set "old" at what age? - Correct answer 65 years old." "In the 2000s what was set as "old"? - Correct answer Closer to 70 years of age." "What is young-old? - Correct answer 65-74 years." "What is middle-old? - Correct answer 75-84 years." "What is old-old? - Correct answer Older than 85 years." "What does aging depend on? - Correct answer Decade during which one was born or his or her history, Gender, Ethnic Group, and Health." "According to Global Aging by 2050 what will happen? - Correct answer The number of persons 60 years and older is likely to exceed those that are 15 years and younger." "What is health influenced by? - Correct answer Culture and age." "What is the definition of health? - Correct answer Wellness is one's whole being: physical, emotional, mental, and spiritual." "What are functional abilities? - Correct answer The person's ability to live independently to enjoy family and life." "What is Maslow's Hierarchy of Human Needs? - Correct answer It is an organized framework for understanding individuals and their concerns during a particular time or situation. To reach higher levels, lower levels must be met first." "What should the gerontological nurse ensure? (Maslow's) - Correct answer The needs of older adults are met and that they can function at a high level of wellness." "What are Maslow's basic needs? - Correct answer Air, food, water, sleep, and homeostasis." "What are Maslow's safe and secure needs? - Correct answer Family, health, morality, and employment." "What are Maslow's needs of belonging? - Correct answer Friendships, family, and sexual intimacy." "What are Maslow's self esteem and self efficacy needs? - Correct answer confidence, achievement, and respect of others." "What are Maslow's self actualization needs? - Correct answer Morality, creativity, acceptance, and lack of prejudice." "What are the roles of a gerontological nurse? - Correct answer Assist the older person to achieve the highest level of functioning. Empower, enhance, and support the client for achievement of wellness. Use available resources." "What are some current initiatives of elder care? - Correct answer Promote geriatric nursing as a whole, provide wed based resources, and build leadership skills though GNLA" "Are clinical practice sites limited to acute care or nursing homes? - Correct answer No, it includes older adults in the community." "What has research investigated? - Correct answer Intervention care of dementia, reducing falls, use of restraints, pain management, delirium, care transitions, and end of life care." "What are generalists? - Correct answer They work in hospitals, homes or subacute and long term facilities, or in the community providing care to individuals and their families." "What are specialists? - Correct answer They work in acute care settings,nursing homes, retirement homes, assisted living facilities, adult day care centers, and senior citizen housing." "Who provides the majority of direct care in a nursing home? - Correct answer CNAs and nursing aides. they are often described as family. They must have the respect that is developed in the culture of the care facility." "What are some roles of gerontology organizations? - Correct answer Demonstrate need for interdisciplinary collaboration in research and practice, improve understanding of direct care amone disciplines, provide nurse with officer and committee chair positions, include national and international concerns, and establish associations for nursing assistants." "What is a vital aspect of health care for older people? - Correct answer Nursing." "What does gerontological nursing specialization provide? - Correct answer Experts in caring for older people." "Who has made an impact on research for older adult care? - Correct answer Gerontological nurses." "What is a most needed specialty? - Correct answer Gerontological Nursing." "What is ethnocentrism? - Correct answer Judging another culture solely by the values and standards of one's own culture." "What does effective cultural competence include? - Correct answer knowledge about ethnicity, culture, language, health beliefs, and skills to optimize intercultural communication." "What are health disparities associated with? - Correct answer Persons of color." "What is the goal of Healthy People 2020? - Correct answer It is to achieve health equity, eliminate disparities, and improve the health of all groups." "How can we reduce health disparities? - Correct answer Cultural competence (nurses learn personal biases, prejudices, attitudes, and behaviors), Cultural awareness (reflect on any biases of ageism and racism), and Cultural knowledge." "What is the western or biomedical system? - Correct answer Disease results from abnormalities in structure and function of body organs and invasion of germs." "What is western or biomedical systems treatment? - Correct answer Destroy invading organisms." "What is western or biomedical systems prevention? - Correct answer Avoiding pathogens, chemicals, activities, and dietary agents that are thought to cause abnormalities." "What is the personalistic or magicoreligious system? - Correct answer Believes that supernatural entities, such as gods, deities, or nonhuman beings (ghosts, ancestors, or spirits) cause illness." "How is health viewed in the personalistic or magicoreligious system? - Correct answer It is viewed as a blessing or reward." "What are some rituals of personalistic or magicoreligious systems? - Correct answer Laying of the hands and prayer circles." "What is the naturalistic or holistic health system? - Correct answer A system which is based on the concept of balance. Disturbances in balance result in disharmony and illness. It stems from china, india, and greece." "What does the diagnosis of the naturalistic or holistic health system require? What are some treatment methods? - Correct answer The type/extant of imbalance. Treatments are methods to restore balance and harmony." "What is the LEARN model? - Correct answer Listen, explain, acknowledge, recommend, and negotiate." "What are cultural skills based on? - Correct answer Mutual respect, listening carefully, attend to verbal and non verbal communication, understand meaning behind the story , explaining perception without judgement, acknowledging differences in goals, and developing a plan that considers both perspective which is mutually acceptable." "What is common in persons of color and what need is the most difficult to meet? - Correct answer Poverty is common and meeting basic needs is difficult." "What is a major element of self concept and a key to self esteem? - Correct answer Cultural identity." "What is the role of an interpreter? - Correct answer To tell the older adult client what the nurse has said and then tell the nurse what the client has said." "What does a translator deal with? - Correct answer Written word." "What is does communication need to be? - Correct answer Respectful." "What is considered disrespectful with some cultures? - Correct answer Eye contact." "What are some things that should be done when using interpreters? - Correct answer Short sentences, avoid metaphors, and a word about gestures." "What are some implications of gerontological nursing and healthy aging? - Correct answer Listening to client while trying to understand the situation, using tools to elicit health care beliefs, collaboration with traditional or alternative healers, understanding the clines belief which provides quality care to promote healthy aging." "What are some long term care beliefs for the culturally diverse? - Correct answer Families are expected to care for older adult." "Where does long term care take place? - Correct answer Long term care takes place in the home, assisted living nursing facility and hospice." "What do older adult friendly communities do? - Correct answer Address basic needs, optimize health and wellness, maximize independence for the frail and disabled, and provide social and civic engagement." "What are some interventions for the older adult who wishes to remain in their home? - Correct answer Adequate transportation, home modification, barrier free housing (wider doors and hallways 36", bathroom on the first floor, outlets at wheelchair level, reinforced walls for support bars)." "What are some models of housing for older adults? - Correct answer Shared housing, population-specific communities, and senior retirement communities." "What do community-based care setting include? - Correct answer Adult day care facilities, residential care facilities, assisted living facilities, and continuing care retirement communities." "What is PACE? - Correct answer Program for all inclusive care for the elderly. It is an alternative to nursing home care." "What kind of people are usually in acute care settings? - Correct answer Those with multiple chronic conditions and co-morbidities." "What is an example of a long term care facility? - Correct answer A nursing home." "What is the cost of care in a facility? - Correct answer On average, $215 per day or $78,475 annually. Care is paid through medicaid, medicare, out of pocket, and private insurance." "What is OBRA? - Correct answer The omnibus reconciliation act of 1987 which was designed to improve care of those in nursing homes. Revisions and updates are frequent. Five star rating system. Regulations to protect residents' rights." "What cultural changes have happened in nursing homes? - Correct answer Care has changed from a medical model to a "home model" of nurturing, support, and empowerment of caregivers. Homelike settings allow the client to make decisions." "Principles of cultural change. - Correct answer Staff empowerment, residential involvement in decision making, individualized rather than routine task oriented care, relationship building, sense of community belonging, meaningful activities, homelike environment, and increased attention to respect staff and the value of culture change." "What are some causes for transitions? - Correct answer Rehospitalizations, infections, new diagnoses, and relapses." "What is a major stressor for the older adult client and family? - Correct answer Relocation. Characteristics include anxiety, insecurity alerted mental stats, depression, loss of control and physical problems." "How can individuals cope with relocation stress? - Correct answer Control over environment, preparation for new situation, close monitoring and assessment from nurses, and familiar/treasured items." "What is intrinsic aging? - Correct answer Changes which come from within." "What is extrinsic aging? - Correct answer Changes which come from environmental factors (exposure to smoke or pollutants)." "What are triggers of aging influenced by? - Correct answer Genetics or by injury/abuse to the body." "What is the biological aging theory? - Correct answer Cells in the body become disorganized or chaotic. Cells no longer replicate. Cellular death occurs." "What is the error (stochastic) theory? - Correct answer Errors are accumulated in the synthesis of cellular DNA and RNA. With the accumulation of replication errors, cells are no longer able to function." "What are the most common aging theories? - Correct answer Wear and tear, cross link, and oxidation stress (free-radical)." "What is the programmed (nonstochastic) theory? - Correct answer Aging is predetermined or "programmed" at cellular level. As more cells cease to replicate, signs of aging occur." "What is the neuroendocrine-immunological theory? - Correct answer Cells of the immune system become more diversified with age. T lymphocytes show more signs of aging than B lymphocytes." "What are some physical changes in aging of the skin? - Correct answer Dryness, thinning and a decrease in elasticity. Blood vessels and bruises are more visible because of a decrease in the epidermis. Lighter appearance from fewer melanocytes. Age spots of liver spots (lentigines) on back of hand wrist and on face. Seborrheic keratoses and thick brown raised lesions appear. Decreased stretching from thinning of dermis. Hypodermis atrophy cause sensitivity to cold." "What are some physical changes in aging of the hair and nails? - Correct answer Hair thins on head. Hair increases in ears nose and eyebrows. Pigmentation lost (graying). Older women develop chin hair and leg and axillary and pubic hair decrease. Nails are hard and thick. Vertical ridges appear and growing is slower." "What are some changes in aging of the musculoskeletal system? - Correct answer Aging affects the ligaments, tendons, and joints, which causes the older person to be more rigid and stiff in movements. Muscle mass decreases. Posture changes as intervertebral disks dehydrate." "What are some changes in aging of the cardiovascular system? - Correct answer Myocardial and blood vessels become stiff. Left ventricle wall thickens and the size of the left atrium slightly increases. Coronary artery blood flow, stroke volume, and cardiac output decreases. Takes longer to accelerate and return to normal. Elasticity decreases, and blood vessels recoil. Veins are stretched and valves become less efficient." "What are some changes in aging of the respiratory system? - Correct answer Recoil is lost. Chest wall stiffens, gas exchange is less efficient, resistance to airflow increases, and effectiveness of cough is reduced." "What are some changes in aging of the renal system? - Correct answer Kidney blood flow decreases, size and function of kidney decrease, and urine creatinine clearance decreases." "What are some physical changes in aging of the endocrine system? - Correct answer Glands atrophy, and rate of secretion decrease. Rate of type 2 diabetes is high in older adults. The rate of hypothyroidism increases." "What are some physical changes in aging of the reproductive system? - Correct answer women cannot procreate after cessation of ovulation. Breasts appear smaller and less firm. Ovaries, uterus and cervix atrophy. Estrogen decreases. Vaginal wall loses ability to lubricate. Testes atrophy and soften, ejaculation is lower and less forceful, testosterone level reduces, men may experience urinary retention." "What are some physical changes in aging of the GI system? - Correct answer Teeth lose enamel and dentin, vulnerable to decay. Taste buds decline in number. Salivary secretion lessens (dry mouth). Pleasure eating decreases. Weight loss occurs. Esophagus and stomach sluggishly empty. Villi in intestine function less and affect absorption. Peristalsis slows. Constipation is common." "What are some physical changes in aging of accessory organs? - Correct answer Liver function tests are unaltered. Incidence of gallstones increase. Serum cholesterol level increases." "What are some physical changes in aging of neurological cognition? - Correct answer Brain size and weight decrease. Sleep disturbances. Mild memory disturbances. Balance difficulties. Injuries increase from decreased sensations in the fingers and palms. Reaction time delayed. Risk for falls increases." "What are some physical changes in aging of the eyes and ears? - Correct answer Sense of smell, sight, and touch decrease. Near vision decreases and lenses thicken. Eyelids lose elasticity and droops. Color perception decreases. Lower eyelids turn out and dry eyes are common. Ear lobes sag elongate and wrinkle. Hearing loss. Stiff and coarse ear hair. Ear wax is thick and dry." "What are some physical changes in aging of the immune system? - Correct answer Immunity is reduced at the cellular level. Oral temp is lower. Decreased response to foreign antigens. Immunoglobulins increase." "What is the relationship between Maslow's Hierarchy and physical changes? - Correct answer Physical changes affect all levels. Level 1 physiologic needs in every body system affected by aging. Upper level needs can be affected by inability to meet physiologic needs." "How long is development? - Correct answer Life long." "What is each persons development defined by? - Correct answer Time and place." "What does development involve? - Correct answer Growth and decline. It is limited and varies." "Types of aging - Correct answer Chronological aging is defined by years. Biological aging is predicted by a person's physical condition. Psychological aging is expressed through ability, control of memory, learning capacity, skills, emotions, and judgment." "What are sociological theories of aging? - Correct answer Theories that explain and predict changes in the roles and relationships of older adults with an emphasis on adjustment." "What is the disengagement theory? - Correct answer Aging is inevitable. Aging results in a decrease in interaction between the aging person and others in society. Withdrawals are natural and accepted." "What is the activity theory? - Correct answer Remain as active as possible. Activity is possible when living in a stable society. The older person has access to positive influences and significant others and opportunities to participate in society." "What is the continuity theory? - Correct answer life satisfaction with engagement or disengagement depend on personality traits. In normal aging traits remain stable. Personality influences role activity and interest in roles. Personality influences life satisfaction." "What is the age stratification theory? - Correct answer Age categories of older adults. Young, middle-aged, and old. Historical content is key to the theory. Social and cultural expressions of age are examined." "What is the social exchange theory? - Correct answer Based on the consideration of the cost benefit model of social participation. Withdrawal or isolation is the result of imbalance between exchanges of older and younger person. Balance determines an older persons satisfaction." "What is the modernization theory? - Correct answer Value in older adults is lost when their skills are no longer considered useful. Is due to technology, urbanization, and mass education." "What is the symbolic interaction theory? - Correct answer Focuses on the interaction between older adult and their environment. When confronted with change, the older person tries to master the new situation while extracting a positive self concept from the environment." "What implications have sociological theories had on gerontological nursing and healthy aging? - Correct answer Provides nurses with useful info and background for enhancing healthy aging and adaption. Have been adapted and applied to contemporary approaches to aging in many ways." "What are psychological theories of aging? - Correct answer Aging is a developmental process experience between birth and death (jungs, developmental, gerotranscendance)" "What is jungs theory of personality? - Correct answer Last half of life has a purpose of its own, allowing fro inner growth, self awareness, and reflection. Personality is directed either externally or internally. Midlife presents questions of dreams values and priorities." "What are developmental theories? - Correct answer Erikson's hierarchy presents developmental stages and tasks. Erikson's last stage of life is to look back and reflect (ego integrity or despair). Peck expanded on Erikson with identification of specific tasks of old age to establish "ego integrity". Havighurst also proposed specific tasks to be accomplished in middle age and later maturity." "What is the theory of gerotranscendence? - Correct answer Human aging brings a shift from the material world to the cosmic world with increased satisfaction. This shift is ongoing and associated with wisdom and spiritual growth." "What is spirituality? - Correct answer The quality of the person resulting from faith, a search for meaning, connection to others, and transcendence itself." "What can cause reflection of life? - Correct answer Physical health, loss of a loved one, understanding that life may be coming to and end." "What is the deepest resource of healing? - Correct answer Spirituality." "What do evidence based guidelines promote? - Correct answer Spiritual assessment and interventions." "What should nurses address in older adults? - Correct answer spiritual and physical needs." "Why are religious needs important? - Correct answer They can enhance the healing process." "What is FICA? - Correct answer The framework of the spiritual assessment tool. Faith, Importance or Influence, Community, Address." "Where does the joint commission require spiritual assessments? - Correct answer Hospitals, nursing homes, and any care setting for the older adult." "How do nurses nurture the spirit of the nurse? - Correct answer They must consider what gives their own life meaning and value. What assists them in offering spiritual support to patients. Taking care of nurses own spiritual needs helps them better meet patients spiritual needs." "What is the process of cognition? - Correct answer Acquiring, storing, sharing, and using information.Its components include language, thought process, memory, execution of function, judgment, attention, and perception. Cognition can remain stable or decline with aging." "What is fluid and crystalized intelligence? - Correct answer Fluid intelligence or "native intelligence" consists of skills that are biologically determined and independent of experience or learning. Examples include: Flexibility in thinking, Inductive reasoning, Abstract thinking, Integration with people to draw conclusions." "What are some specifics of crystalized intelligence? - Correct answer Crystalized intelligence is the knowledge and abilities a person acquires through education and life and includes: Verbal reasoning Word association Social judgment Number skills." "What is memory? - Correct answer Is the ability to retain and store information and thus retrieve the information when needed: Immediate memory Short-term memory Long-term memory. Familiarity, previous learning, and life experiences can compensate for memory loss. Age associated memory impairment (AAMI) is memory loss that is considered normal in light of person's age and educational level." "What strategies maintain and enhance cognition and vitality for life? - Correct answer Managing chronic conditions. Maintaining a healthy weight. Avoiding excess caloric intake. Limiting sodium and fats. Increasing antioxidants. Participating in physical activities. Participating in stimulating. activities. Being social." "How can older adults maximize learning late in life? - Correct answer Must be relevant information. New learning must relate to what the older person already knows. Literacy level and cultural variations play a role. Many older adults have computers and make up the fastest growing age group who owns them." "What is health literacy? - Correct answer Is the ability to obtain, process, and understand basic health information and services to make appropriate decisions regarding health care. Requires more than the ability to read and write. Is the ability to interpret and understand prescriptions, appointment slips, medical education brochures, provider instructions, and consent forms, as well as interact with health professionals." "What is cognitive impairment? - Correct answer Disturbances in memory, orientation, and concentration. Other disturbances affect intelligence, judgement, learning abilities, perception, problem solving, psychomotor abilities, reaction time, and social intactness." "What are the D's of cognitive impairment? - Correct answer Dementia, Delirium, and Depression. All frequently affect older adults. Not normal consequences of aging. Impairments increase with age. progression requires urgent assessment and intervention." "