Geriatrics Practice Questions Unit 4
Promoting a Safe Environment
1. The overall temperature in the gerontological unit is 62°F during the evening shift. In documenting this
concern to the administration, which factor is the most important for the health and well-being of older
adults?
a. It is not fair for older adults to have to deal with an uncomfortable environment.
b. Some of the residents are wearing blankets around their shoulders to keep warm.
c. An ambient temperature of 62°F is unsuitable for older people because they have impaired
thermoregulation.
d. It feels much warmer in the administration wing than out in the client care areas.
ANS: C
Under no circumstances should the temperature drop below 65°F because older adults are at risk for
hypothermia. Furthermore, frail older adults need the temperature to be considerably higher. The issue
is not one of fairness but a more fundamental issue of client safety. Some of the residents wearing
blankets may represent individual temperature preferences. The purpose is to make the point that the
clients are vulnerable to low temperatures, not to make veiled accusations against the administrators.
2. Which of the following statements is true about a safe, effective care environment for older adults?
a. Cold beer with steak and potatoes is a good meal for an older adult on a hot day.
b. Older drivers are more likely to be in a fatal motor vehicle accident than younger drivers.
c. Barrier-free buses and low fares make public transit a safe transportation option.
d. A nurse’s perception of temperature is a useful guide for client thermal needs.
ANS: B
Although older adults have safer driving habits (e.g., less night driving, less driving in heavy trafÏc,
shorter distances, less speeding, or drunk driving) than younger drivers, the physical and sensory
changes of aging contribute to a higher incidence of fatal accidents for older adults. Hot, heavy meals
and alcohol should be avoided when ambient temperatures exceed 90°F. The fear of crime often deters
older adults from using public transit. The older adult’s perception of temperature is the important
factor.
Ashley Andraski Ph.D.c, MSN, BSN, RN
,3. An older adult client was oriented and responded appropriately in the hospital, but he is now
disoriented and confused in his home after discharge. Which of the following issues is the first that the
home nurse should examine to determine whether an environmental issue is contributing to the client’s
condition at home?
a. Complaints of shivering
b. Temperature of household
c. Types of food preparation
d. Presence of radon
ANS: B
Older adults are at higher risk of hypothermia in the community because hypothermia is difÏcult to
detect and because, as hypothermia sets in, the older adult can respond to a lower temperature. This
man has clinical indicators of hypothermia; therefore the home care nurse first assesses the ambient
temperature for a baseline determination because the household temperature should have the most
profound impact on his body temperature. Asking about shivering can be ineffective with an older adult
who is confused and disoriented; the response can be incorrect. However, to display respect, the nurse
should ask the question. The type of food preparation can offer additional clues about the older adult’s
hypothermia and mental status; if he is eating cold foods such as sandwiches and yogurt, then he can be
unwitÝngly contributing to the problem. Presence of radon in the home may lead to lung cancer, not
confusion.
4. The nurse recommends that a client diagnosed with moderate stage Alzheimer’s disease attend a
support group when he becomes defensive about not driving his automobile and the effects it will have
on “being stuck at home.” Which is the priority outcome expected for this client when attending the
group sessions?
a. Facilitates socialization thus minimizing the effects of social isolation
b. Helps with minimizing the loss as a factor in causing depression
c. Provides caregivers with respite while assuring the client is well attended to
d. Allows for the opportunity for a mental health professional to assess the client
ANS: B
Participants attending the driving cessation support groups (DCSG) had an improvement in depression
scores, were less angry, and were happier. Support groups designed specifically to deal with loss of
driving privileges among individuals with dementia may be important in alleviating depressive symptoms
and other negative outcomes associated with cessation of driving. The remaining options represent
possible outcomes but they do not have the priority that minimizing depression has for this client.
Ashley Andraski Ph.D.c, MSN, BSN, RN
, 5. A 79-year-old client resides independently in the community. The visiting home health nurse finds that
despite it being 90°F outside, the windows are closed and the client is wearing a sweater. The nurse
initially recognizes that this behavior may be related to what?
a. Cognitive changes that diminish the individual’s awareness of temperature changes
b. Age-related neurosensory changes that diminish awareness of temperature changes
c. Delirium-related to an acute illness that is affecting body heat production
d. Age-related motor deficiencies that result in self-neglect
ANS: B
Neurosensory changes related to aging tend to delay or diminish the individual’s awareness of
temperature changes and may impair behavior or thermoregulatory responses to dangerously high or
low temperatures. There is no evidence in this scenario that the client has cognitive changes, an acute
illness or is incapable of self-care and such assumptions should not be routinely made based on age
alone.
6. A home care nurse in an area of the country that is prone to tornadoes routinely discusses disaster
preparedness with older adult clients. What is the primary rationale for this intervention?
a. Older adults are less likely to seek formal and informal help when affected by natural disasters.
b. The older adult is more likely to live in a communal environment which provides assistance in times of
natural disasters.
c. Most older adults have insurance to help them recover from material losses due to a natural disaster.
d. Federal and private assistance agencies generally provide older adults with priority attention in time of
natural disasters.
ANS: A
Older adults are less likely to seek assistance than younger adults in times of disaster. The remaining
options are not generally proven to be true for the majority of older adults.
7. A homecare nurse visits an older client who lives in a Smart medical home community environment.
What should the nurse understand about Smart Homes?
a. An emerging technology to enhance safety of older adults by using environmental control systems
b. An assistive technology that keeps data on vital signs, gait, behavior, and sleep without providing an
interactive medical-advising system
Ashley Andraski Ph.D.c, MSN, BSN, RN
Promoting a Safe Environment
1. The overall temperature in the gerontological unit is 62°F during the evening shift. In documenting this
concern to the administration, which factor is the most important for the health and well-being of older
adults?
a. It is not fair for older adults to have to deal with an uncomfortable environment.
b. Some of the residents are wearing blankets around their shoulders to keep warm.
c. An ambient temperature of 62°F is unsuitable for older people because they have impaired
thermoregulation.
d. It feels much warmer in the administration wing than out in the client care areas.
ANS: C
Under no circumstances should the temperature drop below 65°F because older adults are at risk for
hypothermia. Furthermore, frail older adults need the temperature to be considerably higher. The issue
is not one of fairness but a more fundamental issue of client safety. Some of the residents wearing
blankets may represent individual temperature preferences. The purpose is to make the point that the
clients are vulnerable to low temperatures, not to make veiled accusations against the administrators.
2. Which of the following statements is true about a safe, effective care environment for older adults?
a. Cold beer with steak and potatoes is a good meal for an older adult on a hot day.
b. Older drivers are more likely to be in a fatal motor vehicle accident than younger drivers.
c. Barrier-free buses and low fares make public transit a safe transportation option.
d. A nurse’s perception of temperature is a useful guide for client thermal needs.
ANS: B
Although older adults have safer driving habits (e.g., less night driving, less driving in heavy trafÏc,
shorter distances, less speeding, or drunk driving) than younger drivers, the physical and sensory
changes of aging contribute to a higher incidence of fatal accidents for older adults. Hot, heavy meals
and alcohol should be avoided when ambient temperatures exceed 90°F. The fear of crime often deters
older adults from using public transit. The older adult’s perception of temperature is the important
factor.
Ashley Andraski Ph.D.c, MSN, BSN, RN
,3. An older adult client was oriented and responded appropriately in the hospital, but he is now
disoriented and confused in his home after discharge. Which of the following issues is the first that the
home nurse should examine to determine whether an environmental issue is contributing to the client’s
condition at home?
a. Complaints of shivering
b. Temperature of household
c. Types of food preparation
d. Presence of radon
ANS: B
Older adults are at higher risk of hypothermia in the community because hypothermia is difÏcult to
detect and because, as hypothermia sets in, the older adult can respond to a lower temperature. This
man has clinical indicators of hypothermia; therefore the home care nurse first assesses the ambient
temperature for a baseline determination because the household temperature should have the most
profound impact on his body temperature. Asking about shivering can be ineffective with an older adult
who is confused and disoriented; the response can be incorrect. However, to display respect, the nurse
should ask the question. The type of food preparation can offer additional clues about the older adult’s
hypothermia and mental status; if he is eating cold foods such as sandwiches and yogurt, then he can be
unwitÝngly contributing to the problem. Presence of radon in the home may lead to lung cancer, not
confusion.
4. The nurse recommends that a client diagnosed with moderate stage Alzheimer’s disease attend a
support group when he becomes defensive about not driving his automobile and the effects it will have
on “being stuck at home.” Which is the priority outcome expected for this client when attending the
group sessions?
a. Facilitates socialization thus minimizing the effects of social isolation
b. Helps with minimizing the loss as a factor in causing depression
c. Provides caregivers with respite while assuring the client is well attended to
d. Allows for the opportunity for a mental health professional to assess the client
ANS: B
Participants attending the driving cessation support groups (DCSG) had an improvement in depression
scores, were less angry, and were happier. Support groups designed specifically to deal with loss of
driving privileges among individuals with dementia may be important in alleviating depressive symptoms
and other negative outcomes associated with cessation of driving. The remaining options represent
possible outcomes but they do not have the priority that minimizing depression has for this client.
Ashley Andraski Ph.D.c, MSN, BSN, RN
, 5. A 79-year-old client resides independently in the community. The visiting home health nurse finds that
despite it being 90°F outside, the windows are closed and the client is wearing a sweater. The nurse
initially recognizes that this behavior may be related to what?
a. Cognitive changes that diminish the individual’s awareness of temperature changes
b. Age-related neurosensory changes that diminish awareness of temperature changes
c. Delirium-related to an acute illness that is affecting body heat production
d. Age-related motor deficiencies that result in self-neglect
ANS: B
Neurosensory changes related to aging tend to delay or diminish the individual’s awareness of
temperature changes and may impair behavior or thermoregulatory responses to dangerously high or
low temperatures. There is no evidence in this scenario that the client has cognitive changes, an acute
illness or is incapable of self-care and such assumptions should not be routinely made based on age
alone.
6. A home care nurse in an area of the country that is prone to tornadoes routinely discusses disaster
preparedness with older adult clients. What is the primary rationale for this intervention?
a. Older adults are less likely to seek formal and informal help when affected by natural disasters.
b. The older adult is more likely to live in a communal environment which provides assistance in times of
natural disasters.
c. Most older adults have insurance to help them recover from material losses due to a natural disaster.
d. Federal and private assistance agencies generally provide older adults with priority attention in time of
natural disasters.
ANS: A
Older adults are less likely to seek assistance than younger adults in times of disaster. The remaining
options are not generally proven to be true for the majority of older adults.
7. A homecare nurse visits an older client who lives in a Smart medical home community environment.
What should the nurse understand about Smart Homes?
a. An emerging technology to enhance safety of older adults by using environmental control systems
b. An assistive technology that keeps data on vital signs, gait, behavior, and sleep without providing an
interactive medical-advising system
Ashley Andraski Ph.D.c, MSN, BSN, RN
