Geri Final Part 1 Questions and Answers
100% Correct
What action by the nurse is most important for preventing hospital-acquired infections in the
older population? - ANSWER - Appropriate hand hygiene.
Hand hygiene is the most effective infection control action the nursing staff can take.
The nurse on a medical acute care unit is preparing for the admission of an 84-year-old patient
with several diagnosed chronic illnesses. The nurse begins the plan of care for this patient
based on the understanding that the older adult is likely to: - ANSWER - present with a need for
a high level of nursing care.
ANS: D
The older adult is not likely to be admitted to the hospital until a high level of acuity or
complications exists. The other options may be possible, but the majority of older patients are
admitted at a high level of acuity.
. The nurse is planning the discharge of a 70-year-old patient who lives alone and is recovering
from a fractured ankle. What action by the nurse shows an understanding of factors affecting
the patient's ultimate return to preinjury function? - ANSWER - Assesses the barriers to self-
ambulation that exist in the patient's home
ANS: C
In the hospital setting, health care professionals can become so involved in addressing the
acute condition that they fail to appreciate the underlying problems and how these too influence
the patient's health and recovery. Assessing for ambulation barriers in the patient's home has a
long-term effect on the patient's ability to regain independence.
The nurse in an acute care facility is caring for a patient recovering from a cerebral vascular
accident that has resulted in a mild loss of muscle function in his right arm and leg. The nurse is
best addressing the patient's need via the functional model of care when: - ANSWER - d.
placing the telephone where the patient can reach it with his left hand.
,ANS: D
The functional model's main goal may not be curing the disease but managing the disease, with
a focus on self-care and symptom management strategies. Placing the telephone where the
patient can reach it for himself is an example of a symptom management strategy. The other
actions do not increase the patient's functional abilities.
Which statement by a resident best indicates that the resident's psychosocial needs are being
met? - ANSWER - a.
"I'm really enjoying the opportunity to select my own mealtimes."
ANS: A
Psychosocial needs are best met when a patient is encouraged to be independent both
physically and mentally. Making choices is a good example psychosocial needs being
prioritized.
A 70-year-old patient covered by Medicare is being admitted for stabilization of type 2 diabetes.
When asked by the family why their parent's care is being co-managed by a geriatric nurse
practitioner and a physician, the best explanation is that: - ANSWER - research has shown that
this care model often results in shorter hospital stays.
ANS: B
Some studies demonstrate a significant decrease in the length of stay when patients are co-
managed by a nurse practitioner and an attending physician.
The nurse is going to educate an older patient newly diagnosed with type 2 diabetes on how to
test serum glucose levels appropriately. The nurse shows an understanding of the adaptation of
teaching techniques for this age group by: - ANSWER - asking the patient if he has any hearing
or vision deficits.
ANS: B
This population often experiences sensory deficits that can affect their learning capacity. The
other actions are also appropriate, but if the patient has sensory deficits, they must be
addressed before teaching begins.
The nurse is caring for an older adult patient who was admitted with a stage 3 pressure ulcer on
the left heel and who also has a history of Parkinson disease and chronic renal failure. To
,minimize the patient's risk of developing an iatrogenic illness, the nurse: - ANSWER - reviews all
the patient's medications for possible adverse reactions.
ANS: B
Adverse drug reactions frequently precipitate hospitalizations and, although often unreported,
are among the most common iatrogenic events in the acute care setting. The hospital staff
needs to get an accurate drug history of a patient, be aware of pharmacokinetic and
pharmacodynamic changes related to aging, and have a working understanding of drug-
disease, drug-drug, and drug-food interactions in older adults. Nurses should be particularly
aware of drugs that may be high risk when used in older adults. The other actions are important
for patient safety, but the more frequent cause of iatrogenic problems is related to medication
use.
The nurse best addresses the possible intrinsic factors that contribute to falls experienced by
older adult patients in an acute care setting by: - ANSWER - encouraging patients to wear their
glasses.
ANS: A
Risk factors for hospital falls include both intrinsic and extrinsic factors. Intrinsic factors include
age-related physiologic changes and diseases, as well as medications that affect cognition and
balance. The other actions are important safety measures that are helpful to some patients as
well, but good vision is critical for safety.
The nurse caring for an older patient is concerned when the patient begins experiencing mild
confusion. The nurse notes that the vital signs are all within normal limits for this patient. To best
assess related symptoms, the nurse initially: - ANSWER - reviews documentation about how the
patient has been eating.
ANS: B
Anorexia is a symptom of urinary tract infection, which occurs frequently in older adults.
Subclinical infection and inflammation can occur with presenting symptoms such as acute
confusion, functional capacity deterioration, anorexia, or nausea rather than the classic
symptoms of fever and dysuria. Although all actions are appropriate, the nurse suspecting a
urinary tract infection (UTI) will assess eating patterns.
The nurse is caring for a confused patient. Which action by the nurse shows the best
understanding of managing the cascading effects of iatrogenic illnesses in this population
cohort? - ANSWER - d.
, Using restraints to ensure patient safety only as a last resort
ANS: D
Once older adults are hospitalized, immobilization through enforced bed rest or restraint often
results in functional disability, and the subsequent occurrence of iatrogenic illnesses often
represents a vicious circle, referred to as the cascade effect, in which one problem increases
the person's vulnerability to another one. Gerontologic nurses must be leaders in advocating
more appropriate care and treatment of hospitalized older adults to prevent or at least reduce
the occurrence of iatrogenic illness. The other actions are good nursing care but do not relate to
the cascade effect.
An 80-year-old patient with visual and hearing deficits is admitted for hip replacement surgery.
The patient has begun to show mild confusion and has become resistant to care and treatment.
To minimize this problem, the nurse initially edits the patient's care plan to include: - ANSWER -
putting on the patient's glasses and hearing aid as a part of activities of daily living (ADLs).
ANS: B
Older adults have a decreased ability to negotiate within and adapt to an unfamiliar
environment, which can be initially minimized by the use of hearing aids and eyeglasses, for
example. The other actions may be appropriate, but until the sensory deficit is corrected, the
patient will most likely remain confused.
What action by the nurse best shows an understanding of the effects of acute hospitalization on
the functional abilities of the older patient? - ANSWER - d.
Assessing for a decline from original baseline function
ANS: D
The nurse should assess for new onset signs or symptoms of a decline from baseline function
and then implement appropriate interventions before they trigger a downward spiral of
dependency and permanent impairment.
The nurse at an assisted living facility is caring for a 73-year-old cognitively impaired patient
who has recently been admitted. The nurse creates a care plan that strives to help maintain the
patient's independence by including: - ANSWER - d.
regular cueing by staff to direct patient self-care.
100% Correct
What action by the nurse is most important for preventing hospital-acquired infections in the
older population? - ANSWER - Appropriate hand hygiene.
Hand hygiene is the most effective infection control action the nursing staff can take.
The nurse on a medical acute care unit is preparing for the admission of an 84-year-old patient
with several diagnosed chronic illnesses. The nurse begins the plan of care for this patient
based on the understanding that the older adult is likely to: - ANSWER - present with a need for
a high level of nursing care.
ANS: D
The older adult is not likely to be admitted to the hospital until a high level of acuity or
complications exists. The other options may be possible, but the majority of older patients are
admitted at a high level of acuity.
. The nurse is planning the discharge of a 70-year-old patient who lives alone and is recovering
from a fractured ankle. What action by the nurse shows an understanding of factors affecting
the patient's ultimate return to preinjury function? - ANSWER - Assesses the barriers to self-
ambulation that exist in the patient's home
ANS: C
In the hospital setting, health care professionals can become so involved in addressing the
acute condition that they fail to appreciate the underlying problems and how these too influence
the patient's health and recovery. Assessing for ambulation barriers in the patient's home has a
long-term effect on the patient's ability to regain independence.
The nurse in an acute care facility is caring for a patient recovering from a cerebral vascular
accident that has resulted in a mild loss of muscle function in his right arm and leg. The nurse is
best addressing the patient's need via the functional model of care when: - ANSWER - d.
placing the telephone where the patient can reach it with his left hand.
,ANS: D
The functional model's main goal may not be curing the disease but managing the disease, with
a focus on self-care and symptom management strategies. Placing the telephone where the
patient can reach it for himself is an example of a symptom management strategy. The other
actions do not increase the patient's functional abilities.
Which statement by a resident best indicates that the resident's psychosocial needs are being
met? - ANSWER - a.
"I'm really enjoying the opportunity to select my own mealtimes."
ANS: A
Psychosocial needs are best met when a patient is encouraged to be independent both
physically and mentally. Making choices is a good example psychosocial needs being
prioritized.
A 70-year-old patient covered by Medicare is being admitted for stabilization of type 2 diabetes.
When asked by the family why their parent's care is being co-managed by a geriatric nurse
practitioner and a physician, the best explanation is that: - ANSWER - research has shown that
this care model often results in shorter hospital stays.
ANS: B
Some studies demonstrate a significant decrease in the length of stay when patients are co-
managed by a nurse practitioner and an attending physician.
The nurse is going to educate an older patient newly diagnosed with type 2 diabetes on how to
test serum glucose levels appropriately. The nurse shows an understanding of the adaptation of
teaching techniques for this age group by: - ANSWER - asking the patient if he has any hearing
or vision deficits.
ANS: B
This population often experiences sensory deficits that can affect their learning capacity. The
other actions are also appropriate, but if the patient has sensory deficits, they must be
addressed before teaching begins.
The nurse is caring for an older adult patient who was admitted with a stage 3 pressure ulcer on
the left heel and who also has a history of Parkinson disease and chronic renal failure. To
,minimize the patient's risk of developing an iatrogenic illness, the nurse: - ANSWER - reviews all
the patient's medications for possible adverse reactions.
ANS: B
Adverse drug reactions frequently precipitate hospitalizations and, although often unreported,
are among the most common iatrogenic events in the acute care setting. The hospital staff
needs to get an accurate drug history of a patient, be aware of pharmacokinetic and
pharmacodynamic changes related to aging, and have a working understanding of drug-
disease, drug-drug, and drug-food interactions in older adults. Nurses should be particularly
aware of drugs that may be high risk when used in older adults. The other actions are important
for patient safety, but the more frequent cause of iatrogenic problems is related to medication
use.
The nurse best addresses the possible intrinsic factors that contribute to falls experienced by
older adult patients in an acute care setting by: - ANSWER - encouraging patients to wear their
glasses.
ANS: A
Risk factors for hospital falls include both intrinsic and extrinsic factors. Intrinsic factors include
age-related physiologic changes and diseases, as well as medications that affect cognition and
balance. The other actions are important safety measures that are helpful to some patients as
well, but good vision is critical for safety.
The nurse caring for an older patient is concerned when the patient begins experiencing mild
confusion. The nurse notes that the vital signs are all within normal limits for this patient. To best
assess related symptoms, the nurse initially: - ANSWER - reviews documentation about how the
patient has been eating.
ANS: B
Anorexia is a symptom of urinary tract infection, which occurs frequently in older adults.
Subclinical infection and inflammation can occur with presenting symptoms such as acute
confusion, functional capacity deterioration, anorexia, or nausea rather than the classic
symptoms of fever and dysuria. Although all actions are appropriate, the nurse suspecting a
urinary tract infection (UTI) will assess eating patterns.
The nurse is caring for a confused patient. Which action by the nurse shows the best
understanding of managing the cascading effects of iatrogenic illnesses in this population
cohort? - ANSWER - d.
, Using restraints to ensure patient safety only as a last resort
ANS: D
Once older adults are hospitalized, immobilization through enforced bed rest or restraint often
results in functional disability, and the subsequent occurrence of iatrogenic illnesses often
represents a vicious circle, referred to as the cascade effect, in which one problem increases
the person's vulnerability to another one. Gerontologic nurses must be leaders in advocating
more appropriate care and treatment of hospitalized older adults to prevent or at least reduce
the occurrence of iatrogenic illness. The other actions are good nursing care but do not relate to
the cascade effect.
An 80-year-old patient with visual and hearing deficits is admitted for hip replacement surgery.
The patient has begun to show mild confusion and has become resistant to care and treatment.
To minimize this problem, the nurse initially edits the patient's care plan to include: - ANSWER -
putting on the patient's glasses and hearing aid as a part of activities of daily living (ADLs).
ANS: B
Older adults have a decreased ability to negotiate within and adapt to an unfamiliar
environment, which can be initially minimized by the use of hearing aids and eyeglasses, for
example. The other actions may be appropriate, but until the sensory deficit is corrected, the
patient will most likely remain confused.
What action by the nurse best shows an understanding of the effects of acute hospitalization on
the functional abilities of the older patient? - ANSWER - d.
Assessing for a decline from original baseline function
ANS: D
The nurse should assess for new onset signs or symptoms of a decline from baseline function
and then implement appropriate interventions before they trigger a downward spiral of
dependency and permanent impairment.
The nurse at an assisted living facility is caring for a 73-year-old cognitively impaired patient
who has recently been admitted. The nurse creates a care plan that strives to help maintain the
patient's independence by including: - ANSWER - d.
regular cueing by staff to direct patient self-care.
