Gerontology Exam practice questions

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. - answer-2 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. - answer-2 A 69-year-old female presents with knee pain. The nurse hears a dry crackling or grating sound and the client feels the same sensation on exam. The nurse reconizes this as: a. Nothing abnormal for the age of the client b. Crepitation, the sound of osteoarthritis in the knee joint c. Osteoporosis and a softening of the knee joint d. Fluid-filled spaces in the knee joint - answer-B 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 - answer-B 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 - answer-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 - answer-D 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. - answer-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. - answer-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. - answer-2 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 sulfate 3. Guaifenesin (Robitussin) 4. Loratadine (Claritin) - answer-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. - answer-1 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 - answer-C A gerontological clinical specialist is conducting a study on risk factors for osteoporosis and has developed a questionnaire covering risk-reducing and risk-increasing behaviors of older women. The clinical specialist asks experts in the area of osteoporosis to review the tool to establish: a) concurrent validity b) content validity c) interrater reliability d) test-retest reliability - answer-B 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." - answer-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 toenails and using commercial foot care products. 4. Recommending that the participants soak their feet for 10 minutes before cutting their toenails using safe toenail clippers - answer-1 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. - answer-4 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. - answer-2 A male elderly client on long-term auranofin therapy presents with oral ulcers and a pruritic rash and complains of decreased urinary output. The nurse understands that: a. These symptoms can be the adverse effects of gold salt therapy b. These symptoms are unrelated to anything and need a major work-up for diagnosis c. These symptoms represent liver failure d. These symptoms are common when clients are treated for arthritis - answer-A 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 - answer-4 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. - answer-2 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. - answer-3 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 - answer-3 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. - answer-3 All statements are examples of nonpharmacological nursing interventions for a patient experiencing delirium but needing sleep except: a. Providing adequate sleep and awake times b. Encouraging ambulation c. Providing a night light to prevent fears d. Reducing noise levels during periods of sleep - answer-B 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 - answer-D An 80-year-old female decides on a do not resuscitate (DNR) status for herself after discussing her medical concerns with her physician. Which statement best describes the reasoning behing this decision? a. This is ethical reasoning based on self-determination and informed consent b. This is not a medical decision c. This discussion would be meaningless because the family members were not involved d. THis is not an ethical decision - answer-A 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. - answer-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. - answer-2