Chapter 23 My Nursing Test Banks

 

Kozier & Erbs Fundamentals of Nursing, 9/E
Chapter 23

Question 1

Type: MCSA

A nurse is working with a group of clients in a community center, all over the age of 85. This group is referred to as which of the following?

1. Young-old

2. Middle-old

3. Old-old

4. Elite-old

Correct Answer: 3

Rationale 1: Ages 65 to 74 years are referred to as the young-old.

Rationale 2: Ages 75 to 84 are the middle-old.

Rationale 3: Ages 85 to 100 are the old-old,

Rationale 4: individuals over 100 are considered the elite-old.

Global Rationale: Page Reference: 412

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 02 Identify the different categories of older adults as they range from 65 to 100 years of age.

Question 2

Type: MCSA

When working with the older adult age group, the nurse realizes that physiological and psychosocial changes will be evident. Those in this age group who will have at least one chronic disease condition will constitute what portion of the group?

1. 50% of the group

2. 80% of the group

3. 100% of the group

4. 90% of the group

Correct Answer: 2

Rationale 1: According to the CDC (Centers for Disease Control and Prevention, 2004), 50% of older adults have two chronic health conditions

Rationale 2: According to the CDC (Centers for Disease Control and Prevention, 2004), 80% of older adults have one chronic health condition.

Rationale 3: According to the CDC (Centers for Disease Control and Prevention, 2004), this is not a true statement.

Rationale 4: According to the CDC (Centers for Disease Control and Prevention, 2004), this is not a true statement.

Global Rationale: Page Reference: 416

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 Describe the demographic, socioeconomic, ethnicity, and health characteristics of older adults in the United States.

Question 3

Type: MCSA

A nurse is presenting a health education program to a group of older adults at a senior citizens center. Considering the physiological changes of this age group, how should the temperature of the room be set?

1. It should be set at a temperature that is comfortable for the nurse.

2. It should be set cooler than what is comfortable for the nurse.

3. It should be set warmer than the nurses preference.

4. Temperature of the room is not one of the nurses concerns.

Correct Answer: 3

Rationale 1: Because elderly persons have a loss of subcutaneous fat, their tolerance of cold is decreased and they would not be comfortable in a temperature suited to a younger individual.

Rationale 2: Because elderly persons have a loss of subcutaneous fat, their tolerance of cold is decreased and they typically do not enjoy cooler temperatures.

Rationale 3: Because elderly persons have a loss of subcutaneous fat, their tolerance of cold is decreased and they typically enjoy warmer temperatures.

Rationale 4: If the environment is not comfortable to the audience, they will be distracted and not be able to focus or concentrate on the presentation and any information the nurse shares.

Global Rationale: Page Reference: 417

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 Describe the demographic, socioeconomic, ethnicity, and health characteristics of older adults in the United States.
08 Describe the usual physical changes that occur during older adulthood.

Question 4

Type: MCSA

In the review of an elderly clients chart, the nurse reads that the client has sarcopenia. What will the nurse expect to find the client reporting?

1. Weight loss and nausea

2. Hair loss and thin skin

3. Bleeding and bruising tendencies

4. Lack of strength and tiring easily

Correct Answer: 4

Rationale 1: Sarcopenia is not generally related to weight loss or nausea.

Rationale 2: Alopecia is loss of hair.

Rationale 3: Thrombocytopenia may cause bleeding and bruising.

Rationale 4: Sarcopenia is defined as a steady decrease in muscle fibers, a normal physiological change of aging. The age-related mechanism appears to be related to denervation of the muscle and causes elders to often complain about their lack of strength and how quickly they tire.

Global Rationale: Page Reference: 417

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 Describe the demographic, socioeconomic, ethnicity, and health characteristics of older adults in the United States.

Question 5

Type: MCSA

An elderly client comes to the clinic for follow-up after a long hospitalization. When the client asks about increasing strength and endurance, the nurse should respond with which of the following?

1. Your muscles can be strengthened which might help you function better.

2. It wont matter if you exercise. At your age, theres little room for improvement.

3. Once muscle mass is decreased, theres nothing that can be done for strength improvement.

4. Maybe you should think about going to a nursing home. At least the people there will be able to help with your needs.

Correct Answer: 1

Rationale 1: There is evidence that an older adults muscles can be strengthened through exercise and training, with concomitant improvements in functional status.

Rationale 2: It would be inappropriate for the nurse to assume that there is no room for improvement.

Rationale 3: Physical changes associated with the aging process are normal, but not something that cant be improved upon.

Rationale 4: There is evidence that an older adults muscles can be strengthened through exercise and training, with concomitant improvements in functional status. It would be inappropriate for the nurse to suggest that the client is a suitable candidate for long-term care.

Global Rationale: Page Reference: 417, 419

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 Describe the demographic, socioeconomic, ethnicity, and health characteristics of older adults in the United States.
08 Describe the usual physical changes that occur during older adulthood.

Question 6

Type: MCSA

A group of elderly women come to the community center for exercise classes taught by the community health nurse. This activity will help with which of the following?

1. Reverse the effects of aging and cure pain.

2. Slow bone density loss and decrease muscle atrophy.

3. Eliminate the risk for osteoporosis.

4. Prevent pathologic fractures.

Correct Answer: 2

Rationale 1: Exercise and proper nutrition will NOT reverse the effects of aging, nor will they eliminate the risk for osteoporosis.

Rationale 2: Programs of physical activity and proper nutrition will slow bone density loss and decrease muscle atrophy and stiffness that occurs with aging.

Rationale 3: Exercise and proper nutrition will NOT reverse the effects of aging, nor will they eliminate the risk for osteoporosis.

Rationale 4: Pathologic fractures occur spontaneously, without a fall or trauma to the bone. Many are a result of low bone density or tumor.

Global Rationale: Page Reference: 419

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 Describe the demographic, socioeconomic, ethnicity, and health characteristics of older adults in the United States.
08 Describe the usual physical changes that occur during older adulthood.

Question 7

Type: MCSA

A nurse is teaching a wellness class for older adults. In order to address the sensory loss that accompanies the aging process, the nurse should recommend that these clients:

1. Use hearing aids and glasses.

2. Wear shaded glasses indoors to reduce glare.

3. Switch to brighter lighting in their home.

4. Exercise more and eat higher amounts of calcium.

Correct Answer: 3

Rationale 1: Not all elderly people need glasses or hearing aids.

Rationale 2: Changes in vision associated with aging include loss of visual acuity, less power of adaptation to darkness and dim light, decrease in accommodation to near and far objects, loss of peripheral vision, and difficulty in discriminating similar colors. Wearing darker glasses will not increase the brightness of the home.

Rationale 3: Changes in vision associated with aging include loss of visual acuity, less power of adaptation to darkness and dim light, decrease in accommodation to near and far objects, loss of peripheral vision, and difficulty in discriminating similar colors. Having brighter lighting in their home may help with some of these vision changes.

Rationale 4: Exercise and nutrition do not address sensory problems.

Global Rationale: Page Reference: 420

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 08 Describe the usual physical changes that occur during older adulthood.
15 Describe selected health problems associated with older adults.

Question 8

Type: MCSA

A school nurse is bringing a group of students to a nursing home for a social exchange project. Before the students arrive, the nurse reminds them to do which of the following when speaking to the residents?

1. Speak as loud as they can.

2. Speak into the residents ears.

3. Write out what they want to say on a piece of paper.

4. Speak distinctly, while facing the residents.

Correct Answer: 4

Rationale 1: This option assumes that all residents have significant hearing loss, which is ageism.

Rationale 2: This option assumes that all residents have significant hearing loss, which is ageism.

Rationale 3: This option assumes that all residents have significant hearing loss, which is ageism.

Rationale 4: Hearing loss in the elderly is greater in the higher frequencies than the lower. Older adults with hearing loss usually hear speakers with low, distinct voices best and it is always appropriate to speak while facing a target.

Global Rationale: Page Reference: 420

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 08 Describe the usual physical changes that occur during older adulthood.
15 Describe selected health problems associated with older adults.

Question 9

Type: MCSA

A nurse is preparing an education program on safety concerns for elderly adults living in their own homes. To address the sensory changes in this age group, the nurse will recommend that this group have which of the following?

1. Carbon monoxide detectors that are checked on a scheduled basis

2. A list of emergency numbers near the phone

3. Telephones that use a blinking light instead of a ringer

4. Someone to do their cooking for them

Correct Answer: 1

Rationale 1: Decreased or absent sense of smell adds to the safety issues of this age group. Because of this, and if the elderly persons home has natural gas appliances or furnace, a carbon monoxide detector would alert the person of any gas leaks or problems present.

Rationale 2: Emergency numbers by the phone is a good idea, but does not address sensory changes.

Rationale 3: Telephones that utilize a blinking light are used for people who are significantly hearing impaired.

Rationale 4: It is not necessary for someone to do cooking for this age group, though they may be inclined to use more salt due to decreased sense of smell and taste.

Global Rationale: Page Reference: 420

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 08 Describe the usual physical changes that occur during older adulthood.
16 List examples of health promotion topics for older adulthood.

Question 10

Type: MCSA

An elderly client comes to the clinic after checking his blood pressure several times in the local discount store. The nurse checks the blood pressure and finds that it is 146/80. The nurses best response to this client is:

1. Having blood pressure a little high is normal at your age. Yours is fine.

2. Ill recheck this in a while, but your systolic pressure is too high.

3. Well wait and see what the doctor says, but I doubt he will be concerned.

4. You should be on high blood pressure medicine.

Correct Answer: 2

Rationale 1: Now, evidence indicates that a systolic pressure of greater than 140 mm Hg is as problematic in older adults as in younger ones and should be treated.

Rationale 2: Isolated systolic hypertension was considered to be normal in older adults and was frequently not treated. Now, evidence indicates that a systolic pressure of greater than 140 mm Hg is as problematic in older adults as in younger ones and should be treated.

Rationale 3: Now, evidence indicates that a systolic pressure of greater than 140 mm Hg is as problematic in older adults as in younger ones and should be treated.

Rationale 4: It would be up to the physician or primary care provider whether or not to treat. The nurse does not make this decision.

Global Rationale: Page Reference: 421

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 08 Describe the usual physical changes that occur during older adulthood.
15 Describe selected health problems associated with older adults.

Question 11

Type: MCSA

The elderly client comes to the clinic reporting gastrointestinal problems, including frequent constipation and indigestion but denies any recent weight loss. The nurse initially recognizes that these symptoms:

1. Indicate a concern and could be caused by cancer.

2. They indicate the need for an upper and lower GI x-ray series.

3. They could be related to normal changes in muscle tone and activity.

4. They are probably indicative of a gastric ulcer or colitis.

Correct Answer: 3

Rationale 1: It would be premature, as well as outside the scope of nursing practice, for the nurse to consider any other pathology.

Rationale 2: With the normal aging process, there is a decrease in muscle tone, digestive juices, and intestinal activity. These together may lead to indigestion and constipation in the older adult. It would be premature, as well as outside the scope of nursing practice, for the nurse to tell the client that there is a need for invasive testing.

Rationale 3: With the normal aging process, there is a decrease in muscle tone, digestive juices, and intestinal activity. These together may lead to indigestion and constipation in the older adult.

Rationale 4: It would be premature, as well as outside the scope of nursing practice, for the nurse to consider any other pathology.

Global Rationale: Page Reference: 421

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 08 Describe the usual physical changes that occur during older adulthood.

Question 12

Type: MCSA

An older adult client comes to the clinic with reports of not being able to hold her urine, stating: I feel so terrible. This shouldnt happen at my age. The nurses best response is:

1. You shouldnt feel badly. Lots of people have this trouble.

2. Youll probably have to start wearing incontinent briefs. Then you wont be worried about accidents.

3. Getting old isnt much fun, is it?

4. There could be a number of causes for this. I need to ask you some more questions about it.

Correct Answer: 4

Rationale 1: This option inappropriately attempts to minimize the clients concerns.

Rationale 2: Incontinent briefs are useful products for people who have UI, but the cause for all cases must be investigated.

Rationale 3: The client already feels badlythe nurse only makes this feeling worse by adding guilt on top of it.

Rationale 4: Elders may be susceptible to urinary incontinence (UI) because of changes in the kidney and bladder. UI is never normal and the nurse must promptly investigate the cause, onset, and any other symptoms.

Global Rationale: Page Reference: 421

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 08 Describe the usual physical changes that occur during older adulthood.
15 Describe selected health problems associated with older adults.

Question 13

Type: MCSA

An elderly male client comes to the clinic and states to the nurse that he hasnt been interested in sexual intercourse lately. He states: I guess this is part of getting old, too. What should the nurse understand about decreased sexual interest in elderly clients?

1. It does decrease and gradually disappears.

2. It should not be taken as seriously as if the client were a younger person.

3. It is caused by decreased hormone activity and there is little that can be done about it.

4. It decreases but does not disappear.

Correct Answer: 4

Rationale 1: Libido may decrease but not disappear.

Rationale 2: If an older man reports a loss in sexual interest, the nurse should be as concerned as when a younger man reports a loss in sexual activity.

Rationale 3: Decrease in hormone secretion and activity is a normal aging process, but there may be treatment measures that can help if this is the case.

Rationale 4: The major age-related change in sexual response is timing. It takes longer to become sexually aroused, longer to complete intercourse, and longer before sexual arousal can occur again.

Global Rationale: Page Reference: 422

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 08 Describe the usual physical changes that occur during older adulthood.

Question 14

Type: MCSA

In planning any health program for elderly adults, the nurse will implement Eriksons theory of task development. The nurse realizes that in this stage of life, the successful completion of the task allows the person to:

1. Have a feeling of satisfaction from past accomplishments.

2. Make connections with the younger generation.

3. Wish they had their life to live over again.

4. Live out their last years in physical health.

Correct Answer: 1

Rationale 1: Eriksons task of this developmental stage is integrity versus despair. People who develop integrity accept their life with a sense of wholeness and satisfaction with their past accomplishments.

Rationale 2: Making connections with the younger generation is part of the task of the middle adult age group.

Rationale 3: People who despair often believe they made poor choices during life and wish they could live life over.

Rationale 4: Physical health is not part of psychosocial development.

Global Rationale: Page Reference: 422

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 10 Describe developmental tasks of the older adult.

Question 15

Type: MCSA

When consulting Eriksons developmental theory, the nurse assesses that which of the following older adults will have the least difficulty being successful with the task of this stage?

1. A client who felt success through her childrens accomplishments.

2. A client who held his job and work status as the defining feature of his life.

3. A client who maintained a balance between work and home.

4. A client who planned to really enjoy life once she retired.

Correct Answer: 3

Rationale 1: . Those who has been concerned only with the accomplishments of their children can be left with a feeling of emptiness when the children leave.

Rationale 2: People who has been concerned only with the paycheck and their job status can be left with a feeling of emptiness when the job no longer exists.

Rationale 3: People who learned early in life to live well-balanced and fulfilling lives are generally more successful in retirement.

Rationale 4: People who attempt suddenly to refocus and enrich their lives at retirement usually have difficulty.

Global Rationale: Page Reference: 422

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 10 Describe developmental tasks of the older adult.

Question 16

Type: MCSA

A gerontological nurse is helping a potential home health client acquire the supplies that will be needed once the client is discharged from acute care. When considering these supplies, the nurse should remember that:

1. Medicare will cover supplies, but only with a physicians written order.

2. Between insurance supplements and Medicare, the elderly client shouldnt have any difficulty with coverage.

3. Most clients in this age group live on a fixed income, and supplies used should be as economical as possible.

4. Clients have to be responsible for their own supplies.

Correct Answer: 3

Rationale 1: Assuming that all supplies are covered by Medicare when ordered by a physician erroneous.

Rationale 2: Assuming that all supplies are covered by Medicare and/or supplemental insurance is erroneous.

Rationale 3: Financial needs of this age group vary considerably, and problems with income are related to low retirement benefits, lack of pension plans, and increasing length of retirement years. Nurses should be aware of the costs of health care and use supplies that are as economical as possible.

Rationale 4: The nurse should assist the client to apply for whatever assistance programs are available.

Global Rationale: Page Reference: 424

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 05 Describe the development of gerontological nursing and the roles of the gerontological nurse.

Question 17

Type: MCSA

A group of elderly clients are interested in living options available in the community when they may need some assistance with their daily needs. Which of the following would the nurse suggest as possibilities to meet these needs?

1. Adult foster care

2. Group homes

3. Retirement villages

4. Long-term care facilities

5. Adult day-care centers

Correct Answer: 1,2,5

Rationale 1: Retirement villages provide social support, but do not provide assistance with medication and ADLs. Long-term care facilities provide all care when elderly persons are no longer able to care for themselves; they are not considered assistance living. Other options include assisted living centers.

Rationale 2: Retirement villages provide social support, but do not provide assistance with medication and ADLs. Long-term care facilities provide all care when elderly persons are no longer able to care for themselves; they are not considered assistance living. Other options include assisted living centers.

Rationale 3: Retirement villages provide social support, but do not provide assistance with medication and ADLs. Long-term care facilities provide all care when elderly persons are no longer able to care for themselves; they are not considered assistance living. Other options include assisted living centers.

Rationale 4: Retirement villages provide social support, but do not provide assistance with medication and ADLs. Long-term care facilities provide all care when elderly persons are no longer able to care for themselves; they are not considered assistance living. Other options include assisted living centers.

Rationale 5: Retirement villages provide social support, but do not provide assistance with medication and ADLs. Long-term care facilities provide all care when elderly persons are no longer able to care for themselves; they are not considered assistance living. Other options include assisted living centers.

Global Rationale: Page Reference: 424

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 06 Describe the different care settings for older adults.

Question 18

Type: MCSA

An elderly client who has had a stroke is ready for hospital discharge. How should the gerontological nurse case manager support this clients independence?

1. Allow the client to be actively involved in all decisions made.

2. Make arrangements based on what the nurse feels is in the best interest of the client.

3. Work closely with the social worker and physician to make the decisions necessary for the client.

4. Set up a meeting with the family members so decisions can be made.

Correct Answer: 1

Rationale 1: Nurses need to acknowledge the older clients ability to think, reason, and make decisions. Most elders are willing to listen to suggestions and advice, but they do not want to be ordered around. It would be quite appropriate to include the physician or primary care provider, social worker, as well as the family in the decision-making process, but always and foremost, to include the client.

Rationale 2: Nurses need to acknowledge the older clients ability to think, reason, and make decisions. This option does not reflect an understanding of the clients right to autonomy.

Rationale 3: This option does not reflect an understanding of the clients right to autonomy. It would be quite appropriate to include the physician or primary care provider, social worker, as well as the family in the decision-making process, but always and foremost, to include the client.

Rationale 4: This option does not reflect an understanding of the clients right to autonomy. Nurses need to acknowledge the older clients ability to think, reason, and make decisions. It would be quite appropriate to include the physician or primary care provider, social worker, as well as the family in the decision-making process, but always and foremost, to include the client.

Global Rationale: Page Reference: 424

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 05 Describe the development of gerontological nursing and the roles of the gerontological nurse.
15 Describe selected health problems associated with older adults.

Question 19

Type: MCSA

A group of nursing students are doing their first clinical rotation in a long-term care facility. The nurse educator, in meeting the needs of this particular client group, reminds students to:

1. Do all cares for the clients, since theyre unable to do them independently.

2. Always remember that the clients self-respect must be maintained in all interactions of the students.

3. Make sure the clients cares are done in a timely manner, and sometimes that means doing things for the client.

4. Treat this group of clients with a greater level of respect than younger clients.

Correct Answer: 2

Rationale 1: There is much diversity among older clients, and nurses should be wary of stereotyping this group.

Rationale 2: Older people appreciate the same thoughtfulness, consideration, and acceptance of their abilities as younger people do.

Rationale 3: The aging client may be slower and less meticulous in many activities, and many young people err in thinking they are helpful to older people when they take over for them and do the job much faster and more efficiently. This is an unprofessional belief and disregards the clients right to autonomy and independence.

Rationale 4: This is not a practice that a nurse educator would encourage since all clients regardless of age are treated respectfully.

Global Rationale: Page Reference: 424

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 08 Describe the usual physical changes that occur during older adulthood.

Question 20

Type: MCSA

A nurse is working with clients in an assisted living facility. In the past month, there have been several deaths among the residents and their spouses. In helping the remaining residents deal with these deaths, the nurse understands that adjustment may be easier for which of the following residents?

1. A resident who spent most of her days attending to her partner who is now deceased

2. A resident who had a wide circle of friends, besides her spouse

3. A resident who was not inclined to participate in any activities offered at the facility

4. A resident who started to become more dependent on the nursing staff at the facility

Correct Answer: 2

Rationale 1: Independence established prior to the loss of a mate makes adjustment easier.

Rationale 2: Independence established prior to the loss of a mate makes adjustment easier. A person who had meaningful relationships and friendships or economic security, ongoing interests in the community or private hobbies, and a peaceful philosophy of life copes more easily with bereavement.

Rationale 3: Not participating in functions offered may indicate feelings of inadequacy or insecurity after a death has occurred.

Rationale 4: Becoming more dependent on the staff may indicate feelings of inadequacy or insecurity after a death has occurred.

Global Rationale: Page Reference: 425

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 11 Describe psychosocial changes to which the older adult adjusts during the aging process.

Question 21

Type: MCSA

A nurse who works in a long-term care facility has noticed that one of the residents has been showing signs of impaired cognitive and self care abilities over the last 2 weeks. The nurse should:

1. Remember that memory loss is a normal, age-related change.

2. Investigate for possible physiologic problems.

3. Instruct the staff to be extra attentive as this person needs more assistance.

4. Inform the residents family that the resident probably has some form of dementia.

Correct Answer: 2

Rationale 1: Cognitive impairment that interferes with normal life is not considered part of normal aging. A decline in intellectual abilities that interferes with social or occupational functions should always be regarded as abnormal and investigated.

Rationale 2: Cognitive impairment that interferes with normal life is not considered part of normal aging. A decline in intellectual abilities that interferes with social or occupational functions should always be regarded as abnormal and investigated.

Rationale 3: This option does not address the loss of function the client is experiencing.

Rationale 4: This option is premature and not within the scope of nursing practice.

Global Rationale: Page Reference: 425, 428

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 08 Describe the usual physical changes that occur during older adulthood.
12 Explain changes in cognitive abilities that occur during the aging process.

Question 22

Type: MCSA

A client has been diagnosed with dementia. The family wants to know how to plan for the future. The best response by the nurse is:

1. Your family members symptoms will get worse, but there are medications to stop the progress.

2. You should plan right now on which long-term care facility you will want to utilize when the time comes.

3. Dementia is a progressive deterioration. Its important for you to clearly understand what to look for in symptoms.

4. Dementia can be treated once the cause is known.

Correct Answer: 3

Rationale 1: There are no cures, but some medications may help to slow the progression.

Rationale 2: Family members must be educated on the course of dementia and be encouraged to learn as much about coping skills as possible.

Rationale 3: Dementia is a progressive loss of cognitive function. The most common type is Alzheimers disease. The cause is unknown. The most prominent symptoms are cognitive dysfunctions, including decline in memory, learning, attention, judgment, orientation, and language skills. Family members must be educated on the course of dementia and be encouraged to learn as much about coping skills as possible.

Rationale 4: There are no cures, but some medications may help to slow the progression.

Global Rationale: Page Reference: 428

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12 Explain changes in cognitive abilities that occur during the aging process.

Question 23

Type: MCSA

A client has had Alzheimers dementia for a period of time and continues to live at home with his spouse. Which of the following is the gerontological nurses responsibility?

1. Make sure the client is being prescribed appropriate medication.

2. Provide support for the spouse.

3. Assess the client early to ensure proper care.

4. Find a suitable long-term care facility for the client.

Correct Answer: 2

Rationale 1: Medication prescription is not a nursing responsibility

Rationale 2: The nurses responsibility is to provide supportive nursing care, accurate information, and referral assistance, if necessary, to the caregiver. Caregivers may experience physical and emotional exhaustion while they render continuous care.

Rationale 3: It is important for the nurse to do an ongoing assessment of both the client and the caregiver as the clients condition deteriorates.

Rationale 4: The nurses responsibility is to provide supportive nursing care, accurate information, and referral assistance, if necessary, but finding a suitable long term facility is not a nursing responsibility.

Global Rationale: Page Reference: 428

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 05 Describe the development of gerontological nursing and the roles of the gerontological nurse.

Question 24

Type: MCSA

Which of the following statements is correct regarding an elderly clients risk of developing both dementia and delirium?

1. Delirium is easily distinguished from dementia.

2. Dementia is reversible and treatable.

3. Delirium is an acute and reversible syndrome.

4. Dementia is the only condition that is characterized by changes in memory, judgment, language, mathematic calculation, abstract reasoning, and problem-solving ability.

Correct Answer: 3

Rationale 1: Both dementia and delirium have many of the same characteristics. .

Rationale 2: . Delirium is an acute, reversible syndrome; dementia is not..

Rationale 3: Once the underlying pathology is treated, the delirium disappears.

Rationale 4: Both dementia and delirium have many of the same characteristics..

Global Rationale: Page Reference: 428

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 15 Describe selected health problems associated with older adults.

Question 25

Type: MCSA

A hospitalized elderly client is recovering from an acute illness. As the client nears the end of his hospitalization, he questions the nurse about medications and care after discharge. The gerontological nurse should:

1. Informing the physician the client needs to go to a nursing home.

2. Assess the clients independence and ability to function in his own home before discharge.

3. Tell the client not to worry about going home.

4. Invite the clients family to come to the hospital so the nurse can explain the clients care to them.

Correct Answer: 2

Rationale 1: Informing the physician the client needs long-term care is inappropriate at this point.

Rationale 2: Older adults often perceive that being in the hospital could change their ability to be autonomous and independent. As a result, the nurse needs to assess the older adults stage or perception of need for control and autonomy during his hospitalization and his fears and hopes about being discharged from the hospital setting.

Rationale 3: Telling the client not to worry is not therapeutic and does not address his concerns.

Rationale 4: The client is a capable adult and should be included in all decision-making situations not having them deferred to the family.

Global Rationale: Page Reference: 427

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 05 Describe the development of gerontological nursing and the roles of the gerontological nurse.

Question 26

Type: MCSA

During care activities, the 80-year-old client talks about the good old days and often repeats the same stories. What action should the nurse plan?

1. Request a psychological consult for the client.

2. Support this as reminiscence therapy.

3. Redirect the client to other topics of conversation.

4. Vary caregivers assigned to the client.

Correct Answer: 2

Rationale 1: There is no need for a psychological consult. This is not abnormal behavior for this age group.

Rationale 2: This type of conversation is a necessary part of successful aging, and the nurse should support the reminiscence.

Rationale 3: It is not necessary to redirect the client to other topics of conversation since reminiscencing is not an unhealthy behavior.

Rationale 4: The elders generally respond better to familiar caregivers.

Global Rationale: Page Reference: 426

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 12 Explain changes in cognitive abilities that occur during the aging process.

Question 27

Type: MCMA

A group of elderly clients are interested in living options available in the community when they might need some assistance with their daily needs. Which of the following would the nurse suggest as possibilities to meet these needs?

Standard Text: Select all that apply.

1. Adult foster care.

2. Group homes.

3. Retirement villages.

4. Long-term care facilities.

5. Adult daycare centers.

Correct Answer: 1,2,5

Rationale 1: This is an option that appears to meet the stated needs of the clients.

Rationale 2: This is an option that appears to meet the stated needs of the clients.

Rationale 3: Retirement villages provide social support, but do not provide assistance with medication and ADLs.

Rationale 4: Long-term care facilities provide all care when elderly persons are no longer able to care for themselves; they are not considered assisted living.

Rationale 5: This is an option that appears to meet the stated needs of the clients.

Global Rationale: Page Reference: 424

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 06 Describe the different care settings for older adults.

Question 28

Type: MCMA

The nurse shows an appropriate understanding of the health promotion needs of an older adult client when:

Standard Text: Select all that apply.

1. Offering to arrange a pneumococcal vaccine for a client turning 60 years old.

2. Assessing the 62-year-old client for situational depression.

3. Discussing smoking cessation classes with a 64-year-old.

4. Asking a 78-year-old client whether he had his cholesterol tested within the last 3 years.

5. Measuring the 79-year-old clients height and weight.

Correct Answer: 2,3,5

Rationale 1: Appropriate health promotion practices would encourage such a vaccine for the client 65 years of age or older.

Rationale 2: Appropriate health promotion practices would encourage depression screenings for older adult clients.

Rationale 3: Appropriate health promotion practices would encourage smoking cessation classes for older adult clients.

Rationale 4: Appropriate health promotion practices would encourage such screening for older adult clients only until the age of 75.

Rationale 5: Appropriate health promotion practices would include regular measuring of both height and weight for older adult clients.

Global Rationale: Page Reference: 429

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16 List examples of health promotion topics for older adulthood.

Question 29

Type: MCMA

The nurse shows an understanding of the prevalent health concerns specific to the older adult client when the nurse:

Standard Text: Select all that apply.

1. Discusses the need for proper lightingespecially at nightto minimize the risk of falls.

2. Assesses amount and frequency of the clients alcohol consumption patterns.

3. Assesses the clients orientation to time, place, and person, as well as short-term memory.

4. Discusses the clients views on long-term residential care if the need arises.

5. Asks the client to name and provide the reason for each medication he is currently taking.

Correct Answer: 1,2,3,5

Rationale 1: Healthcare problems of the older adult population include risk for injuries, especially from falls.

Rationale 2: Healthcare problems of the older adult population include alcohol abuse/misuse.

Rationale 3: Healthcare problems of the older adult include dementia.

Rationale 4: While discussing such plans might become necessary, it is not considered a health problem topic for general discussion.

Rationale 5: Healthcare problems of the older adult population include drug abuse/misuse.

Global Rationale: Page Reference: 418, 426-428

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 15 Describe selected health problems associated with older adults.

Kozier & Erbs Fundamentals of Nursing, 9/E Test Bank

Copyright 2012 by Pearson Education, Inc.

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