Chapter 32: Health Promotion and Care of the Older Adult My Nursing Test Banks

Chapter 32: Health Promotion and Care of the Older Adult

Cooper and Gosnell: Foundations and Adult Health Nursing, 7th Edition

MULTIPLE CHOICE

1.When discussing aging, to whom does the term older adulthood apply?

a. Age 55 and above
b. Age 65 and above
c. Age 70 and above
d. Age 75 and above

ANS: B

Older adulthood begins at about age 65.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1068

OBJ: 1 TOP: Aging KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

2.When the nurse discusses prevention of cardiac disease, falls, and depression with a group of older adults, the benefits of what are important to stress?

a. Nutrition
b. Medications
c. Exercise
d. Sleep

ANS: C

Primary prevention stresses exercise for the prevention of cardiac disease, falls, and depression.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1069

OBJ:1TOP:Health promotion

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

3.When was the Social Security Act, which was the first major legislation providing financial security for older adults, passed?

a. 1930
b. 1935
c. 1940
d. 1945

ANS: B

The first major legislation to provide financial security for older adults was the Social Security Act of 1935.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1073

OBJ: 1 TOP: Legislation KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

4.When assessing the skin of an older adult patient who is complaining of pruritus, what should the nurse advise the patient to avoid to reduce further drying of her skin?

a. Perfumed soap
b. Hard-milled soap
c. Antibacterial soap
d. Lotion soap

ANS: C

Antibacterial soap is very drying.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1075

OBJ:8TOP:Integumentary alterations

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

5.Because thin skin and lack of subcutaneous fat predisposes the older adult to pressure ulcers, the nurse alters the care plan to include turning the bedfast patient how often?

a. Once every shift
b. Every 4 hours
c. Each evening
d. Every 2 hours

ANS: D

Pressure ulcers can be avoided by repositioning the patient every 2 hours.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1076

OBJ:8TOP:Integumentary alterations

KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance

6.At mealtime, the older adult seems to be eating less food than would be adequate. Compared to the younger adult, what is a requirement for the older adult?

a. More fluids
b. Less calcium
c. Fewer calories
d. More vitamins

ANS: C

The older adult requires 30 calories per kilogram of body weight, whereas the younger adult requires 40 calories.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1077

OBJ:5TOP:Gastrointestinal alterations

KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance

7.The older patient informs the nurse that food has no taste and therefore the patient has no appetite. What is this most likely caused by?

a. Tasteless food
b. Overuse of salt
c. Lack of variety
d. Loss of taste buds

ANS: D

Older adults may experience a loss of appetite. Change in taste as a result of decreased saliva production and a decreased number of taste buds may make food unappealing.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1078

OBJ:5TOP:Gastrointestinal alterations

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

8.An older adult is having difficulty swallowing. What position should the nurse recommend to aid in swallowing?

a. Chin parallel
b. Chin upward
c. Chin down
d. Chin to the side

ANS: C

The upright position, leaning slightly forward with the chin down, improves swallowing with the assistance of gravity.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1079

OBJ:8TOP:Gastrointestinal alterations

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

9.The patient complains to the nurse about a newly developed intolerance to milk. What should the nurse suggest to fulfill calcium needs?

a. Rye bread
b. Yogurt
c. Apples
d. Raisins

ANS: B

Lactose, primarily found in milk, is a common source of food intolerance. Dairy products are an important source of calcium, which is needed to prevent osteoporosis. Lactose-intolerant individuals need to replace milk with cheese and yogurt, which are processed and digested more easily.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1079

OBJ:8TOP:Gastrointestinal alterations

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

10.The older adult patient complains to the nurse about nocturia. This problem is most likely related to:

a. loss of bladder tone.
b. decrease in testosterone.
c. decrease in bladder capacity.
d. intake of caffeine.

ANS: C

At least 50% of older men and 70% of older women must get up two or more times during the night to empty their bladders, a condition known as nocturia (excessive urination at night). The most significant age-related change is the decrease in bladder capacity.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1081

OBJ: 5 TOP: Incontinence KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

11.The older adult female patient is concerned about incontinence when she sneezes. What is the correct terminology for this type of incontinence?

a. Urge incontinence
b. Stress incontinence
c. Overflow incontinence
d. Functional incontinence

ANS: B

Stress incontinence results from increased abdominal pressure, which occurs with  coughing or sneezing. Urge incontinence occurs after a sudden urge to void and is associated with cystitis, tumors, stones, and CNS disorders. Overflow incontinence is associated with diabetic neuropathy and spinal cord injuries. Functional incontinence results from unwillingness or inability to get to the toilet.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1081

OBJ: 5 TOP: Incontinence KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

12.A change of aging related to the circulatory system includes decreased blood vessel elasticity. For what should the nurse assess?

a. Confusion
b. Tachycardia
c. Hypertension
d. Retained secretions

ANS: C

The blood vessels become less elastic because of aging and may lead to increased blood pressure.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1083

OBJ:5TOP:Circulatory alterations

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

13.What should be suggested to a patient to aid with the pain of claudication?

a. Rest
b. Exercise
c. Cross legs
d. Stand

ANS: A

A nursing intervention to relieve pain is to recommend the patient rest periodically until the pain subsides. Exercise and standing for long periods of time can exacerbate the pain. Crossing the legs can limit blood flow to the extremities and increase pain.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1084

OBJ:8TOP:Circulatory alterations

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

14.The nurse recommends a breathing technique to help a patient with chronic obstructive pulmonary disease (COPD) to empty the lungs of used air and to promote inhalation of adequate oxygen. What is this method of breathing called?

a. Pursed-lip breathing
b. Increased inspiration
c. Vital capacity
d. Decreased expiration

ANS: A

Pursed-lip breathing can help empty the lungs of used air and promote inhalation of additional oxygen.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1086

OBJ: 8 TOP: Chronic obstructive pulmonary disease (COPD)

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

15.The nurse reminds the 80-year-old patient that her respiratory system has decreased resistance to respiratory infections. For what is this patient at increased risk?

a. COPD
b. Bronchitis
c. Pneumonia
d. Atelectasis

ANS: C

Decreased resistance to respiratory infections places older adults at higher risk for pneumonia.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1086

OBJ:5TOP:Respiratory alterations

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

16.The nurse recognizes that an older adult patient with COPD has a higher incidence of developing which age-related skeletal change that will alter the ability to exchange air effectively?

a. Osteoporosis
b. Arthritis
c. Kyphosis
d. Osteomyelitis

ANS: C

Kyphosis, usually caused by osteoporosis, is a curvature of the spine that alters respiration and air exchange.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1089

OBJ:5TOP:Musculoskeletal alterations

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

17.What is a major difference between rheumatoid arthritis and osteoarthritis?

a. Rheumatoid arthritis is degenerative.
b. Rheumatoid arthritis only affects patients over 40 years of age.
c. Rheumatoid arthritis is inflammatory.
d. Rheumatoid arthritis is curable.

ANS: C

Rheumatoid arthritis is an inflammatory disease; osteoarthritis is degenerative. Rheumatoid arthritis can affect patients at any age. Neither type of arthritis is curable.

PTS: 1 DIF: Cognitive Level: Application REF: Pages 1087-1088

OBJ: 5 TOP: Arthritis KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

18.For what is the older adult patient at increased risk because of age-related changes in the musculoskeletal system?

a. Fractures due to poor uptake of calcium
b. Heart attacks due to increased effort to ambulate
c. Respiratory failure due to kyphosis
d. Falls related to posture changes

ANS: D

Falls are the leading cause of accidental death in individuals over 65, in part because of posture changes brought on by aging.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1087, Table 32-8

OBJ:7TOP:Musculoskeletal alterations

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

19.The nurse is assisting an older adult patient out of bed when suddenly the patient begins to fall. What is the likely cause of the fall?

a. Fever
b. Orthostatic hypotension
c. Dehydration
d. A decrease in venous return

ANS: B

Orthostatic hypotension occurs when the patient changes position. In the older adult, the loss of elasticity in the vessels slows the vascular accommodation to sudden postural changes to a standing position.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1101

OBJ:10TOP:Musculoskeletal alterations

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

20.To help prevent falls related to muscle weakness, what type of exercises should be selected for the aging patient?

a. Daily
b. Running
c. Weight-bearing
d. Aerobic

ANS: C

Appropriate interventions to increase muscle strength begin with weight-bearing exercises. They do not have to be done daily to be effective. Running and aerobic exercise would not be appropriate or effective for the aging patient.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1101

OBJ:8TOP:Musculoskeletal alterations

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

21.What is the best test to identify the risk of osteoporosis in postmenopausal women?

a. Skeletal x-ray
b. Bone density scan
c. Calcium blood level
d. CAT scan

ANS: B

Bone density testing can identify women at risk for fractures.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1089

OBJ:5TOP:Osteoporosis

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

22.When an older female patient complains of painful sexual intercourse, what should the nurse recognize as the probable cause?

a. Urinary incontinence
b. Arthritic joints
c. Kyphosis
d. Mucosal drying

ANS: D

Sexual intercourse may be uncomfortable because of drying of the mucosa of the vagina.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1092

OBJ:5TOP:Reproductive alterations

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

23.What is age-related vision change caused by the loss of elasticity of the lens called?

a. Nearsightedness
b. Cataracts
c. Presbyopia
d. Blepharitis

ANS: C

Age-related changes include presbyopia and farsightedness resulting from a loss of elasticity of the lens. Cataracts are due to opacity of the lens.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1093

OBJ:5TOP:Sensory alterations

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

24.When communicating with an older adult patient who has difficulty hearing, how should the nurse change her speech?

a. Speak very loudly
b. Speak rapidly
c. Lower the tone of the voice
d. Raise the tone of the voice

ANS: C

To communicate with a patient with a hearing loss, the nurse should lower the tone of the voice.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1095

OBJ:8TOP:Sensory alterations

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

25.Which symptom of diabetes distorts tactile sensation?

a. Proprioception
b. Loss of visual acuity
c. Progressive paresis
d. Peripheral neuropathy

ANS: D

Peripheral neuropathy is the presence of abnormal sensation and it distorts tactile sensation.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1091

OBJ: 4 TOP: Diabetes KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

26.What is the result of a slowing of the impulse transmission in the nervous system?

a. Hypertension
b. Hearing deficit
c. Decrease in tactile sensations
d. Longer reaction time

ANS: D

When nerve impulses in the nervous system of an older adult slow down, the result is a longer reaction time.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1095

OBJ:5TOP:Neurologic alterations

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

27.What is the most common cause of dementia?

a. Multi-infarct
b. Medications
c. Alzheimer disease
d. Parkinson disease

ANS: C

Alzheimer disease is the most common cause of dementia.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1098

OBJ: 9 TOP: Dementia KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance

28.What is one positive aspect of Parkinson disease?

a. The disease does not alter ability to communicate
b. Anti-Parkinson drugs have few side effects
c. Intellectual function is not impaired
d. Involuntary movements can be controlled

ANS: C

Parkinson disease does not impair the intellect. The disease does alter the ability to communicate. Anti-Parkinson drugs have many side effects. The involuntary movements associated with the disease cannot be controlled.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1099

OBJ:4TOParkinson disease

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

29.When should family members of a stroke victim expect to see some of the neurologic involvement disappear?

a. Within 2 to 3 weeks
b. Within 1 to 2 months
c. Within 3 to 6 months
d. Within 6 to 9 months

ANS: C

Some of the initial neurologic deficits of a Cerebrovascular Accident may disappear in 3 to 6 months.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1100

OBJ: 4 TOP: Stroke KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

30.When communicating with an older adult patient, the nurse becomes aware of the fact that the patient is well satisfied with his accomplishments over a lifetime and has no regrets concerning aging. Which of Eriksons developmental stages has the patient achieved?

a. Acceptance
b. Withdrawal
c. Ego integrity
d. Interaction

ANS: C

The last stage of life is acceptance of life and it results in ego integrity.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1072, Box 32-4

OBJ: 3 TOP: Aging KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity

31.Which areas are affected only minimally by age?

a. Physical activity
b. Productivity
c. Cognition
d. Sexuality

ANS: C

Aging has little influence on cognition. Only through disease processes is cognition altered.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1096

OBJ: 5 TOP: Aging KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

32.How often does a 76-year-old need a screening for preventative health?

a. Every 2 years
b. Every 6 months
c. Every 3 years
d. Every year

ANS: D

A complete physical is recommended annually after 75.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1070, Table 32-1

OBJ:6TOP:Health promotion

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

33.When assessing the older adult, the nurse considers which aspect of the patients routine as a possible contributor to constipation?

a. Intake of antacids several times a day
b. Taking a laxative once a week
c. Excessive exercise routine
d. Eating two apples a day

ANS: A

Intake of antacids is constipating. All other options decrease the risk of constipation.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1080

OBJ: 8 TOP: Constipation KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

MULTIPLE RESPONSE

34.What should the nurse do to help the dysphagic patient? (Select all that apply.)

a. Sit the patient upright
b. Reduce distraction during mealtime
c. Offer fluid from a straw
d. Thicken liquids
e. Cue the patient to swallow

ANS: A, B, D, E

Offering fluids using a straw increases the possibility of choking or aspiration. All other options would be beneficial to the dysphagic patient.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1079

OBJ:8TOP:Gastrointestinal alterations

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

35.Which statements are myths that have been disproved concerning aging? (Select all that apply.)

a. All older adults are senile.
b. Most older adults live in their own homes.
c. Older adults are poor.
d. Older adults have frequent contact with family members.
e. Older adults are disabled.

ANS: A, C, E

All older adults are not senile; this is a myth. Mental decline is not inevitable. Older adults are not all poor; this is a myth. Older adults have a lower poverty rate than younger adults. Older adults are not all disabled; this is a myth. Most are able to manage their own care. Most older adults do live in their own homes and have frequent contact with family members.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1072, Box 32-3

OBJ:2TOP:Aging Myths

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

36.Which approaches should be included when teaching medication safety to an older, homebound adult? (Select all that apply.)

a. Always dispose of expired medications in the toilet or the sink; never throw them in the trash can.
b. Never share medications with others.
c. If a medication is not finished as prescribed, save it for future use.
d. Keep medications in their original containers.
e. Always request child-proof containers, even if the patient has trouble opening the lids.

ANS: A, B, D

Expired medications should always be disposed of in the toilet or sink; they should never be thrown in the trash where they could be retrieved by others. Medications should never be shared with anyone else. Medications should always be stored in their original containers. A prescription should always be taken as prescribed by the physician. Medications should never be saved for future use. If an older adult has trouble opening child-proof medication containers, he should request non-childproof lids.

PTS: 1 DIF: Cognitive Level: Application REF: Pages 1101-1103

OBJ:8TOP:Medication practices

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

COMPLETION

37.When bathing an 80-year-old woman who lives on a farm, the nurse assesses brown macules on the patients hands and forearms. The nurse recognizes these as _________.

ANS:

lentigo

Lentigo is a term that refers to brown-pigmented lesions on the skin of the older person who has spent a great deal of time in the sun. These macules are also called age spots.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1075

OBJ:5TOP:Integumentary alterations

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

38.The nurse initiates the application of a draw sheet on every bedfast patient on her unit to facilitate lifting and to prevent _________ forces.

ANS:

shearing

Shearing forces cause skin damage by friction; for instance, when a patient is dragged across bed linens during a position change.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1076

OBJ:8TOP:Integumentary alterations

KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

39.The nurse recognizes that a term referring to mechanical difficulty of swallowing is ___________.

ANS:

dysphagia

Dysphagia is a term that refers to mechanical difficulties in swallowing.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1079

OBJ:5TOP:Gastrointestinal alterations

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

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