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Question 1 (5 points)

An 88-year-old, being admitted to rule out lung cancer, is assessed using the short form of the Geriatric Depression Scale tool. When it is determines that the earned score is 9, the nurse initially:

Question 1 options:

Asks if they have any thoughts of committing suicide.

Recognizes that this score is not indicative of depression.

Knows it is not unusual for clients this age to earn such a score.

Notifies the client’s healthcare provider immediately.

Question 2 (5 points)

A widowed grandmother is about to assume the role of custodial parent for her 6-year-old grandchild. Which intervention has priority when preparing the grandmother for long-term success in this new role?

Question 2 options:

Reviewing the developmental milestones of childhood.

Identifying local sources of child counseling services.

Discussing the common challenges of parenting a 6 year old.

Teaching stress management and relaxation techniques.

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Question 3 (5 points)

The client is diagnosed with dyslipidemia. This diagnosis is supported when the client’s lipid panel indicates a: Select all that apply.

Question 3 options:

Triglyceride level of triglyceride levels (>2000 mg/dL).

Low Density Lipids (LDL) level of 120 mg/dL.

Total Cholesterol level of 260 mg/dL.

High Density Lipids (HDL) level of 70 mg/dL.

Glucose level of 230 mg/dL.

Question 4 (5 points)

Which factor is the greatest barrier to an older adult living independently?

Question 4 options:

Deficits in vision and/or hearing resulting in safety issues.

Limited finances that prevent upkeep and maintenance of a residence.

Depression that occurs after the death of a spouse or significant other occurs.

The manifestation of cognitive impairment resulting from dementia or Alzheimer’s.

Question 5 (5 points) Question 5 Unsaved

Compared with acute pain, persistent pain requires the nurse to:

Question 5 options:

Monitor vital signs more frequently.

Document the character of the pain as burning.

Administer analgesics at least every 4 hours.

Educate the client to the benefit of specific lifestyle changes.

Question 6 Unsaved

When diagnosed with diverticulosis, a client asks how this problem occurred. Which assessment data identifies a risk factor for diverticulosis?

Question 6 options:

Drinks a quart of whole milk daily.

Takes an over the counter laxative twice weekly.

History of a Helicobacter pylori infection.

Maintains a diet low in fiber.

Question 7 (5 points) Question 7 Unsaved

When focusing best on the goal of enhancing the health and well-being of the older residents of extended care living facility, the nurse:

Question 7 options:

Assures that they all receive their medications and treatments on time.

Assesses each new resident to determine their food and beverage preferences.

Asks the nursing assistant to “allow the residents to dress themselves but to check that they are dressed appropriately.”

Documents that “the residents appeared to enjoy the opportunity to socialize at the weekly Sunday brunch.”

Question 8 (5 points) Question 8 Unsaved

The nurse best addresses the spirit of the Healthy People 2020 project regarding the older adult when:

Question 8 options:

Providing information regarding where free flu vaccinations are being given to those over 65 years of age.

Facilitating a “Walking for your Health” program for residents of a senior living apartment complex.

Arranging for a registered nutritionist to hold a “Grandparents and their Grandchildren Cooking Together” class.

Encouraging their utilization of government sponsored health and wellness programs that target the senior citizen.

Question 9 (5 points) Question 9 Unsaved

When acting as a fictive kin, in which activity will a paid caregiver engage?

Question 9 options:

Being responsible for paying the client’s bills.

Organizing the client’s birthday celebration.

Accompanying the client to doctor’s appointments.

Assuring the client has clean, appropriate clothing available.

Question 10 (5 points) Question 10 Unsaved

An older adult is being treated for severe pain resulting from a history of osteoarthritis. In her discharge teaching, which information is most important to the successful management of the pain?

Question 10 options:

Check for incompatibilities before taking any new medications.

Arrange to take a dose of analgesic prior to physical activity.

To take the analgesic around the clock as prescribed.

Be alert for the signs of overdose toxicity.

Question 11 (5 points) Question 11 Unsaved

Which diagnostic laboratory test should the nurse anticipate being ordered for the purpose of evaluating an individual’s acute, unexplained weight loss? Select all that apply.

Question 11 options:

A complete blood count (CBC).

Urinalysis.

Fecal occult blood.

Serum potassium.

Serum electrolytes.

Question 12 (5 points)

When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse best ensures an understanding of oral hypoglycemic medications when providing:

Question 12 options:

The package insert and assessing the client’s reading skills.

The client with the website address for the American Diabetes Association.

Oral explanations and sending the client home with a written copy.

The information in paragraph form as opposed to numbered line fashion.

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Question 13 (5 points) Question 13 Unsaved

While the older African-American is at the highest risk for developing Alzheimer’s disease, the nurse demonstrates an understanding of this disease process’s risk factors when assessing this population’s:

Question 13 options:

Weight and elimination patterns.

Heart rate and capillary refill status.

Blood pressure and glucose serum levels.

Muscle strength and reflex times.

Question 14 (5 points) Question 14 Unsaved

When best promoting a sense of well-being, the role of the nurse caring for a terminally ill client is to:

Question 14 options:

Assume responsibility regarding medical decision making.

Encourage the client to identify his/her idea of a peaceful death.

Provide information regarding hospice care’s ability to prolong life.

Help empower the client to achieve his/her potential for wellness.

Question 15 (5 points) Question 15 Unsaved

The nurse admitting a client to a same day surgery unit makes the decision to notify the surgical team to cancel the procedure based on the client’s statement that:

Question 15 options:

“Will I start taking my St John’s Wort as soon as I can eat again?”

“I’ve haven’t taken my ginkgo for exactly 10 days.”

“I didn’t want to risk catching a cold so I took my Echinacea with just a sip of water.”

“It seemed strange not taking my garlic pill this morning.”

Question 16 (5 points) Question 16 Unsaved

The nurse shows understanding of the need to promote healthy skin in the older adult when encouraging the client to: Select all that apply.

Question 16 options:

Wear a wide-brimmed hat when outdoors.

Pad feet with socks when wearing shoes.

Clean the skin with a moisturizing soap.

Bathe in tepid water.

Always wear gloves in the winter.

Question 17 (5 points) Question 17 Unsaved

What is true about instruments to assess for depression in older adults?

Question 17 options:

Older adults tend to score inaccurately low (indicating less depression) than younger adults on the Zung Self-Rating Depression Scale.

The shortened Geriatric Depression Scale does not contain a question to evaluate suicide potential.

The Beck Depression Inventory is designed for gerontological patients.

The Geriatric Depression Scale is administered by a health care provider in an interview with the older adult.

Question 18 (5 points) Question 18 Unsaved

The family member of a patient asks if vitamin C will prevent aging. In formulating an appropriate response, the nurse considers the:

Question 18 options:

Free radical theory.

Immunity theory.

Clinker theory.

Continuity theory.

Question 19 (5 points) Question 19 Unsaved

Which housing arrangement would best address the family who wants to provide housing for an older family member who has a large degree of physical and cognitive independence and a desire to be closely involved with the family?

Question 19 options:

Dedicating the spare bedroom in the home to the family member

A house at a senior retirement community.

A “granny” apartment in a separate part of the house.

Private room at a residential care facility.

Question 20 (5 points) Question 20 Unsaved

An older resident of a long-term care facility diagnosed with dementia has in the last 48 hours become more confused than usual and while usually requiring help with toileting has been incontinent of urine. The client’s healthcare provider orders a complete blood count and serum electrolytes. When the lab tests are all within normal limits the nurse initially:

Question 20 options:

Attributes the changes in the resident’s functioning to advancing dementia.

Suggests that the resident be placed on broad-spectrum antibiotics to prevent infections.

Speaks with the healthcare provider regarding the changes in the client’s function and the possibility of obtaiing a urine culture.

Changes the plan of care to include bladder training and implement a 24-hour calorie count.

Question 21 (5 points) Question 21 Unsaved

An 81-year-old patient is being discharged from the hospital to home. She is on seven different medications, which are to be taken at four different times during the day. What would be most useful in helping this patient manage her medications? The nurse makes the greatest impact on the safe management of an 81-year-old client’s medication administration when included in discharge education is:

Question 21 options:

The package inserts from all of the medications for the client to read.

A pillbox with compartments for each day and each of the doses.

A written list of all the client’s medications and administration routine.

A suggestion that the client’s daughter administer the medications.

Question 22 (5 points) Question 22 Unsaved

A 78-year-old is admitted to the long-term care facility after a hospitalization for pneumonia. The client has a history of a right cerebrovascular accident and dysphagia. When preparing the room for this patient, what equipment is most important in the care of this patient?

Question 22 options:

A room located within sight of the nursing station

An adjustable height bed that goes low to the floor

A suction machine

Oxygen at bedside

Question 23 (5 points) Question 23 Unsaved

The nurse is managing the care of an older client experiencing the symptoms of heat fatigue. Which intervention will the nurse implement to help resolve the condition? Select all that apply.

Question 23 options:

Helping the client assume a comfortable resting position.

Monitoring the client’s intake of electrolyte replacement fluids.

Withholding the client’s prescribed antidiuretic medication.

Documenting that the client’s skin remains pale, moist and cool.

Keeping the environmental humidity low and temperature cool.

Question 24 (5 points) Question 24 Unsaved

Based on recent studies, which statement regarding touch and touch zones is most accurate?

Question 24 options:

Persons age 66 to 100 are the most often touched.

Newly graduated nurses tend to touch clients less often than do nursing students.

When performing peri-care the nurse is working within the zone of intimacy.

The comfort of touch depends on place, situation, social status, and age.

Question 25 (5 points) Question 25 Unsaved

Based on current demographic data, which statement identifies a predictive trend regarding the health care needs of society?

Question 25 options:

There will be an increasing need for health programs for older males.

More nursing services will be required to serve the needs of the population 85 years of age and older.

Fewer nurses will be needed to care for the older, especially in long-term care facilities.

North Dakota is likely to experience the greatest need for gerontological nurses.

Question 26 (5 points) Question 26 Unsaved

Which intervention to manage wandering in clients in a long-term care facility should be implemented? Select all that apply.

Question 26 options:

Camouflaging doorways.

Close observation to identify the person’s individual patterns.

Engaging the person in social interactions.

Using physical restraints to prevent wandering to maintain safety.

Providing enclosed pathways for walking.

Question 27 (5 points) Question 27 Unsaved

When using the Fulmer SPICES assessment tool the nurse expects to ask:

Question 27 options:

“Do you think that you sleep well?”

“Are you ever incontinent of urine?”

“When was the last time you fell?”

“Who helps you when you can’t do something by yourself?”

Question 28 (5 points) Question 28 Unsaved

A woman is terminally ill. Although it has never been discussed in the family nor stated outright by her physician, she suspects that she will die because of her illness. Upon which concept will the nurse base therapeutic intervention on?

Question 28 options:

Closed awareness.

Suspected awareness.

Mutual pretense.

Mutual pretense.

Question 29 (5 points) Question 29 Unsaved

When an older adult client is diagnosed with restless leg syndrome (RLS), the nurse is confident that client education on the condition’s contributing factors has been effective when the client states:

Question 29 options:

“A warm bath at night instead of in the morning is my new routine.”

“Eating a banana at breakfast assures me the potassium I need.”

“I’ve cut way back on my caffeinated coffee, teas and sodas.”

“I elevate my legs on a pillow so as to improve circulation.”

Question 30 (5 points) Question 30 Unsaved

State Death with Dignity Laws require that the terminally ill client be:

Question 30 options:

Educated regarding treatment alternatives.

Over the age of 55.

Be supported in their decision by immediate family members.

Eligible for federal support services.

Question 31 (5 points) Question 31 Unsaved

Serious and well controlled research studies on aging have been available:

Question 31 options:

Only in the past 50 years

Since the turn of the 20th century

Following the Great Depression

Since the year 2000

Question 32 (5 points) Question 32 Unsaved

Which activity would a couple in the reorientation phase of their retirement engage in?

Question 32 options:

Establishing a new budget that will allow them to travel to see the grandchildren.

Reading magazines devoted to making decisions about retirement plans.

Looking for ways to ‘fill up the days.’

Volunteering at the local animal shelter.

Question 33 (5 points) Question 33 Unsaved

What factor is an important contribution to polypharmacy in older adults?

Question 33 options:

Inadequate communication among medical care providers.

Implementation of Medicare Part D prescription drug benefit.

Use of generic medications.

Increasing popularity of dietary and herbal supplements.

Question 34 (5 points) Question 34 Unsaved

Which is the most likely reason that Type 2 diabetes mellitus is often difficult to diagnose in older adults?

Question 34 options:

Presenting symptoms occur very quickly.

The disease rarely occurs in older adults.

The classic symptoms may not be present in older adults.

There are no recognizable symptoms; it is a “silent killer.”

Question 35 (5 points) Question 35 Unsaved

An older client in a long-term care facility is receiving an annual physical and is ordered laboratory tests that include a complete blood count, serum electrolytes, and thyroid tests. When the client’s son questions why these tests are being ordered by saying, “Dad is 85 and supposed to be sleepy,” the nurse’s response is based on an understanding that:

Question 35 options:

The healthcare provider ordering the tests needs to explain the rationale to the son.

When conducted annually, all of the tests are helpful in promoting maximum health for older adults in the long-term care setting.

The tests are useful, but only if clinically indicated.

The complete blood count and serum electrolytes are useful screening tests, but the usefulness of the thyroid test should be questioned.

Question 36 (5 points) Question 36 Unsaved

Which reaction to the loss of a spouse or long-term partner is a unique example of older adult male bereavement?

Question 36 options:

Withdrawing from friends and family.

Remarrying within months of the loss.

Focusing on ‘doing’ rather than ‘feeling.’

Experiencing moderate to severe depression.

Question 37 (5 points) Question 37 Unsaved

It is imperative that nursing take a leadership role in providing effective health care across the lifespan and in various health care settings. Which intervention will have the greatest impact on achieving positive outcomes concerning that issue?

Question 37 options:

An acute care facility providing continuing education credits for geriatric nursing in-services.

A baccalaureate degree nursing program including a geriatric care course into the curriculum.

A professional nursing organization provides advanced practice status as a geriatric specialist.

A long-term care facility’s nursing director is a certified geriatric nurse practitioner.

Question 38 (5 points) Question 38 Unsaved

In order to focus on the older population with the greatest risk for suicide the nurse would conduct a depression screening that targets:

Question 38 options:

African-American men.

White men.

White women.

African-American women.

Question 39 (5 points) Question 39 Unsaved

Which outcome regarding the effects of touch on the skin is not supported by current research?

Question 39 options:

Brings about sensory stimulation.

Help relieves physical and psychosocial pain.

Known to reduce anxiety and tension.

Improves skin integrity.

Question 40 (5 points) Question 40 Unsaved

The nurse is caring for a client with a newly diagnosed chronic illness. In answering the client’s questions, the nurse most accurately responds when basing the response on the fact that:

Question 40 options:

The most prevalent form of disease in older adults at this time is acute illness.

Although chronic illness lasts a long time, the condition primarily affects the client.

Chronic illness is lifelong, and coping can be influenced by perceived uncertainty.

The client’s acquisition of knowledge of the disease will guarantee successful coping.

Question 41 (5 points) Question 41 Unsaved

What research finding is the basis for care planning of the client receiving palliative care?

Question 41 options:

Palliative care is most useful when implement in the last 6 months of life.

Pain management is inadequately addressed among the terminally ill population.

Palliative care is only offered to patients whose deaths are imminent.

Resuscitation in the case of a cardiac or respiratory arrest is not implemented.

Question 42 (5 points) Question 42 Unsaved

When working with a bereaved individual, the goal of nursing interventions is to:

Question 42 options:

Assist the individual to go through the stages of grief work in the optimal order.

Assist the individual to attain a healthy adjustment to the loss experience.

Encourage the individual to talk about his or her feelings about the deceased individual.

Offer support and advice about how to successfully achieve grief work.

Question 43 (5 points) Question 43 Unsaved

Which information will the nurse manager include when discussing the major differentiation between delirium and dementia with novice nurses: Select all that apply.

Question 43 options:

The delirious client learns to make up answers to hide their confusion.

Delirium requires increased monitoring at night.

The client diagnosed with dementia generally looks frightened.

Dementia results in a steady decline in cognitive abilities.

Delirium is characterized by fluctuations in alertness.

Question 44 (5 points) Question 44 Unsaved

The nurse is facilitating a support group for older adults who have recently experienced losses in their lives. What is the basis for the nurse’s understanding of how the individual participants will display stress?

Question 44 options:

An individual’s age has the most influence on the amount of stress they will experience.

Stress tolerance is fairly consistent in both males and females.

Stress is a natural occurrence to loss and is always manifested in physical signs.

There are individual differences in how in how individuals define, perceive, and react to stress.

Question 45 (5 points) Question 45 Unsaved

The Beers list is an effective tool for healthcare professionals prescribing and/or managing the medication therapy of older adults since it identifies medications that for this population:

Question 45 options:

Are not typically covered by drug benefit plans.

Have a higher than usual risk for injury.

Are likely to be abused

Generally cause allergic reactions.

Question 46 (5 points) Question 46 Unsaved

An older client admitted to the hospital after having sustained a fall at home is diagnosed with a right hip fracture and experienced a surgical reduction of the fracture. At 2:30 AM, she awakens from sleep insisting that her daughter is in the other room and wants to see her. Attempts to reorient her to the surroundings are unsuccessful. In reviewing the client’s record, what data would be considered a primary risk factor for the delirium?

Question 46 options:

History of dementia.

Death of the client’s husband last month.

The client’s age.

History of cardiac disease.

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Question 47 (5 points) Question 47 Unsaved

Your client is cared for at home by his son and daughter-in-law, who are also responsible for the care of their four preschool-aged children. What is true of this “sandwich” generation?

Question 47 options:

The conflicts that arise from caring for both older adults and children can be very stressful.

The majority of middle-aged adults are faced with balancing the care of parents and children.

The average age of adults caring for parents is in the late 30s and early 40s.

The majority of caregivers affected by this “sandwich” generation are males.

Question 48 (5 points) Question 48 Unsaved

An African-American woman has taken on the responsibility of raising her grandchild. Which intervention will best address a need commonly identified in this specific population?

Question 48 options:

Providing her with a list of local afterschool children’s programs.

Suggesting she enroll in a local community center’s senior support group.

Scheduling her for a complete physical examination.

Encouraging her to walk 1 mile 3 days a week.

Question 49 (5 points) Question 49 Unsaved

The nurse interviewing an older adult for a nursing history recognizes that the client is experiencing symptomology inconsistent with normal aging of the urinary tract when the client reports: Select all that apply.

Question 49 options:

Finding it more difficult in the last few months to start voiding.

Having two bladder infections in the last 4 years.

Getting up once or twice each night to urinate.

Occasionally experiencing pain when urinating.

Needing to urinate every at least every two hours during the day.

Question 50 (5 points) Question 50 Unsaved

The nurse sits at the bedside of a comatose, terminally ill older client reading the wishes expressed in the numerous cards the client has received. Which concept of grief work is the nurse addressing with this intervention?

Question 50 options:

Everyone needs social interaction.

The nurse needs to ‘attend to the patient.’

hearing is believed to be the last sense to be lost.

The individual is living until they are dead.

Question 51

A 97-year-old patient is admitted to the medical unit with a productive cough and bilateral congestion and is reporting weakness. His vital signs are 106/78, 82, 24, and a temperature of 97 degrees F. (oral). When told that it is suspected that he has pneumonia, his granddaughter replies, “Grandpa is running a fever so it can’t be an infection.” The nurse’s response is based on the knowledge that:

Question 51 options:

The temperature needs to be taken tympanically.

In a 97-year-old, a temperature of 97 degrees F. is considered febrile.

A lack of fever cannot be used to rule out an infection in older adults.

Oral temperatures are always inaccurate in older adults.

Question 52

When assessing the intellectual abilities of an older adult, the nurse demonstrates an understanding of a major barrier to reliable testing of this population when:

Question 52 options:

Sharing with the client that the test can be scheduled at “whatever time is good for you.”

Providing the client with frequent rest periods.

Stating, “Just take your time and try to relax; there are no wrong answers to this test.”

Assuring that the area is well-lit and quiet.

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