Description

INSTANT DOWNLOAD COMPLETE TEST BANK WITH ANSWERS
 
Pearson Custom For Older Adult Nursing Care By Nancy J.Brown And Linda Kimbrough –
Test Bank
 
Sample  Questions

Brown Older Adult Nursing Care, 1/E
Chapter 1

Question 1

Type: MCSA

An experienced nurse is attempting to explain the term gerontology to a novice nurse. Which of the following explanations made by the experienced nurse would be accurate?

  1. “Gerontology involves the study of the diagnosis and treatment of diseases affecting the elderly.”
  2. “Gerontology encompasses the study of all areas of the aging process, including physical, psychological, social, spiritual, and financial, as well as the impact these have on the aging person.”
  3. “Gerontology focuses on the physical changes occurring in the elderly and the effects of these changes on all aspects of their lives.”
  4. “Gerontology emphasizes the study of the healthy, well, aging adult in society.”

Question 2

Type: MCSA

The home health nurse visits a 75-year-old client who is homebound and uses a walker when ambulating, due to aftereffects of a stroke. Which of the following age-related terms would be the most comprehensive in describing this client?

  1. Old-old
  2. Middle-old
  3. Frail elderly
  4. Vigorous elderly

 

Question 3

Type: MCSA

Which of the following comments made by a nurse regarding an older adult client would indicate ageism?

  1. “This client has several questions for his physician regarding his upcoming procedure.”
  2. “You are going to love working with this client. He is such a cute, funny, little old man.”
  3. “I think this client is depressed. He is isolating himself in his room and not speaking.”
  4. “This client is going to need some further sessions on how to administer his insulin.”

 

Question 4

Type: MCMA

The nurse would recognize which of the following statements as representing myths regarding aging?

Standard Text: Select all that apply.

  1. More than 2/3 of older adults are active in their communities.
  2. The majority of older adults eventually end up in nursing homes.
  3. Older adults need to exercise their minds daily to stay mentally strong.
  4. The majority of older adults suffer from problems associated with memory loss.
  5. The majority of older adults have outlived their ability to contribute anything to society.

Question 5

Type: MCSA

A nurse in a medical facility enters the room of a newly admitted older adult to do an admission assessment. Which of the following communication techniques employed by the nurse would indicate a general respect for the client’s cultural background?

  1. Sit within a foot of the client’s bed, at eye level.
  2. Address the client with a title and last name.
  3. Begin the interview with formal assessment questions.
  4. Address all assessment questions to the male family member.

 

Question 6

Type: MCSA

A home-health nurse is visiting an older adult client. When performing the client’s medication review, the nurse discovers that two of the client’s prescriptions have run out and have not been refilled. At this point, which of the following nursing actions would be most prudent?

  1. Notify the client’s physician that the client is being noncompliant with the medications.
  2. Perform a mental status exam to assess whether the client is suffering from dementia.
  3. Ask the client for more information regarding the reasons for not refilling the prescriptions.
  4. Refer the client to social services in order to assist with financial support for the client’s medications.

 

Question 7

Type: MCSA

The nurse accompanies the physician into the room of an older adult who is scheduled to have a surgical procedure the next day. The physician explains the risks and benefits of the procedure to the client, as well as the care and medications to expect following the procedure. The physician has the client sign the consent and then leaves the room. The nurse notices that the client has a very puzzled facial expression. The client says, “What did he just say?” What should the nurse’s next action be at this point?

  1. Declare the client incompetent in the nurse’s progress notes.
  2. Explain the procedure in detail to the client’s family members.
  3. Report the physician to the American Medical Association (AMA).
  4. Notify the physician that the client does not fully understand the procedure.

 

Question 8

Type: MCSA

A client has been in hospital for 5 days. The case manager is discussing the client’s discharge to a skilled nursing facility with the client and the client’s family. A family member states, “He will need at least two months of care at this facility, and all he has is Medicare coverage.” The case manager would be giving correct information by making which of the following replies?

  1. “Medicare is all he will need no matter how long he has to stay in the skilled nursing facility.”
  2. “Medicare will cover the first 100 days if he requires skilled nursing care during that time.”
  3. “You will need to apply for Medicaid coverage immediately, as Medicare coverage won’t be sufficient.”
  4. “You will need to get some long-term care insurance for him as soon as possible in order to cover all of the costs.”

 

Question 9

Type: MCSA

An aging adult client is being discharged from the hospital. The client has decided to enter an “aging in place” housing option upon discharge. Which of the following would be a correct definition of this type of housing option?

  1. Aging in place consists of a one- to two-bedroom apartment in which the monthly rent includes housekeeping, a dining package, a basic health and wellness program, and services of an on-call nurse.
  2. Aging in place consists of a single level garden home with a monthly home-owner’s fee which includes yard and home maintenance.
  3. Aging in place involves a room in a skilled nursing facility in which the client’s health care and daily living needs are fully met.
  4. Aging in place consists of a large room for the client in which activities of daily living are met by certified nurse’s aides, and nursing care is provided as needed.

 

Question 10

Type: MCSA

A new nurse’s supervisor overhears her complain, “I don’t know why we have to work with so many old people! I’m tired of seeing their wrinkled bodies.” Which of the following responses by the supervisor would give the novice nurse accurate, timely information beneficial to the nurse’s practice?

  1. “You need to develop a ‘poker face,’ and get on with your work. Everyone does not have a gorgeous body.”
  2. “The aging population is growing. As a professional, your role is that of an advocate for the aged adult patient. You need to treat each patient with dignity and respect.”
  3. “Your role is to be kind and sweet to each of your patients. The elderly are so needy, and you are able to use a lot of your nursing skills with them.”
  4. “Perhaps you should think about leaving the nursing profession. You are going to be seeing a lot more older adult patients in the coming years.”

Question 11

Type: MCMA

Which of the following principles would be appropriate for the nurse to implement when communicating with an older adult client?

Standard Text: Select all that apply.

  1. Speak clearly.
  2. Face the client while speaking.
  3. Talk at an angle above the client’s head.
  4. Always address the client by his or her first name.
  5. Make certain that necessary assistive devices are in use.

 

Question 12

Type: MCMA

An aging adult female client is being assessed for nursing home placement. Which factors would contribute to this client’s placement in a nursing home?

Standard Text: Select all that apply.

  1. A substantial income
  2. Being a widow
  3. Incontinence
  4. Cognitive intactness
  5. Multiple chronic disorders

 

Question 13

Type: MCMA

Which of the following older adult clients would be able to give informed consent for a medical procedure?

Standard Text: Select all that apply.

  1. Clients over the age of 85
  2. Anyone with late-stage dementia
  3. Clients declared incompetent
  4. Mildly mentally retarded clients
  5. Appointed power of attorney

 

Question 14

Type: MCMA

The following list represents assessment data collected by an admitting nurse on an older adult client. Identify the data associated with a decreased life expectancy.

Standard Text: Select all that apply.

  1. Current weight : 205 pounds; (ideal weight: 184.5)
  2. Smokes 1 1/2 packs of cigarettes daily
  3. African American ethnicity
  4. Sedentary life style
  5. Diet low in sugar and saturated fat

 

Question 15

Type: MCMA

A nurse on a long-term care unit is about to begin a “Reminiscence Group” with several older adult clients. A student nurse on the unit asks the nurse what the primary goals are of this type of group. The nurse correctly identifies which of the following goals?

Standard Text: Select all that apply.

  1. Make clients aware of current events.
  2. Increase interaction among clients.
  3. Increase the clients’ levels of self-esteem.
  4. Aid in the nurse’s detection of cognitive deficits.
  5. Encourage sharing of memories among clients.

 

Brown Older Adult Nursing Care, 1/E
Chapter 2

Question 1

Type: MCSA

A nurse just attended a conference on “The Older Adult.” Which of the following statements by the nurse would be a complete and accurate definition of senescence?

  1. “This term denotes the eventual and continuing physical decline of the person’s body throughout life.”
  2. Senescence describes the cognitive decline of the aging adult individual, along with the accompanying personality changes.”
  3. “This term refers to the progressive decline of body processes, loss of fertility and the ultimate death of an individual.”
  4. Senescence suggests the ‘fading away’ of the aging individual’s personality over a gradual period of time.”

 

Question 2

Type: Matching

Place the theory of aging below in the left column to coincide with the correct definition given in the right column.

  1. Wear and tear
  2. Free radicals
  3. Programmed longevity
  4. Glycation

Standard Text: Click and drag the options below to move them up or down.

_____ 1. Cells create energy, which produces unstable oxygen molecules, leading to impaired cell functioning.
_____ 2. Cross-linked proteins accumulate, interfering with cell replacement and slowing body functioning.
_____ 3. Genetics determine the number of times cells can replicate prior to death.
_____ 4. Important parts of cells and body tissues deteriorate, and cell repair slows.

 

 

Question 3

Type: MCSA

An older adult client on a medical unit is about to undergo a knee replacement. The client jokes with the nurse caring for him, saying, “I guess the warranty on this old knee just ran out.” The client’s comment could be said to be based upon which biological theory of aging?

  1. Disengagement
  2. Wear and tear
  3. Activity
  4. Glycation

 

Question 4

Type: MCSA

According to the immunological theory of aging, an individual ages due to which one of the following reasons?

  1. Genetic mutations
  2. Presence of free radicals
  3. Shrinkage of the thymus gland
  4. Decline in human growth hormone

 

Question 5

Type: MCSA

An older adult client tells the nurse that he feels great satisfaction in his life accomplishments and is proud of all of his children. According to Erikson’s life course perspective theory of aging, the nurse would correctly describe this client’s life development stage as which of the following?

  1. Ego integrity
  2. Engagement
  3. Active satisfaction
  4. Adaptive continuity

 

Question 6

Type: MCSA

An older adult client in an assisted living facility is encouraged daily by the charge nurse to attend all group social activities available, participate in volunteer projects at the facility, and join the facility’s exercise group. This nurse would appear to be operating from which of the following psychosocial theories of aging?

  1. Disengagement Theory
  2. Continuity Theory
  3. Life Course Perspective Theory
  4. Activity Theory

Question 7

Type: MCSA

The nurse is caring for an older adult from the Native American culture. Which of the following beliefs about older adults within this culture would the nurse need to consider?

  1. The eldest son would be the designated member of the family to care for the client.
  2. The client would no longer be a valued member of the family and would be considered expendable.
  3. As an older member of the family, the client would be considered wise and essential to the preservation of the client’s culture.
  4. The client’s culture very much values “filial piety” within the entire extended family.

 

Question 8

Type: MCMA

The nurse is assessing a client admitted with the diagnosis of progeria. The nurse would expect to see which of the following findings?

Standard Text: Select all that apply.

  1. Inability to understand/follow instructions
  2. Abnormally excessive hair growth
  3. Thin, pinched nose
  4. A lack of body fat
  5. Wrinkled skin

Question 9

Type: MCSA

The older adult client asks the nurse to explain the rationale behind the dietician informing him to include more foods containing vitamin C and E in his diet. Which response by the nurse would show a correct understanding of the relationship between theories of aging and current research on extension of life?

  1. “Vitamins C and E are strong antioxidants. Antioxidants in foods have been shown in research to protect against cell damage associated with the aging process.”
  2. “Vitamins C and E assist the body in the release of hormones that increase in the aging process.”
  3. “Vitamins C and E help to release free radicals within the body, which assists in increasing life expectancy.”
  4. “Vitamins C and E increase cross-linking in the body, which strengthens body tissues and cells.”

 

Question 10

Type: MCSA

An older adult asks a nurse to recommend any supplements that the nurse is aware of that would help the client live a longer and healthier life. Which reply by the nurse indicates a correct understanding of the value of supplements in extending life expectancy?

  1. “Vitamin A, C, and E, as well as wine and certain hormones, have been conclusively proven to extend one’s life.”
  2. “Taking human growth hormone, as well as melatonin, will help you to avoid running out of these hormones, enabling you to live a longer life.”
  3. “The Federal Food and Drug Administration fully endorses the addition of specific hormones and vitamin supplements to your daily diet in order to prolong your life.”
  4. “The effects on aging of adding certain antioxidant supplements, as well as calorie restriction and addition of hormones, have really only been studied in animals and have not been proven in humans.”

 

Question 11

Type: MCMA

The nurse is preparing to administer an estrogen preparation to an older adult female client. The nurse is aware that several other hormones, besides estrogen, normally decrease with age, including which of the following?

Standard Text: Select all that apply.

  1. Testosterone
  2. Human Growth Hormone
  3. Thyroid Hormones
  4. Cortisol
  5. Melatonin

 

Question 12

Type: MCMA

An older adult asks a parish nurse at the church what to do to stay as young and healthy as possible. What are some researched actions to promote health that the nurse can suggest to this client?

Standard Text: Select all that apply.

  1. Drastic calorie restriction
  2. Limited intake of antioxidants
  3. Careful control of blood sugar
  4. Avoidance of too much sun
  5. Limiting number of cigarettes to half a pack a day
  6. A low-carbohydrate diet

 

Question 13

Type: MCSA

The gerontological nurse is aware that the number of super-centenarians is increasing within health care. The super-centenarian is which of the following ages?

  1. 75 to 84 years old
  2. 100 years old
  3. 110 years or older
  4. 99 years old

Question 14

Type: MCMA

Aspects of research in the area of senescence affect nursing practice in terms of ethics. Identify some of these areas of ethical concern.

Standard Text: Select all that apply.

  1. Super-centenarians
  2. Use of vitamin supplements
  3. Stem cell research
  4. Gene therapy
  5. Cryonics

Question 15

Type: MCSA

Which of the following problems associated with the increasing number of aging adults in society will have an impact on nursing practice in the future?

  1. Infectious diseases
  2. Substance abuse
  3. Chronic illnesses
  4. Decreasing population

 

Brown Older Adult Nursing Care, 1/E
Chapter 3

Question 1

Type: Matching

Match the definitions of the stages of sleep in the right column with the correct stage of sleep named in the left column.

  1. Stage 1, NREM
  2. Stage 2, NREM
  3. Stage 3, NREM
  4. Stage 4, NREM
  5. REM sleep
_____ 1. Relaxed, light sleep, brain waves slow, no eye movement
_____ 2. Vitals signs and metabolism decrease; groggy if awakened
_____ 3. Drifting to sleep period; easily aroused
_____ 4. Beginning of deeper, more restorative sleep
_____ 5. Pronounced muscle relaxation except eyes; very relaxed state.

 

 

Question 2

Type: MCSA

An older adult client complains to the nurse about obtaining inadequate rest at night. The client expresses concern about “…getting on yet another prescribed medication,” and asks the nurse to suggest some alternative methods that would promote rest. Which response by the nurse would indicate accurate, helpful information for this client?

  1. “Try to eat your heaviest meal in the evening. This will cause you to feel groggy and get to sleep more easily.”
  2. “Keep your room at a nice warm temperature. This will create a warm, cozy environment which will stimulate sleep.”
  3. “If you nap during the day, make sure that you don’t sleep more than thirty minutes to an hour or you will probably interfere with your nighttime rest.”
  4. “If you drink, try a glass of wine right before bed. This will relax you and help you fall asleep.”

.

 

Question 3

Type: MCSA

An older adult male client accompanied by his wife is being assessed by a nurse practitioner in a walk-in clinic. The client’s wife reports that the client “…snores very loudly at night, and he stops breathing for almost a minute several times during the night.” With this information, the nurse practitioner suspects that the client is suffering from which of the following disorders affecting sleep?

  1. Chronic obstructive sleep apnea
  2. Gastroesophageal reflux disease (GERD)
  3. Chronic obstructive pulmonary disease (COPD)
  4. Decreased REM sleep pattern

 

Question 4

Type: MCMA

A home health nurse is assigned a new older adult client. The nurse visits the client to make an initial assessment. This includes assessing the safety of the client’s home environment. Which of the following potential safety hazards would be necessary for the nurse to note?

Standard Text: Select all that apply.

  1. Water temperature set at 120°F
  2. Use of space heaters in the home
  3. Walker sitting next to the bedside
  4. Throw rugs that are not tacked down
  5. Smoke alarms present in main areas

 

Question 5

Type: MCSA

A home health nurse and a nurse’s aide see several older adult clients during the day to admit them into home health care. Each client is assessed for risk for falls. Which of the clients listed below would be at highest risk?

  1. A female client living in a one-story facility who practices tai-chi, owns a cat, and takes a nonsteroidal anti-inflammatory medication daily for osteoarthritis.
  2. A client with diabetic neuropathy who is taking two antihypertensive medications and two hypoglycemic agents daily, and who scored 35 seconds on the “Up and Go” test
  3. A male client with osteoporosis who takes calcium supplements daily, exercises with hand weights twice a week, and uses a cane when walking
  4. A client with hypothyroidism and hypertension who takes thyroid preparations and antihypertensive medications daily and, when tested for balance, stood for 5 seconds on one foot before wobbling

 

Question 6

Type: MCSA

An older adult client’s daughter asks the nurse’s opinion concerning whether or not she should take her mother’s car keys from her and prevent her from driving. The nurse would base the response on the assessment of which one of the following risk factors in particular?

  1. Limited range of motion of the arms
  2. Decreased fine motor coordination
  3. Limited range of motion of the neck
  4. Muscle weakness

 

Question 7

Type: MCSA

An ambulatory older adult client has been assessed by the nursing staff to be a high fall risk due to muscle weakness and orthostatic hypotension. Which of the following nursing interventions would be best to prevent a fall injury in this client?

  1. Confining client to a bedside chair or a wheelchair when the client is awake
  2. Use of a vest-type restraint when the client is up in a chair or in a wheelchair
  3. Use of hip protectors on the client when the client is up in the hallways
  4. Client education regarding slow change of position and use of wall rails in the hallway

Question 8

Type: MCMA

The nurse is aware that pharmacokinetics affects older adult clients differently than younger clients. Which of the following effects, in terms of pharmacokinetics, would be seen in older adult clients?

Standard Text: Select all that apply.

  1. Increased gastrointestinal motility resulting in faster absorption of medications
  2. Higher concentration of water-soluble medications, causing possibility of adverse reactions
  3. Hypertrophy of the kidneys, resulting in faster excretion of medications, preventing therapeutic effects
  4. Decreased drug metabolism and increased half-lives of medications, causing drug accumulation and possible toxicity
  5. A lack of albumin, causing too few protein-binding sites, resulting in more free drug and possibility of drug interactions and toxicity

 

Question 9

Type: MCMA

A home-health nurse is paying a visit to an older adult client who suffers from severe cardiovascular disease and takes multiple medications and supplements. The nurse needs to keep which of the following facts in mind in order to do an accurate assessment of this client’s medications?

Standard Text: Select all that apply.

  1. All OTC and herbal supplements need to be reviewed due to the danger of possible drug interactions.
  2. Most older adults are compliant when it comes to taking their medications as prescribed.
  3. The client’s renal and cardiac status needs to be considered in relation to the doses of the medications ordered.
  4. Generally speaking, older adults tolerate their prescribed medications well and show little evidence of side effects.
  5. The danger of drug toxicity always needs to be assessed in older adults who have renal or cardiac impairment.

 

 

Question 10

Type: MCSA

The nurse is aware pharmacokinetics is affected by physical changes in the older adult. The excretion of medications would be influenced by which of the following physical changes associated with the aging process?

  1. Decreased renal blood flow, decreased kidney size, and loss of nephrons
  2. A natural decrease in albumin and an increased amount of fat tissue
  3. Shrinkage of the liver, decreased hepatic blood flow, and decreased liver enzyme production
  4. Change in the pH of the stomach, as well as decreased gastrointestinal blood flow and peristaltic movement.

 

Question 11

Type: MCSA

The nurse is reviewing the physician’s orders on several older adult clients’ charts. Which of the following orders would cause the nurse concern?

  1. gabapentin (Neurontin)
  2. duloxetine (Cymbalta)
  3. meperidine (Demerol)
  4. propranolol (Inderal)

 

Question 12

Type: MCSA

An older adult client suffering from terminal cancer is about to be discharged from the hospital to go home. The client’s physician orders a fentanyl transdermal patch for the client to manage severe pain. The nurse needs to educate the client about avoiding which of the following activities while wearing the patch?

  1. Taking a hot bath or shower
  2. Eating a large meal
  3. Resting in the bed or in a recliner
  4. Being in close proximity to other people while wearing the patch

 

Question 13

Type: MCSA

A nurse is preparing to do a pain assessment on an older adult client who is recovering from abdominal surgery. Which of the following charting entries would denote a complete assessment by the nurse?

  1. “Pain described as a ‘7’ on a 0–10 scale. Describes pain as ‘deep and intermittent,’ and requests prn pain medication.”
  2. “States pain is ‘knifelike-stabbing’ and is located below the incision. Reports the pain to be ‘5’ on a 0–10 scale. Prn pain medication administered.”
  3. “Describes pain as ‘throbbing and deep.’ Reports that the pain is located to the left of the umbilicus. No pain med requested.”
  4. “Rates pain as a ‘6’ on the Faces Pain Intensity Scale. States the pain is located on the left side of the abdomen.”

 

Question 14

Type: MCSA

A nurse caring for an Hispanic older adult client states to the supervisor, “The client never complains of pain when I ask him about it, but from his eyes, I get the feeling that he is in pain.” The nursing supervisor would be most accurate with which one of the following statements?

  1. “If he says that he is not in pain, then we need to honor that. He is the only one who can evaluate his pain.”
  2. “You know how men are. Don’t argue with him or you will be threatening his sense of masculinity and machismo.”
  3. “He probably doesn’t want to bother you with what he feels is a minor concern. You will need to educate him on the importance of receiving pain medication before the pain is too acute.”
  4. “You are probably letting your own feelings color your pain assessment. Just because you think he may be in a lot of pain doesn’t mean that he is. Maybe you would be, but that’s your perception.”

 

Question 15

Type: MCSA

The nurse is evaluating an older adult client’s pain. The client describes the pain as “constant and cramping in the abdominal area.” The nurse would be accurate in categorizing the client’s pain as what type?

  1. Neuropathic
  2. Proprioceptive
  3. Adjuvant
  4. Nociceptive

 

Brown Older Adult Nursing Care, 1/E
Chapter 4

Question 1

Type: MCSA

An older adult client in the final stages of terminal cancer expresses to the nurse his gratitude for a “wonderful, fulfilling life.” The client expresses pride in his four grown children and grandchildren. He states, “I have really gotten to do almost everything I have ever wanted to do.” The nurse is aware that this client is expressing attainment of which of the developmental levels that Erikson and Maslow described in their theories?

  1. Ego Integrity; Self-Actualization
  2. Generativity; Self-Actualization
  3. Ego Integrity; Positive Reminiscence
  4. High Self-Esteem; Self-Satisfaction

Question 2

Type: MCMA

An older adult client is admitted to a mental health facility for depression. The client expresses low self-esteem. The nurse recognizes that in order for the client to achieve a positive developmental outcome, the client’s self-esteem must be increased. What are some nursing interventions that would help achieve this outcome?

Standard Text: Select all that apply.

  1. Keep client expectations very high.
  2. Keep a nonjudgmental attitude with the client.
  3. Keep client focused on the future.
  4. Make all choices for the client to reduce stress.
  5. Plan mutually developed goals with the client.

 

Question 3

Type: MCSA

An older adult client is discussing current life stressors with a psychiatric nurse practitioner at a mental health center. The client is facing forced retirement. Which remark made by the client would indicate to the nurse that the client is coping with this issue in an adaptive manner?

  1. “Well, I’m sure that it’ll be okay. I really wasn’t prepared for this, but somehow we’ll make it all work out for the best.”
  2. “You know, I wasn’t really ready for this right now, but I took up oil painting a few years back, and I wouldn’t mind having more time to paint and go traveling.”
  3. “I could just kick myself for not getting my doctorate a few years back. That would have made me indispensable to the company.”
  4. “I really don’t think that the company will want to lose me. I think they’ll cave at the last minute.”

 

Question 4

Type: MCSA

The psychiatric nurse practitioner in a crisis clinic sees several older adult clients within a week’s time. Which of the following clients would the nurse assess as being most at risk for ineffective coping with stress?

  1. A 65-year-old client with high cholesterol who has just begun a diet and exercise program and recently retired
  2. A 70-year-old retired school teacher whose husband died a year ago and who is very active in her church and community
  3. The 78-year-old diabetic client who has been raising two grandchildren alone, from a daughter who is a substance abuser
  4. The 59-year-old former jogger with osteoarthritis in the knees who now goes swimming three times a week

 

Question 5

Type: MCMA

What are some interventions that the nurse can use to help meet an older adult client’s spiritual needs?

Standard Text: Select all that apply.

  1. Quietly place a bible at the client’s bedside.
  2. Allow quiet time for the client to meditate or pray if desired.
  3. Take time to listen to client’s feelings about his or her illness.
  4. Share own belief system with client and pray with him/her.
  5. Inquire about the possible spiritual needs of the client.

Question 6

Type: MCSA

A nurse is taking care of an older adult client with a serious illness. The nurse would assess potential spirituality needs in the client when the client asks which of the following questions?

  1. “How are the chemotherapy medications going to affect me?”
  2. “How long do you think I have before my symptoms get more severe?”
  3. “What do you think that I did in the past to deserve this punishment?”
  4. “What can I do to make myself stronger to put up with side effects?”

 

Question 7

Type: MCSA

The nurse is leading an educational talk on sexuality for a group of older adults at a senior citizen’s center. Which of the following statements by a group member would indicate the need for further teaching?

  1. “I shouldn’t drink alcohol before having sex or I may not be able to perform.”
  2. “I can use a water-soluble lubricant before sex so that it won’t be painful.”
  3. “I should still engage in ‘safe sex’ practices since I am a single male!”
  4. “Since I recently had a heart attack, I really should abstain from sex.”

Question 8

Type: MCMA

An older adult female client complains to the nurse during a visit to the gynecologist that she is unable to have sex with her husband due to discomfort from her arthritis. Which of the following responses would be accurate for the nurse to include?

Standard Text: Select all that apply.

  1. Changes in positioning may make having sex more comfortable.
  2. Other expressions of affection, such as hugging and kissing, can be used to express sexuality.
  3. Avoidance of having actual intercourse would be the most beneficial and sensible.
  4. Taking a cold shower prior to intercourse will numb the joints and lessen the pain.
  5. Rest periods before and after sexual intercourse can help make the event more comfortable.

 

Question 9

Type: MCSA

An older adult client has recently been diagnosed with a terminal illness. While the nurse is caring for the client, the client makes the comment, “I have done my best to be a good person all life. I don’t understand why God is doing this to me!” By this comment, the nurse recognizes that the client is in which of Kübler-Ross’s stages of grief?

  1. Denial
  2. Anger
  3. Depression
  4. Acceptance

 

Question 10

Type: MCMA

The family of a dying older adult client has asked for information on hospice care. Which of the following information should the nurse include in the teaching?

Standard Text: Select all that apply.

  1. The goal of hospice care is to prolong the life of the client for as long as possible.
  2. Hospice care treats the physical, spiritual, and psychosocial needs of the client.
  3. The ultimate goal of hospice care is to make the client as comfortable as possible.
  4. Only absolutely necessary hygiene care will be provided so as not to disturb the client.
  5. During this care, if the client is not hungry, the client will not be forced to eat or drink.

 

Question 11

Type: MCSA

The older adult client expresses to the nurse concern that he will not be able to “put things right” with his estranged son before he dies. The nurse recognizes this remark as indicating the client is experiencing which of the following issues?

  1. Complicated grieving
  2. Kübler-Ross’s bargaining stage
  3. Spirituality needs
  4. A common fear of the dying client

Question 12

Type: MCSA

An older adult female with late stage dementia is admitted to the emergency department with bruising evident on her abdomen, and genital lacerations. The admitting nurse suspects possible physical and sexual abuse. Which of the following actions would be most appropriate for the nurse to take next?

  1. Take photographs of the client’s injuries.
  2. Call the local law enforcement authorities.
  3. Follow state law regarding reporting the abuse.
  4. Obtain a detailed history from the client herself.

 

Question 13

Type: MCSA

The nurse can best promote psychosocial health in the older adult client experiencing loss by engaging in which of the following actions?

  1. Allowing the client plenty of “alone time” in the room
  2. Discouraging crying on the client’s part
  3. Encouraging the client’s expression of feelings about the loss
  4. Taking the client’s mind off of the loss by talking about other subjects

 

Question 14

Type: MCSA

An older adult client is admitted to a medical facility with the following diagnoses: diabetes, pneumonia, rheumatoid arthritis, and a urinary tract infection. The admitting nurse understands that which two of these disorders can be caused or aggravated by stress?

  1. Diabetes, pneumonia
  2. Diabetes, rheumatoid arthritis
  3. Pneumonia, rheumatoid arthritis
  4. Rheumatoid arthritis, urinary tract infection

 

Question 15

Type: MCSA

A nurse manager overhears a novice nurse telling a coworker, “I really don’t think the hospital should hire people over 60 years of age. They are too slow and cannot do their share of the work.” The nurse manager recognizes that the impact of the new nurse’s statement on older adult nurses might be considered which of the following?

  1. Burn-out
  2. Depression
  3. Ignorance
  4. Stressor

 

Brown Older Adult Nursing Care, 1/E
Chapter 5

Question 1

Type: MCSA

When assessing the integumentary system of an older adult, which of the following observed changes would the nurse consider abnormal?

  1. Edema
  2. Pale, cool skin
  3. Loss of hair
  4. Thick toenails

 

Question 2

Type: MCMA

The nurse manager is discussing the rationale for the susceptibility of the older adult client to skin breakdown with a group of nursing assistants. What reasons should the nurse manager include in the teaching?

Standard Text: Select all that apply.

  1. Increase in nerve endings
  2. Thinning of layers of skin
  3. Increased pain perception
  4. Decrease in blood flow
  5. Decrease in melanocytes

Question 3

Type: Matching

Match the expected skin change found in an older adult client identified in the left column below with the correct description of the expected skin change found in the right column.

  1. Xerosis
  2. Seborrheic keratosis
  3. Senile lentigo
  4. Actinic keratosis
  5. Senile purpura
_____ 1. Concentrated areas of melanocytes commonly found on the backs of the hands and on the face, arms, and legs
_____ 2. Small, flat, scaly, red, yellow, or brown patch associated with years of sun exposure
_____ 3. Dry and scaly skin
_____ 4. Slightly elevated brown, gray, or yellow lesion
_____ 5. A rashlike collection of bruises and petechiae

 

 

Question 4

Type: MCSA

To promote daily skin care for the older adult, the nurse would include which of the following suggestions in the teaching?

  1. Daily bathing
  2. Use of a sunscreen with at least 8 SPF (sun protection factor)
  3. Limiting daily sun exposure from 10 AM to 3 PM only
  4. Routine moisturizing of the skin

Question 5

Type: MCSA

An older adult client comes to a long-term care facility with a beginning pressure ulcer developing in the sacral area. Which of the following nursing interventions would be appropriate for tertiary preventive care for this client?

  1. Daily inspection of the sacral area
  2. Weekly moisturizing of the skin
  3. Implementation of a turning schedule
  4. Addition of vitamin D to the diet

 

Question 6

Type: MCSA

A nurse is assessing the feet of an older adult client, paying particular attention to evidence of which potential unexpected issue?

  1. Lunulae
  2. Thickening of the toenails
  3. Flattening of toenail beds
  4. Toenail fungal infection

 

Question 7

Type: MCSA

An older adult client presents to the emergency room with what is diagnosed by the physician as herpes zoster. Which of the following infection control precautions should the nurse implement in caring for this client?

  1. Use of N-95 Respirator
  2. No particular precautions
  3. Wearing gloves with direct contact
  4. Use of mask, gloves, shoe covers, and gown

 

Question 8

Type: MCSA

An older adult client comes to a walk-in clinic complaining of pain coming from an open ulcer on the ventral aspect of the left foot. The client states that there is also intermittent pain in the left calf when walking. The nurse assesses the client’s left foot, which is a bluish-whitish color with a faint pedal pulse. The nurse suspects that the client is suffering from which of the following disorders?

  1. Cellulitis of the left foot
  2. An ischemic ulcer of the left foot
  3. A pressure ulcer of the left foot
  4. Basal cell carcinoma of the left foot

 

Question 9

Type: MCSA

The nurse manager is explaining the importance of good perineal care for older adult clients with diabetes to a group of nursing assistants. The nurse bases the teaching on the knowledge that these clients would be at high risk of developing which of the following integumentary system disorders?

  1. Cellulitis
  2. Psoriasis
  3. Herpes zoster
  4. Candida fungal Infection

 

Question 10

Type: HOTSPOT

The nurse reads in an older adult client’s chart a description of a stage II pressure ulcer on the client’s skin. Place an “X” by the photo below which best depicts a stage II pressure ulcer.

Standard Text: Click on the correct area on the image.

Question 11

Type: MCSA

The nurse is palpating the edematous ankles of an older adult client. The nurse is able to depress the tissue to a depth of 6 mm. The nurse identifies this as what type of pitting edema on the client’s record?

  1. 4+
  2. 3+
  3. 2+
  4. 1+

 

Question 12

Type: MCSA

The nurse is assessing the respiratory status of an African American client with a diagnosis of end-stage pulmonary fibrosis. In order to correctly assess for cyanosis in this client, the nurse would need to observe the color of what part of this client’s integumentary system?

  1. Sclera of the eyes
  2. Earlobes
  3. Nail beds
  4. Oral mucous membranes

Question 13

Type: MCSA

The nurse in a long-term care facility is teaching a group of nursing assistants the proper interventions to use to promote skin integrity in older adult residents. Which information should the nurse include?

  1. “Be sure to elevate the head of the bed at least 45 degrees when feeding the resident or providing oral care.”
  2. “Massage all bony prominences during the resident’s bed bath in order to increase circulation to these areas.”
  3. “Be certain that the resident’s bed, bedside chair, and wheelchair are free of wrinkles, crumbs, and any kind of debris.”
  4. “Establish a turning schedule for each resident, making certain to turn each resident every four hours.”

 

Question 14

Type: MCMA

The nurse formulates the following nursing diagnosis for an older adult client recovering from surgery: Risk for Disturbed Body Image related to altered physical appearance associated with surgery to remove large basal cell carcinoma of the face. Which of the following nursing interventions would be appropriate for the nurse to include for this diagnosis?

Standard Text: Select all that apply.

  1. Discuss client’s feelings about the surgery.
  2. Do not allow the client to view the surgical site.
  3. Manage all of the aspects of the surgical wound care.
  4. Contact a social worker for referral to support groups.
  5. Perform treatments in a matter-of-fact manner.

 

Question 15

Type: MCSA

The nurse consults a dietician for assistance in promoting wound healing in a client with a stage II pressure ulcer. Which of the following groups of nutrients would the nurse expect the dietician to suggest?

  1. Calcium, vitamin D, and protein
  2. Protein, vitamin C, and zinc
  3. Zinc, calcium, and vitamin B
  4. Vitamin B, protein, and calcium

 

Brown Older Adult Nursing Care, 1/E
Chapter 6

Question 1

Type: MCSA

The nurse notices a pattern of weight loss in one of the older adult residents in a long-term care facility. Checking the resident’s record, the nurse finds that the resident has been eating progressively less of the food trays served for the past week. Which of the following actions would be most appropriate for the nurse to take at this time?

  1. Check the resident’s intake independently for the next few days.
  2. Assess the resident’s mouth, checking for sores, bad teeth, or badly fitting dentures.
  3. Call the resident’s physician and receive an order for an appetite stimulant medication.
  4. Confer with the dietician and the resident’s physician regarding nutritional supplements for the resident.

 

Question 2

Type: MCSA

A nurse in a long-term care facility observes a nursing assistant feeding a resident so rapidly that the resident barely has time to swallow each bite. The nurse takes the nursing assistant aside for a discussion. What would the nurse identify as being the greatest risk of this nursing assistant’s action?

  1. Loss of resident’s dignity
  2. Overfeeding resident
  3. Potential for aspiration
  4. Gastroparesis

 

Question 3

Type: MCSA

The nurse is teaching an older adult client about expected changes that occur with aging that may predispose the client to constipation. Which of the following information should the nurse include?

  1. “You will avoid a lot of problems associated with slowing down of your gut and resulting constipation by taking a regular laxative daily.”
  2. “You begin to produce fewer digestive enzymes; this causes your food not to be broken down as well, causing constipation.”
  3. “Decreased saliva production interferes with your chewing and swallowing of food, thereby putting you at risk for constipation.”
  4. “A decrease in the peristaltic movement of your intestines contributes to content remaining in the intestines longer, which predisposes you to constipation.”

 

Question 4

Type: MCMA

An older adult client asks the nurse to list some foods that would help to promote colon health. The nurse should include which of the following food items on the list?

Standard Text: Select all that apply.

  1. Beefsteak
  2. Whole grains
  3. Broccoli
  4. Refined starches
  5. Cantaloupe

 

Question 5

Type: MCSA

A nurse practitioner assesses several older adult clients in a walk-in clinic. The nurse would find which of the following clients to be most at risk for nutritional deficiencies?

  1. Client on a fixed income, paraplegic, receiving physical therapy twice weekly, on food stamps
  2. Sedentary client, living alone, wearing dentures, on pain medication every four hours for chronic back pain
  3. Female client living with her spouse, walks two miles daily, has own teeth, and uses a laxative daily
  4. Client ambulatory with a walker, does own cooking, has son residing in home who assists with buying groceries for the home

 

Question 6

Type: MCSA

An older adult client in an acute care health care facility has a history of dysphagia following a stroke. Which of the following nursing actions would be appropriate in the care of this client?

  1. Place client in supine position immediately after feeding.
  2. Make certain client receives a clear, liquid diet at each meal.
  3. Examine client’s mouth after meals for presence of food particles.
  4. Give client frequent sips of water with each bite of solid food.

 

Question 7

Type: MCMA

A nurse practitioner is teaching an older adult client recently diagnosed with GERD (gastroesophageal reflux disease) actions that can be taken to reduce symptoms. Which of the following advice from the nurse would be appropriate?

Standard Text: Select all that apply.

  1. Limit the number of meals per day to 1 or 2.
  2. Eat the supper meal within 30 minutes of going to bed.
  3. Avoid alcohol, chocolate, mint, and caffeine in the diet.
  4. Remain upright for at least an hour after meals.
  5. Try to lose any excess weight.

 

Question 8

Type: MCSA

An older adult client in a long-term care facility has developed persistent diarrhea. Based on the diagnosis, which of the nursing diagnoses would be highest priority for this client?

  1. Risk for Impaired Skin Integrity
  2. Disturbed Body Image
  3. Bowel Incontinence
  4. Risk for Deficient Fluid Volume

 

Question 9

Type: MCSA

An older adult client with diabetes asks the nurse to explain what can be done for signs and symptoms of a “diabetic gut.” Which of the following guidelines should the nurse include?

  1. Eat three large meals at regular times daily.
  2. Maintain blood sugar within normal limits.
  3. Report episodes of bleeding to physician.
  4. Avoid alcohol and caffeine in the diet.

 

Question 10

Type: Matching

The nurse is preparing to do an abdominal assessment on an older adult client. Drag and drop the assessment techniques in the left column into the correct sequence for an abdominal assessment in the right column.

_____ 1. Palpation
_____ 2. Auscultation
_____ 3. Percussion
_____ 4. Inspection

 

 

Question 11

Type: MCHS

Place a “1” in the appropriate quadrant of the abdomen where the nurse should begin an assessment for bowel sounds. Place a “2” in the next quadrant, a “3” in the third quadrant to be auscultated in a bowel sounds assessment, and a “4” in the final quadrant.

 

Question 12

Type: MCSA

The nurse is preparing to assess bowel sounds in an older adult client. The nurse does not hear any bowel sounds after two minutes of auscultation in each quadrant. What would the next appropriate nursing intervention be?

  1. Document that no bowel sounds were heard.
  2. Auscultate for an additional 1–3 minutes in each quadrant.
  3. Palpate for presence of possible impaction.
  4. Obtain a physician order for a nasogastric tube insertion.

 

Question 13

Type: MCSA

The nurse has recently taught a group of nursing assistants the proper way to feed older adult clients with dysphagia. Which of the following statements by one of the nursing assistants would require follow-up?

  1. “I can use an ice cube around the client’s lips before I give him a bite to help with swallowing.”
  2. “I should feed the client slowly and make sure to put the bite in the middle of his tongue.”
  3. “I need to make sure to do my client’s oral care right after I feed him, to check for food left in his mouth.”
  4. “I need to be sure to get the client to eat all of his bites of solid food before I feed him any of the liquids.”

Question 14

Type: MCSA

An older adult client is facing surgery to remove a large section of the colon due to diverticulitis. There is a good chance that the client will have to have a temporary colostomy. The nurse is planning care for this client. Which of the following would be a high priority psychosocial nursing diagnosis for this client at this time?

  1. Risk for Disturbed Body Image related to alteration in bowel elimination associated with creation of colostomy
  2. Ineffective Coping related to lack of confidence in ability to accept new colostomy
  3. Spiritual Distress related to anticipated physical impairment
  4. Imbalanced Nutrition: Less than Body Requirements related to poor absorption of nutrients

 

 

Question 15

Type: MCSA

For an older adult client with the nursing diagnosis of Imbalanced Nutrition: Less than Body Requirements related to poor appetite, what nursing action would be appropriate to implement?

  1. Do not allow the client to snack between meals.
  2. Make certain that foods are kept minimally seasoned.
  3. Allow client’s family to bring in favorite foods from home.
  4. Observe client’s intake to ensure that at least 50% of meals are eaten.

 

 

Brown Older Adult Nursing Care, 1/E
Chapter 7

Question 1

Type: MCSA

A healthy older adult client complains to the parish nurse at a health fair about a need to “get up to urinate” once or twice a night and asks the nurse for an explanation. Which of the following information should the nurse include in the response?

  1. “This is known as nocturia, and it is most likely due to aging. Older adults tend to produce more urine at night.”
  2. “This is not normal. You need to get checked for a kidney problem as soon as possible.”
  3. “You are most likely drinking too much at night. Hold off on any liquids for two hours before bedtime, and it shouldn’t be a problem.”
  4. “You are losing too much water at night which could lead to dehydration. Dehydration can make you more prone to falling, especially at night.”

 

Question 2

Type: MCMA

The nurse is teaching a group of nursing assistants about age-related changes in the urinary system that predispose older adult clients to incontinence. The nurse needs to include which of the following information in the teaching?

Standard Text: Select all that apply.

  1. Thickening of the urethral walls in females
  2. Prostate enlargement in males
  3. Hypoactive detrusor muscles in the bladder
  4. An overall decrease in bladder capacity
  5. Weakening of pelvic floor muscles in women

 

Question 3

Type: MCSA

An older adult client presents to the emergency room with nausea and vomiting, dizziness, weakness, and fever. The client’s family states that the client has also been acting “confused” over the past few hours. A physician-ordered catheter is inserted with return of dark amber-colored urine. The admitting nurse suspects that the client is suffering from which of the following conditions?

  1. Kidney failure
  2. Dehydration
  3. Bladder infection
  4. Low oxygen level

 

Question 4

Type: MCSA

A female older adult client expresses concern to the nurse practitioner that she is having difficulty “having relations” with her husband due to extreme discomfort with intercourse. The nurse is aware that the client is describing which one of the following conditions associated with age-related changes to the reproductive system?

  1. Cystocele
  2. Dysuria
  3. Vaginitis
  4. Dyspareunia

 

Question 5

Type: MCSA

A nurse at a health unit is conducting a class on “Safe Sex” for a group of older adults. Which of the following informational items will the nurse want to include in the teaching?

  1. “Older adults really do not have to worry about protected sex as most do not have sex often enough for it to be a risk.”
  2. “There is no need for older women to fear any sexually transmitted illnesses because older men faithfully use condoms.”
  3. “Since most of you came from a more innocent generation, you don’t need to worry about coming into contact with anyone with a sexually transmitted illness.”
  4. “Because older women have thinner vaginal tissue associated with aging, they are at greater risk of contracting a sexually transmitted illness (STI) such as AIDS.”

 

Question 6

Type: MCSA

A 71-year-old adult female client asks the nurse practitioner at the gynecologist’s office why she requires a Pap smear after having a total hysterectomy for endometrial cancer. “I don’t have a cervix any longer,” the client reasons. Which of the following responses by the nurse would be most accurate?

  1. “Since you had a total hysterectomy to remove cancer, it is still important for me to screen you for any existing cancer cells.”
  2. “Since you are over 70 and have had normal Pap smears for the past two years, I can ask the doctor to stop doing Pap smears on you.”
  3. “Pap smears are just a normal screening procedure on every woman. Medicare covers it for you every year, so why not take advantage of it?”
  4. “If you are still sexually active, you need to have a yearly Pap test to screen you for any existing sexually transmitted illnesses.”

 

Question 7

Type: MCMA

An older adult client with diabetes has been diagnosed with possible kidney dysfunction and is admitted to the hospital for testing. The client asks the nurse to explain what types of testing to expect. Which of the following information would the nurse want to include in the explanation?

Standard Text: Select all that apply.

  1. CBC (complete blood count)
  2. Hemodialysis
  3. Kidney biopsy
  4. Creatinine and blood urea nitrogen (BUN) levels
  5. Thyroid levels

 

Question 8

Type: Matching

The nurse is aware that many older adults suffer from some type of incontinence. Match the type of incontinence below with the corresponding correct description in the right column.

  1. Urge
  2. Stress
  3. Overflow
  4. Functional
_____ 1. Incomplete bladder emptying associated with weak bladder muscles or obstruction to urine flow, causing overdistention of the bladder
_____ 2. Overactive detrusor muscles leading to hypercontractility of the bladder and strong desire to urinate
_____ 3. Mobility issues that make getting to the bathroom in time a problem, resulting in “accidents”
_____ 4. Inability to “hold” urine in bladder due to weak pelvic floor muscles

 

Question 9

Type: MCSA

An older adult client in an assisted living facility has been experiencing urinary incontinence associated with having difficulty getting to the bathroom in a timely manner due to residual weakness in the left side of the body following a recent stroke, plus the need for a walker. Which of the following nursing interventions would manage the client’s incontinence while preserving self-esteem?

  1. Teach the client to perform sets of Kegel exercises at least twice a day for 8 to 10 times a set.
  2. Place the client on scheduled voiding times, alert the staff to this client’s needs, and make certain the pathway to the bathroom is uncluttered and lighted.
  3. Insert a prescribed indwelling catheter with a collection bag attached to the client’s leg.
  4. Place adult diapers on the client, changing them at regular intervals throughout the day and night.

 

Question 10

Type: MCSA

A home health nurse, paying a visit to a male older adult client with hypertension, is concerned after finding the client’s blood pressure reading to be much higher than usual. The client confesses that he stopped taking his prescribed blood pressure medication. When asked to explain, the client stated that he is in a new relationship and wanted to “be able to perform.” Which of the following responses would be most appropriate for the nurse to make?

  1. “Do you want to die while having sex? You must take your blood pressure medicine daily no matter what.”
  2. “Some blood pressure medicines cause erectile dysfunction. Let’s talk with your physician to see if there is another antihypertensive that will work on your blood pressure without this side effect.”
  3. “Erectile dysfunction is mostly caused by anxiety and is temporary. Please take your blood pressure medicine or you may have a stroke.”
  4. “I will have to report to the doctor that you are not following his recommended regimen. I do not think that what you have told me is a reasonable excuse for endangering your life.”

 

Question 11

Type: HOTSPOT

The nurse is aware that assessing skin turgor is one way to gain information about hydration status. Indicate below with 2 Xs the best two places to assess for skin turgor in older adult clients.

 

Standard Text: Click on the correct area on the image.

 

Question 12

Type: MCMA

A nurse is teaching a group of older adult females about the breast self-examination. What information does the nurse need to include in the teaching?

Standard Text: Select all that apply.

  1. Breast self-examination needs to be performed bi-monthly either by oneself or by trained healthcare personnel.
  2. Use tips of fingers in a circular motion, moving up and down over the area of each breast.
  3. Examine each breast while sitting with the arm hanging down at the side being examined.
  4. Examine each breast while lying down with a pillow under the shoulder on the side being examined.
  5. Woman can choose to discontinue breast self-examinations after age 75.

 

Question 13

Type: MCSA

An older adult client is admitted to the acute care medical facility for increasing problems with incontinence. Upon assessment, the nurse discovers that the client recently began experiencing a loss of a small amount of urine whenever she picked up a load of laundry to put into the washing machine and whenever she sneezed hard. Which one of the following nursing diagnoses would be appropriate for this client?

  1. Stress Incontinence R/T abdominal pressure against weakened pelvic muscles
  2. Functional Incontinence R/T impaired mobility associated with lifting heavy loads of laundry
  3. Urge Incontinence R/T overactive bladder response to abdominal pressure
  4. Reflex Incontinence R/T activation of detrusor muscles associated with diaphragmatic pressure

 

Question 14

Type: MCMA

An older adult client is being discharged from the hospital following a severe urinary tract infection. The client asks the nurse how to avoid future urinary tract infections. The nurse providing discharge instructions needs to include which of the following information in the teaching?

Standard Text: Select all that apply.

  1. Drink 8 ounces of cranberry juice daily to acidify urine.
  2. Perform weekly perineal care.
  3. Drink four glasses of water daily while awake.
  4. Observe color, clarity, and odor of urine daily.
  5. Take any antibiotic ordered for UTI exactly as prescribed.

Question 15

Type: MCSA

An older adult client asks the nurse practitioner if there are any medications that can be prescribed for urge incontinence. The nurse would be accurate in naming which one of the following medications?

  1. Finasteride (Proscar)
  2. Duloxitine (Cymbalta)
  3. Oxybutinin (Ditropan)
  4. Trimethoprim/sulfamethoxazole (Bactrim DS)

 

Brown Older Adult Nursing Care, 1/E
Chapter 8

Question 1

Type: Matching

Many expected changes in the musculoskeletal system occur in older adults, predisposing them to other conditions. Match some of these conditions below with the correct description in the right column.

  1. Osteoporosis
  2. Kyphosis
  3. Ankylosis
  4. Plantar fasciitis
_____ 1. Inflammation of the ligament stretching from the ball of the foot to the heel
_____ 2. Exaggerated posterior curve of the thoracic spine
_____ 3. Reduction in bone mass
_____ 4. Stiffening of the ligaments

 

 

Question 2

Type: MCSA

A nurse practitioner in a big city walk-in clinic sees many older adult clients from various ethnic groups daily. The nurse would expect to see the least evidence of osteoporosis in which of the following ethnic groups?

  1. Asian Americans
  2. European Americans
  3. African Americans
  4. Hispanic Americans

Question 3

Type: MCSA

An older adult client is being measured for height by a nurse at a health fair. When the nurse gives the client the number, the client states, “I must be shrinking, I used to be a lot taller than that!” The nurse can attribute the client’s loss of height to which of the following expected changes in the musculoskeletal system associated with aging?

  1. Loss of muscle mass
  2. Deterioration of joint cartilage
  3. Stiffening of the ligaments
  4. Loss of bone mass

 

Question 4

Type: MCSA

The nurse has just completed a lecture and demonstration of range-of-motion exercises to a group of nursing assistants in a long-term care facility. The nurse recognizes the need for follow-up teaching when a nursing assistant makes which of the following comments?

  1. “When clients can’t move themselves, I can help clients’ joints remain functional by going through a series of movements for each joint.”
  2. “I should gauge the degree to which I move the client’s joints by their pain level. It needs to hurt a little. You know what they say, ‘No pain, no gain.’”
  3. “I can assist clients in doing their activities of daily living (ADLs) and these activities, such as brushing their teeth and combing their hair, help provide movement for different joints.”
  4. “When I perform passive range-of-motion exercises for clients who cannot move, I help prevent contractures and atrophy.”

 

Question 5

Type: FIB

A healthy older adult employee at a health care facility is maintaining an exercise program at the facility’s health club. The employee asks the health club’s nurse what a safe pulse rate would be to ensure a good cardiovascular workout. The nurse takes the employee’s pulse at rest and finds it to be 72. The nurse figures that a good work-out pulse rate for this client would be__________.

Standard Text: Record your answer rounding to the nearest whole number.

Question 6

Type: MCSA

What type of cardio/endurance exercise would be best for the nurse to recommend to an older adult client with arthritis?

  1. Tai chi
  2. Weightlifting with small weights
  3. Water aerobics
  4. Therapy bands

Question 7

Type: MCSA

An older adult client presents to the emergency room with complaints of “shooting pains that run down my left leg every time I walk. The pains stop when I sit down.” Based on the client’s complaints, the nurses suspects that the client is suffering from what condition?

  1. Gout
  2. Contractures
  3. Lumbar stenosis
  4. Polymyalgia rheumatica

 

Question 8

Type: MCSA

An older adult client comes to a walk-in clinic with complaints of severe muscle pain. The admitting nurse notes that the client has been taking a statin medication for high cholesterol. The nurse is alerted to which of the following potential side effects of this type of medication?

  1. Gout
  2. Polymyalgia rheumatica
  3. Ankylosis
  4. Rhabdomyolysis

 

Question 9

Type: MCSA

An older adult client is recovering from surgery for a broken hip. The nurse is aware that the client’s affected hip needs to be kept in which of the following positions during healing?

  1. Adduction
  2. Abduction
  3. Internal rotation
  4. External rotation

 

Question 10

Type: MCSA

The home health nurse is preparing to assess an older adult client using the “Get Up and Go” test. What is the primary purpose of this assessment tool?

  1. To assess client’s abilities to perform activities of daily living (ADLs)
  2. To examine the client’s environment for various fall hazards
  3. To evaluate the client’s range of motion in the hip joints
  4. To observe any client difficulties with gait or balance

 

Question 11

Type: MCSA

While using inspection and palpation to assess the musculoskeletal system of an older adult, it is extremely important for the nurse to remember to do which of the following?

  1. Compare and contrast each side of the body
  2. Compare upper body strength with that of the lower body
  3. Compare strength and range of motion of the client to other clients of the same age
  4. Compare strength and range of motion of the client to clients of younger ages

 

Question 12

Type: MCSA

An older adult client asks the nurse to explain what type of exercise would be best to slow the sarcopenia and osteopenia that accompany aging. The nurse would be correct in making which of the following response?

  1. Walking
  2. Swimming
  3. Yoga
  4. Tai chi

 

Question 13

Type: MCSA

The spouse of an older home health client who has been assessed as a fall risk has asked the nurse to explain how to ensure that the client will not fall in the home. Which of the following points would the nurse include in the teaching?

  1. Encourage client to arise rapidly to ensure good blood flow to muscles prior to ambulation.
  2. Urge client to participate in a 30-minute daily exercise program for strength, flexibility, and balance.
  3. Pad the walkway area with plenty of soft throw rugs to break any falls that the client may experience.
  4. When in the home environment, have the client use furniture to maintain balance rather than cumbersome assistive devices.

 

Question 14

Type: MCSA

A home health nurse is teaching an older adult client with rheumatoid arthritis about the NSAID (nonsteroidal anti-inflammatory drug) and the corticosteroid medication that the client is currently taking. Which of the following information does the nurse need to include in the teaching?

  1. Make certain that the client takes the NSAID on an empty stomach to increase absorption.
  2. As soon as the client experiences relief from pain, the corticosteroid should be discontinued.
  3. The medications need to be taken at regular times as prescribed to obtain maximum pain relief.
  4. Be sure to take the prescribed NSAID/corticosteroid medications immediately after any exercise or activity sessions.

 

Question 15

Type: MCSA

An older adult client is in a skilled nursing unit following a bout of pneumonia. The illness has left him weak but able to participate in activities of daily living (ADLs). The nurse correctly assigns the nursing assistant to perform which type of range-of-motion exercises with this client?

  1. Active-assisted
  2. Passive
  3. Active
  4. Complete

 

Brown Older Adult Nursing Care, 1/E
Chapter 9

Question 1

Type: MCSA

During a physical exam, an older adult female client asks the nurse to explain what causes the large number of varicose veins in her legs. Which one of the following responses by the nurse contains accurate information?

  1. “During the aging process, the veins dilate, the vein valves don’t close properly, blood is returned to the heart inefficiently, and fluid stays down in the legs, causing varicose veins and swelling to occur.”
  2. “The kidneys decrease in functioning due to aging, and excess fluid is pumped into the veins, causing them to dilate and distort.”
  3. “Plaque deposits build up in the veins, preventing adequate blood flow and causing the veins to swell and deform.”
  4. “A sedentary lifestyle, along with the aging process, causes the veins to become inflamed which then causes them to enlarge and become distorted.”

.

 

Question 2

Type: MCSA

After taking the blood pressure of a frail older adult client, the nurse observes petechiae in the area where the cuff was located. The nurse suspects which of the following conditions at this point?

  1. Atherosclerotic damage to the capillaries in the body
  2. Capillary fragility due to aging and minor trauma
  3. Increased blood pressure caused by the aging process
  4. Decreased cardiac output due to aging, causing insufficient blood flow

 

Question 3

Type: MCSA

A nursing student asks the instructor to explain why the blood pressure of an older adult is typically higher than that of a younger adult. Which of the following information does the nurse educator need to include in the teaching?

  1. “The blood pressure of every older adult does not increase. It is totally dependent on the individual’s lifestyle choices, the types of foods the person eats, and how much exercise they get.”
  2. “Incomplete closure of venous valves or their obstruction causes a back-up of fluid in the older adult’s veins, which drives up the blood pressure.”
  3. “Plaque build-up in the arteries, as well as stiffening of the arteries due to the aging process, causes the blood to be pumped under more pressure, driving up the systolic blood pressure.”
  4. “Physiological changes in the body do not cause the blood pressure of older adults to increase. Higher blood pressure is strictly due to the stressors accumulated in the person’s lifetime.”

Question 4

Type: MCMA

What are some primary preventive measures that the nurse can suggest to a younger adult to promote a healthy circulatory system as one gets older? Select all that apply.

Standard Text: Select all that apply.

  1. Diet high in saturated fats
  2. Daily consumption of at least 10 oz. of red wine
  3. Regular schedule of aerobic exercise
  4. Avoidance of second-hand smoke
  5. Diet rich in natural fiber

Question 5

Type: MCSA

Which of the following serum lipid blood test readings would alert the nurse to notify the charge nurse or primary care provider of coronary heart disease risk in an older adult?

  1. Total cholesterol: 170 mg/dL
  2. High density lipoproteins (HDL) 60 mg/dL
  3. Triglycerides 180 mg/dL
  4. Low density lipoproteins (LDL) 120 mg/dL

 

Question 6

Type: MCMA

An older adult client is admitted to the healthcare facility with a diagnosis of arterial ulcers on both lower extremities. The admitting nurse would expect to see what assessment findings related to this diagnosis?

Standard Text: Select all that apply.

  1. Ulcers located on the shins
  2. Normal skin temperature upon palpation
  3. Intermittent claudication evident on ambulation
  4. Normal pedal pulses upon palpation
  5. Evidence of significant edema

 

Question 7

Type: MCSA

An older adult client asks the nurse in the doctor’s office for advice concerning treatment of her painful varicose veins. What information should the nurse include in the teaching?

  1. Avoid wearing elastic stockings
  2. Elevate legs when supine or sitting
  3. Avoid walking or movement of legs
  4. Try to sit most of the day

 

Question 8

Type: MCSA

An older adult client is admitted to an acute care facility with a diagnosis of anemia. The admitting nurse would expect to assess which of the following signs and symptoms in this client?

  1. Flushed skin and reddened conjunctivae
  2. Decreased pulse and respirations
  3. Fatigue, dyspnea
  4. Extreme itching

Question 9

Type: MCSA

Besides aging, what are other contributing factors to the development of leukemia in older adult clients?

  1. Chemical exposure, radiation exposure
  2. Bruising, petechiae, and bleeding gums
  3. Epstein-Barr virus and genetic factors
  4. Iron-poor diet and vitamin B deficiency

 

Question 10

Type: MCSA

While auscultating an older adult client’s carotid arteries, the nurse assesses the presence of a bruit. The nurse is aware that this signifies which of the following conditions?

  1. Hypertension
  2. Atherosclerosis
  3. Heart failure
  4. Cardiomegaly

 

Question 11

Type: MCSA

The nurse uses palpation to assess the presence of edema in an older adult client. The nurse bears in mind that edema of cardiac origin has which of the following characteristics?

  1. Is firm to the touch
  2. Involves all soft tissue areas
  3. Is non-pitting
  4. Resolves with rest and elevation

Question 12

Type: MCSA

What would the nurse need to assess in a client with a diagnosis of thrombophlebitis?

  1. Pedal pulse on the affected side only
  2. Pale color and cool temperature on the affected side
  3. Bilateral capillary refill time
  4. Muscle atrophy bilaterally

Question 13

Type: MCMA

An older adult client with severe cardiovascular disease expresses anxiety and fear about the possibility of death. Which of the following nursing actions would be helpful for this client?

Standard Text: Select all that apply.

  1. Take care of all of the client’s activities of daily living (ADL) needs.
  2. Suggest that the client keep a journal to write down feelings.
  3. Name several fears that other clients with this disorder have.
  4. Have the client name weaknesses and strengths in himself.
  5. Explain advance directives to the client and options available.

 

 

Question 14

Type: MCMA

An older adult client has a nursing diagnosis of Activity Intolerance related to an impaired cardiac pump. The nurse caring for this client would expect to observe which of the following defining characteristics to support this diagnosis?

Standard Text: Select all that apply.

  1. Apical pulse rate of 72 bpm
  2. Flushed facial skin color
  3. Chest pain
  4. Dyspnea
  5. Respiratory rate of 22 bpm

Question 15

Type: MCSA

An older adult client is admitted into the cardiac unit for a medical diagnosis of heart failure. The admitting nurse assesses 4+ pitting edema bilaterally in the feet and ankles and auscultation reveals crackles in the lung bases. Based upon this data, which of the following would be a high priority nursing diagnosis for this client?

  1. Risk for Excess Fluid Volume R/T impaired circulation
  2. Ineffective Tissue Perfusion R/T inability of heart to deliver adequate oxygen to cells
  3. Ineffective Breathing Pattern R/T increase in respiratory rate to compensate for reduced heart function
  4. Excess Fluid Volume R/T to impaired cardiac pump

 

Brown Older Adult Nursing Care, 1/E
Chapter 10

Question 1

Type: MCMA

When assessing the respiratory status of older adult clients, the nurse is aware that which of the following findings involving the respiratory system are ones that are expected due to the aging process?

Standard Text: Select all that apply.

  1. Hemoptysis
  2. Inflexible chest wall
  3. Weakened cough reflex
  4. Obstructive sleep apnea
  5. Inflammation of bronchioles

Question 2

Type: MCSA

A clinic nurse is auscultating the lung sounds of a 70-year-old healthy older adult client and hears diminished sounds in both lung bases. The nurse correctly attributes this finding to what probable condition?

  1. Decreased respiratory inflation associated with rigid chest wall
  2. Consolidation in the lungs due to impending pneumonia
  3. Weakened cough reflex associated with the aging process
  4. Development of chronic obstructive pulmonary disease

 

Question 3

Type: MCSA

The nurse is teaching a group of nursing assistants about the rationale for good respiratory care of older adult clients following surgery. Which information should the nurse include in the teaching?

  1. “All older adults develop what is known as a barrel chest, which makes it harder to get them in a good position for coughing and deep breathing following surgery.”
  2. “The older adult’s cough reflex is weakened by aging and they can’t move fluid up and out as well as younger adults, making them more prone to postoperative respiratory infections.”
  3. “Older adults develop areas of empty spaces within their lungs due to natural collapse of many of the air sacs within the lungs, making them more prone to respiratory complications.”
  4. “The large majority of older adults develop a problem in which they stop breathing for periods of time when they are asleep. This occurs, also, during the postoperative period in which they are sedated.”

 

Question 4

Type: MCSA

An older adult client recovering from a hip replacement suddenly develops acute pain in the chest and shortness of breath and begins coughing up small amounts of blood. The nurse caring for the client immediately notifies the physician, suspecting which of the following conditions?

  1. Tuberculosis
  2. Atelectasis
  3. Lung embolus
  4. Hemoptysis

 

Question 5

Type: MCSA

An older adult client receives a TB (tuberculosis) skin test as a requirement for admission to a long-term care facility. The nurse reads the test as positive. The nurse would be accurate in implementing which action at this point?

  1. Discussing with the client’s doctor the need for prophylactic TB medication.
  2. Discussing with the client’s doctor the need for a second TB test to rule out a false positive
  3. Halting admission to the long-term care facility and quarantining the client in the current facility
  4. Obtaining an order from the client’s physician for a follow-up chest x-ray to rule out TB

 

Question 6

Type: MCSA

An older adult client with a history of asthma uses an albuterol bronchodilator inhaler daily on an as-needed basis, as well as fluticasone, an inhalation steroid. The home health nurse, reviewing the client’s self-administration of these medications, would recognize the need for follow-up teaching with which client statement?

  1. “I need to use the steroid inhaler before I do the bronchodilator inhaler so that the bronchioles will be less irritated and the bronchodilator will work better.”
  2. “I need to let my doctor know if I’m having a lot of trouble with symptoms even when I am following my medication regimen as directed.”
  3. “I need to do the albuterol inhaler before the steroid, so the airways will open wider for the steroid to work better.”
  4. “If I become shaky and irritable while using these inhalers, it may be that I’m using them too often, and I need to notify my physician if I’m having an increase in symptoms.”

Question 7

Type: MCSA

An older adult client attending a health education class asks the nurse educator what has been found to be the greatest contributing factor to the development of chronic obstructive pulmonary disease (COPD) in older adults. The nurse would be correct in giving which of the following responses?

  1. Genetics
  2. Smoking
  3. Pollution
  4. Age-related changes

Question 8

Type: MCSA

When questioned by the nurse as to whether or not an older adult client had received his seasonal flu shot, the client replied that he is healthy and didn’t see the need for it. The nurse would be accurate in giving which response?

  1. “You are probably being prudent. It is better to avoid the chance of getting influenza from the vaccine itself, if you are healthy otherwise.”
  2. “It would really be better for you to receive the vaccine. The vaccine is 100% effective in preventing the flu, which can be very dangerous for older adults.”
  3. “Older adults are advised to receive the influenza vaccine because, due to the aging process, they are more at risk for complications and even death from the virus.”
  4. “Older adults have more built-in immunity against the flu virus, so your decision not to get the vaccine is very generous. It may give someone else an opportunity.”

 

Question 9

Type: MCSA

An older adult client with a history of chronic obstructive pulmonary disease is being treated currently for issues surrounding a new problem of obstructive sleep apnea. The nurse caring for this client would expect the client’s physician to order which of the following treatments for sleep apnea?

  1. Respiratory therapy to fit the client with a CPAP (continuous positive air pressure) mask and machine
  2. Self-administration of bronchodilator and steroid inhalers 30 minutes before retiring to sleep for the night
  3. Respiratory therapy to fit the client with a BiPAP (bi-level positive air pressure) mask and machine
  4. Administration of two liters of supplemental oxygen per nasal cannula during the time the client is asleep

 

Question 10

Type: MCSA

The nurse is performing a respiratory assessment on an older adult client. Upon inspection of the client’s hands, the nurse notices clubbing of the fingers. The nurse is aware that this finding is indicative of a history of what condition?

  1. Anemia
  2. Hypoxemia
  3. Hyperglycemia
  4. Hypercapnia

 

Question 11

Type: MCSA

The nurse uses a pulse oximeter on an older adult client with a respiratory illness. The client’s reading is 94. The nurse needs to do which of the following interventions?

  1. Nothing. This is a normal oxygen saturation level for an older adult.
  2. Call the client’s physician to obtain an order for a bronchodilator.
  3. Apply prescribed 2 L of oxygen per nasal cannula to increase the client’s saturation level.
  4. Instruct the client to inhale several times, cough, and repeat the pulse oximeter test.

 

Question 12

Type: MCSA

A client who reports problems with dyspnea while in bed needs to be asked which of the following assessment questions by the nurse?

  1. “Does your partner ever tell you that you stop breathing during the night?”
  2. “Have you had your pneumonia vaccine this year?”
  3. “Do you know if you have a history of allergies?”
  4. “Does your breathing improve if you use extra pillows?

 

Question 13

Type: MCMA

The health care team in a long-term care setting has come up with the nursing diagnosis of Anxiety related to the inability to breathe easily for an older adult client with chronic obstructive pulmonary disease. Which of the following interventions would be appropriate for the team to implement now with this client?

Standard Text: Select all that apply.

  1. Ask the client to quantify his or her anxiety level on a scale from zero to ten.
  2. Make assumptions through observation about what triggers the client’s anxiety.
  3. Communicate with the client in order to assist him or her to validate his feelings.
  4. Allow the client to take a dependent role and make decisions for him or her regarding care.
  5. Teach the client about the disease process and answer any questions he or she may have.

 

Question 14

Type: MCSA

In planning nursing care for any older adult client with a respiratory condition, what are two priority nursing implementation strategies, regardless of the condition?

  1. Ensuring that client coughs and does deep breathing regularly
  2. Assessing respiratory status frequently and maintaining a patent airway
  3. Providing adequate hydration and regular pulmonary rehabilitation for the client
  4. Having the older adult avoid crowds and use frequent hand washing

Question 15

Type: MCSA

An older adult client has recently been diagnosed with late-onset asthma. The nurse assessing this client would expect to see which one of the following signs/symptoms?

  1. Hemoptysis
  2. Clubbing of fingers
  3. Tightness in chest
  4. Crackles on auscultation

 

Brown Older Adult Nursing Care, 1/E
Chapter 11

Question 1

Type: MCSA

The nurse is aware that the older adult client is more prone to developing infections than the younger adult primarily due to a change in what gland of the aging endocrine system?

  1. Thymus
  2. Pineal
  3. Adrenal
  4. Pituitary

 

Question 2

Type: MCSA

An older adult client at a health fair obtains a finger-stick for a capillary blood sugar reading from a nurse. There is a reading of 150 mg/dL, fasting. When advising this client on what steps to take next, the nurse keeps in mind that older adults are predisposed to Type II diabetes mellitus due to what age-related change in the endocrine system?

  1. Shrinkage of the thymus gland
  2. Insulin resistance of body tissues
  3. Decreased pituitary functioning
  4. Decreased thyroid hormone secretions

 

Question 3

Type: MCSA

What expected change in the older adult’s endocrine system makes it especially important for the nurse to pay attention to an older adult client’s electrolyte lab values when the client is either ill or has had surgery?

  1. Delayed release of insulin from the pancreas
  2. Secretion of less melatonin by the pineal gland
  3. A decrease in production of aldosterone
  4. Halting of the production of progesterone

 

Question 4

Type: MCSA

An older adult client has been diagnosed as being pre-diabetic. The client asks for advice from the nurse on how to keep this condition from becoming diabetes. What response by the nurse contains accurate information?

  1. “There really is not anything that you can do at this point. If you are already pre-diabetic, then chances are you will become diabetic very soon. You really need to watch your blood sugars very closely.”
  2. “You need to go ahead and purchase a glucose monitor and keep track of your blood sugars first thing in the morning and after each meal.”
  3. “Basically this condition is caused by the slowing of your basal metabolic rate. If you increase this with exercise, you’ll be able to prevent diabetes.”
  4. “There are several changes that you can make in terms of your diet, the amount of exercise and stress in your life, and how much you weigh. Working on these areas can lower your risk for developing diabetes.”

 

Question 5

Type: MCMA

The nurse is instructing a group of older adult clients with diabetes in aspects of proper foot care. Which of the following important information should the nurse include in the teaching?

Standard Text: Select all that apply.

  1. Assess the feet daily, even the soles.
  2. Be sure to let feet air dry after bathing.
  3. Apply lotion all over the feet and between the toes.
  4. Wash feet with warm, not hot water.
  5. Cut toenails straight across after bathing.

Question 6

Type: MCSA

The spouse of an older adult client with diabetes calls the home health nurse and reports that his current capillary blood sugar reading is 68 mg/dL, and that he is still awake, sitting up, and following commands. The spouse asks what should be done. Which reply by the nurse would be accurate?

  1. “Give the client 1/2 cup of juice or about 7 hard candies right now. Check the blood sugar level again in 15 minutes and call me back.”
  2. “Call 911 right now and have the client transported to the emergency room for administration of IV glucose. I’ll meet you there.”
  3. “Don’t do anything. The blood sugar isn’t low enough to treat yet. Just watch the client and give him his medications as ordered.”
  4. “Just watch the client. If he becomes unable to eat or drink anything, squirt some frosting into his mouth, and retake his blood sugar level in an hour.”

 

Question 7

Type: MCSA

The nurse educator asks a nursing student to name signs and symptoms of diabetes mellitus in an older adult. Which of the following responses by the nursing student would indicate a good understanding of this topic?

  1. “Older adults may show subtle signs and symptoms of diabetes mellitus, such as depression, urinary incontinence, lethargy, chronic pain, or unexplained weight loss.”
  2. “Just the three Ps of diabetes: polydipsia, polyuria, and polyphagia. Those are the classic signs and symptoms of diabetes in anyone regardless of age.”
  3. “The client would show evidence of weight gain, puffy skin, activity intolerance, and loss of appetite.”
  4. “Older adults may show signs and symptoms of anxiety, weight loss, cardiac arrhythmias, and muscle weakness.”

 

Question 8

Type: MCSA

An older adult client with a history of psychiatric illness is admitted to the emergency room with the following signs and symptoms: headache, confusion, restlessness, combativeness, and nausea and vomiting. Lab work reveals hyponatremia. The client’s records state that he has been taking haloperidol for years. Based on this information, the emergency room nurse suspects which of the following conditions?

  1. HHS (Hyperosmolar Hyperglycemic State)
  2. SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion)
  3. DI (Diabetes Insipidus)
  4. Thyroid crisis

 

Question 9

Type: MCSA

An older adult female client comes into a walk-in clinic and tells the nurse that she has recently gained weight although her appetite has decreased. She has been having trouble with constipation and an overall lack of energy. The nurse observes the client’s skin to be very dry and flaky and she appears to be losing some hair. Based upon all of the client’s signs and symptoms, the nurse would expect the client to be diagnosed with which of the following endocrine conditions?

  1. Thyrotoxicosis
  2. Polydipsia dehydration
  3. Andropause
  4. Hypothyroidism

 

Question 10

Type: MCSA

The nurse is assessing an older adult client just admitted to a long-term care facility. The nurse palpates nonpitting edema in the shin area of the client’s legs. The nurse is aware that this type of edema is associated with what type of condition?

  1. Cardiac disease
  2. Kidney dysfunction
  3. Hypothyroidism
  4. Venous Insufficiency

 

Question 11

Type: MCMA

An older adult client diagnosed with hyperthyroidism is being interviewed by the admitting nurse of a medical facility. During the interview, the nurse would expect to observe what signs/symptoms of hyperthyroidism?

Standard Text: Select all that apply.

  1. Nervousness, fidgeting
  2. Complaints of being cold
  3. Edema
  4. Flat affect
  5. Complaints of being hot

 

Question 12

Type: MCSA

After taking the blood pressure of an older adult client, the nurse finds the pulse pressure to be widened. The nurse is aware that this is often a finding in what endocrine condition?

  1. Hypothyroidism
  2. Hyperthyroidism
  3. Diabetes mellitus
  4. Thyrotoxicosis

 

Question 13

Type: MCSA

An older adult client is admitted into a long-term care facility. The client has been diagnosed with diabetes for thirty years. His capillary blood sugars stay within normal limits with two doses of insulin daily. He has developed diabetic neuropathy in both of his feet. In planning nursing care for this client, which of the following would be a priority nursing diagnosis?

  1. Risk for Injury R/T impaired sensory perception
  2. Deficient Knowledge: disease process and therapies R/T diagnosis of DM and unfamiliarity with the disease
  3. Risk for Infection R/T impaired immune system
  4. Imbalanced Nutrition: Less than Body Requirements R/T inability to use glucose for metabolic needs

 

Question 14

Type: MCSA

An older adult client diagnosed with diabetes and diabetic nephropathy is admitted into the emergency room following an automobile crash. The client is scheduled for a pelvic CT scan due to possible internal injuries. In preparing the client for the CT scan, the nurse remembers to notify radiology that the client cannot have IV dye for the procedure. What is the rationale for the nurse’s action?

  1. The client could go into anaphylactic shock from the dye.
  2. The dye could cause the client to go into ESRD (end-stage renal disease).
  3. The state of the client’s veins is questionable due to his long-term diabetes.
  4. The medications that the client takes would interact with the IV dye.

 

Question 15

Type: MCSA

An older adult with Type II diabetes mellitus is admitted into the health care facility for pneumonia. The client has been taking Glucophage (metformin) to manage his blood sugar at home. He is put on both bronchodilator and corticosteroid inhalers to assist with his breathing while in the hospital. What would the nurse caring for this client expect to see in regard to his blood sugar levels while hospitalized?

  1. Blood sugar levels will be decreased.
  2. There will be no change in the blood sugar levels.
  3. Blood sugar levels will be increased.
  4. Blood sugar levels will vacillate unpredictably.

 

Brown Older Adult Nursing Care, 1/E
Chapter 12

Question 1

Type: MCSA

When an older adult client with dementia begins to have trouble balancing his checkbook and finding the right words to say when talking, the nurse is aware that what part of the client’s brain is being affected by the dementia?

  1. Frontal lobe
  2. Parietal lobe
  3. Temporal lobe
  4. Occipital lobe

 

Question 2

Type: MCSA

What is one common change in the nervous system of the older adult client that the nurse needs to be aware of which puts the client at greater risk of injury?

  1. Hypersensitive reactions
  2. Decreased sensation
  3. Increased sensation
  4. Intensified hemiplegia

 

Question 3

Type: MCSA

What age-related change in the nervous system of the older adult does the nurse know predisposes the older adult client to slowed thinking processes, slowed decision making, and decreased memory?

  1. Decreased sensation
  2. A deficiency of dopamine
  3. Slowed nerve transmission
  4. Decreased reflexes

 

Question 4

Type: MCMA

A nurse working in an assisted living facility is planning activities for the older adult clients with the planned outcome of promoting the clients’ brain health. What type of activities should the nurse plan to assist in meeting this outcome?

Standard Text: Select all that apply.

  1. Social isolation
  2. Playing strategy games
  3. Watching television
  4. Talking with others
  5. Tai chi

Question 5

Type: MCMA

An older adult client is being discharged from an acute care medical facility following a mild stroke. The family is concerned about the client having additional strokes at home. The nurse tells the family about some assessments they can do at home if they suspect another stroke. What information does the nurse need to include in the teaching?

Standard Text: Select all that apply.

  1. Have the client smile and look for symmetry on the client’s face.
  2. Have the client speak a simple sentence and check clarity of speech.
  3. Ask the client to perform basic math calculations and check accuracy.
  4. Have the client raise both arms and check for drifting of arm downward.
  5. Ask the client to balance on one foot for two minutes and assess unsteadiness.

 

Question 6

Type: MCSA

In working with an older adult client in a rehabilitation facility following a stroke, the nurse must keep in mind that the goal of tertiary prevention is what?

  1. Prompt identification of neurological disorder
  2. Ascertaining what deficits the client may have
  3. Focusing on the maintenance of whatever skills the client still possesses
  4. Improvement of function, mobility, and psychosocial adjustment

 

Question 7

Type: MCSA

An older adult male client is admitted to the long-term care facility with advanced Parkinson’s disease. The nurse going to assess this client would expect to see which of the following signs and symptoms?

  1. Tremors, slurred speech, drooling, slow body movement
  2. Numbness in a limb, aphasia, visual disturbance, weakness
  3. Seeing double, severe headache, vomiting, difficulty walking
  4. Hemiplegia, blackened vision in both eyes, slurred speech, tremors

Question 8

Type: MCMA

An older adult client is admitted to an acute care hospital post CVA (cerebrovascular accident or stroke). He is currently unresponsive except to pain. What nursing interventions would be appropriate for this client at this time?

Standard Text: Select all that apply.

  1. Maintain a patent airway.
  2. Turn and position client every 4 hours.
  3. Provide active range-of-motion exercises.
  4. Monitor vital signs frequently.
  5. Assess neurological signs frequently.

 

Question 9

Type: MCSA

An older adult client in a long-term care facility had a bad stroke a few weeks ago. Which following sign/symptom would suggest to the assessing nurse that the client suffered damage to the right hemisphere of the brain from the stroke?

  1. Right-sided weakness
  2. An awareness of deficits/losses
  3. Inability to recognize familiar objects
  4. Client neglect of the affected side of the body

 

Question 10

Type: MCSA

An older adult client is brought to the emergency room by his son who reported that the client “passed out” in the front yard while mowing the lawn. The client is awake now. He has spontaneous eye response and is able to follow commands (e.g., hold arm out for blood pressure to be taken). He is able to talk with the nurse but does not remember what day it is or why his son brought him to the emergency room. The nurse, using the Glasgow Coma Scale, would give this client which of the following scores?

  1. 15
  2. 14
  3. 12
  4. 10

Question 11

Type: MCSA

When using the Glasgow Coma Scale with older adult clients exhibiting neurological signs/symptoms, the nurse is aware that the scale gives a quantifiable score in which three areas?

  1. Best eye, motor, and verbal response
  2. Best eye, facial, and auditory response
  3. Best motor, nerve, and facial response
  4. Best verbal, auditory, and nerve response

 

Question 12

Type: MCSA

An older adult client fell in the bathtub and hit his head. He was rushed to the emergency room by his family. How often should the nurse assess this client neurologically?

  1. Once per shift
  2. Every 2 hours
  3. Every 15 minutes until stable
  4. Every 60 minutes unless sleeping

 

Question 13

Type: MCSA

An older adult client has a nursing diagnosis of Impaired Verbal Communication related to a stroke. Which of the following nursing actions would not be appropriate for the nurse to implement to facilitate this client’s communication?

  1. Speak slowly and clearly.
  2. Keep encouraging an aphasic client to speak.
  3. Let the client know if speech is not understood.
  4. Ask one question at a time.

 

Question 14

Type: MCSA

In obtaining a history from an older adult client with a neurological impairment, what is an important factor for the nurse to consider?

  1. The client should be the primary source of the history.
  2. The client’s level of consciousness is assessed after obtaining the history.
  3. If the client’s responses are not normal, continue to ask more in-depth questions.
  4. Any history of mental illness should not be probed due to privacy considerations.

.

 

Question 15

Type: MCSA

When the nurse is determining expected outcomes in planning care for older adult clients with neurological disorders, it is very important for the nurse to consider which one of the following factors?

  1. The client needs to be compared to other clients with the same diagnosis.
  2. The focus of the planning needs to be on long-range outcomes for the client.
  3. The client should be the one to decide his functional potential and work toward that.
  4. In planning outcomes a reasonable time frame needs to be established.

Brown Older Adult Nursing Care, 1/E
Chapter 13

Question 1

Type: MCSA

An older adult client complains to the nurse practitioner, “I’ve started seeing what looks like little bugs in my line of vision. It’s annoying!” The nurse practitioner explains to the client that this is caused by which of the following visual changes associated with aging?

  1. Vitreous detachment
  2. Retinal detachment
  3. Loss of elasticity in lens
  4. Clouding of the crystalline lens

 

Question 2

Type: MCSA

A home health nurse visits an older adult client who lives alone at home. The nurse advises the client to have carbon monoxide and smoke detectors installed. This advice is based on which of the following?

  1. Current fire safety codes mandate installation of carbon monoxide detectors and smoke detectors in the home.
  2. Older adults experience an expected, progressive loss of the sense of smell which makes it difficult for them to detect smoke or gas leaks.
  3. Older adults often experience olfactory hallucinations in which they imagine smelling smoke, etc. The detectors would verify/discredit these “smells.”
  4. Older adults live in older homes with unsafe electrical wiring that may cause an unexpected house fire.

 

Question 3

Type: MCSA

A home health nurse informs the family of an older adult client that the client needs to stay in the air-conditioned house during the heat wave because the client has a greater chance of developing hyperthermia. The nurse bases this information on which of the following expected age-related change in the body?

  1. Degenerative changes in the cochlea
  2. Decrease in the size of the hypothalamus in the brain
  3. Thickening of the tympanic membrane
  4. Decrease in response to body temperature regulation

Question 4

Type: MCMA

A diet which the nurse could recommend to an older adult client wanting to keep his eyes healthy would include which of the following food types/supplements?

Standard Text: Select all that apply.

  1. Leafy green vegetables
  2. B vitamins and thiamin
  3. Omega 3 fatty acids
  4. A, C, and E vitamins
  5. Red meat

 

Question 5

Type: MCSA

A nurse practitioner is performing the Weber test on an older adult client. The client reports hearing the sound from the tuning fork equally on both sides of his head. The nurse documents this as which of the following findings?

  1. Indicative of right-sided hearing loss
  2. Indicative of left-sided hearing loss
  3. Indicative of bilateral hearing loss
  4. Indicative of normal hearing

 

Question 6

Type: MCSA

A nurse is assisting with a vision/hearing clinic at a local church health fair which is composed largely of older adult African American parishioners. The nurse would be especially alert for any signs/symptoms suggesting which of the following eye or ear disorders?

  1. Glaucoma
  2. Presbycusis
  3. Otosclerosis
  4. Presbyopia

 

Question 7

Type: MCSA

An older adult client is brought to the emergency room by his spouse. He is complaining of a sudden, sharp pain that developed in his right eye. He says he has become acutely sensitive to light and feels very nauseous. He also says he sees “halos” around all lights. The admitting nurse suspects that the client is suffering from which of the following eye disorders?

  1. Open-angle glaucoma
  2. Age-related macular degeneration (AMD)
  3. Closed-angle glaucoma
  4. Diabetic retinopathy

 

Question 8

Type: MCMA

An older adult client who smokes was recently diagnosed with diabetes and diabetic retinopathy. The client says to the nurse, “I’m scared. I don’t want to go blind. What can I do to protect my eyes?” What information does the nurse need to include in the teaching?

Standard Text: Select all that apply.

  1. Stay on a high-fat diet in order to keep the lipid levels up to protect the eyes.
  2. Monitor A1c and glucose levels and keep them as close to normal as possible.
  3. Keep appointments bi-annually with an ophthalmologist.
  4. Exercise on a regular basis throughout the week.
  5. Stop smoking.

 

Question 9

Type: MCSA

An older adult client with a hearing loss is being interviewed by the nurse. Which of the following techniques would be best for the nurse to use while interviewing this client?

  1. Shout loudly in front of the client’s face.
  2. Face the client and exaggerate pronunciation with your lips.
  3. Sit in darkness so the client can focus on your voice.
  4. Make use of gestures to help clarify meaning for the client.

Question 10

Type: MCSA

The nurse is preparing to perform a whisper test on an older adult to screen for hearing loss. Which of the following describes the results which indicate that the client may have hearing loss?

  1. Difficulty hearing a whispered word from the nurse from 2 feet away with the opposite ear occluded by a hand
  2. Problems accurately repeating three words that the nurse whispers into each of the client’s ears separately
  3. Inability to hear the nurse whisper instructions regarding hospital rules from the doorway of the client’s room
  4. Failure of the client to raise his hand simultaneously with the nurse whispering several words at different intervals

 

Question 11

Type: MCSA

When palpating the eyes of an older adult client during a physical assessment, which of the following consistencies would indicate a normal finding?

  1. Spongy
  2. Firm like wood
  3. Firm like a grape
  4. Mushy

 

Question 12

Type: MCSA

When inspecting the sclera of an African American older adult, the nurse can normally expect to see which of the following colors?

  1. Whitish
  2. Bluish
  3. Reddish
  4. Yellowish

Question 13

Type: MCSA

The nurse in an assisted living facility notices that one of the older adult residents with a hearing impairment is consistently not wearing his hearing aids. Which action should the nurse take next?

  1. Ascertain from the client the reason for not wearing the hearing aids.
  2. Pick up the hearing aids and assist the client in placing them in his ears.
  3. Notify the client’s physician and report noncompliance with the medical regimen.
  4. Inform the client that if he does not wear them, the nurse will have to report him to the physician.

 

Question 14

Type: MCSA

An older adult client in a long-term care facility suffers from vision loss associated with age-related macular degeneration, dry type. Which of the following safety precautions would be advisable for the nurse to take on the unit to ensure the client’s safety?

  1. Periodically rearrange furniture in the client’s room to stimulate the client’s existing vision.
  2. Advise the client to wear socks alone while ambulating in order to protect the feet against bumps.
  3. Always be observant for potential obstacles in the client’s usual pathway and clear them for the client.
  4. Provide the client with an orange cane to use to check for obstacles in the client’s path.

Question 15

Type: MCMA

What are some appropriate measures that the nurse can take with an older adult client in a long-term care facility who is hearing impaired?

Standard Text: Select all that apply.

  1. Allow the client to choose the method that best enhances hearing.
  2. Keep living areas dimly lit to promote relaxation.
  3. Always approach the client from behind with a touch.
  4. Develop a trusting nurse–client relationship.
  5. Keep the environment as quiet as possible.

Brown Older Adult Nursing Care, 1/E
Chapter 14

Question 1

Type: MCSA

The nurse who is assessing the mental wellness of an older adult client bears in mind that the U.S. Surgeon General’s definition of mental wellness addresses which of the following areas?

  1. Level of consciousness
  2. Ability to adapt to stress and cope
  3. Compliance with medication
  4. The range of emotions one experiences in one day

Question 2

Type: MCSA

An older adult client at a psychiatric day facility asks a nurse for some tips on how to stay mentally healthy. Which of the following should the nurse include in the teaching?

  1. “Engage in some sort of hobby or activity to keep mentally active, and be flexible to adapt to the constant change in one’s life.”
  2. “Keep your attitudes tending toward neutral; that way when disappointments occur, you won’t be taken by surprise.”
  3. “Don’t stress yourself out by setting goals for yourself. Just take one day at a time as it comes.”
  4. “Spend the majority of your time alone. One is then able to destress and spend time collecting one’s thoughts.”

 

Question 3

Type: MCSA

A nurse working with an older, recently widowed adult client in a senior center suggests that the client begin volunteering in the center. By doing so, the nurse has focused on which of the following suggested methods for maintaining mental wellness?

  1. Maintaining mental abilities
  2. Disease prevention
  3. Socialization
  4. Humor

Question 4

Type: MCSA

In an assistive living facility, the nurse overhears one nursing assistant tell another nursing assistant, “I never try to joke with any of the clients here. I am afraid of making someone mad or making them cry.” Which one of these responses would be the correct thing to say to this nursing assistant?

  1. “You’re exactly right with your approach. It’s always best for you to let the client set the tone for the conversation. Never try to joke with them.”
  2. “Sometimes the clients do such funny things around here that it is impossible not to laugh at them. I always say I’m laughing with them.”
  3. “Joking shows great insensitivity to the clients’ numerous life problems. Most of them have very serious difficulties—they are no laughing matter.”
  4. “As long as you are not laughing at the client, engaging in some joking is really beneficial. Humor has been shown to increase physical, mental, and emotional health.”

 

Question 5

Type: MCSA

The nurse is using the Beck Inventory short form that assesses items such as pessimism, sense of failure, dissatisfaction, guilt, etc., to screen an older adult client for a mental health disorder. For what disorder does this particular Beck Inventory screen?

  1. Schizophrenia
  2. Depression
  3. Mania
  4. Anxiety disorder

 

Question 6

Type: MCSA

A nurse is interviewing an older adult client at the mental health clinic to determine whether the client is experiencing dementia or depression. What finding in the nurse’s assessment would rule out dementia?

  1. Weight loss
  2. Lack of pleasure in usual activities
  3. Restlessness
  4. Rapid onset of signs and symptoms

 

Question 7

Type: MCSA

An older adult client calls a mental health crisis line and tells the volunteer nurse who answers that he is thinking of committing suicide. What question should the nurse ask the client next?

  1. “How long have you been thinking about it?”
  2. “Do you have any guns or knives around you?”
  3. “Do you have a plan in mind of how you will do it?”
  4. “How do you think you will commit the act?”

Question 8

Type: MCSA

During a mental status exam conducted on an older adult client, the nurse asks the client to explain the meaning of “Don’t put the cart before the horse.” The client states, “If you do, the horse will run right into the cart and fall down.” The client is demonstrating which of the following signs?

  1. Impaired problem-solving ability
  2. Ability to think abstractly
  3. Intact cognitive processes
  4. Inability to think abstractly

Question 9

Type: MCSA

The nurse assisting in a mental health clinic sees several older adult clients during the day. Which client shows several risk factors for potential suicide?

  1. An 86-year-old white male with vague complaints of general aches and pains who has admitted to drinking alcohol prior to the visit, and speaks of feeling “no good”
  2. A 70-year-old African American female whose husband just died recently and has had to go back to work to supplement her income
  3. A 65-year-old white male who has been married for 45 years and recently retired from his job as a postal worker
  4. A 78-year-old Hispanic female who lives with her daughter and son-in-law and helps to look after her four grandchildren while the couple works

 

Question 10

Type: MCSA

An older adult male is admitted to the emergency room with a suspected heart attack. The client complains of dizziness, sweating, shortness of breath, heart palpitations, and increased anxiety. After running several tests, including an EKG, lab work, and vital signs assessment, the physician has ruled out a heart attack. The nurse assesses the client’s vital signs; after 2 hours his results are within normal ranges. What condition does the nurse associate with the client’s symptoms?

  1. Caffeine overdose
  2. Panic attack
  3. Over-exertion
  4. Cardiac disease

 

Question 11

Type: MCMA

Nurses can identify which of the following risk factors for older adults having physical or mental health problems related to alcohol abuse?

Standard Text: Select all that apply.

  1. Have recently begun using alcohol to cope
  2. Have several medical conditions
  3. Reside close to several family members
  4. Take several prescribed medications
  5. Abuse alcohol on a regular basis

Question 12

Type: MCSA

An older adult client with a history of schizophrenia has recently been placed on a new neuroleptic (antipsychotic) medication. When the client begins to experience restlessness and an inability to sit still, the nurse suspects which of the following side effects from the medication?

  1. Dystonia
  2. Akathisia
  3. Dyskinesia
  4. Tardive dyskinesia

Question 13

Type: MCSA

An older adult client in a long-term care facility recently began isolating himself in his room and no longer participates in the daily card games that he used to enjoy. Three days ago he began refusing food. In terms of client safety, what should the nurse caring for this client do next?

  1. Instruct the nursing assistants caring for the client to feed the client if he will not feed himself.
  2. Inform the rest of the nursing staff that the client has decided to die and should be allowed to die in a dignified manner if that is his wish.
  3. Ask the client the reason for not eating and also question whether he is thinking of suicide.
  4. Obtain an order from the client’s physician to have a percutaneous endoscopic gastrostomy tube (PEG) inserted into the client for feedings.

 

Question 14

Type: MCSA

An older adult client on a geriatric psychiatric unit is actively hallucinating. What manner of interacting with this client should the nurse use?

  1. Speak loudly to get the client’s attention.
  2. Touch the client’s shoulder to reassure him or her.
  3. “Play along” with the hallucination experience.
  4. Ask the client about the content of the hallucinations.

 

Question 15

Type: MCSA

An older adult client has a long history of bipolar disorder. Which of the following medications does the nurse recognize as being less risky in treating this client?

  1. Divalproex sodium (Depakote)
  2. Lithium (Eskalith)
  3. Clozapine (Clozaril)
  4. Paliperidone (INVEGA)

Brown Older Adult Nursing Care, 1/E
Chapter 15

Question 1

Type: MCSA

Of the following tasks, which one would the nurse expect the older adult client to perform better than a younger adult?

  1. Playing a current video game
  2. Working a new machine
  3. Planning a family reunion
  4. Figuring out a new digital camera

Question 2

Type: MCMA

The nurse would expect to see a gradual decline in which of the following cognitive abilities in an older adult?

Standard Text: Select all that apply.

  1. Naming of objects
  2. Attention span
  3. Verbal fluency
  4. Language skills
  5. Logical analysis

 

Question 3

Type: MCSA

An older adult client with dementia in a long-term care facility is unable to remember how to dress himself and now requires nursing assistants to help with his activities of daily living. The nurse in charge recognizes the client’s deficit as what type of memory loss?

  1. Episodic
  2. Semantic
  3. Declarative
  4. Procedural

 

Question 4

Type: MCSA

The son of a healthy older adult female client assists his mother in moving from home into an assisted living facility. One evening soon after the move, the client becomes very anxious and hurries through the hallways at the facility asking everyone she sees, “Where am I? Where is my son?” The nurse in charge of the facility suspects that the client is experiencing which of the following conditions?

  1. Onset of dementia
  2. Episode of delirium
  3. Acute anxiety attack
  4. Manic episode

Question 5

Type: MCSA

An older adult client is admitted into the emergency room from home after experiencing a recent infection and fever. The family states that he “just went crazy.” Currently the client is very disoriented, appears to be having visual hallucinations, and is showing delusional thinking patterns, thinking he is in prison and saying, “They won’t let me out.” The admitting nurse suspects the client is experiencing what subtype of delirium?

  1. Hypoactive
  2. Mixed
  3. Manic
  4. Hyperactive

 

Question 6

Type: MCMA

An older adult female client tells the home health nurse about her fears of becoming senile. She asks the nurse to tell her some signs of Alzheimer’s dementia (AD). What information should the nurse include in the response?

Standard Text: Select all that apply.

  1. Occasionally forgetting where one puts items (such as purse, car keys, etc.)
  2. Taking a longer period of time to complete normal activities
  3. Making poor judgment decisions
  4. Experiencing hallucinations or delusional thinking
  5. Exhibiting changes in personality and behavior

Question 7

Type: MCSA

A family member of an older adult client with Alzheimer’s dementia (AD) asks the nurse if there is anything that can be done to ward off AD if it “runs in the family.” The nurse tells the family member that there are modifiable risk factors. What is a modifiable risk factor that the nurse can identify for this family member?

  1. Age
  2. Heart health
  3. Gender
  4. Genetics

Question 8

Type: MCSA

A family member of an older adult client diagnosed with Alzheimer’s dementia voices concern to the home health nurse about her mother’s worsening memory. The family member states that the client tries to help in the kitchen but often forgets what task she is supposed to be doing. The client also doesn’t remember attending recent events, like her grandchild’s baptism. The client will not even go to church with her daughter anymore. With this information, the nurse suspects that the client is in what stage of AD?

  1. Mild or early
  2. Moderate or mid-stage
  3. Moderately severe
  4. Severe or late-stage

Question 9

Type: MCSA

An older adult client in the late stages of Alzheimer’s dementia begins putting everything in her mouth that comes close to her hands. The nurse is aware that this is an example of which of the following signs of Alzheimer’s dementia?

  1. Agnosia
  2. Hyperorality
  3. Perseveration
  4. Apraxia

 

Question 10

Type: MCSA

The nurse is aware of medications that can be used to slow the progression of Alzheimer’s dementia in older adult clients. Which one of the following would the nurse recognize as being one of these medications?

  1. Olanzapine (Zyprexa)
  2. Quetiapine (Seroquel)
  3. Rivastigmine (Exelon)
  4. Amantadine (Symmetrel)

Question 11

Type: MCSA

An older adult client with moderately severe Alzheimer’s dementia (AD) asks the nurse if she has seen her 6-year-old twins around. She is upset and says, “They’re missing.” The nurse is aware that the woman’s twins are adults with children of their own. However, the nurse uses validation therapy with the client. Which of the following responses illustrates this type of therapy?

  1. “You know your twins are grown now, and they come and see you quite often.”
  2. “Come, come, don’t get upset. Let’s go and have some coffee and put that puzzle together.”
  3. “Ma’am, don’t you remember? They came and saw you just yesterday, along with your grandchildren.”
  4. “No, I haven’t seen them, but tell me about them while I help you look for them.”

 

Question 12

Type: MCSA

An older adult client with moderate Alzheimer’s dementia (AD) is visited by her daughter and grandchildren at the long-term care facility. They all have ice cream together in the cafeteria. Later that afternoon, the nurse asks the client how the visit was. The client states, “My son and I had such a lovely time. We went outside and watched the birds.” The nurse recognizes the client’s comment as an example of which of the following signs of AD?

  1. Confabulation
  2. Perseveration
  3. Aphasia
  4. Agnosia

 

Question 13

Type: MCSA

The wife of an older adult client with Alzheimer’s dementia expresses to the home health nurse, “I really can’t put up with this much longer. I have to watch him all the time like a child.” The wife has a monotone voice and has a very sad facial expression. How would it be best for the nurse to respond at this point?

  1. “It sounds like you are really tired and stressed out.”
  2. “Are you thinking of hurting yourself?”
  3. “He is not a child, you know. Can your family help out?”
  4. “What about your husband? He can’t take care of himself.”

 

Question 14

Type: MCMA

When an older adult client with Alzheimer’s dementia becomes more and more aphasic, what are some appropriate techniques the nurse can use when communicating with the client?

Standard Text: Select all that apply.

  1. Use a loud, commanding voice
  2. Listen without being distracted
  3. Correct verbal mistakes of the client
  4. Focus on the client’s feelings
  5. Keep minimal direct eye contact

Question 15

Type: MCSA

A daughter of an older adult client with Alzheimer’s dementia (AD) asks the home health nurse what to do about the client’s wandering behavior at night. What information should the nurse include in the response?

  1. “Place numerous pillows throughout the house. That way if he does fall when he wanders at night, he won’t get hurt.”
  2. “You may need to change your sleeping schedule and try sleeping when he does, so that you can keep an eye on him at night.”
  3. “You might try covering the client’s bedroom door with a poster of some type. This may distract him from opening the door.”
  4. “Try to give the client a little extra of his antipsychotic medication at night; it may help him sleep.”

Brown Older Adult Nursing Care, 1/E
Chapter 16

Question 1

Type: MCSA

An older adult client with intellectual disabilities (ID) is staying in a supervised apartment setting. The client’s IQ has been measured at 60. At this IQ level, the nurse would classify this client as which of the following severity levels of ID?

  1. Mild
  2. Moderate
  3. Severe
  4. Profound

 

Question 2

Type: MCSA

An older adult client with intellectual disabilities (ID) with an IQ of 45 stays in a group home on the grounds of a facility for the intellectually and developmentally disabled. The nurse who makes periodic supervisory visits to the group home would expect what abilities from this client?

  1. Performance of simple tasks with supervision
  2. Performance of basic self-care skills
  3. Performance of semi-skilled labor with supervision
  4. Independent performance in the community

 

Question 3

Type: MCSA

The majority of adults with intellectual and developmental disabilities (I/DD) reside in what setting?

  1. Group homes
  2. Institutions
  3. Skilled nursing facilities
  4. Family homes

 

Question 4

Type: MCSA

A family member of an older adult with I/DD asks a nurse where in town she could find resources to help her mother. What information should be included in the nurse’s response?

  1. “The local area agency on aging should have a list of resources available in this community.”
  2. “The yellow pages probably have a list of agencies that you could call to find resources.”
  3. “I think you could probably get on the internet and find local resources.”
  4. “The library should have a list of available resources for you.”

 

Question 5

Type: MCMA

The nurse is aware that the older adult client with Down syndrome is subject to many health disorders. Which of the following are common disorders to which these clients are predisposed?

Standard Text: Select all that apply.

  1. Klenbock’s disease
  2. Congenital gastrointestinal atresia
  3. Parkinson’s disease
  4. Hyperthyroidism
  5. Obsessive-compulsive disorder

Question 6

Type: Matching

The older adult with intellectual/developmental disabilities (I/DD) is often prone to develop oral conditions. Match the oral condition below with the correct corresponding possible cause found in the right-hand column of the table.

  1. “Chipmunking”
  2. Gingivitis
  3. Xerostoma
  4. Broken teeth
_____ 1. Poor systemic health, medications, allergies
_____ 2. Seizure disorder, behavioral tendency to chew hard, nonedible objects
_____ 3. Difficulty chewing, dysphagia, inability to feel food in the mouth
_____ 4. Poor oral hygiene

 

 

Question 7

Type: MCSA

An 80-year-old mother is the caregiver for a 60-year-old older adult client with intellectual/developmental disabilities (I/DD). A 30-year-old grandson also lives with the family. The client receives home health care twice a week for bathing and assistance with activities of daily living. When the LPN/LVN comes for the usual visit, she finds the client in bed soaked in urine. The sheets on the bed are dirty. The mother has a very fearful attitude, and the LPN/LVN notices several bruises on her arms. What would be the appropriate action for the nurse to take next?

  1. Following the chain of command, report the possibility of elder abuse to the supervisor at the home health agency.
  2. Immediately call the local law enforcement officials and directly report the abuse to them.
  3. Ask the client’s mother where her grandson is and question him about the client’s and mother’s conditions.
  4. Clean up the client and the bed, check on the mother’s condition, and re-evaluate at the next visit.

 

Question 8

Type: MCMA

The mother of an older adult client with intellectual/developmental disabilities (I/DD) calls the local health unit and asks the nurse what immunizations are necessary for the client. Which of the following statements should the nurse include in her response?

Standard Text: Select all that apply.

  1. Influenza vaccine annually
  2. Pneumococcal vaccine only if concurrent medical conditions
  3. Immunizations for hepatitis A and B
  4. Tetanus booster every 10 years
  5. Diphtheria booster every 10 years

Question 9

Type: MCSA

An older adult client, aged 56, with intellectual disabilities (I/DD) has recently been placed on hormone replacement therapy (HRT.) Her caregiver asks the nurse at the gynecologist’s office how often the client should receive a pelvic exam and a Pap smear. Which one of the following responses gives accurate information?

  1. Every three to five years is sufficient
  2. Every year due to HRT
  3. Every 2 years due to Medicare
  4. Every 10 years until 65 years old

 

Question 10

Type: MCSA

When the older adult son with moderate intellectual and developmental disabilities (I/DD) (IQ of 50) develops Type II diabetes, his mother/caregiver asks the nurse what the possibility would be for the son to be responsible for his own medication/capillary blood sugar testing. Which of the following represents an accurate response by the nurse?

  1. “There really is no point in trying to teach your son to take care of this. He just doesn’t have the mental capacity. You’ll need to learn how to take care of it.”
  2. “I will teach and observe your son diligently, and you can help. We’ll see how he accepts the responsibility, review his progress with his physician, and go from there.”
  3. “This will be a snap. I will go over the regimen a couple of times with him, and he should be able to handle it.”
  4. “At your son’s age, and your current age and ability, it would be best to consider placing your son in some type of alternate housing at this point.”

 

Question 11

Type: MCSA

When the nurse is assessing the client with intellectual/developmental disabilities (I/DD), what are some important points for the nurse to consider while interviewing the client?

  1. Make certain to interview client alone.
  2. Conduct the interview in an open area.
  3. Gather all necessary information in one session.
  4. Make certain to include the client’s family.

 

Question 12

Type: MCSA

When the nurse is conducting an assessment interview of a client with intellectual/developmental disabilities (I/DD), the nurse will want to assess the client’s functional academic skills. What questions would the nurse ask to provide information regarding this subject?

  1. Questions about following printed instructions, reading labels, and handling money
  2. Questions about getting and keeping a job and reading/understanding a work schedule
  3. Questions regarding judgment and other issues which would impact the client’s safety
  4. Questions about the client’s ability to interact with others and communicate effectively

 

Question 13

Type: MCMA

An older adult client with intellectual/developmental disabilities (I/DD) can no longer stay with his mother as her health is failing. The client and his mother are visiting the long-term care facility to which the client will soon be relocating. What are some interventions the nurse at the facility can employ to make the client’s transition a smooth one?

Standard Text: Select all that apply.

  1. Take the client on a tour of the facility.
  2. Direct conversation to the mother.
  3. Keep the reason for the move between the staff and the mother.
  4. Ask about the client’s current daily schedule.
  5. Give the client a special events calendar of the facility.

 

Question 14

Type: MCSA

The nurse has formulated a nursing diagnosis of Altered Nutrition: More than Body Requirements related to overeating and lack of exercise for an older adult client with Down syndrome (DS). What would be an appropriate nursing action to take to assist in working on this client’s problem?

  1. Have client screened for hyperthyroidism.
  2. Keep client’s blood sugar readings within normal limits.
  3. Monitor client’s weight at different times of the day.
  4. Determine type of exercise that is possible for the client.

Question 15

Type: MCSA

The nurse works with clients with intellectual/developmental disabilities from families of different ethnic backgrounds. Which of the following ethnic groups would more than likely involve the entire family in the care of the client with I/DD?

  1. Eastern European
  2. Asian American
  3. African American
  4. Native American

 

Brown Older Adult Nursing Care, 1/E
Chapter 17

Question 1

Type: MCSA

Which of the following statements is true in regard to LPNs (LVNs) in management positions?

  1. LPNs/LVNs are not allowed in management positions as mandated by the National Federation of Licensed Practical Nurses (NFLPN).
  2. The LPN (LVN) is defined as an “informal leader” by the state’s Nurse Practice Act.
  3. LPNs (LVNs) have a limited ability to delegate, depending on the state’s Nurse Practice Act in which they are practicing.
  4. LPNs (LVNs) are only allowed in management positions if they have passed a national certification test on management.

 

Question 2

Type: MCSA

The LPN (LVN) in the United States today is most likely going to work with what population and in what setting?

  1. Pediatric/Hospitals
  2. Adolescents/Clinics
  3. Older Adults/Hospitals
  4. Older Adults/Long-term care

Question 3

Type: Matching

There are many leadership styles in management. Match the following leadership styles with the correct definition in the right-hand column.

  1. Laissez faire
  2. Democratic
  3. Transformational
  4. Autocratic
  5. Multicratic
_____ 1. Manager makes the decisions; task oriented; manager wants job done his or her way.
_____ 2. Leaders do not manage, supervise or direct. Staff is in charge. Used by leaders who want staff to like them.
_____ 3. Leaders energetic/enthusiastic; excellent communicators; want to see everyone on the team succeed.
_____ 4. Leader includes staff in decision making; Leader makes final decision; Leader knows staff well and teamwork is encouraged.
_____ 5. Leader includes staff in decision making; Leader makes final decision; Leader knows staff well and teamwork is encouraged.

 

Question 4

Type: MCSA

An LPN (LVN) nurse manager of a long-term care facility holds a team meeting with a group of nursing assistants to discuss the problem of clients not receiving fresh water during the day. The manager asks the staff to break up into small groups and brainstorm ideas on how to take care of the client’s hydration needs more efficiently. After receiving the ideas, the group discusses each and the manager decides on the final plan. What leadership style is the manager practicing with this group of nursing assistants?

  1. Autocratic
  2. Laissez faire
  3. Transformational
  4. Democratic

 

Question 5

Type: MCMA

In order to communicate effectively with subordinates, an LPN/LVN nurse manager needs to keep which of the following guidelines in mind?

Standard Text: Select all that apply.

  1. Recognize nonverbal communication in self and others.
  2. Validate the other person’s understanding of what is said.
  3. Pay attention to content of speech, not feelings behind it.
  4. Keep a somewhat passive attitude when communicating.
  5. Show respect for whoever is speaking.

 

Question 6

Type: MCSA

An LPN (LVN) nurse manager uses the POP plan of time management as part of her management style. Which of the following is a correct description of what is included in the POP plan?

  1. Pondering, officiating, performing
  2. Plotting, overseeing, presiding
  3. Planning, organizing, prioritizing
  4. Prepping, operating, proceeding

 

Question 7

Type: MCSA

An LPN (LVN) asks a nurse manager about rules regarding delegation of duties in the workplace. The manager explains the “5 Rights of Delegation” to the LPN/LVN. Which response by the nurse manager includes the appropriate rights?

  1. “These include the right job for the right person, under the right circumstances, with the right communication and direction, and right supervision and evaluation.”
  2. “The 5 rights include the right job, right person, right time, right place, and right performance.”
  3. “These rights include the right person delegating the job, the right task, the correct skills involved, and satisfactory results.”
  4. “The 5 rights of delegation include divvying up the menial tasks at hand to the people under you, staying after them until they finish the job, and, finally, telling them exactly what a good or bad job they did.”

 

Question 8

Type: MCSA

A nurse manager delegates the task of removing an indwelling catheter from an older adult client to an LPN (LVN). Prior to completing this task, the LPN (LVN) delegates emptying the collection bag of the indwelling catheter to a nursing assistant. If neither the nursing assistant nor the LPN (LVN) carry out the performance of the duties they were delegated, who is ultimately accountable?

  1. The nursing assistant, as an unlicensed health care provider
  2. The nurse manager, as the licensed professional in charge
  3. The LPN (LVN) to the fact that the nurse manager delegated originally to her
  4. The physician who ordered the catheter to be removed from the client

Question 9

Type: MCSA

An LPN (LVN) nurse manager at a long-term care facility is studying conflict resolution styles. The LPN (LVN) discovers that one style in particular is generally found to work the best. Which style is this?

  1. Collaboration
  2. Accommodation
  3. Compromise
  4. Authoritarianism

Question 10

Type: MCSA

There is a growing problem on the long-term care unit between the nurses and the nursing assistants. The nurses feel that the nursing assistants take too many breaks and leave a lot of their work for the nurses to do. The nursing assistants feel overworked and as though the nurses think they are “too good” to help them with any of their tasks. The nurse manager on the unit wants to handle this issue with a conflict resolution style. Which one should the nurse use that would have the best results in this situation?

  1. Avoidance
  2. Authoritarianism
  3. Accommodation
  4. Compromise

Question 11

Type: MCSA

An LPN (LVN) working at a long-term care facility is interested in pursuing certification in wound care to advance professionally. Which of the following national organizations would give the LPN (LVN) the greatest opportunities for wound care certification?

  1. The National Association for Practical Nurse Education and Service, Inc. (NAPNES)
  2. The National Federation of Licensed Practical Nurses (NFLPN)
  3. National Alliance of Wound Care (NAWC)
  4. American Academy of Wound Management (AAWM)

 

Question 12

Type: MCSA

An LPN (LVN) student who is graduating soon already has a job at a local long-term care facility. This facility requires their LPN (LVN) employees to take the National Association for Practical Nurse Education and Service, Inc. (NAPNES) certification exam for pharmacology. When would the LPN (LVN) be eligible to take this exam?

  1. After successfully completing the NCLEX-PN® exam (National Council Licensure Examination for Practical Nurses)
  2. Immediately upon graduation from the nursing program
  3. After working in a long-term care facility for 5 years as an LPN (LVN)
  4. While still a student in the LPN (LVN) program

 

Question 13

Type: MCSA

A male employee in a long-term care facility is accused by an alert older adult female client of touching her inappropriately during a transfer from her wheelchair to the bed. The nurse manager is called in on this alleged employee infraction. What should the nurse manager’s next action be?

  1. Issue the employee a performance improvement plan (PIP)
  2. Suspend the employee pending a full investigation
  3. Dismiss the client’s complaint as unsubstantiated
  4. Terminate the employee immediately.

Question 14

Type: MCSA

An experienced nursing assistant is given an assignment by the charge nurse to feed an older adult client with dementia. The client is well-known in the facility for often attempting to bite employees. The nursing assistant refuses the assignment. What would be best for the nurse manager to do now?

  1. Assign the job to someone else.
  2. Suspend the employee without pay for insubordination.
  3. Have an informal discussion with the nursing assistant.
  4. Interview the employee privately and issue a PIP (Performance Improvement Plan).

 

Question 15

Type: MCSA

A group of nurses and nursing assistants are discussing their LPN (LVN) nurse manager in the break room. One nursing assistant says, “Our manager really doesn’t even care about us. She only cares about looking good to the director.” What kind of nonproductive leadership style is the manager apparently using with her staff?

  1. Autocratic
  2. Self-sacrificing
  3. All-powerful
  4. Overprotective parent