Ch. 24 Older Adult

Question 1

A nurse is planning to write a grant for a health-promotion project in the community. Which of considerations should the nurse make when determining the appropriate population for this project?

A. The fastest growing population is children under the age of 12
B. The fastest growing population is young Black American adults
C. The fastest growing population is White middle-age adults
D. The fastest growing population is non-white older adults age 65 and older

Answer 1

D. The fastest growing population is non-white older adults age 65 and older

Question 2

Which of the following statements made by a client best identifies someone who would likely to be receptive to health-promotion interventions?

A. “I have a new grandchild and want to be part of her life”
B. “My mother lived until she was 90, so a long life is in my genes”
C. “Some chronic illness is just a part of aging”
D. “I hope I’ll live a lot longer, it one never knows”

Answer 2

A. “I have a new grandchild and want to be part of her life”

Question 3

Which of the following statements concerning nutrition and older adults is true?

A. Older adults who live in their own homes are more likely to be malnourished than older adults living in a nursing home
B. Older adults lose their desire for high-fat, salty foods
C. Meals served in long-term care institutions are usually more well balanced than foods eaten by older adults living at home
D. Many older adults are not aware of food assistance programs

Answer 3

D. Many older adults are not aware of food assistance programs

Question 4

Which of the following statements concerning urinary incontinence is correct?

A. Urge incontinence occurs when one has the urge to void but is unable to do so
B. Stress incontinence is associated with emotional turmoil
C. Functional incontinence is associated with environmental barriers
D. Incontinence with high post-void residual occurs when someone laughs or sneezes

Answer 4

C. Functional incontinence is associated with environmental barriers

Question 5

Which of the following measures is appropriate for treating urinary incontinence?

A. Increase caffeine to tighten urinary sphincter
B. Utilize voiding schedules
C. Decrease fiber to lessen pressure on the bladder from the colon
D. Avoid Pilates, which have been shown to inflame pelvic floor in the elderly

Answer 5

B. Utilize voiding schedules

Question 6

A 75-year old man tells the nurse that he has difficulty staying asleep during the night. Which of the following responses should be made by the nurse?

A. “It is best to avoid milk or reading before bedtime”
B. “I’ll ask the nurse practitioner to prescribe a sleeping pill for you”
C. “Taking naps during the day can help relieve excessive fatigue and will help you sleep better”
D. “Let’s talk about your sleep schedule and things that may prevent you from getting a restful night’s sleep”

Answer 6

D. “Let’s talk about your sleep schedule and things that may prevent you from getting a restful night’s sleep”

Question 7

A nurse is conducting a community education program about cognition in older adults. Which of the following information should be included?

A. Some form of mild dementia is a normal part of aging
B. Confusion is a reliable indicator of dementia
C. Assessment for dementia should be part of routine physical exams
D. Elders who score below 27 points on the Mini-mental state exam (MMSE) are not likely to have a cognition problem

Answer 7

C. Assessment for dementia should be part of routine physical exams

Question 8

A nurse has recently accepted the position of unit nurse manager on a long-term care unit. Which of the following directives should the nurse give to the staff nurses?

A. Encourage residents to participate in unit activities such as Scrabble and bingo
B. Demonstrate the caring aspect of nursing by dressing residents before breakfast
C. Discourage exercise for patients with Parkinson because it has been shown to accelerate muscle stiffness
D. Switch places at the table every 3 weeks and change roommates every 6 weeks to alleviate boredom

Answer 8

A. Encourage residents to participate in unit activities such as Scrabble and bingo

Question 9

Which of the following statements is correct concerning the “obesity paradox” as it pertains to older adults?

A. Obesity in older adults is more detrimental than it is for younger adults
B. Unlike younger people, fruits and vegetables cause obesity in elderly people
C. Obesity in older adults is not related to caloric intake or exercise
D. Obesity in older adults is not clearly linked with shorter life span

Answer 9

D. Obesity in older adults is not clearly linked with shorter life span

Question 10

Which of the following is correct concerning heat regulation in the older adult?

A. Remaining indoors where temps are 90 degrees or higher is recommended
B. Increased sweating, characteristic of older adults, increases the risk of dehydration
C. Increased use of salt, secondary to declining taste, increases the risk for heat stroke
D. The ability to feel heat and cold is typically enhanced in the elderly due to thinner skin

Answer 10

A. Remaining indoors where temps are 90 degrees or higher is recommended

Question 11

According to Erikson’s theory of development, which of the following older adults has successfully navigated the stage of ego integrity versus despair?

A. 72-year old man who is reluctant to retire because “work is everything to me”
B. 78-year old woman who has scheduled her third face lift
C. 80-year old man who has informed his children that he has made his funeral arrangements
D. 67-year old woman who is depressed because she has not been promoted at work for the past 10 years

Answer 11

C. 80-year old man who has informed his children that he has made his funeral arrangements

Question 12

A couple in their sixties has assumed responsibility for raising their two grandchildren ages 9 and 12 because the children’s parents died in a car accident. Which of the following is nursing interventions is a priority to help the grandparents cope with the responsibility of raising their grandchildren?

A. Connecting them with the “Grandparents Raising Grandchildren” support group
B. Encouraging them by remind them how they successfully raised their own children
C. Volunteering to provide respite time for them as needed
D. Assuring them that their stress level will lessen, as they gain confidence

Answer 12

A. Connecting them with the “Grandparents Raising Grandchildren” support group

Question 13

A nurse is conducting a staff development program about human sexuality for nurses who work in a long-term care facility. Which of the following statements is accurate?

A. “The desire for sexual intimacy declines rapidly with age”
B. “Older adults are very well-informed about sexuality”
C. “Older adults need to practice safe sex”
D. “The danger of contracting STDs during sexual intimacy is extremely low in older adults”

Answer 13

C. “Older adults need to practice safe sex”

Question 14

The clinic nurse has seen the following four widows today. Which of the following persons is demonstrating a healthy coping pattern for her loss?

A. The widow who discusses very little except the loss of her husband 3 years ago
B. The widow who talks about the “good time” she and her husband had before his illness and death 1 year ago
C. The widow who states that life is not worth living without her husband, who died 2 years ago
D. The widow who blames herself for her husband’s death because she did not “make him go” to the doctor

Answer 14

B. The widow who talks about the “good time” she and her husband had before his illness and death 1 year

Question 15

A nurse is assigned to provide care for a 96-year old bedridden man who experiences severe pain from a chronic neurological disease. The man asks the nurse to please help him leave this world so that his suffering will end. Which of the following actions would be most appropriate for the nurse to take?

A. Assist the doctor with the man’s request
B. Refuse to care for the man
C. Contact the pain care specialist
D. Provide the man with names of doctors who participate in assisted suicide

Answer 15

C. Contact the pain care specialist

Question 16

A nurse is conducting a home visit for an older adult in the summer. Which of the following items should the nurse locate in the home in the interest of preventing a heat stroke?

A. Fan
B. Porch chair
C. Synthetic blend clothing
D. Air thermometer

Answer 16

A. Fan

Question 17

The community health nurse has obtained a grant to offer a “Safe Driving” series for older adults. Which of the following information should the nurse stress during the series?

A. Traffic fatalities involving older adults occur mainly at dusk
B. The cause of two-vehicle accidents is frequently an older driver striking another car
C. The average blood alcohol level in older adults involved in accidents is higher than the blood alcohol level of younger drivers involved in accidents
D. Relearning the art of defensive driving can reduce the likelihood that an older driver will be involved in a motor vehicle accident

Answer 17

D. Relearning the art of defensive driving can reduce the likelihood that an older driver will be involved in a motor vehicle accident

Question 18

As part of a community-wide flu vaccination program for older adults, the nurse is assisting at a vaccination clinic. Which of the following questions should the nurse ask before administering the vaccine?

A. “Do you have any food allergies?”
B. “Have you had the pneumococcal vaccine?”
C. “Have you had the flu in the past 5 years?”
D. “Do you have Medicare?”

Answer 18

A. “Do you have any food allergies?”

Question 19

A man tells a nurse that he is concerned about his risk and his wife’s risk of developing cancer. Which of the following statements concerning cancer is accurate?

A. PSA assessment alone is not ideal for purposes of screening for prostate cancer
B. Breast cancer risks are lower in women who have never had children
C. Smoking does increase the risk of cancer but non-smoking tobacco products do not increase risk
D. Increased immune function to adults after age 65 impacts cancer rates

Answer 19

A. PSA assessment alone is not ideal for purposes of screening for prostate cancer

Question 20

Which of the following statements is the best definition of Polypharmacy?

A. The use of more than five medications prescribed by different physicians
B. The use of multiple medications for the same or different health problems
C. The use of multiple pharmacies and self-management of medications
D. The use of multiple medications and supplements simultaneously

Answer 20

B. The use of multiple medications for the same or different health problems

Question 21

A person is preparing to return home following a 2-week hospital stay for congestive heart failure and pneumonia. Which of the following referrals would be most beneficial for the person?

A. Transportation assistance
B. Home-delivered meals
C. Adult day care
D. Home health nursing

Answer 21

D. Home health nursing

Question 22

The son of a 70-year old man dying of cancer asks the nurse to tell him about the hospice program, so he can help his father decide if the program would be of benefit to him. Which of the following responses should be given by the nurse?

A. “At hospice, your father will be heavily medicated, so he will not have pain”
B. “All of your father’s care will be provided by nurses at hospice”
C. “Hospice care can take place either at home or in a hospice facility”
D. “Visiting hours are about the same at hospice as they are here in the hospital”

Answer 22

C. “Hospice care can take place either at home or in a hospice facility”

Question 23

A community health nurse is working with a diverse population of older adults within the community. Based on the data from the National Health Interview survey, which of the following assumptions should be made by the nurse when working with this diverse population?

A. White Non-hispanic older adults tend to require more assistance with their activities of daily living
B. Hispanic older adults tend to rate their health as poorer than other ethnic groups
C. Older adults who tend to rate their health as fair or poor are also financially poor
D. Older adults tend to require more assistance with activities of daily living than with meeting their routine needs

Answer 23

C. Older adults who tend to rate their health as fair or poor are also financially poor

Question 24

A woman who is being discharged from the hospital is oriented to person, place, and time, and her memory is intact. She has occasional forgetfulness without a consistent pattern of memory loss. Which of the following housing options would be most appropriate for this woman?

A. Independent living
B. Retirement community
C. Assisted living
D. Nursing facility

Answer 24

B. Retirement community

Question 25

Which of the following interventions will have the greatest impact on reducing constipation in older adults? Select all that apply.

A. Offering strained fruit and vegetable juices to increase fiber content in the diet
B. Encouraging fluids between meals
C. Administering laxatives on a daily basis
D. Assisting with ambulation

Answer 25

A. Offering strained fruit and vegetable juices to increase fiber content in the diet
B. Encouraging fluids between meals
D. Assisting with ambulation

Question 26

Which of the following factors would be considered predictors of satisfaction with retirement? Select all that apply.

A. Participation in competitive sports but most especially golf
B. Adequate income
C. Having grandchildren
D. Good functional ability

Answer 26

B. Adequate income

D. Good functional ability

Question 27

The nurse working in a retirement community for older adults is conducting a psychosocial assessment of all residents to screen for depression and suicidal ideation. Which of the following questions should the nurse ask during the assessment process? Select all that apply.

A. “Have you thought about harming yourself?”
B. “Are you still playing bridge every Thursday?”
C. “How does your congestive heart failure affect your life?”
D. “Do you still have any money left in your IRA account”

Answer 27

A. “Have you thought about harming yourself?”
B. “Are you still playing bridge every Thursday?”
C. “How does your congestive heart failure affect your life?”

Question 28

Which of the following nursing interventions implies respect for a person’s spirituality? Select all that apply.

A. Changing the position of the bed in a Muslim client’s room so that it faces east
B. At the request of a Buddhist patient, asking the home health aide to pick up incense when she next shops for the patient
C. Saying a silent prayer with a client, at the client’s request
D. Praying out loud in the room of a dying client

Answer 28

A. Changing the position of the bed in a Muslim client’s room so that it faces east
B. At the request of a Buddhist patient, asking the home health aide to pick up incense when she next shops for the patient
C. Saying a silent prayer with a client, at the client’s request

Question 29

A nurse is conducting a community health-education program about osteoporosis with a group of older adults. Which of the following individuals in attendance is at greatest risk for developing osteoporosis? Select all that apply.

A. 65-year old Asian woman who smokes one pack of cigarettes per week
B. 80-year old white man who has three glasses of wine per day
C. 74-year old white woman on daily oral prednisone for emphysema
D. 68-year old black man who has a sedentary lifestyle

Answer 29

A. 65-year old Asian woman who smokes one pack of cigarettes per week
B. 80-year old white man who has three glasses of wine per day
C. 74-year old white woman on daily oral prednisone for emphysema

Question 30

An 80-year old person admitted to the hospital. During the health assessment process, the nurse should screen for which of the following conditions? Select all that apply.

A. Polypharmacy
B. Renal insufficiency
C. Illegal drug use
D. Alcoholism

Answer 30

All of the above.