Question 1

Which question will provide the most useful information when the nurse is performing a comprehensive geriatric assessment of an older adult who is being assessed for admission to an assisted-living facility?

Accepted Answer

A)   "Do you have a history of heart disease?"
B)   "Are you able to prepare your own meals?"
C)   "Have you had any recent infections?"
D)   "How frequently do you see a doctor?" B

Question 2

While obtaining a health history from a 68-year-old patient, the nurse learns that the patient takes daily supplements of antioxidants beta carotene, selenium, and vitamin E. The nurse recognizes that the use of these substances in slowing the aging process is related to the biologic aging theory of

Accepted Answer

A)   telomere-telomerase decrease.
B)   free radicals.
C)   somatic mutation.
D)   programmed cell death. B

Question 3

To help prevent drug-drug interactions in an older adult patient taking many medications, the most appropriate instruction by the nurse is,

Accepted Answer

A)   "Do not take any over-the-counter (OT
C)   drugs with your prescription drugs."
B)   "Be sure to have all of your prescriptions filled at the same pharmacy."
C)   "Bring all the medications, supplements, and herbs that you use to every health care appointment."
D)   "Use a medication reminder system so that you won't forget to take your medications as scheduled." C

Question 4

To obtain the most complete information when doing an assessment for an 81-year-old patient, the nurse will

Accepted Answer

A)   review the patient's chart for the history of medical problems.
B)   interview both the patient and the primary patient caregiver.
C)   use a geriatric assessment instrument to evaluate the patient.
D)   ask the patient to write down medical problems and medications.

Question 5

When developing the plan of care for an older adult who is hospitalized for an acute illness, the nurse should

Accepted Answer

A)   use a standardized geriatric nursing care plan.
B)   plan for likely long-term-care transfer to allow additional time for recovery.
C)   consider the preadmission functional abilities when setting patient goals.
D)   minimize activity level during hospitalization.

Question 6

The home health nurse is caring for a 71-year-old patient who lives alone and is taking seven different prescribed medications for chronic health problems. The nurse will plan to

Accepted Answer

A)   use a marked pillbox to set up the patient's medications.
B)   discuss the option of moving to an assisted-living facility.
C)   call the health care provider about stopping some of the medications.
D)   visit the patient daily to administer the medications.

Question 7

The family of an 85-year-old with chronic health problems and increasing weakness is considering placing the patient in a long-term care facility. Which action by the nurse will be most helpful in assisting the patient to make the transition?

Accepted Answer

A)   Have the family select a LTC facility that is relatively new.
B)   Obtain the patient's input about the choice of LTC facility.
C)   Ask that the patient be placed in a private room at the facility.
D)   Explain the reasons for the need to live in LTC to the patient.

Question 8

A 42-year-old who is providing home care for a parent tells the nurse, "I don't feel comfortable giving Mom her medications yet, but I think I will be able to do it with a little more practice." Which nursing diagnosis is most appropriate?

Accepted Answer

A)   Caregiver role strain related to inability to safely give medications
B)   Anxiety related to lack of confidence
C)   Risk for situational low self-esteem
D)   Readiness for enhanced therapeutic regimen management

Question 9

When admitting an 88-year-old patient to the hospital, the nurse should plan to

Accepted Answer

A)   interview the patient before the physical assessment.
B)   speak slowly and loudly while facing the patient.
C)   determine whether the patient uses glasses or hearing aids.
D)   obtain a detailed medical history from the patient.

Question 10

As the home health nurse is teaching a 72-year-old patient who lives alone about a new medication, the patient replies "I just don't learn new information like I used to." The nurse will plan to

Accepted Answer

A)   schedule the patient for daily visits for medication administration.
B)   teach the patient's family members to give the medications.
C)   spend more time discussing the medications with the patient.
D)   tell the patient it is not safe to take medications independently.

Question 11

Which nursing actions will the nurse take to assess for possible malnutrition in a 69-year-old patient? (Select all that apply.)

Accepted Answer

A)   Review laboratory results.
B)   Ask about transportation needs.
C)   Determine food likes and dislikes.
D)   Observe for depression.
E)  Assess teeth and oral mucosa.F)  Question about salt use.

Question 12

Which information obtained by the home health nurse when making a visit to an 88-year-old with mild forgetfulness is of concern?

Accepted Answer

A)   The patient's son uses a marked pillbox to set up the patient's medications weekly.
B)   The patient has lost 10 pounds (4.5 kg)  during the last month.
C)   The patient is cared for by a daughter during the day and stays with a son at night.
D)   The patient tells the nurse that a close friend recently died.

Question 13

When assessing a 68-year-old Latina patient who has diabetes, which question will the nurse ask in determining the impact of ethnicity on the patient's health care choices?

Accepted Answer

A)   "Who helps you with your care at home?"
B)   "How do you pay your medical bills?"
C)   "What do you think helps people get better?"
D)   "Which type of insulin do you use?"

Question 14

A confused and agitated 76-year-old patient with a broken arm is brought to the emergency department by a family member. To determine whether elder abuse is the cause of the patient's injury, the nurse should

Accepted Answer

A)   have the family member stay in the waiting area while the patient is assessed.
B)   ask the patient how the injury occurred and observe the family member's reaction.
C)   make a referral for a home assessment visit by the home health nurse.
D)   notify an elder protective services agency about the possible abuse.

Question 15

When admitting a 79-year-old patient who has urinary urgency and a possible urinary tract infection (UTI), the nurse should first

Accepted Answer

A)   assess the patient's orientation.
B)   inspect for abdominal distension.
C)   question the patient about hematuria.
D)   invite the patient to use the bathroom.

Question 16

Appropriate approaches used by the long-term care nurse to provide teaching to a 73-year-old who has just been diagnosed with diabetes include which of the following? (Select all that apply.)

Accepted Answer

A)   Schedule a visit by another resident who is diabetic.
B)   Demonstrate food choices using food photographs.
C)   Avoid discussion of the patient's favorite foods.
D)   Remind the patient that a lot of damage has already occurred.
E)   Encourage the patient's family to participate in teaching sessions.F)  Ask the patient about past experiences with lifestyle changes.

Question 17

When caring for an older adult who lives in a rural area, the nurse will plan to

Accepted Answer

A)   assess the patient for chronic diseases that are unique to rural areas.
B)   ensure that the patient has transportation to appointments with the health care provider.
C)   obtain adequate medications for the patient to last for 4 to 6 months.
D)   suggest that the patient move to an urban area for better health care.

Question 18

The home health nurse is developing a care plan for an alert and active 85-year-old patient who takes multiple medications for chronic cardiac and respiratory disease. The patient lives with family members who work during the day. An appropriate nursing diagnosis is

Accepted Answer

A)   social isolation related to weakness and fatigue.
B)   caregiver role strain related to need to adjust family employment schedule.
C)   risk for injury related to drug-drug interactions.
D)   compromised family coping related to the patient's many care needs.

Question 19

An alert and well-oriented 78-year-old patient with multiple health problems rarely gets out of bed and complains of having "no energy" and feeling increasingly weak. The patient has had an 11-pound weight loss over the last year. The nurse should initially

Accepted Answer

A)   ask the patient about daily dietary intake.
B)   schedule regular range-of-motion exercise.
C)   discuss long-term care placement with the patient.
D)   describe normal changes with aging to the patient.

Question 20

The home health nurse is making an 8:00 AM visit to a confused older patient who lives with a daughter. Which information most indicates a need for further action by the nurse?

Accepted Answer

A)   The patient is unable to remember the nurse's name.
B)   The patient has not yet taken the daily medications.
C)   The patient is weaker than on the previous visit.
D)   The patient's daughter asks about respite services.

Exam 6: Older Adults