Gerontology

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. The fastest-growing group of older adults are aged:

a) 60-64
b) 65-74
c) 75-84
d) 85-100

2. Which of the following most accurately describes the health of the majority of older adults?

a) They enjoy good health.
b) They have multiple chronic illnesses.
c) They rate their health as poor.
d) They live in nursing homes.

3. Nurses can most strongly impact the health of older adults by

a) encouraging older adults to ask for assistance to meet their personal needs and to provide home repairs.
b) assessing alterations in capabilities and teaching needed about nutrition, safety, and teaching needed about nutrition, safety, and exercise information.
c) assessing symptoms of medical problems and reviewing medical interventions.
d) providing sensitive responsive nursing care during hospitalization of any older adult.

4. Wellness is measured by

a) the number and severity of medical conditions the older adult has.
b) the number and frequency of medications the older adult takes.
c) the personal perspective of the older adult regarding his/her life satisfaction.
d) the ability of the older adult to perform activities of daily living and instrumental activities of daily living.

5. Identify the four essential tools for aging:

a) Exercise routine, proper nutrition, peer support, and coping mechanisms.
b) Proper nutrition, peer support, patience, and problem-solving skills.
c) Exercise routine, patience, social activities, and problem-solving skills.
d) Coping mechanisms, social activities, medical care, and exercise routine.

6. Healthy life-styles in older adults are hindered by

a) financial barriers
b) strong self-motivation.
c) strong capacity for change.
d) good sense of humor.

7. Older adults who attend Bingo every Wednesday and church every Sunday because they have always attended these activities are examples of which aging theory?

a) Activity theory
b) Disengagement theory
c) Continuity theory
d) Play theory

8. The older adult who retires from a full-time job and becomes a full-time volunteer at the senior center is an example of which aging theory?

a) Activity theory
b) Disengagement theory
c) Continuity theory
d) Play theory

9. The ultimate goal of gerontological nurses is to

a) enhance quality of life for older adults by increasing their social support.
b) cure medical problems experienced by older adults by providing information about their medical problems.
c) assist older adults to maintain independence by connecting them with agencies in the community that will help them.
d) prevent or delay onset of physical, functional, and social deficits in older adults.

10. The nurse observes how a mother who is an older adult interacts with her daughter. The nurse takes the mother's apical pulse, respirations, blood pressure, and asks questions about any changes in the way she feels or ability to perform activities of dail

a) Palpation
b) Percussion
c) Ausculation
d) Observation

11. An older adult reported no difficulty breathing but repeatedly placed her hand on her chest and took an extra deep breath. This is an example of what type of communication?

a) Verbal communication
b) Nonverbal communication
c) Noncongruent communication
d) Active listening

12. The nurse asked the older adult if she was worried about something. The nurse then allowed a period of silence in order to:

a) Put pressure on the older adult to be truthful.
b) Allow the older adult time to collect her thoughts.
c) Allow herself time to think up her next question.
d) Give the older adult's family a chance to join the conversation.

13. An older adult tells the nurse, "I didn't say anything to my daughter about not feeling well because I didn't want to be a bother." The nurse responded by giving recognition. Which of the following responses would be the best response to give recognitio

a) You hid your illness and allowed yourself to become very ill.
b) I'm sure you hid your illness because you thought you would get better.
c) You didn't want to be a bother?
d) Did I understand you to say that you weren't feeling well?

14. The older client who finds it difficult to read the newspaper unless the newspaper is held farther away is experiencing what kind of change in vision?

a) Cataracts
b) Arcus senilis
c) Macular degeneration
d) Presbyopia

15. Which of the following statements about urinary function in older adults is false?

a) Incontinence is a normal consequence of aging.
b) Decrease in bladder capacity can cause urinary frequency.
c) Benign prostatic hypertrophy causes frequency and retention.
d) Dilute urine is a normal consequence of aging.

16. Which of the following neurological abilities is expected to change with advanced aging?

a) Reflexes
b) Intelligence
c) Creativity
d) Problem solving

17. The most stressful psychosocial life change for older adults is

a) death of a spouse.
b) death of best friend (same sex).
c) move to retirement community.
d) retirement from job of 30 years.

18. The nursing code that defines nursing's primary function as service to mankind is:

a) Nightingale Pledge
b) International Code of Nursing Ethics
c) American Nurses Association Code for Nurses
d) Code of Nursing Behavior

19. Your client decides to sign a Living Will because he does not want to live if health problems cause any decrease in quality of life. The ethical theory being applied is:

a) Utilitarianism
b) Deontology
c) Natural law
d) Ethical egoism

20. A physician tells a client that he must have surgery, and the nurse directs the client to sign a consent for surgery without giving explanation or options. The ethical principle the doctor and nurse are utilizing is:

a) Autonomy
b) Beneficence
c) Paternalism
d) Veracity

21. A client tells the nurse that he hasn't been taking his medication because he can't afford to pay for it. The client asks the nurse not to tell anyone. This information is confidential. The most appropriate nurse's action would be to

a) tell the client's family.
b) chart the information.
c) tell the doctor.
d) not tell anyone.

22. A female Chinese client has been diagnosed with breast cancer. The physician told the son and discussed treatment options including a mastectomy, lumpectomy, chemotherapy, or radiation. The client's son tells the nurse his mother would never want to k

a) tell the physician the client doesn't want to know her diagnosis.
b) tell the physician the client refuses treatment and is embarrassed to discuss her condition.
c) tell the physician that in the client's culture the family would make medical decisions.
d) tell the physician that the client does not know her diagnosis or treatment options.

23. Which of the following is not an example of an Advance Directive:

a) A Living Will
b) A health care proxy
c) A do-not-resuscitate order
d) A will

24. What should you do if you are in an ethical dilemma in which you feel you are being asked by the client, client's family, and institution to act in an immoral manner?

a) Follow the rules of the institution to maintain your job.
b) Follow your own beliefs because you have to live with yourself.
c) Ask to be removed from the situation because of the complexity.
d) Ask the client and client's family to accept your right to say no.

25. Comfort measures would not include:

a) Food
b) Oxygen
c) Pain medication
d) Mouth care

26. If you are the nurse who restrains an older adult, what is the most important intervention to prevent being sued?

a) Call the MD and chart the reason for applying restraints.
b) Communicate reason for applying restraints to family.
c) Tie the restraints in such a manner that the client has maximum movement.
d) Communicate with other clients why the person is being restrained.

27. The title for a person who has been given the responsibility of making financial decisions for another designated person is:

a) Durable Power of Attorney
b) Durable Power of Attorney for Health Care
c) Guardian
d) Proxy or surrogate

28. The legislation that requires that all persons being admitted to a health care institution have to be informed about advanced directives is:

a) Uniform Durable Power of Attorney
b) Patient Self-Determination Act
c) Patient's Bill of Rights
d) Older Americans Act

29. The resident's son tells you that he is proceeding to obtain guardianship of his mother. The resident has told you that her son is after her money. What should you do to try to protect her legal rights?

a) Tell the son his mother is competent.
b) Chart information supporting the resident's competence.
c) Tell the physician the resident is competent.
d) Have a patient care conference to discuss the situation.

30. What is the difference between legal and ethical rules?

a) Legal rules are always rigid, and ethical rules vary with the situation.
b) Legal rules vary with the law, and ethical rules vary with the person.
c) Legal rules vary with the state, and ethical rules vary with the country.
d) Legal rules are rigid, and ethical rules vary with the institution.

31. The fastest-growing segment of the elderly population in the United States is:

a) Native Americans
b) Hispanic Americans
c) African Americans
d) Asian Americans

32. When the nurse needs a family member to interpret for a Hispanic American woman who does not speak English, the nurse's first choice would be:

a) The client's oldest daughter
b) The client's sister
c) The client's oldest son
d) The client's youngest daughter

33. African American elders are usually cared for

a) in nursing homes.
b) in a relative's home.
c) in state institutions.
d) in religious institutions.

34. When a nurse meets a Navajo client, how can the nurse show the client respect?

a) Don't make eye contact.
b) Firmly shake hands.
c) Stand at a distance.
d) Bow to the client.

35. When a Jewish elderly client is experiencing pain, you would expect the client to

a) become very quiet and withdrawn.
b) report pain to family members who will tell you.
c) try to control the pain with self-treatment before reporting.
d) tell the nurse, speaking emphatically with hand gestures.

36. When providing nursing care for an Asian American elder, which of the following actions would be most sensitive to her cultural differences?

a) Pat her hand and maintain close physical contact.
b) Avoid prolonged eye contact and physical contact.
c) Maintain prolonged eye contact to show respect and caring.
d) Spend a long time talking to her in order to improve your relationship.

37. The most important factor to successful aging is:

a) Financial resources
b) Healthy environment
c) Social support
d) Positive self-image

38. Which of the following statements describing stress is most accurate?

a) A stressful event depends on the person's perception of the event.
b) A stressful event is defined by religious beliefs.
c) A stressful event is defined by cultural beliefs.
d) A stressful event is defined by a person's support system.

39. Which of the following statements about caregiver stress is most accurate?

a) The caregiver feels stressed because of the physical demands from providing care.
b) The caregiver feels stressed because of the mental distress related to providing care.
c) The caregiver feels stressed because of the physical and psychological demands from providing care.
d) Caregivers feel stressed because they have less personal time to meet their own needs.

40. Which of the following statements most accurately describes respite care?

a) Respite care is temporary care provided to allow the caregiver a release from caregiving tasks.
b) Respite care is permanent care provided to decrease the caregiver's responsibility for providing caregiving.
c) Respite care is temporary care provided to decrease the caregiver's responsibility for providing caregiving.
d) Respite care is permanent care provided to allow the caregiver a release from caregiving task.

41. Mrs. Renal, a client with advanced renal failure, states that she feels she is too old to use xtraordinary means to keep herself alive. Your best initial response is:

a) Peritoneal dialysis isn't considered extraordinary means.
b) I didn't think you were that old. How old are you?
c) Peritoneal dialysis will allow you to continue your usual activities.
d) What do you already know about peritoneal dialysis?

42. The nurse wants to give Mrs. Renal support to help her adapt to peritoneal dialysis. Which of these statements is most appropriate for an older adult?

a) You have made so many changes in you life, this is just one more.
b) You can do anything you want to do; you are in control.
c) I know that you have the ability to make the necessary changes.
d) You can learn to make changes as you go through life.

43. Which of the following statements regarding sexuality in elderly people is most accurate?

a) Sexual desires diminish with old age.
b) Sexual desires and function continue into old age.
c) Sexual desire continues, but sexual function diminishes.
d) Sexual activities in older adults are limited to kissing.

44. A 75-year-old man reports that he is having sexual difficulty having an erection. The best initial response by the nurse would be:

a) You are too old to be having sexual relationships; you are expecting too much of your body.
b) Have your partner provide more manual stimulation and you will have an erection.
c) There are many ways to improve your ability to have an erection. What have you tried?
d) At your age, sexual needs should be met by kissing and touching your partner, not by intercourse.

45. Which of the following nutritional practices would be considered unusual for American older adults?

a) Skipping a meal on a daily basis.
b) Taking medications that interact with food.
c) Eating a well-balanced diet on a daily basis.
d) Eating most meals alone.

46. Assessment of body shape is important in relation to weight to identify obesity. What body shape is considered a major indicator of health problems related to obesity?

a) Waist smaller than buttocks.
b) Waist and buttocks equally large.
c) Extremely heavy arms and legs.
d) All of the above

47. Which condition does not make an older adult prone to malnutrition?

a) Alzheimer's disease
b) Stroke
c) Parkinson's disease
d) Myocardial infarction

48. Which of the following statements about dysphagia in nursing home residents is most accurate?

a) Ninety percent of nursing home residents have dysphagia.
b) Approximately 60% of nursing home residents have dysphagia.
c) Approximately 25% of nursing home residents have dysphagia.
d) Most nursing home residents do not have dysphagia.

49. A complication of taking calcium supplements is:

a) Constipation
b) Kidney stones
c) Diarrhea
d) Polyuria

50. Normal body mass index (BMI) is:

a) 20-30
b) 22-27
c) 24-34
d) None of the above

51. An example of a miotic drug that contracts the pupil is:

a) Pilocarpine
b) Timoptic
c) Diamox
d) None of the above

52. When vitreous humor inside the eye tugs or pulls on the retina, the older adult reports seeing:

a) Flashing lights
b) Floaters
c) Tunnel vision
d) Diminished vision

53. When speaking to an older adult with minimal hearing loss, the nurse should

a) talk as loud and possible.
b) talk in a low-tone voice.
c) talk in a high-tone voice.
d) talk in a soft voice.

54. Hearing aids are most helpful for older adults with

a) hearing deficits due to neuron malfunction.
b) hearing deficits due to decreased conduction.
c) hearing deficits due to old age.
d) hearing deficits due to presbycusis.

55. A nursing intervention that would not help xerostomia is

a) artificial saliva.
b) sugar-free candy.
c) lemon juice.
d) liquid or soft foods.

56. Altered function in which of the following would not impact an older adult's nutritional state?

a) Olfactory
b) Gustatory
c) Vision
d) Oculomotor

57. The assessment that most accurately identifies an older adult who is fall-prone is:

a) Vision
b) Balance
c) Strength
d) Cognitive

58. Which of the following descriptions of REM sleep is most accurate?

a) Eye movement occurs and biological body is restored
b) Eye movement occurs and the body is mentally restored.
c) Eye movement is absent and the biological body is restored.
d) Eye movement is absent and the body is mentally restored.

59. REM sleep should account for what percentage of an older adult's nightly sleep?

a) 5%
b) 0.1
c) 0.25
d) 50%

60. Transient insomnia or the inability to sleep for a few days is most frequently caused by:

a) Medication
b) Food
c) Stress
d) Disease

61. Which of the following statements about sleep apnea is most accurate?

a) Sleep apnea disturbs the person's sleep but is not a medical concern.
b) Sleep apnea not only disturbs a person's sleep, but can also threaten his/her life.
c) Sleep apnea seldom disrupts a person's sleep and is not a medical concern.
d) Sleep apnea not only disturbs a person's sleep, but also is a minimal medical threat.

62. The night nurse in a long-term care residence notices that a resident is having multiple periods of sleep apnea. The most important nursing intervention the nurse can perform to maintain the resident's safety for the night is:

a) Turn the resident on his side.
b) Monitor the resident's blood pressure.
c) Monitor the resident's heart rate
d) Wake him and keep him awake.

63. Which of the following statements about the effect of normal aging on medication dosage is most accurate?

a) Older adults require adjusted medication dosage because of increased total body fluid.
b) Older adults require adjusted medication dosage because of albumin concentration.
c) Older adults require adjusted medication dosage because of increased muscle mass.
d) Older adults require adjusted medication dosage because of increased body fat.

64. Which of the following symptoms is typical of digitalis toxicity?

a) Nausea, headache, and bradycardia
b) Diarrhea, drooling, and tachycardia
c) Diarrhea, fever, and bradycardia
d) Vomiting, ringing in the ears, and fever

65. Heatstroke in an older adult can be recognized by which of the following symptoms?

a) Weakness
b) Dry hot skin
c) Perfuse perspiration
d) Arm pain

66. Home safety is a special concern with older adults because most falls occur in the home. Which of the following is a hazard for falls?

a) Low beds
b) High toilet seats
c) Grab bars
d) Low chair seats

67. Which of the following statements about use of restraints with older adults is most accurate?

a) Restraints involve numerous risks, direct and indirect.
b) Restraints involve numerous direct risks.
c) Restraints involve numerous indirect risks.
d) Restraints protect older adults from harming themselves.

68. The most frequent crime against older adults is:

a) Home robbery
b) Public robbery
c) Rape
d) Homicide

69. The nurse witnesses a caregiver taking food away from an older adult before the older adult is done eating. This is an example of what kind of abuse?

a) Neglect
b) Physical abuse
c) Abandonment
d) Exploitation

70. Which of the following statements describing caloric intake for older adults is most accurate?

a) Caloric intake for older adults is the same for a middle-aged person.
b) Caloric intake for older adults is more than for a middle-aged person.
c) Caloric intake for older adults is less than for a middle-aged person.
d) Caloric intake for older adults depends on their height.

71. Older adults should decrease which of the following nutrients in their diet?

a) Fat
b) Carbohydrates
c) Fiber
d) Vitamins

72. The most accurate statement about autonomy as a coping skill is:

a) Autonomy means the person has a mind of his or her own.
b) Autonomy means preferring to be alone rather than in a group.
c) Autonomy means that information and conversations are kept confidential.
d) Autonomy means having the ability to be independent and make decisions.

73. Most older adults live in

a) nursing homes.
b) their own home.
c) assisted living.
d) apartments.

74. How often do the majority of older adults need assistance with health care?

a) Daily
b) Weekly
c) Monthly
d) Occasionally

75. When planning care for an older adult who cannot be left alone, which of the following could provide 24-hour care?

a) Home health care
b) Day care
c) Senior center
d) Hospice

76. An older adult is standing in front of a clerk at a fast-food counter. The clerk looks beyond the older adult and asks the person behind the older adult for his order. This is an example of:

a) Preference
b) Oversight
c) Disgust
d) Ageism

77. A group of older adults is working on crafts. One older adult in the group is acting out and disrupting a group. Which of the following actions by the nurse would be most effective at stopping the distruptive behavior?

a) The nurse said to the disruptive older adult, "Please sit down, you are disrupting the group."
b) The nurse places a hand on the disruptive older adult’s shoulder and said, “I really like the craft you are making.”
c) The nurse said to the group, "Please ignore him; he is just showing off."
d) The nurse sat down next to the disruptive older adult and said, “Do you need some help with your craft?”

78. Does a hospitalized older adult have the right to refuse to be restrained?

a) Yes, if the older adult is competent.
b) Yes, if the older adult has a guardian.
c) No, it is a medical judgment.
d) No, the hospital is responsible for maintaining his/her safety.

79. The guidelines for prescribing medications for older adults is

a) Start high and go slow.
b) Start low and go fast.
c) Start low and go slow.
d) Start high and go fast.

80. Which of the following frequently occurring conditions in older adults is most often underreported?

a) Confusion
b) Falling
c) Incontinence
d) Drug interactions

81. One of the most appealing advantages of subacute care is:

a) Lower cost
b) Smaller, friendlier environment
c) Quality staff
d) Acute care

82. The Social Security Act allowed federal involvement in nursing homes. What year was the Social Security Act passed?

a) 1915
b) 1925
c) 1935
d) 1945

83. Medicare and Medicaid reimbursement for residents in long-term care facilities is based on:

a) Resource utilization group (RUG)
b) Diagnostic resource group (RUG)
c) Medical diagnosis
d) Functional disability

84. Poor older adults receive federal assistance with their medical expenses through:

a) Medicaid
b) Medicare
c) Veterans' Administration
d) Long-term care insurance

85. Long-term care refers to:

a) Nursing homes
b) A continuum of services
c) Multiple community settings
d) Nonacute care

86. If the older adult has a distended jugular vein when he is standing, it is an indication of

a) congestive heart failure.
b) myocardial infarction.
c) angina.
d) stroke.

87. Which of the following is an important sign of circulatory insufficiency?

a) Decreased pulse rate
b) Increased pulse rate
c) Increased respirations
d) Decreased urinary output

88. When comparing an older adult's systolic blood pressure when sitting and standing, how much difference is considered normal

a) Any difference is abnormal
b) 5 mm Hg
c) 10 mm Hg
d) 20 mm Hg

89. Which of the following is the priority nursing intervention for activity intolerance in a client with compromised cardiovascular function?

a) Provide frequent orientation to time and place.
b) Teach isometric exercises.
c) Maintain supplemental oxygen.
d) Teach about disease process.

90. The most important assessment to make about angina is

a) the activity that precipitates the pain.
b) the rating of pain.
c) the site of pain.
d) the number of nitroglycerin tablets that relieve pain.

91. Which of the following statements about nicotine is most accurate?

a) Nicotine is not addictive and increases metabolism.
b) Nicotine is addictive and increases metabolism.
c) Nicotine is not addictive and decreases metabolism.
d) Nicotine is nonaddictive and decreases metabolism.

92. Subjective symptoms of weight loss, cough, dyspnea, and fatigue are associated with:

a) pneumonia.
b) tuberculosis.
c) lung Cancer.
d) COPD.

93. The purpose of a two-step PPD is to

a) verify a positive PPD reading.
b) be sure the PPD was administered correctly.
c) give the immune system a second chance to respond.
d) determine if the size of the induraion increases.

94. The respiratory condition that is intermittent and reversible is:

a) Emphysema
b) Pneumonia
c) Tuberculosis
d) Asthma

95. A desirable oxygen saturation for an older adult with COPD is:

a) 80-84%
b) 85-89%
c) 90-94%
d) 95-100%

96. Which of the following bones seldom breaks because of decreased bone density due to osteoporosis?

a) Radius
b) Humerus
c) Femur
d) Vertebrae

97. Which of the following is not a typical symptom associated with osteomalacia?

a) Bowing and bending of legs
b) Cyst formation
c) Bone masses
d) Skeletal pain

98. The most common type of arthritis is:

a) Osteoarthritis
b) Rheumatoid arthritis
c) Gouty arthritis
d) Spondylosis

99. When an older adult walks with small, stiff steps and narrow base of support, the nurse would suspect the older adult hasL

a) Osteoarthritis
b) Spondylosis
c) Rheumatoid arthritis
d) Paget's disease

100. Which of the following observations would cause a nurse to be especially concerned that an older adult's hip was fractured?

a) Pain and tenderness in hip area
b) Swelling and bruising in hip area
c) Lack of alignment of femur
d) Witnessing the older adult fall

101. The cause of essential tremors is:

a) Parkinson's disease
b) Mild cerebral dysfunction
c) Mild extrapyramidal dysfunction
d) Mild epilepsy

102. The three typical symptoms of Parkinson's disease are:

a) Tremor, rigidity, and bradykinesia
b) Rigidity, slowness, and weak voluntary movements
c) Tremor, slowness, and weak voluntary movements
d) Tremor, bradykinesia, and slowness

103. Odler adults who have transient ischemic attacks are more apt to have a:

a) Brain tumor
b) Stroke (CVA)
c) Myocardial infarction
d) Brain hemorrhage

104. The primary aim of nursing care for an older adult with a CVA in acute care would be to

a) prevent depression.
b) prevent further disability.
c) maintain self-esteem.
d) reteach ADL (activities of daily living).

105. How often should an older adult bathe in a week?

a) Once
b) Three times
c) Five times
d) Daily

106. Eczema can best be described as:

a) Skin with scattered red lesion
b) Skin with exudate and crusting
c) Skin with dry, hard bumps
d) Skin with multiple white spots

107. Herpes zoster is caused by

a) the chickenpox virus.
b) acquiring AIDS.
c) acquiring a lymphoma.
d) the measles virus.

108. Diabetic ketoacidosis (DKA) is a serious complication of diabetes that is caused by absolute deficiency of insulin. A test that can be performed at home that would identify ketoacidosis is:

a) Glucometer (blood sugar 100)
b) Glucometer (blood sugar 200)
c) Urine test for sugar
d) Urine test for ketones

109. Hyperthyroidism in older adults may manifest itself as:

a) Angina
b) Congestive heart failure
c) Myocardial infarction
d) Heart palpitations

110. Which of the following statements about thyroid cancer in older adults is most accurate?

a) Thyroid cancer in older adults is usually not encapsulated.
b) Thyroid cancer in older adults is usually associated with few symptoms.
c) Thyroid cancer in older adults is associated with high mortality rates.
d) Thyroid cancer in older adults is associated with long recuperation.

111. Bradycardia or tachycardia in the older adult may be due to which of the following endocrine glands?

a) Parathyroid
b) Adrenal
c) Thyroid
d) Pancreas

112. The diagnosis of diabetes is made if the fasting blood sugar is:

a) 100 mg/dL
b) 113 mg/dL
c) 126 mg/dL
d) 139 mg/dL

113. The major antibody in the blood is:

a) IgM
b) IgA
c) IgC
d) IgG

114. Older adults with decreased immune response will

a) have no difficulty maintaining homeostasis during an infection.
b) have an atypical inflammation response with low-grade fever.
c) have an effective response to influenza vaccine.
d) have better memory for antigens after age 60.

115. How does aging affect T cells in an older adult?

a) T cells decrease in number.
b) T cells decrease in strength.
c) T cells decrease in specificity.
d) T cells decrease in ability to reproduce.

116. The leading infections causing death in older adults are:

a) Urinary tract infections and skin infections
b) Urinary tract infections and pneumonia
c) Skin infections and influenza
d) Pneumonia and influenza

117. Typical signs of pneumonia in an older adult are:

a) Fever and crackles
b) Fever and pleuritic chest pain
c) Anorexia and change in activity pattern
d) Anorexia and wheezes in lower lungs

118. Which of the following is a typical presenting symptom of a urinary infection in older adults?

a) Frequency
b) Urgency
c) Incontinence
d) Urinating small amounts

119. If an older adult client has difficulty swallowing and holds food in his mouth, the nurse should be careful to prevent

a) nausea and vomiting.
b) overfeeding the client.
c) getting food stuck in his throat.
d) aspiration.

120. Which of the following would help an older adult with a hiatal hernia?

a) Lay down after meals.
b) Sleep on a soft, flat bed.
c) Eat spicy food.
d) Eat small, frequent meals.

121. Which of the following statements about the relationship between ulcers and milk is most accurate?

a) Milk increases gastric secretion and is contraindicated with an ulcer.
b) Milk decreases gastric secretion and is useful for an ulcer.
c) Milk protects the stomach mucosa by coating it and is useful for an ulcer.
d) Milk is not effectively broken down by hydrochloric acid and is contraindicated for an ulcer.

122. Symptoms of a volvulus in an older adult are

a) nausea, vomiting, and diarrhea.
b) severe epigastric pain and dry heaves.
c) uncontrolled belching and diarrhea.
d) severe epigastric pain and belching.

123. An older adult does not know he has gallstones until

a) an abdominal x-ray reveals them.
b) acute pain occurs.
c) they leave the gallbladder.
d) the gallbladder ruptures.

124. Which of the following is an age-related change in the bladder?

a) Bladder empties completely
b) Able to postpone voiding
c) Decreased urinary infections
d) Decreased capacity

125. A normal prostate is the size of a(n):

a) Orange
b) Grape
c) Lemon
d) Walnut

126. Signs of chronic renal failure include

a) itchy, moist skin.
b) oliguria.
c) clear mental state.
d) low blood urea nitrogen.

127. The primary risk factor for bladder cancer is:

a) Alcohol
b) Soft drinks
c) Coffee
d) Smoking

128. The most frequently occurring cancer in men is:

a) Bladder
b) Prostate
c) Lung
d) Kidney

129. The type of incontinence that occurs during a cough or sneeze is:

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

130. Diagnosis of Alzheimer's disease is made by:

a) Excluding other conditions
b) Computed tomography (CT) scan
c) Lumbar puncture
d) Magnetic resonance imaging (MRI)

131. The cardinal symptom of Alzheimer's disease in the early phase is:

a) Loss of long-term memory
b) Short attention span
c) Loss of short-term memory
d) Unable to use sound judgment

132. Which of the following is a nursing intervention to help manage an older adult with Alzheimer's disease who wanders?

a) Encourage the older adult to walk as desired.
b) Leave doors open to increase walking path.
c) Have older adult wear identification.
d) Have three meals a day with no snacks.

133. The best nursing intervention for aggressive actions by an older adult with Alzheimer's disease is:

a) Scold him for his behavior.
b) Divert his attention.
c) Set limits to his behavior.
d) Ignore his behavior.

134. Which of the following is a nonreversible confusion?

a) Disorientation
b) Pseudodementia
c) Delirium
d) Dementia Chapter 24: Supporting Mental Health

135. The primary characteristic of mentally healthy older adults who age successfully is to

a) share their problems.
b) have social support.
c) control their lives.
d) cope with problems.

136. Physiological changes of aging can

a) not be changed.
b) be modified by health practices.
c) be totally changed by health practices.
d) be modified by medical treatment.

137. Health promotion strategies for older adults include:

a) Using several over-the-counter drugs
b) Participating in daily exercise
c) Skipping meals
d) Ignoring friends

138. A nursing intervention that would help control aggressive behavior in an older adult is to

a) increase environmental stimuli.
b) decrease structured activities.
c) implement behavior modification.
d) allow behavior to continue.

139. The most important nursing intervention for a dying patient is to

a) check pulse of the patient.
b) maintain clean, fresh bedding.
c) listen to the patient.
d) check respirations for a patient.

140. The goal of pain management for a dying patient is

a) to keep pain at a low level.
b) to provide intermittent relief.
c) to keep patient semicomatose.
d) to keep pain from occurring

141. The primary aim of hospice care is to

a) provide support and care for terminally ill.
b) provide curative care and provide emotional support.
c) provide in-home services for older adult.
d) provide nursing care for terminally ill.

142. Which of the following would need support when a hospice patient dies?

a) Family and caregiver
b) Caregiver and nursing staff
c) Health care staff and family
d) Nursing staff and family

143. How long does hospice expect to provide care for a terminally ill patient?

a) 3 months
b) 6 months
c) 9 months
d) A year

144. Which of the following will pay for hospice care of an older adult?

a) Medicare Part A
b) Medicare Part B
c) Social Security
d) Veterans' Association Chapter 26: Choices in Gerontological Nursing

145. The American Nurses Association changed the term geriatric nursing to gerontological nursing to

a) revitalize the image of the specialty area.
b) focus on holistic approach rather than disease.
c) focus on the health care term approach.
d) Respond to reports of poor care in nursing homes.

146. The estimated percent of hospital beds currently occupied by older adults is:

a) 12%
b) 0.25
c) 0.5
d) 75%

147. Subacute care in a nursing home is specifically for

a) a person recovering from an acute illness.
b) a chronically ill person who can no longer live independently.
c) a chronically ill person who is dying.
d) an older adult who needs help with activities of daily living.

148. The supervisor assumes responsibility for the "span of control," which means

a) The number of employees under the supervisor.
b) The area of the institution that is under the supervisor.
c) The role responsibility the supervisor has for clients.
d) The area of control specified in the job description.