Gerontological Nursing

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 length of time a person can be predicted to live is called:

a) Life span
b) Life expectancy
c) Age identity
d) Ageism

2. Medicare Advantage Prescription Drug Plan is also known as Medicare Part _________.

a) A
b) B
c) C
d) D

3. The number one chronic condition affecting the population aged 65 and over is:

a) Heart disease
b) High blood pressure
c) Varicose veins
d) Arthritis

4. Less than 5 % of the older population is in a nursing home, assisted living community or other institutional setting at any given time.

a) true
b) false

5. The study of the connection between aging and disease processes are termed:

a) Wear and tear
b) Disposable soma theory
c) Biogerontology
d) Mutation accumulation theory

6. The primary organ(s) of the immune system is(are):
  1. Spleen
  2. Thymus
  3. White blood cells
  4. Bone marrow

a) 1
b) 2 and 3
c) 3
d) 2 and 4
e) 1 and 4

7. The _________ theory views older adults as a group with distinct norms, beliefs, expectations, habits and issues that separate them from the rest of society.

a) Disengagement
b) Subculture
c) Activity
d) Continuity

8. One of the developmental tasks of later life according to Robert Butler and Myrna Lewis (1982)is to:

a) Develop psychological pleasures
b) Share life experiences
c) Accept the meaning of life
d) Prepare for death

9. By _________, one quarter of America's older population will belong to a minority racial or ethnic group.

a) 2015
b) 2020
c) 2025
d) 2050

10. A blunted nocturnal response in the black American population results in:

a) Heart disease
b) Strokes
c) Hypertension
d) Cancer

11. A disease uncommon among Native Americans at the start of the 20th century, now affects Native Americans 2.3 times as much as white Americans:

a) Obesity
b) Stroke
c) Hypertension
d) Diabetes

12. It is not difficult to detect overt ageism in our society.

a) true
b) false

13. In this phase a somewhat euphoric period begins, a "honeymoon period" in which fantasies from the preretirement phase are tested:

a) Reorientation phase
b) Retirement routine phase
c) Disenchantment phase
d) Retirement phase

14. Body shrinkage due to reduced hydration, loss of cartilage and thinning of the vertebrae all contribute to:

a) Fractures and brittle bones
b) A stature decrease
c) Slight flexure of the wrist and hip
d) A decrease in bone mass

15. Short-term memory lasts from 30 seconds to 30 minutes.

a) true
b) false

16. In _________, performance also can be compared with best practices or industry averages through a process of benchmarking.

a) Meta-analysis
b) Cost-analysis

17. The major role played by nurses is that of a(n):

a) Caregiver
b) Educator
c) Advocate
d) Innovator

18. The goal of holistic care is:

a) Treat disease
b) Coordinate theories
c) Serve the needs of the total person
d) Maintain a physical balance

19. Which of the following must be present for malpractice to exist:
  1. False imprisonment
  2. Duty
  3. Negligence
  4. Invasion of privacy
  5. Injury

a) 1, 3, and 4
b) 3 and 5
c) 1 and 2
d) 2 and 4
e) 2, 3, and 5

20. This document appoints a person selected by the patient to make decisions on the patient's behalf should the patient be unable to make or communicate his or her decisions:

a) A living will
b) A durable power of attorney for health care

21. In this philosophy good acts are those from which the greatest number of people will benefit and gain happiness:

a) Egoism
b) Relativism
c) Utilitarianism
d) Absolutism

22. This principle states nurses should be truthful and respect our words and duty to patients:

a) Beneficence and justice
b) Fidelity and veracity
c) Autonomy and confidentiality

23. Supportive and preventative services support independent individuals in maintaining their self-care capacity so they can avoid physical, emotional, social, and spiritual problems.

a) true
b) false

24. Examples of partial and intermittent care services are:
  1. Home health care
  2. Financial services
  3. Housing
  4. Adult day services
  5. Respite care
  6. Transportation

a) 2, 3, and 6
b) 1 and 5
c) 2 and 6
d) 1, 4, and 5
e) 3 and 4

25. At the far end of the continuum of care are services such as:

a) Case management and day treatment
b) Assisted living and parish nurse programs
c) Hospital and nursing home care
d) Group homes and home monitoring

26. Holism begins with:

a) Good self-care practices
b) Making connections with other health-care professionals
c) Meditating
d) Having yearly check-ups

27. Andropause which is a decline in testosterone levels:
  1. Results in graying and loss of hair
  2. Does not occur in all men
  3. Is a slow process
  4. Can be reversed with hormones

a) 1 and 2
b) 2 and 3
c) 3 and 4
d) 2 only
e) 4 only

28. Sex is bad for a heart condition is an obstacle to a fulfilling sex life in old age.

a) true
b) false

29. Probably the most important spiritual need of all is:

a) Hope
b) Meaning and purpose
c) Love
d) Forgiveness

30. The Harris-Benedict equation is also called the:

a) Basal metabolic rate
b) Caloric Needs Index
c) Body Requirements Test
d) Resting Energy Expenditure

31. The guidelines for, "My Plate for Older Adults" limit foods high in:
  1. Carbohydrates
  2. Calcium
  3. Trans and saturated fats
  4. Salt
  5. Added sugars

a) 1 and 4
b) 2 and 3
c) 3, 4, and 5
d) 1, 3, and 5

32. Difficulty moving food from the esophagus into the stomach is called _________ dysphagia.

a) Transfer
b) Transport
c) Delivery

33. Falling asleep earlier in the evening and awakening earlier in the morning is a behavior referred to as:

a) Phase advance
b) Sleep latency
c) Circadian sleep-wake cycles
d) Sleep quality

34. Stress causes stimulation of the _________ gland, the release of adrenocorticotrophic hormone and an increase in the body's adrenaline supply.

a) Thyroid
b) Adrenal
c) Pituitary
d) Medulla oblongata

35. Chronic pain is pain that has been present for 6 months or longer.

a) true
b) false

36. This is a branch of physical medicine that uses physical therapy, joint manipulation, and postural correction:

a) Chiropractic
b) Naturopathy
c) Acupuncture
d) Osteopathy

37. The sixth leading cause of death in the older adult is:

a) Accidents
b) Pneumonia
c) Infections
d) Polypharmacy

38. The master healer color that gives a sense of well-being is:

a) Red
b) Purple
c) White
d) Green

39. The postfall syndrome is the fear of:

a) Loss of function
b) Intolerable pain
c) Falling again
d) Paralysis

40. Which of the following routes of drugs are not absorbed efficiently:
  1. Inhaled
  2. Oral
  3. Rectal
  4. Topical
  5. Intravenous
  6. Intramuscular

a) 1, 2, 3, and 4
b) 2 and 3
c) 4, 5, and 6
d) 2, 3, and 4
e) 2, 3, and 6

41. In 1991 Dr. Mark H. Beers published a paper that:

a) Listed side effects of antipsychotics
b) Discussed polypharmacy
c) Identified drugs that carry high risks for older adults
d) Gave examples of food and drug interactions

42. Enteric-coated and sustained release tablets can be crushed.

a) true
b) false

43. A full expiration is more difficult than inspiration for older individuals.

a) true
b) false

44. A basic, although extremely significant measure to promote productive coughing is:

a) Proper positioning
b) Cleaning the humidifier
c) Proper use of expectorants
d) Good fluid intake

45. The Reversal Diet:

a) Allows caffeine and other stimulants
b) Has no calorie restrictions
c) Suggests 20% of the calories from fat
d) Omits fast foods

46. In Class ___ of CHF, physical activity is significantly limited.

a) 1
b) 2
c) 3
d) 4

47. Based on researchers' findings, patients with chronic NSAID use who are hypertensive with coronary artery disease need to:

a) Avoid taking NSAIDs
b) Continue taking NSAIDs under a doctor's care
c) Take the lowest dose possible to control pain

48. When cleaning the teeth of an unconscious patient, the nurse should use:

a) Swabs
b) Lemon and glycerine sponges
c) Gauze dipped in mouthwash
d) A soft bristle toothbrush

49. Most patients with GERD have this type of hiatal hernia:

a) Rolling type
b) Sliding type

50. Incontinence is a normal consequence of aging.

a) true
b) false

51. The initial goal for incontinent individuals is to:

a) Identify the cause
b) Adhere to a toileting schedule
c) Review medications
d) Teach Kegel exercises

52. This type of gynecological cancer is the leading cause of death:

a) Breast cancer
b) Endometrial cancer
c) Vaginal cancer
d) Ovarian cancer

53. More than half of men over 70 years of age have histologic evidence of prostate cancer.

a) TRUE
b) FALSE

54. For most adults to exercise a muscle it should be done twice weekly:

a) With heavy weights
b) On a weight machine
c) And do 8 to 12 repetitions
d) Using one's own resistance

55. Sarcopenia is best defined as:

a) Decrease in muscle strength
b) Age-related loss of muscle mass
c) Demineralization of bones
d) Inability to do active ROM exercises

56. The progressive deterioration and abrasion of joint cartilage with the formation of new bone at the joint surfaces is:

a) Rheumatoid arthritis
b) Osteoporosis
c) Osteomalacia
d) Osteoarthritis

57. When cutting toenails, they should be:
  1. Cut even with the top of the toe
  2. Filed and not cut
  3. Cut straight across
  4. Soaked in warm water first
  5. Cleaned first with an orange stick

a) 3 and 4
b) 1 and 5
c) 2 and 4
d) 2 and 5
e) 1 and 3

58. The brain has a greater ability to compensate after injury than does the spinal cord, but the ability to compensate declines with age.

a) true
b) false

59. When performing a dysarthria assessment you ask the patient to pronounce "me, me, me" to test the:

a) Pharynx
b) Tongue
c) Lips

60. The first step in the management or correction of a hearing problem is through professional evaluation and a(n):

a) Inspection for cerumen
b) Weber Rinne test
c) Ability to hear a watch tick
d) Audiometric examination

61. Which of the following contributes to hearing impairment:
  1. Syphilis
  2. Hypertension
  3. Diabetes
  4. Hypothyroidism
  5. Arteriosclerosis

a) 1 and 2
b) 2 and 5
c) 2 only
d) 3, 4, and 5
e) 1, 3, and 4

62. Diabetics with the metabolic syndrome have which of the following:
  1. High triglycerides
  2. Low density lipoproteins
  3. Hemoglobin AlC greater than 8
  4. High cholesterol
  5. Central obesity

a) 1 and 3
b) 2 and 4
c) 2, 3, and 5
d) 1, 4, and 5
e) All but 5

63. One way to prevent a shearing force is to:

a) Not elevate the head of the bed more than 30 degrees
b) Turn every 2 hours
c) Use lamb's wool and heel protectors on bony prominences
d) Do ROM exercises to keep the tissues nourished

64. Which of the following foods have a positive effect on immunity:

a) Organ meats and fresh vegetables
b) Eggs and carbohydrates
c) Unsulfured molasses and garlic
d) Dairy products and fish

65. Research supports the belief that cranberry juice reduces urinary tract infections.

a) true
b) false

66. Influenza is acquired thru:

a) Direct contact with contaminated objects
b) Inhaling infected droplets

67. Complimentary and alternative medicine therapies are used by nearly half of all Americans and by more than % of people with cancer.

a) 95
b) 90
c) 85
d) 80

68. The symptoms of depression can mimic those of:

a) Delirium
b) Anxiety
c) Dementia
d) Suicide

69. Suicide rate is the highest among older:

a) White men
b) Native Americans
c) African American males
d) White women

70. The behavior is inappropriate and the patient may be unsteady on his or her feet. The patient has difficulty with coordinated movements. These are symptoms of:

a) Delirium
b) Dementia

71. The last step in chronic care coaching is to assist in setting realistic goals, developing plans, prioritizing and seeking resources.

a) true
b) false

72. Which of the following are symptoms of frailty:
  1. Limitation in fulfillment of role
  2. Self-care neglect
  3. Unplanned weight loss (10or more pounds in the past year)
  4. Low grip strength
  5. Fatigue, poor endurance

a) 2 and 4
b) 1, 2, and 3
c) 3, 4, and 5
d) 4 and 5

73. ____________ is one of the major complications older adults face intraoperatively and postoperatively.

a) Hypotension
b) Hypothermia
c) Infection
d) Hemorrhage

74. In the hierarchy of nursing home resident's needs, the holism level includes psychological, social and spiritual aspects.

a) true
b) false

75. A particular vulnerable group of caregivers are:

a) Grandchildren
b) Oldest son
c) Middle-aged daughters
d) A "significant other"

76. The goal of pain management is to:

a) Control the severity
b) Treat pain promptly when it occurs
c) Use alternatives first such as acupuncture, diversion, and hypnosis
d) Prevent pain from developing