NB 316 / NB 316 Exam 2 Gerontology | Questions with Answers | Download To Score A

NB 316 / NB 316 Exam 2 Gerontology | Questions with Answers Exams 2 1. The nurse is attempting to justify the need for education in cultural competence in the health care venue. Which of the following statements accurately reflects the need for nurses to be culturally competent? A) Life expectancies among minorities are expected to increase while those among non-minorities are expected to decrease. B) Government and health care organizations have ignored the need for culturally appropriate care. C) The proportion of health care consumers who are minorities will increase significantly in the future. D) Nurses have a moral obligation to achieve cultural competency with all cultural groups. 2. The nurse is beginning a new job in an area with a large African American population. Which of the following statements recognized by the nurse best captures a characteristic of African Americans? A) Older African Americans are more likely than other Americans to live alone. B) Female-headed households are common among African Americans. C) African Americans have a more positive subjective self-perception of health than do other Americans. D) Lifestyle and risk factors account for the differences in health between African Americans and other Americans. 3. The nurse has observed an increasing number of Asian patients in the hospital. Which of the following statements is true of older Asian Americans? A) Chinese and Japanese Americans are likely to be recent immigrants to the United States. B) Health is often viewed as a state of physical and spiritual harmony. C) Older Asian Americans are more likely than other Americans to live alone. D) Care of elders is commonly provided in institutional environments such as nursing homes. 4. The nurse's colleague states, “Older people who live in the country are a lot healthier than city folk.” How can the nurse respond most accurately to this statement? A) “The differences aren't large, but rural adults do have better health outcomes than do city dwellers.” B) “But chronic conditions are more common among rural adults.” C) “Overall, yes. Higher levels of family support translate into longer average life spans for rural adults.” D) “Unfortunately, no. And this is mostly attributable to the problem of homelessness.” 5. The nurse realizes the need to educate a colleague when the colleague states the following: A) “I know that the consequences of racism are still present and they're linked to health disparities.” B) “I'm sure the percentage of patient-care hours that we spend working with minority patients is bound to increase.” C) “There's a huge amount of diversity within the group that's labeled 'Asians and Pacific Islanders.'” D) “It's inaccurate to link the prevalence of particular diseases with particular minority groups.” 6. A nurse has recently begun to provide care to older adults in a large, urban hospital. Having lived until recently in an ethnically homogenous region, the nurse has begun to recognize the significant differences in priorities and perspectives of patients from other cultural groups and has taken action to learn about these groups. What stage of cultural self-assessment is this nurse demonstrating? A) Unconscious incompetence B) Conscious incompetence C) Conscious competence D) Unconscious competence 7. A nurse's colleague has recommended that the nurse read up on some of the more common cultural groups in the area. How should the nurse interpret information that is available about cultural groups in the United States? A) Cultural generalizations can be useful and accurate, but they do not replace individualized assessment and care. B) It is simplistic and problematic to make generalized claims about members of a particular cultural group. C) Characteristics of cultural groups are normally consistent between every member of that group. D) It is unjust to categorize individual patients as being members of a specific cultural group. 8. Following knee replacement surgery 10 days earlier, a 79-year-old woman has been diagnosed with an infection in the knee. A sample of synovial fluid has been cultured in order to determine the causative microorganism and to select an appropriate antibiotic. This course of events characterizes what major health belief system? A) Magico-religious paradigm B) Holistic paradigm C) Scientific (biomedical) paradigm D) Analytical paradigm 9. A nurse has identified several practice improvements that will promote culturally competent care. Performing a thorough and reflective cultural self-assessment will result in which of the following outcomes for the nurse? A) Identification of the flaws and weaknesses of the nurse's own culture B) An accurate ranking of different cultures according to their specific merits C) The ability to assess patients according to their cultural affiliation rather than individual characteristics D) A progression from judgmental views of other cultures to a recognition of positive attributes 10. The nurse at a long-term care facility has completed the admission assessment of a 79-year-old male resident. The resident has identified himself as gay and has expressed sadness at having to leave his partner of several decades in order to move to the facility. The nurse should recognize that this resident is likely to have a history of A) homelessness. B) stigmatization. C) nominal employment or unemployment. D) infectious diseases. 1. The nurse is using the Functional Consequences Theory as a lens for planning patient care in a health care facility. The nurse recognizes that which of the following is an element of this nursing theory? A) Most problems affecting older adults may be attributed to age-related changes. B) Most functional consequences cannot be addressed through nursing interventions. C) Wellness is a concept that is broader than just physiologic functioning. D) The Functional Consequences Theory is a more comprehensive alternative to holistic nursing care. 2. The nurse is working with a 79-year-old female patient with a diagnosis of osteoporosis. Which of the following interactions best exemplifies the nurse's understanding of the relationship between age- related changes and risk factors? A) The nurse performs strength and mobility training appropriate to the patient's age and diagnosis. B) The nurse teaches the patient about bone density in older women and the role of vitamin D and calcium intake. C) The nurse plans interventions in light of the body-mind-spirit interconnectedness of the patient. D) The nurse teaches the patient about how her risk factors are a consequence of age. 3. The nurse is teaching a colleague about the difference between age-related changes and risk factors. Which of the following examples best demonstrates an age-related change? A) An older adult with a diagnosis of diabetes mellitus B) An older adult who is obese C) An older adult with obstructive lung disease D) An older adult with decreased bowel motility 4. The nurse is differentiating between an 81-year-old patient's age-related changes and his risk factors for disease. Which of the following characteristics of the patient would the nurse consider as a risk factor? A) Chronic bronchitis B) Loss of bone density C) Decreased vital lung capacity D) Delayed gastric emptying 5. The nurse is identifying positive functional consequences as part of the development of an older patient's care plan. Which of the following statements best captures the concept of positive functional consequences? A) They are synonymous with functional assessment. B) They are the result of conscious intent. C) They are not outcomes of age-related changes. D) They result from automatic actions or purposeful interventions. 6. The Functional Consequences Theory accounts for the important role that each of the domains of nursing play in the wellness of older adults. Which of the following situations best demonstrates the effect of environment on the older adult? A) A resident of a care facility experiences a fall because there are not grab bars outside his bathtub. B) A hospital patient develops Clostridium difficile-related diarrhea because a care provider did not perform adequate hand-washing. C) A man cannot afford a wheeled walker and suffers a fall while trying to mobilize using his cane. D) A woman develops emphysema as a result of her 70 pack-year history of cigarette smoking. 7. The Functional Consequences Theory can be applied to promote wellness in older adults in diverse settings. Which of the following examples demonstrates this application? A) Organizing an interdisciplinary meeting to discuss the available treatment options for an older adult with an acute illness B) Facilitating early mobilization to prevent muscle wasting and loss of function in an older hospital patient C) Deferring the final decision regarding an older man's choice of assisted living facility to the man's son and daughter D) Placing a 76-year-old woman on the waitlist for a kidney transplant 8. A nurse is aware that addressing issues related to connectedness and quality of life is central to the Functional Consequences Theory. Which of the following actions is most likely to enhance the older adult's connectedness? A) Teaching a patient who has had a below-the-knee amputation how to care for his stump B) Organizing a client's intravenous antibiotic therapy on an outpatient basis C) Performing a focused respiratory assessment on a client who has a diagnosis of lung cancer D) Changing a policy so that a husband and wife can remain in the same room of a care facility 9. A nurse who provides care for older adults in a long-term care setting is aware of the importance of maintaining residents' connectedness to society. How can this aspect of quality of life be best achieved? A) Ensuring that there are multiple television sets available to residents of the facility B) Arranging regular visits by school children to the facility C) Conducting reminiscence therapy D) Allowing residents to have input into the meal planning at the facility 10. A 79-year-old man is dismayed that his driver's license will not be renewed, an action that his primary care provider states is a result of his loss of visual acuity and increased reaction time. This man is experiencing the consequences of A) risk factors. B) age-related changes. C) positive functional consequences. D) wellness outcomes. 1. A 77-year-old man was put on broad-spectrum antibiotics when he was hospitalized for sepsis. He has a history of rheumatoid arthritis and a recurring problem with pneumonia. Which of the following theories best explains why he has had these concerns? A) Apoptosis theory B) Neuroendocrine theory C) Immunity theory D) Genetic theory 2. Until recently, a 77-year-old woman lived alone in her own home. Her younger sister assisted her with grocery shopping, and they would occasionally have lunch together. Recently, the woman fell on some ice and fractured her ankle. Her orthopedic surgeon and her case manager have obtained for her a short-term placement in a long-term care facility for rehabilitation physical therapy. After the patient's physical therapy is finished and her ankle is healed, the patient tells her nurse that she wants to stay at the facility; she is very happy living there and likes the social interaction that she experiences there. Which of the following theories of aging best describes the status of this patient? A) Activity theory B) Person–environment fit theory C) Life-course theory D) Theory of thriving 3. Which of the following statements best explains the relevance of psychological theories for gerontological nursing? A) Human needs theory allows the nurse to determine priorities of nursing care for older adults. B) Life-span development theories support the belief that it may be difficult to initiate behavioral changes in older adults. C) Psychological theories explain why nurses should focus their discussion more on the present than on the past when talking with older adults. D) Psychological theories explain why reminiscence groups may not be beneficial for older adults. 4. A 55-year-old adult female patient recently learned she has type 2 diabetes. She does water aerobics three times a week, has completed a diabetes education class, and does blood glucose monitoring herself. Her blood sugar and hemoglobin A1c have improved and she has lost weight. Which of the following statements best describes this patient's actions? A) Age stratification theory B) Life-course development C) Compression of morbidity D) Longevity and senescence theory 5. You are asked by the son of an 81-year-old patient about vitamins, antioxidants, and age-related macular degeneration. Which of the following theories of aging will help you most when responding to him? A) Immunity theory B) Wear-and-tear theory C) Free radicals theory D) Nonstochastic theory 6. A group of nurses is involved in the planning and implementation of a health promotion campaign that is aimed at older adults. Which of the following questions is the best guide to such a campaign? A) “How can we help older adults maintain wellness as they age?” B) “What can we do to increase life expectancy in our region?” C) “How can we help older adults avoid age-related changes? D) “What is stopping older adults from living longer lives?” 7. A gerontological nurse is aware that quality of life is an important consideration when assessing the functioning of older adults. What measure should the nurse use when appraising older adults' quality of life? A) Gerotranscendence B) Life expectancy C) Senescence D) Active life expectancy 8. A 74-year-old woman has recently begun integrating more fresh fruit and vitamin supplements into her diet in an effort to increase the levels of antioxidants in her body. This woman's actions indicate an understanding of what theory of aging? A) Cross-linkage theory B) Program theory of aging C) Immunosenescence D) Free radical theory 9. The subculture theory of aging has been proposed to explain some of the sociocultural aspects of the aging process. Which of the following characteristics of older adults is explained by the subculture theory? A) Older adults have little control over the biological effects of the aging process. B) Older adults have a decreased need for social interaction and peer support as they become older. C) Older adults may see their status with their peers in terms of economic achievement. D) Older adults may interact much more with other older adults than with members of other age groups. 10. A nurse is aware that many health care providers prioritize the role of biology in the aging process. What is a weakness of biologic theories of aging? A) Biologic theories do not account for the differences in life expectancy between males and females. B) Biologic theories are unable to explain the role of cell division in life expectancy and the aging process. C) Biologic theories of aging do not adequately address issues of wellness and quality of life. D) Biologic theories of aging are unable to explain the significant increases in life expectancy that occurred in the 20th century. 1. A nurse is leading a word-quiz game with a group of nursing home residents because the nurse knows this activity will assist the residents in maintaining A) Fluid intelligence B) Adaptive thinking C) Crystallized intelligence D) Psychomotor memory 2. A 69-year-old woman has recently been diagnosed with mild cognitive impairment and has asked the nurse to help her remember things better. Which of the following nursing diagnoses is appropriate for this older adult? A) Knowledge deficit B) Altered thought processes C) Health-seeking behaviors D) Altered health maintenance 3. A 70-year-old man tells his nurse that he is “worried that I'm losing his mind.” He reports that he has difficulty remembering names as well as he used to, and adds that he has missed two health care appointments in the past month because he forgot about them. The nurse initiates a memory training program for him, although the nurse has been unable to identify any risk factors that might affect the older adult's cognitive abilities. Which of the following questions is the best approach to evaluating the effectiveness of the memory training program? A) “Have you seen an improvement in your memory?” B) “Are you less worried about your memory now?” C) “How have the memory training techniques helped you?” D) “Are you using the memory training techniques now?” 4. Which of the following teaching methods is most appropriate for a 1-hour group health education program on nutrition for older adults? A) Limiting background noise and using a brightly colored Food Guide Pyramid B) Establishing a learning environment that is challenging and stimulating C) Giving the participants a handout and allowing them to take notes D) Using an overhead projector to list nutritional requirements for older adults 5. Which of the following points should the nurse emphasize when educating older adults about memory and cognition? A) Long-term memory loss is normal. B) Using calendars, notes, and imagery can help enhance memory. C) Drinking caffeinated beverages for mental stimulation is a good idea. D) Having a diminished capacity for learning is an inevitable part of growing older. 6. A 54-year-old woman has brought her father to an appointment at a community clinic because of his increasingly frequent lapses in memory. What assessment question is most likely to identify his potential risk factors for impaired cognitive functioning? A) “What did your mother and father die of?” B) “What line of work were you in?” C) “What medications are you currently taking?” D) “Where are you currently living?” 7. A 74-year-old man is distraught at the fact that he recently forgot an important appointment as well as lost his wallet. The man has always prided himself in being intelligent, alert, and informed, so even minor lapses in cognition are a source of stress. How should the man's nurse best interpret these recent deficits in memory? A) The man is likely experiencing the early stages of Alzheimer disease. B) The man is likely experiencing a temporary state of delirium that will self-resolve. C) The man may be experiencing age-related changes in personality. D) The man may be experiencing benign senescent forgetfulness. 8. A nurse leads a reminiscence session each Monday afternoon at a long-term care facility. Why does storytelling hold the potential for a positive impact on the cognition of older adults? A) Storytelling is a therapeutic distracter from daily stressors that negatively impact cognition. B) Creative activities can positively benefit the structure, and thus function, of the brain. C) Creative arts and storytelling provide accurate assessment data on which appropriate care can be based. D) Reminiscence therapy promotes social interaction and relieves symptoms of dementia and delirium. 9. A nurse who provides care in a long-term care setting is aware that the cognitive function of older adults does not necessarily decline on an inevitable trajectory. What action has the greatest potential to enhance the cognitive function of residents and prevent cognitive declines? A) Encourage older adults to openly express their emotions and opinions. B) Provide residents with four or five low-fat, high-protein meals during the day. C) Encourage older adults to participate in mentally stimulating activities. D) Present older adults with numerous opportunities to make autonomous decisions. 10. Mrs. Terence, age 82, lives with a number of health problems, including type 2 diabetes and chronic venous ulcers. Despite these challenges, she has confided in the nurse that she feels more satisfied with her life now than when she was a younger woman. Mrs. Terence is exemplifying what phenomenon? A) Metamemory B) The paradox of well-being C) Crystallized intelligence D) Neuroplasticity 1. A 75-year-old woman who often used to go out to dinner with her friends has stopped from going out because she has been experiencing urinary incontinence and is afraid of having an “accident” in public. When her daughter asks her why she doesn't go out with her friends anymore, she says, “I'm getting too old for such foolishness.” Her daughter asks her to go to the doctor for an evaluation, but she refuses to do so. Which of the following is occurring with this older adult? A) She is experiencing learned helplessness and low self-efficacy. B) She sees incontinence as an inevitable consequence of aging. C) She views her incontinence as a negative functional consequence of growing old. D) She is unable to find a doctor who is sympathetic and willing to find a solution. 2. An older woman returns to her hospital room after abdominal surgery. As the nurse completes her assessment, the patient asks the nurse to pin her “prayer cloth” to her pillow. Which of the following things should the nurse say or do first? A) Say, “I will pin it on your pillow in a couple of hours after you are stable.” B) Ask, “What is the purpose of a prayer cloth? Did you make it?” C) Ask, “What religion do you practice? Did your minister give the prayer cloth to you?” D) Pin the prayer cloth to her pillow since it is an essential part of her spiritual health. 3. Which of the following interventions can assist nursing home residents in promoting their psychosocial health? A) Planning dining room arrangements according to room and hall assignments B) Dressing residents exclusively for ease in going to and from the restroom C) Adapting the environment to compensate for residents' sensory impairments D) Positioning the residents who are in wheelchairs solely for ease in getting out of the dining area 4. A registered nurse is teaching a nursing assistant about the impact of culture on older adults' well-being. Which of the following statements by the nursing assistant indicates a need for further teaching? A) “A cultural background has little influence on individuals' standards for 'normal' or 'abnormal' behavior.” B) “Western cultures often have a very rigid distinction between health and illness.” C) “Culture may influence mental health and illness in individuals.” D) “Culture may determine an individual's expression of symptoms or clinical manifestations.” 5. Which of the following policies would promote a sense of control for an older adult in an assisted living facility? A) Holding resident council meetings twice monthly and inviting all residents to attend B) Posting a meal menu every Sunday and telling the residents that they must notify the kitchen in advance if they want a menu change C) Designing all the emergency pull cords so they blend in with the wallpaper and are inconspicuous D) Teaching the nurses' aides to use the passkey to do spot checks on every resident at least twice during the night to ensure that the residents are safe 6. A nurse who works with older adults recognizes that late adulthood is a time of life that is characterized by a number of significant life events. What psychosocial consequences occur because of life events that are common in late adulthood? (Select all that apply) A) A broadening of social networks B) Adjusting to relocation from home C) Adjustment to a lower income D) Adaptation to chronic illnesses E) Coming to terms with one's mortality 7. A 69-year-old woman is saddened by her recent diagnosis of type 2 diabetes, as stressor that will make numerous demands on her life in the coming years. Which of the following actions demonstrates a problem-focused approach to this stressor? A) Eliciting support and sympathy from her sister and neighbor B) Obtaining diabetic cookbooks and learning to change her cooking habits C) Seeking out a second opinion from another physician D) Determining to make no lifestyle changes despite her new diagnosis 8. A nurse on a subacute, geriatric medicine unit is aware that patients' levels of psychosocial functioning have a significant impact on multiple aspects of their lives. Which of the following consequences is known to result from impaired psychosocial function? A) Anxiety B) Elevated blood glucose level C) Increased independence D) Cerebrovascular accident (stroke) 9. A nurse who manages the care in a nursing home has organized a Health Aging Class for residents. Which activity should be prioritized during these classes? A) The nurse teaches skills and tools that they can use to develop better psychosocial health. B) Participants role-play their responses to life events that may occur in their near future. C) The nurse assesses group members' strategies around dealing with life events. D) Participants share their experiences around dealing with psychosocial changes. 10. A nurse is responsible for leading a Healthy Aging Class at a community health center. What question should the nurse use to generate discussion among participants in this setting? A) “How did you adjust to your move from your house to the assisted living facility Irma?” B) “Are you satisfied with the care that you're getting from your family doctor, Elizabeth?” C) “Donald, could you tell us why your grandson is living with you?” D) “Have you had any tests done on your heart since we last met, Marie?” 1. The nurse is responsible for performing a psychosocial assessment of an older adult living in the community. Which of the following statements best captures the nature of psychosocial assessment? A) It is a formalized psychological test of the individual's condition and needs. B) It aids in identifying and analyzing personality traits of the individual. C) It helps to identify the individual's need for psychiatric care. D) It is a component of holistic nursing care of older adults. 2. While the nurse is performing a recently admitted hospital patient's morning care, the patient states, “I'm pretty sure I'll never see my own apartment again.” Which of the following responses by the nurse best demonstrates effective communication? A) “What is it that makes you feel that way, ma'am?” B) “I'm sure that's not going to be the case.” C) “All in all, you're doing quite fine actually.” D) “There's a lot that we can do, dear, to make sure that you do.” 3. The nurse recognizes the need to assess the patient's abstract thinking. Which of the following questions is most useful in the assessment of a patient's abstract thinking ability? A) “Do you know why you are in hospital right now?” B) “What do a dog and a cat have in common?” C) “What goals do you have for your treatment and recovery?” D) “What would you do if you found a stamped, addressed letter on the ground?” 4. The nurse recognizes that many formal, public social supports go underutilized. Which of the following factors most contributes to the low rate of use of social supports by older adults? A) There are many misperceptions of these programs by older adults. B) Service programs are not eligible for public funding. C) The quality of care in public service programs is frequently substandard. D) Having available friends and family disqualifies an older adult from public services. 5. The nurse has excluded a spiritual assessment component from the larger psychosocial assessment of a patient. What is the most justifiable rationale the nurse could give for excluding spiritual assessment? A) “Because nurses are not skilled at meeting spiritual needs, it is not a valid area of assessment.” B) “Spirituality is a deeply private matter that is best left for the patient to initiate.” C) “Sufficient data on a patient's spiritual beliefs can be extrapolated from his or her ethnicity and background.” D) “A spiritual assessment is not always relevant to the health issues at hand, especially in high- acuity situations.” 6. A nurse is conducting a comprehensive psychosocial assessment of a woman who has recently moved to the long-term care facility. How should the nurse best assess the woman's motor function? A) Observe the woman as she walks into or out of the room. B) Assess the woman's deep tendon reflexes using a hammer. C) Perform passive range of motion exercises on the woman's arms and legs. D) Position the woman supine and ask her to perform a leg lift with each leg separately. 7. A nurse is aware of the high incidence and prevalence of cognitive deficits among older adults, and consequently prioritizes the assessment of clients' orientation. What strategy should the nurse use in this domain of psychosocial assessment? A) Ask the client his or her name, location, and the time of day. B) Have a broad discussion with the client around his or her geographic and temporal context. C) Have a conversation with the client about his or her perceived challenges to cognitive functioning. D) Ask whether the client believes himself or herself to be fully oriented. 8. A psychosocial assessment addresses many dimensions of an older adult's present reality. Which of the following statements may suggest that an older adult in the hospital may be experiencing low self- esteem? A) “I don't know who's going to take care of my husband while I'm in the hospital.” B) “I used to be the kind of person who was completely independent until not that long ago.” C) “When I was younger, I worked around the clock and now I can't even make it to the toilet.” D) “I'm worried about what's going to happen once I get out of here.” 9. Mrs. Holt, age 89, is a resident of a nursing home who has recently accused several members of the care staff of repeatedly stealing jewelry and cash from her overbed table despite the fact that the facility's policy requires residents to keep such valuables in locked storage outside of residents' rooms. The nurse has responded empathically to Mrs. Holt's accusations and has explained why this is impossible, to no avail. The nurse would recognize the potential that this resident is experiencing A) delusions. B) depression. C) unresolved anger. D) illusions. 10. A psychosocial assessment addresses many dimensions of an older adult's present reality. What question may a nurse ask to gauge a client's insight? A) “Where would you go if you were discharged from the hospital today?” B) “How would you spend $100 if you were given it today?” C) “What are the similarities between a tree and a flower?” D) “Why do you think that your doctor admitted you to the hospital?” 1. Which of the following is a priority nursing intervention for the management of delirium? A) Giving the patient low-dose oxygenation and maintaining his or her fluid and electrolyte balance B) Reducing noise and placing familiar objects in the patient's environment C) Giving the patient a clock, a watch, and calendars to provide the patient with temporal orientation. D) Providing psychological support through cognitive and social stimulation 2. A nurse is conducting a class at a senior citizens' center on factors that protect against dementia. Which of the following statements by an older adult in the class indicates a need for further teaching by the nurse? A) “Engaging in exercise will not help prevent symptoms of dementia.” B) “Taking vitamin C, vitamin E, and fish oil will help preserve my thinking processes.” C) “Engaging in social activities that have meaning to me will help prevent dementia.” D) “I've heard there are studies that now say the statin drugs help prevent dementia.” 3. Which of the following statements about cholinesterase inhibitors is true? A) Exelon (Rivastigmine) is more likely to interact with other drugs and may be poorly tolerated. B) Nausea, vomiting, diarrhea, and loss of appetite can be prevented or reduced by starting with a low dose. C) Galantamine (Reminyl) is effective only for behavioral symptoms with Alzheimer's and vascular dementia. D) Older adults should have a “drug holiday” with the cholinesterase inhibitors to improve their functioning. 4. Which of the following are examples of appropriate communication techniques for dealing effectively with people with dementia? A) Ask open-ended questions so the person feels he or she can make choices. B) For people in the later stages of Alzheimer's disease, talk as you would to a child. C) Maintain good eye contact and use a relaxed and smiling approach. D) When the person forgets something, remind him or her not to forget next time. 5. Which of the following interventions specifically facilitates performance of independent activities of daily living in an older adult with dementia? A) Using simple pictures, written cues, or color codes to identify items in the environment b Offering finger foods and nutritional snacks if the person will not sit at the dining table to eat C) Placing nonglossy, glare-free pictures of familiar people in very visible places in the older adult's environment D) Keeping the older person's environment free of clutter, and keeping medications and poisons in an inaccessible area 6. An 80-year-old man was referred to a neurologist after several months of worsening cognitive deficits and has subsequently been diagnosed with Alzheimer disease. Which statement by the nurse to the man's family demonstrates appropriate use of terminology? A) “It's very difficult and stressful when a loved one becomes senile.” B) “Even though your father is demented, we will do all we can to promote his quality of life.” C) “This form of organic brain syndrome is a common health problem in the ninth decade of life.” D) “We always try our best to foster wellness in persons who have dementia.” 7. Mr. Holdom was diagnosed 3 years ago with a cognitive impairment, a condition that worsened over the next several months and which culminated in his recent death. An autopsy revealed numerous infracted brain regions resulting from vessel occlusions. Mr. Holdom most likely suffered from which type of dementia? A) Alzheimer's disease B) Vascular dementia C) Lewy body dementia D) Frontotemporal dementia. 8. A long-time resident of an assisted living facility has just been diagnosed with Alzheimer's disease. A nurse who provides care at the facility has remarked to a colleague, “It's a real shame, but at least she'll never know what's happening to her.” What fact should underlie the colleague's response? A) Older adults with Alzheimer's disease and other dementias rarely have insight into their cognitive deficits. B) Many persons with dementia are acutely aware of the fact that they are experiencing a cognitive deficit. C) Certain types of dementia are occasionally marked by older adults' awareness of their disease. D) An awareness of dementia is an indication that the condition is either latent or resolving. 9. A gerontological nurse has been providing ongoing care for an older adult who has a diagnosis of dementia. What goal should the nurse prioritize when conducting ongoing assessment of this client? A) Identifying strategies that can be used to cure the client's dementia B) Identifying genetic or lifestyle factors that may have contributed to the client's dementia C) Determining whether the client has Alzheimer's disease, Lewy body dementia, frontotemporal lobe dementia, or vascular dementia D) Identifying factors affecting the client's functioning and quality of life 10. A nursing home is in the planning stages of building a new wing that will be specifically designed for the needs of older adults who have dementia. What design characteristic should be included in this new facility? A) Monochromatic walls and floors that are a neutral color B) Pictures, signs, and color codes for identifying places C) Bright, glossy floors that can provide sensory stimulation D) Bright lighting during the day and total darkness at night 1. A nurse is aware that the manifestations of depression in older adults may differ from those in younger people. Which of the following lists of symptoms indicate depression in the older adult? A) Decreased energy, dysphasia, anorexia, unresponsiveness to suggestions B) Vague fatigue, weakness, inconsistent and easily forgotten complaints C) Strong attempts to perform well, poor attention to task, labile affect D) Impaired perceptions, possible apathy, evasiveness, limited awareness of symptoms 2. The nurse is reviewing the side effects of antidepressants with a group of older adults. Which of the following statements by a member of the group indicates that the nurse's teaching has been effective? A) “Although effects of an antidepressant can be seen in 1 week, a fair trial of an antidepressant is 3 weeks.” B) “Fluoxetine should be given in the morning because it can cause agitation.” C) “I need to maintain my fluid intake while on antidepressant medication.” D) “The length of antidepressant treatment is usually 3 months for a first-time depression.” 3. Which of the following statements about depression and functional impairment is true? A) Hyperkalemia and hypocalcemia increase the older adult's risk for depression. B) Depression can lead to hip fracture and increase susceptibility to infection. C) Taking valsartan (Diovan) can increase the risk of an older adult having depression. D) Hypernatremia increases the older adult's risk for depression. 4. Which of the following statements is true about theories of late-life depression? A) The cognitive triad theory says that adverse events impair one's ability to appraise oneself. B) Depression is caused by decreased plasma cortisol levels and decreased activity of the hypothalamic-pituitary-adrenal axis. C) The learned helplessness theory can help identify factors that protect older adults from depression. D) Researchers have identified a specific cause-and-effect relationship between depression and dementia. 5. Which of the following questions would be appropriate for level 1 assessment of the immediate risk of suicide? A) “Under what circumstances would you take your life? Have you ever started to act on a plan to harm yourself?” B) “Do you have a plan for taking your life? What action would you take if you were to harm yourself?” C) “Does your life feel worthless? Do you ever think about escaping from your problems?” D) “Do you think about harming yourself? Do you ever think about taking your own life?” 6. A gerontological nurse is conducting an assessment of an older adult who has a history of depression. Assessment reveals that the client has been drinking up to two bottles of wine each day for the last several months. What should the nurse teach the client about alcohol use and depression? A) “If you choose to use alcohol to address your depression, it's best to limit it to four to five drinks each day.” B) “We recommend that everyone over the age of 70 abstains from drinking alcohol.” C) “Alcohol has been shown to contribute to depression and vice versa.” D) “If you quit drinking, your depression will likely improve.” 7. Mrs. Gaines has been accompanied by her daughter during her latest visit to her primary care provider. Her daughter has expressed concern about her mother's increasing apathy, isolation, and apparent sadness over the past several months, and Mrs. Gaines acknowledges many of the symptoms of depression. What assessment should Mrs. Gaines' care provider prioritize when attempting to identify the etiology of her depression? A) Functional assessment B) Medication assessment C) Musculoskeletal assessment D) Cardiovascular assessment 8. Which of the following statements by residents of a nursing home should prompt the nurse to assess for depression? A) “Lately I wake up for the day at 4:00 or 5:00 in the morning and can't fall asleep again.” B) “I've got these cravings for sugary and salty snacks more than I used to.” C) “I've never been too prone to headaches, but these days I always seem to have one.” D) “I don't know why this sore on my ankle just won't heal this time.” 9. A nurse who provides care on an acute care for elders (ACE) unit recognizes the high incidence and prevalence of depression among older adults. Which of the following statements represents the priority for follow-up and interventions? A) “I can't shake this feeling that I've got a cloud hanging over me these days.” B) “I feel like I've got no appetite these days and it takes everything in me just to eat a little meal.” C) “I used to be a powerhouse of energy when I was younger, and now all I can do is sit in a chair.” D) “I think it would be better for everyone if I wasn't here anymore.” 10. Mrs. Hernandez was diagnosed with depression shortly after relocating to the nursing home 6 weeks ago. What intervention should the nurse who is providing care for Mrs. Hernandez implement to address her depression? A) Teaching Mrs. Hernandez about the problem of suicide in older adults B) Providing opportunities for Mrs. Hernandez to engage with other residents C) Directing Mrs. Hernandez to list all the positive aspects of her present circumstances D) Appointing another resident as a “buddy” to accompany Mrs. Hernandez during the day