, NURS 3325 Holistic Care Older Adult
Test #1
1. A nurse assesses the risk of the members of an older adult community. Which
individuals is most likely to be living at or below the poverty line?
A couple who are both 72 years old
A Hispanic couple who are both in their 60s
A white 73-year-old man
An 83-year-old single woman
Rationale: Women and those over the age of 75 are most likely to live in poverty.
Couples and those 65 to 74 are less likely to live in poverty. Five percent of older
white men live in poverty.
2. A nurse care for an older adult client whose current hospital admission is prompted by
an exacerbation of chronic renal failure. Which action by the nurse will best emphasize
the goal of client wellness?
Teach the client that health problems do not have to affect daily routines
Ask that the client’s code status be changed to “do not resuscitate”
Explore the client’s abilities and strengths
Show the client others who are more ill
Rationale: A focus on existing strengths and abilities can foster wellness in older
adults, even when they are experiencing health challenges. It is inappropriate to
compare clients with each other, and changing client’s code status unlikely to
promote wellness, even if this is necessary. It is inaccurate to claim that health
problems do not affect daily routines.
3. A nurse assesses a community of older adults. Which person is at highest risk for a
shortened life expectancy?
A nurse born in 1957
A homemaker born in 1957
A college professional born in 1956
A nuclear engineer born in 1958
Rationale: Socioeconomic characteristics that are most strongly correlated with
healthy aging are poverty and lower educational level. Limited English proficiency
and poor health literacy skills are two variables that have a negative impact on
health and functioning. The college professor, engineer, and nurse positions
require more education that a homemaker.
, 4. A diabetes nurse is providing care for an older adult client who is a regular client of the
hospital’s outpatient diabetes clinic. What assessment question most clearly addresses
this client’s potential for optimal function?
“How can we help you to take ownership of your own health?”
“What are some goals that you have for maximizing your level of wellness?”
“Is there anything that you’re doing that might be exacerbating your diabetes?”
How long do you think that you’ll be able to live independently?”
Rationale: Eliciting and older adult’s goals for wellness and high functioning can
help promote these outcomes. Questions about a client’s living situation, disease
management, and personal responsibility may or may not promote wellness.
5. A nurse performs a reflective cultural self-assessment. Which outcome should the nurse
expect?
Progression from judgmental views of other cultures to recognition of positive
attributes
An accurate ranking of different cultures according to their specific merits
The ability to assess clients according to their cultural affiliation that their
individual characteristics
Identification of the flaws and weakness of the nurse’s own culture
Rationale: The process of cultural competence is a progression from judgmental
attitudes and practices to positive approaches. It does focus primarily on the
deficits of one’s own culture, and it does not replace individualized assessment
and care with cultural generalizations. Culturally competent care does not involve
“ranking” different cultures.
6. A nurse has observed an increasing number of older Asian Americans in the hospital.
Which statement regarding Asian cultures will best assist the nurse to plan nursing care
for this group?
Asian Americans view health as a state of physical and spiritual harmony
Older Asian Americans are more likely than Americans to live alone
Asian Americans as a group have lower mortality rates
Asian Americans commonly care for older adults by placing them in institutional
environments.
Rationale: While it is true that Asian Americans as a group have lower mortality
rates at all ages, the statement that best assists the nurse to plan care of the
Asian client is that a common view of health from the Asian perspective is that of
harmony in the spiritual and physical contexts. Asian Americans are less likely to
live alone. It is more common for older Asian Americans to live with family than
in nursing homes.
7. A nurse at a long-term care facility has completed the admission assessment of an older
adult resident. The resident identifies as gay and has expressed sadness at having to
leave the resident’s partners of several decades in order to move to the facility. The
nurse should recognize which in this individual’s history?
Test #1
1. A nurse assesses the risk of the members of an older adult community. Which
individuals is most likely to be living at or below the poverty line?
A couple who are both 72 years old
A Hispanic couple who are both in their 60s
A white 73-year-old man
An 83-year-old single woman
Rationale: Women and those over the age of 75 are most likely to live in poverty.
Couples and those 65 to 74 are less likely to live in poverty. Five percent of older
white men live in poverty.
2. A nurse care for an older adult client whose current hospital admission is prompted by
an exacerbation of chronic renal failure. Which action by the nurse will best emphasize
the goal of client wellness?
Teach the client that health problems do not have to affect daily routines
Ask that the client’s code status be changed to “do not resuscitate”
Explore the client’s abilities and strengths
Show the client others who are more ill
Rationale: A focus on existing strengths and abilities can foster wellness in older
adults, even when they are experiencing health challenges. It is inappropriate to
compare clients with each other, and changing client’s code status unlikely to
promote wellness, even if this is necessary. It is inaccurate to claim that health
problems do not affect daily routines.
3. A nurse assesses a community of older adults. Which person is at highest risk for a
shortened life expectancy?
A nurse born in 1957
A homemaker born in 1957
A college professional born in 1956
A nuclear engineer born in 1958
Rationale: Socioeconomic characteristics that are most strongly correlated with
healthy aging are poverty and lower educational level. Limited English proficiency
and poor health literacy skills are two variables that have a negative impact on
health and functioning. The college professor, engineer, and nurse positions
require more education that a homemaker.
, 4. A diabetes nurse is providing care for an older adult client who is a regular client of the
hospital’s outpatient diabetes clinic. What assessment question most clearly addresses
this client’s potential for optimal function?
“How can we help you to take ownership of your own health?”
“What are some goals that you have for maximizing your level of wellness?”
“Is there anything that you’re doing that might be exacerbating your diabetes?”
How long do you think that you’ll be able to live independently?”
Rationale: Eliciting and older adult’s goals for wellness and high functioning can
help promote these outcomes. Questions about a client’s living situation, disease
management, and personal responsibility may or may not promote wellness.
5. A nurse performs a reflective cultural self-assessment. Which outcome should the nurse
expect?
Progression from judgmental views of other cultures to recognition of positive
attributes
An accurate ranking of different cultures according to their specific merits
The ability to assess clients according to their cultural affiliation that their
individual characteristics
Identification of the flaws and weakness of the nurse’s own culture
Rationale: The process of cultural competence is a progression from judgmental
attitudes and practices to positive approaches. It does focus primarily on the
deficits of one’s own culture, and it does not replace individualized assessment
and care with cultural generalizations. Culturally competent care does not involve
“ranking” different cultures.
6. A nurse has observed an increasing number of older Asian Americans in the hospital.
Which statement regarding Asian cultures will best assist the nurse to plan nursing care
for this group?
Asian Americans view health as a state of physical and spiritual harmony
Older Asian Americans are more likely than Americans to live alone
Asian Americans as a group have lower mortality rates
Asian Americans commonly care for older adults by placing them in institutional
environments.
Rationale: While it is true that Asian Americans as a group have lower mortality
rates at all ages, the statement that best assists the nurse to plan care of the
Asian client is that a common view of health from the Asian perspective is that of
harmony in the spiritual and physical contexts. Asian Americans are less likely to
live alone. It is more common for older Asian Americans to live with family than
in nursing homes.
7. A nurse at a long-term care facility has completed the admission assessment of an older
adult resident. The resident identifies as gay and has expressed sadness at having to
leave the resident’s partners of several decades in order to move to the facility. The
nurse should recognize which in this individual’s history?
