Test Bank for Gerontological Nursing 3rd Edition by Tabloski

Test Bank Gerontological Nursing 3rd Edition Tabloski Gerontological Nursing, 3/eChapter 01 Question 1 Type: MCSA The nurse is preparing discharge instructions for an 84-year-old patient that includes plans for smoking cessation.The nurse believes that since the patient has been smoking for years, he isn't going to stop now. Which concept does this nurse's belief reflect? 1. Negative stereotyping 2. Character assessment 3. Reality orientation 4. Senescence Correct Answer: 1 Rationale 1: Often people characterize the elderly in a negative way, believing that after a certain age, thingscannot be changed. This is the concept of stereotyping in a negative way. Reference: Page 4 Rationale 2: Character assessment is not an identified concept of gerontology but is a process of identifyingaspects of an individual's personality and character. Reference: Page 4 Rationale 3: Reality orientation is not an identified concept of gerontology but is a strategy to assist individuals when confused or delusional. Reference: Page 4 Rationale 4: Senescence is the process of aging. Reference: Page 4 Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 3. Identify common myths of aging and their contribution to ageism. Question 2 Type: MCMA The nurse is planning to conduct a blood pressure screening at a local senior citizen's high-rise apartment building in the inner-city impoverished location. What are characteristics of the residents living in this location? Standard Text: Select all that apply. 1. Older women 2. Married men and women 3. Widowed women 4. Less educated women 5. Residents living alone Correct Answer: 1,3,4,5 Rationale 1: Women now comprise the majority of the older population and in the United States, women outnumber men. Reference: Page 7 Rationale 2: In the United States, women outnumber men and the ratio of men to women over the age of 65 is 49 men to every 100 women. Reference: Page 7 Rationale 3: Since the life expectancy of men in the United States is less than that of women, the majority of the residents will most likely be widowed. Reference: Page 7 Rationale 4: Older women are more likely to be less educated and have fewer years of labor experience, making older women more likely to live in poverty. Reference: Page 7 Rationale 5: Since older women are more likely to be widowed, they are more likely to live alone. Reference: Page 7 Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 1. Interpret demographic data according to race, gender, and age. Question 3 Type: MCSA While completing an admission assessment, the nurse learns that a female adult patient has smoked one pack/day for 20 years and works at a chemical plant. From this information, what is this patient at risk for developing? 1. Decreased fertility 2. Increased life expectancy because she is female 3. No difference in risk because of social and occupational circumstances 4. Environmental and occupational hazards that may affect life expectancy Correct Answer: 4 Rationale 1: Given the limited information on the chemical exposures, it is inconclusive to consider any effect on fertility. Reference: Page 8 Rationale 2: If women begin to approach the rates of tobacco and face the same environmental hazards as men, the gender gap in life expectancy may narrow. Reference: Page 8 Rationale 3: If women begin to approach the rates of tobacco and face the same environmental hazards as men, the gender gap in life expectancy may narrow. Reference: Page 8 Rationale 4: Exposure to environmental and occupational risk factors has been known to affect life expectancy in men and will have the same effect on women given similar circumstances. Reference: Page 8 Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: 2. Relate leading causes of morbidity and mortality among older adults. Question 4 Type: MCSA An African American male patient has a blood pressure of 180/104 mm Hg. When asked about the blood pressure, the patient states that he is not on any medication and is unsure if the blood pressure level is unsafe. What should the nurse do? 1. Nothing since the blood pressure may not be accurate and does not need to be addressed 2. Initiate secondary prevention to prevent the progression of illness. 3. Nothing since this is normal for someone in the hospital 4. Reassess the blood pressure with the patient in a standing position. Correct Answer: 2 Rationale 1: There is no way of knowing if the patient's blood pressure is inaccurate. Even if it is not, the blood pressure should be measured again and addressed. Reference: Page 10 Rationale 2: One good strategy to control chronic illness and prevent progression and disability is to identify opportunities to diagnose and treat chronic illnesses. The nurse should initiate secondary prevention to prevent the progression of illness in the patient. Reference: Page 10 Rationale 3: This is not a normal blood pressure even if the patient is in the hospital. Reference: Page 10 Rationale 4: This is no evidence to support that this patient's blood pressure needs to be reassessed in the standing position. Reference: Page 10 Global Rationale: Cognitive Level: Analyzing Client Need: Physiological Integrity Client Need Sub: Reduction of Risk Potential Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 4. Describe the effects of chronic disease. Question 5 Type: MCSA An older patient is worried about the cost of healthcare and supplies now that he has been diagnosed with type 2 diabetes mellitus. How should the nurse respond to this patient's concerns? 1. "I believe that some parts of Medicare will cover preventative care, such as diabetes monitoring." 2. "You only need to check your blood sugar once a day, so the cost should not be too high." 3. "Don't worry. I don't think the total bill will be too much." 4. "I don't know anything about insurance." Correct Answer: 1 Rationale 1: At the current time, Medicare pays for a yearly wellness visit and routine physical examination. Medicare also covers diabetes screening and diabetes self-management training. Reference: Pages 10-11 Rationale 2: The patient may need to check the blood glucose level more than once a day. This statement would be inappropriate for the nurse to respond. Reference: Pages 10-11 Rationale 3: The patient is stating concern, so telling him not to worry or assuming that even one day of costs is affordable is inappropriate. Reference: Pages 10-11 Rationale 4: Stating that the nurse does not know anything about insurance is unacceptable. Changes in Medicare coverage occur on an ongoing basis and the nurse should keep track of these changes by visiting the Medicare website or calling the local Medicare office. Reference: Pages 10-11 Global Rationale: Cognitive Level: Applying Client Need: Psychosocial Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: 4. Describe the effects of chronic disease. Question 6 Type: MCMA The nurse is assessing an older female patient admitted to the hospital for generalized weakness and a cough. Which assessment findings would be considered normal changes related to aging? Standard Text: Select all that apply. 1. Elevated blood pressure 2. Needing to urinate every 3 hours 3. Needing to wear eye glasses for reading 4. Pulse rate 104 beats per minute and thready 5. Respiratory rate 22 per minute after walking a short distance Correct Answer: 2,3,5 Rationale 1: Even though the arteries stiffen with age, an elevation in blood pressure needs to be investigated and not assumed that it is a normal change related to aging. Reference: Page 17 Rationale 2: With aging, bladder capacity declines. Needing to urinate every 3 hours would be evidence of reduced bladder capacity. Reference: Page 17 Rationale 3: With aging, difficulty focusing up close would necessitate the need for reading glasses. This would be considered a normal change with aging. Reference: Page 17 Rationale 4: Even though the heart muscle thickens with age, a pulse rate of 104 and thready needs to be investigated and not assumed that it is a normal change related to aging. Reference: Page 17 Rationale 5: Maximum breathing capacity may decline by about 40% between the ages of 40 and 70. A respiratory rate of 22 per minute after walking a short distance can be considered a normal change related to aging. Reference: Page 17 Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 5. Contrast several major theories of aging. Question 7 Type: MCSA The family of an older male patient asks why the patient needs to be hospitalized for pneumonia when the youngest daughter had the same infection a few months ago and was treated at home. How should the nurse respond to the family?