LEVEL II FINAL DISCUSSION QUESTIONS AND CORRECT
ANSWERS
When meeting the unique preoperative teaching needs of an older adult, the
nurse plans a teaching program based on the principle that learning:
A. Reduces general anxiety
B. Is negatively affected by aging
C. REQUIRES CONTINUED REINFORCEMENT
D. Necessitates readiness of the learner
C
Neurologic aging causes forgetfulness and slower response time; repetition increases
learning. Option A is a general principle applicable to all learning. The older adult has no
more difficulty learning than a younger person, although it may take longer. Option D is
a general principle applicable to all learning.
Which statement by the nursing assistant indicates a correct understanding of
the nursing assistant role?
A. "I will turn off clients' IVs that have infiltrated."
B. "I WILL TAKE CLIENTS' VITAL SIGNS AFTER THEIR PROCEDURES ARE
OVER."
C. "I will use unit written materials to teach clients before surgery."
D. "I will help by giving medications to clients who are slow in taking pills."
B
Monitoring vital signs after procedures is within the scope of a nursing assistant's role.
Options A,C,D is an intervention that should be performed by the RN or LVN, not UAP.
A state's nurse practice act does not allow a registered nurse (RN) to suture
wounds. The practitioner offers to teach the RN how to suture and tells the RN
that minor wounds may be sutured without supervision. The nurse should:
,A. REFUSE TO SUTURE THE WOUNDS
B. Follow the practitioner's instructions
C. Report the situation to the state board of nursing
D. Agree to suture wounds in the practitioner's presence
A
A state's nurse practice act is the ultimate source relative to a nurse's professional
practice; a nurse may not function outside of the legal definition of nursing practice.
Performing suturing, with or without supervision, conflicts with the state's nurse practice
act, and the nurse would be functioning outside the legal scope of nursing practice. The
state board of nursing does not have jurisdiction concerning this procedure.
A client is scheduled for surgery. Legally, the client may not sign the operative
consent if:
A. Ambivalent feelings are present and acknowledged
B. ANY SEDATIVE TYPE OF MEDICATION HAS RECENTLY BEEN GIVEN
C. A discussion of alternatives with two physicians has not occurred
D. A complete history and physical has not been performed and recorded
B
Sedation may interfere with the client's knowledge of the consent form. Many clients
face contradictory feelings regarding their impending surgery, but their consent is legal
unless they withdraw the consent. A second opinion is not required for a consent to be
legal. A complete history and physical examination are needed before surgery, but they
do not affect the legality of consent.
A day after an explanation of the effects of surgery to create an ileostomy, a 68-
year-old male client remarks to the nurse, "It will be difficult for my wife to care
for a helpless old man." This comment by the client regarding himself is an
example of Erikson's conflict of:
A. Initiative vs guilt
B. INTEGRITY VS DESPAIR
, C. Industry vs inferiority
D. Generativity vs stagnation
B
According to Erikson, poor self-concept and feelings of despair are conflicts manifested
in those who are older than 65 years of age. Option A is a conflicted manifested in early
childhood between 3 and 6 years of age. Option C is manifested during the ages from 6
to 11 years. Option D is manifested during middle adulthood, 45 to 65 years of age.
An 80-year-old female is admitted to the hospital because of complications
associated with severe dehydration. The client's daughter asks the nurse how her
mother could have become dehydrated because she is alert and able to care for
herself. The nurse's best response is:
A. "The body's fluid needs decrease with age because of tissue changes."
B. "Access to fluid may be insufficient to meet the daily needs of the older adult."
C. "Memory declines with age, and the older adult may forget to ingest adequate
amounts of fluid."
D. "THE THIRST REFLEX DIMINISHES WITH AGE, AND THEREFORE THE
RECOGNITION OF THE NEED FOR FLUID IS DECREASED."
D
For reasons that are still unclear, the thirst reflex diminishes with age, and this may lead
to a concomitant decline in fluid intake. There is no data to support option A. Option B is
not true for an alert person who is able to perform the activities of daily living. In option
C, research does not support progressive memory loss in normal aging as a contributor
to decreased fluid intake.
A 90-year-old female resident of a nursing home falls and fractures the proximal
end of her right femur. The surgeon plans to reduce the fracture with an internal
fixation device. The general fact about the older adult that the nurse should
consider when caring for this client is that:
A. Aging causes a lower pain threshold
B. PHYSIOLOGICAL COPING DEFENSES ARE REDUCED
ANSWERS
When meeting the unique preoperative teaching needs of an older adult, the
nurse plans a teaching program based on the principle that learning:
A. Reduces general anxiety
B. Is negatively affected by aging
C. REQUIRES CONTINUED REINFORCEMENT
D. Necessitates readiness of the learner
C
Neurologic aging causes forgetfulness and slower response time; repetition increases
learning. Option A is a general principle applicable to all learning. The older adult has no
more difficulty learning than a younger person, although it may take longer. Option D is
a general principle applicable to all learning.
Which statement by the nursing assistant indicates a correct understanding of
the nursing assistant role?
A. "I will turn off clients' IVs that have infiltrated."
B. "I WILL TAKE CLIENTS' VITAL SIGNS AFTER THEIR PROCEDURES ARE
OVER."
C. "I will use unit written materials to teach clients before surgery."
D. "I will help by giving medications to clients who are slow in taking pills."
B
Monitoring vital signs after procedures is within the scope of a nursing assistant's role.
Options A,C,D is an intervention that should be performed by the RN or LVN, not UAP.
A state's nurse practice act does not allow a registered nurse (RN) to suture
wounds. The practitioner offers to teach the RN how to suture and tells the RN
that minor wounds may be sutured without supervision. The nurse should:
,A. REFUSE TO SUTURE THE WOUNDS
B. Follow the practitioner's instructions
C. Report the situation to the state board of nursing
D. Agree to suture wounds in the practitioner's presence
A
A state's nurse practice act is the ultimate source relative to a nurse's professional
practice; a nurse may not function outside of the legal definition of nursing practice.
Performing suturing, with or without supervision, conflicts with the state's nurse practice
act, and the nurse would be functioning outside the legal scope of nursing practice. The
state board of nursing does not have jurisdiction concerning this procedure.
A client is scheduled for surgery. Legally, the client may not sign the operative
consent if:
A. Ambivalent feelings are present and acknowledged
B. ANY SEDATIVE TYPE OF MEDICATION HAS RECENTLY BEEN GIVEN
C. A discussion of alternatives with two physicians has not occurred
D. A complete history and physical has not been performed and recorded
B
Sedation may interfere with the client's knowledge of the consent form. Many clients
face contradictory feelings regarding their impending surgery, but their consent is legal
unless they withdraw the consent. A second opinion is not required for a consent to be
legal. A complete history and physical examination are needed before surgery, but they
do not affect the legality of consent.
A day after an explanation of the effects of surgery to create an ileostomy, a 68-
year-old male client remarks to the nurse, "It will be difficult for my wife to care
for a helpless old man." This comment by the client regarding himself is an
example of Erikson's conflict of:
A. Initiative vs guilt
B. INTEGRITY VS DESPAIR
, C. Industry vs inferiority
D. Generativity vs stagnation
B
According to Erikson, poor self-concept and feelings of despair are conflicts manifested
in those who are older than 65 years of age. Option A is a conflicted manifested in early
childhood between 3 and 6 years of age. Option C is manifested during the ages from 6
to 11 years. Option D is manifested during middle adulthood, 45 to 65 years of age.
An 80-year-old female is admitted to the hospital because of complications
associated with severe dehydration. The client's daughter asks the nurse how her
mother could have become dehydrated because she is alert and able to care for
herself. The nurse's best response is:
A. "The body's fluid needs decrease with age because of tissue changes."
B. "Access to fluid may be insufficient to meet the daily needs of the older adult."
C. "Memory declines with age, and the older adult may forget to ingest adequate
amounts of fluid."
D. "THE THIRST REFLEX DIMINISHES WITH AGE, AND THEREFORE THE
RECOGNITION OF THE NEED FOR FLUID IS DECREASED."
D
For reasons that are still unclear, the thirst reflex diminishes with age, and this may lead
to a concomitant decline in fluid intake. There is no data to support option A. Option B is
not true for an alert person who is able to perform the activities of daily living. In option
C, research does not support progressive memory loss in normal aging as a contributor
to decreased fluid intake.
A 90-year-old female resident of a nursing home falls and fractures the proximal
end of her right femur. The surgeon plans to reduce the fracture with an internal
fixation device. The general fact about the older adult that the nurse should
consider when caring for this client is that:
A. Aging causes a lower pain threshold
B. PHYSIOLOGICAL COPING DEFENSES ARE REDUCED
