(Test Bank) Basic Geriatric Nursing

Williams, 6

Nursing

Test Bank

6th Edition

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Test Bank for Basic Geriatric Nursing, The downloadable file consists of 172 pages, and the total size of the file is 1.72 MB. Purchase now only for highly discounted price.

Author(s): Williams

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MULTIPLE CHOICE 1. What fact explains the shift of health care focus toward the older adult in the late 1960s? a. Disability was viewed as unavoidable. b. Complications from disease increased mortality. c. Older adults’ needs are similar to those of all adults. d. Preventive health care practices increased longevity. ANS: D Increased preventive health care practices, disease control, and focus on wellness helped people live longer. DIF: Cognitive Level: Comprehension REF: p. 1 OBJ: 2 TOP: Aging Trends KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 2. To what age group does the term “aged” apply? a. 55–64 years of age b. 65–74 years of age c. 75–84 years of age d. 85 and older ANS: C The term aged refers to persons who are 75 –84 years of age. DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1 TOP: Age Categories KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 3. Which of the following is true of ageism? a. It is discrimination against persons solely on the basis of age. b. It causes a person to fear aging. c. It involves the use of cultural sensitivity to address concerns of aging. d. It focuses on resources for the older adult. ANS: A Ageism is a negative belief pattern that influences persons to discriminate against p ersons solely on the basis of age and can lead to destructive behaviors toward the older adult. DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: 3 TOP: Ageism KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 4. What is the most beneficial legislation that has influenced health care for the older adult? a. Medicare and Medicaid Test Bank for Basic Geriatric Nursing, 6e Patricia Williams (All Chapters) Chapter 01: Trends and IssuesTest Bankb. Elimination of the mandatory retirement age c. The Americans with Disabilities Act d. The Drug Benefit Program ANS: A The broadest sweeping legislation beneficial to the older adult is Medicare and Medicaid. The elimination of the mandatory retirement age does not apply to health care. The Americans with Disabilities Act deals with all Americans with disabilities, not just the older adult. The Drug Benefit Program was added to Medicare, but deals only with medications. DIF: Cognitive Level: Comprehension REF: pp. 15 -16 OBJ: 6 TOP: Legislation KEY: Nursing Process Step: Implementation MSC: NCLEX: N/A 5. What housing option for the older adult offers the privacy of an apartment with restaurant -style meals and some medical and personal care services? a. Government -subsidized housing b. Long -term care facility c. Assisted -living center d. Group housing plan ANS: C Assisted -living arrangements offer the privacy of an apartment or condominium with meals prepared and served, limited medical care, and a variety of personal services. DIF: Cognitive Level: Knowledge REF: p. 13 OBJ: 9 TOP: Housing Options KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The 75 -year-old man who has been hospitalized following a severe case of pneumonia is concerned about his mounting hospital bill and asks if his Medic are coverage will pay for his care. What would be the most helpful response by the nurse? a. Medicare Part C pays 50% of all medical costs for persons older than 65. b. Medicare Part B pays hospital costs and physician fees. c. Medicare Part A pays for inpatient hospital costs. d. Medicare Part D pays 80% of the charges made by physicians. ANS: C Medicare Part A pays inpatient hospital costs, Part B pays 80% of physi cian’s charges, and Part D helps defray prescription drug costs. Medicare Part C allows individuals to receive health insurance through private insurance companies and typically pays entire costs. DIF: Cognitive Level: Application REF: p. 15 OBJ: 6 TOP: Medicare Provisions KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 7. The daughter of a patient who has been diagnosed with terminal cancer asks whi ch documents are required to allow her to make health care decisions for her parent. Which response would provide the most information to the daughter? a. Advance directives indicate the degree of intervention desired by the patient. b. A ‘Do Not Resuscitate’ document signed by the patient transfers authority to the next of kin. c. A durable power of attorney for health care transfers decision -making authority for health care to a designated person. d. A living will transfers authority to the physician. ANS: C A durable power of attorney for health care transfers the authority for decision making to a designated person. An advance directive specifies the type of care an individual desires when he cannot speak for himself. The durable pow er of attorney is only one type of advance directive. A “Do Not Resuscitate” document states that the patient wishes to die naturally with no intervention. A living will prohibits the use of life -prolonging measures. DIF: Cognitive Level: Application REF: p. 18 OBJ: 11 TOP: Advance Directives KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 8. The daughter of a resident in a long -term care facility is frustrated with her 80-year-old mother’s refusal to eat. Which response would be the most appropriate? a. The refusal to eat is an effort to maintain a portion of independence and self-direction. b. The refusal to eat is an indication of approaching Alzheimer disease. c. The refusal to eat is an effort to gain attention. d. The refusal to eat is an indication of the dislike of the institutional food. ANS: A Loss of independence and control is a s ignificant issue for the older adult. Some residents will exercise whatever control they may retain. DIF: Cognitive Level: Application REF: p. 20 OBJ: 11 TOP: Loss of Independence KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 9. When do the conditions of a living will go into effect? a. When the patient declares that desire in writing b. When a family member indicates the desire for curative therapy to cease c. When two physicians agree in writing that the criteria in the living will have been met d. When the physician and a family member agree that the criteria in the living will have b een met ANS: C Two physicians must agree in writing that the criteria of the living will have been met before the document can go into effect. DIF: Cognitive Level: Comprehension REF: p. 18 OBJ: 11 TOP: Living Wills KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 10. In the 1980s, Medicare initiated a program of diagnosis -related groups (DRGs) to reduce hospital costs. How did the DRGs reduce hospital costs? a. By classifying various diagnoses as ineligible for hospitalization b. By allotting a set amount of hospital days and prospective payment on the basis of the admitting diagnosis c. By specifying particular physicians to treat specified diagnoses d. By using frequency of a particular diagnosis to set a payment schedule ANS: B DRGs set up a system of preset hospitalization time and payment on the basis of the admitting diagnosis. DIF: Cognitive Level: Comprehension REF: pp. 15 -16 OBJ: 6 TOP: DRGs KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 11. Which of the following facilities would be recommended for a patient who has had a hip replacement and needs physical therapy? a. Basic care facility b. Skilled care facility c. Subacute care facility d. Assisted -living residence ANS: B Skilled care facilities offer not only basic care but also services from trained licensed professionals such as nurses, physical therapists, speech therapists, and occupational therapists. DIF: Cognitive Level: Application REF: p. 15 OBJ: 9 TOP: Extended -Care Facilities KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 12. The 80 -year-old woman who is recovering from a stroke is being sent to a skilled care facility. She is concerned about the expense. The nurse can decrease anxiety by explaining that Medicare will cover extended -care facility costs for what period of time? a. A period of 30 days b. A period of 45 days for physical therapy c. A period of 100 days for needed skilled care d. Until she is able to be discharged home ANS: C Medicare will cover skilled care costs for 100 days. After 100 days, the resident must revert to private pay or ancillary long -term care insurance. DIF: Cognitive Level: Comprehension REF: p. 15 OBJ: 8 TOP: Extended Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care 13. Which senior citizen political action group uses volunteers and lobbyists to advance the interests of older adults? a. American Association of Retired Persons (AARP) b. National Council of Senior Citizens (NCSC) c. National Alliance of Senior Citizens (N ASC) d. Gray Panthers ANS: A The AARP uses volunteers and lobbyists to advance the interests and welfare of older adults. DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: 7 TOP: Political Action Groups KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 14. Which caregiver could be found guilty of elder abuse? a. A daughter who uses her mother’s Social Security money to purchase her mother’s medication b. A son who puts an alarm on the front door to prevent his mother from wandering out of the house c. A wife who allows her mentally competent husband to refuse to take a bath for a week d. A frail spouse who is unable to bathe or change the clothes of her physically dependent husband ANS: D Unintentional abuse or neglect can occur when the caregiver lacks the stamina to meet care needs. Even though physically unable, the frail wife is guilty of elder abuse. The wife should seek assistance to prevent neglect. DIF: Cognitive Level: Analysis REF: p. 21 OBJ: 13 TOP: Elder Abuse KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 15. What is the most frequent response to elder abuse by the abused older adult? a. Anger b. Physical retaliation c. Notification of authorities d. Nothing at all ANS: D Fear of retaliation or abandonment keeps most abused older adults silent. DIF: Cognitive Level: Application REF: p. 23 OBJ: 14 TOP: Response to Abuse KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 16. What reason is often stated by nurses today for not seeking careers in gerontology? a. The physical work is too difficult. b. Their technical skills are not used. c. There is too much challenge. d. There are limited options for employment. ANS: B Many nurses feel that their technical skills will not be used in the care of the older adult. There are many employment options th at offer challenge and fulfillment. DIF: Cognitive Level: Comprehension REF: p. 5 OBJ: 2 TOP: Employment Options KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 17. “Baby boomers” is a term used to classify which of the following persons? a. Those who entered school in 1945 b. Those who served in the military in World War II c. Those who were born between 1946 and 1964 d. Those who were eligible for Social Security benefits in 2000 ANS: C Baby boomers are those born between 1946 and 1964. The impact of the retirement of this cohort is unprecedented in terms of the impact on society. DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: 5 TOP: Baby Boomers KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 18. What type of abuse is demonstrated by restraining an older adult in a recliner ? a. Physical abuse b. Neglect c. Emotional abuse d. Self-neglect ANS: A Physical abuse is any action that causes physical pain or injury. Inappropriate use of drugs, force -feeding, physical restraints, and punishment of any kind are examples of physical abuse. DIF: Cognitive Level: Application REF: p. 22 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 19. Which type of elder abuse is demonstrated by the nonprovision of medical care? a. Physical abuse b. Neglect c. Emotional abuse d. Self-neglect ANS: B Neglect is a passive form of abuse in which caregivers fail to provide for the needs of the older person under their care. Failure to provide necessary medical care may constitute neglect because with no means of going to the doctor or pharmacy, the older person may suffer or even die. DIF: Cognitive Level: Application REF: p. 22 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 20. Which type of elder abuse is demonstrated by a health care worker eating a resident’s candy without permission? a. Physical abuse b. Neglect c. Emotional abuse d. Self-neglect ANS: C Emotional abuse is more subtle and difficult to recognize than physical abuse or neglect. It often includes behaviors such as isolating, ignoring, or depersonalizing older adults. Health care workers eating a resident’s candy without permission is an ignor ant behavior that can be depersonalizing. DIF: Cognitive Level: Application REF: p. 22 OBJ: 13 TOP: Types of Abuse KEY: Nursing Process Step: N/A MSC: NCLEX: N/A MULTIPLE RESPONSE 21. The nurse is aware that a person’ s attitude about aging is influenced mainly by his or her __________. ( Select all that apply. ) a. life experiences b. income level c. level of education d. current age e. occupation ANS: A, D A person’ s current age and life experiences are the main influences on his or her attitude relative to aging. DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: 2 TOP: Attitudes Toward Aging KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: P sychosocial Adaptation 22. Gerontology encompasses application to __________. ( Select all that apply. ) a. appropriate housing b. health care c. public education d. business ventures e. government -sponsored pensions ANS: A, B, C, D Gerontological concerns extend and influence provision of appropriate housing, health care, public education, business ventures, and political stands relative to the welfare of the older adult. DIF: Cognitive Level: Application REF: p. 2 OBJ: 1 TOP: Geron tology KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 23. Medicare Part C allows eligible persons to receive Medicare benefits via the services of private insurance companies through which of the following? ( Select all that apply. ) a. Health maintenance organization (HMO) b. Preferred provider organization (PPO) c. Provider -sponsored organization (PSO) d. Private fee for service organization (PFFS) e. Medical service organization (MSO) ANS: A, B, C, D Medicare Part C allows benefits via the services of managed care organizations. Medical service organization is not one of them. DIF: Cognitive Level: Comprehension REF: p. 16 OBJ: 6 TOP: Medicare Part C KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 24. Which emotional response would be expected from a family who is coping with an aging loved one’s diminishing abilities and increased care needs? ( Select all that apply. ) a. Grief b. Anger c. Frustration d. Loss e. Resentment ANS: A, B, C, D As the family witnesses the decline of a loved one and attempts to respond to the increasing care needs, the emotional responses are varied and changing. The responses include grief, anger, frustration, loss, and confusion. DIF: Cognitive Level: Applicati on REF: p. 20 OBJ: 11 TOP: Impact of Aging on the Family KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 25. What characteristics are typical for a caregiver of an aging family member? ( Select all that apply. ) a. 32 years of age b. Female c. Having full -time employment d. Having a care recipient older than 70 e. Giving care for an average of 18 years ANS: B, C, D, E The average age of the caregiver is 46. DIF: Cognitive Level: Application REF: p. 19 OBJ: 11 TOP: Characteristics of Family Caregiver KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 26. Which of the following are indicators of self -neglect in the aging person? ( Select all that apply. ) a. Misbalanced checkbook b. Reduced personal hygiene c. Increased alcohol consumption d. Irritability e. Loss of weight ANS: A, B, C, E Indicators may be to manage personal finances, reduced hygiene, substance abuse, and loss of weight due to inability to obtain adequate food. Irritability is not a consistent characteristic. DIF: Cognitive Level: Application REF: p. 21 OBJ: 11 TOP: Self-Neglect KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 27. The nurse reminds a group of prospective caregivers that elder abuse may take the form of __________. ( Select al l that apply. ) a. caring for physical needs b. misappropriation of finances c. psychological intimidation d. emotional depersonalization e. abandonment ANS: B, C, D, E Elder abuse may take the form of physical injury, misusing the older person’s finances for personal gain, psychological intimidation, and depersonalization and abandonment. DIF: Cognitive Level: Application REF: pp. 21 -23 OBJ: 13 TOP: Elder Abuse KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Reduction of Risk 28. Research by the National Institute on Aging found which of the following to be correct? (Select all that apply. ) a. Older patients receive less information rega rding health management than younger patients. b. Information on lifestyle changes were directed at younger people. c. Older patients were denied timely appointments for evaluation of acute illnesses. d. Rehabilitation programs offered limited services to the older adult. e. Older patients receive less evaluation and fewer treatment options for acute illnesses. ANS: A, B, D, E The study showed there was less information on health management and lifestyle changes. Rehabilitation programs were limited in their service to the older adult, and only 47% of physicians interviewed felt the older patient received the same evaluation for acute illnesses. DIF: Cognitive Level: Application REF: pp. 3 -5 OBJ: 2 TOP: Attitudes Toward Aging KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 29. The Nursing Compete nce in Aging initiative advocates enhancing nurses’ __________. (Select all that apply. ) a. knowledge in gerontics b. skills in geriatrics c. opportunities for employment d. political sensitivity for the older adult e. attitudes related to the older adult ANS: A, B, E The Nursing Competence in Aging initiative advocates for all nurses greater knowledge, skills, and broader attitudes toward the older adult. DIF: Cognitive Level: Comprehension REF: p. 5 OBJ: 12 TOP: Attitudes Toward Aging KEY: Nursing Process Step: N/A MSC: NCLEX: N/A COMPLETION 30. The nurse clarifies that the term that refers to the promotion of high -level functioning and supportive care to older adults is __________. ANS: gerontics DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: 10 TOP: Gerontics KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 31. The nurse reminds a patient who was born in 1965 that eligibility for full Social Security benefits for persons of this age is now the age of __________. ANS: 67 DIF: Cognitive Level: Knowledge REF: p. 3 OBJ: 2 TOP: Change of Social Security Benefits KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 32. The nurse clarifies that the point at which a person on Medicaid Part D must assume full cost of medication is called the __________ ____ ______. ANS: donut hole The “donut hole” is the point at which the insured has used up the $2850 worth of coinsurance for drugs and must pay the full cost of medication until the amount of out -of-pocket expenses reaches $4750. DIF: Cognitive Level: Com prehension REF: p. 16 OBJ: 8 TOP: Donut Hole KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care Chapter 02: Theories of Aging Test Bank MULTIPLE CHOICE 1. How does a theory differ from a fact? a. A theory proves how different influences affect a particular phenomenon. b. A theory attempts to explain and give some logical order to observations. c. A theory is a collection of facts about a particular phenomenon. d. A theory shows a relationship among facts about a particular phenomenon. ANS: B A theory is an unproven concept that attempts to explain and give some logical order to observations. For a theory to become a fact, there must be reproducible evidence. DIF: Cognitive Level: Comprehension REF: p. 27 OBJ: 1 TOP: Fact vs. Theory KEY: Nurs ing Process Step: N/A MSC: NCLEX: N/A 2. The biological theory of aging uses a genetic perspective and suggests that aging is a programmed process in which a. each person will age exactly like those in the previous generation b. a “biological clock” ticks off a predetermined number of cell divisions c. genetic traits can overcome environmental influences d. age-related physical changes are controlled only by genetic factors ANS: B The biological theory of programmed process suggests that there is a “biologic clock” set with a predetermined number of cell divisions that will occur before the introduction of the aging process. DIF: Cognitive Level: Application REF: p. 27 OBJ: 2 TOP: Biological Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 3. The Gene The ory of aging suggests which of the following ? a. The presence of a “master gene” prolongs youth. b. Genes interact with each other to resist aging. c. Specific genes target specific body systems to initiate system deterioration. d. The activation of harmful genes initiates the aging process. ANS: D The Gene Theory suggests that there is an activation of harmful genes that initiates the aging process. DIF: Cognitive Level: Application REF: p. 27 OBJ: 2 TOP: Gene Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 4. The theory that identifies an unstable molecule as the causative factor in aging is the _____ theory. a. free radical b. molecular c. neuroendocrine d. crosslink ANS: A The free radical theory identifies free radicals —unstable molecules —that will cause aging after accumulation in the body. DIF: Cognitive Level: Knowledge REF: p. 28 OBJ: 2 TOP: Free Radical Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 5. A patient uses good health maintenance practices. What aging theory most accurately relates to the patient’s practices? a. Wear -and-tear b. Free radical c. Neuroendocrine d. Molecular ANS: A The wear -and-tear the ory suggests that health maintenance practices will prevent wear and tear on the cells of the body and will delay the aging process. DIF: Cognitive Level: Analysis REF: p. 28 OBJ: 2 TOP: Wear -and-Tear Theory KEY: Nursing Process Step: Assessment MSC: NCLE X: Health Promotion and Maintenance: Prevention and Early Detection of Disease 6. The patient asks the nurse to describe the neuroendocrine theory of aging. What would be an appropriate response by the nurse? a. It relates thyroid function to age -related changes. b. Adrenal corticosteroids inhibit the aging process. c. The stimulation and/or inhibition of the hypothalamus causes age -related changes. d. The adrenal medulla inhibits epinephrine, causing age -related changes. ANS: C The neuroendocrine theory proposes that the hypothalamus stimulates or inhibits the pituitary gland to produce hormones that initiate the aging process. DIF: Cognitive Level: Comprehension REF: p. 28 OBJ: 2 TOP: Neuroendocrine Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 7. What is true of the psychosocial theories of aging? a. They focus on methods to delay the aging pro cess. b. They are directed at decreasing depression in the older adult. c. They are organized to enhance the perception of aging. d. They attempt to explain responses to the aging process. ANS: D Psychosocial theories attempt to explain the various responses of persons to the aging process. DIF: Cognitive Level: Comprehension REF: p. 29 OBJ: 3 TOP: Focus of Psychosocial Therapies KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 8. What is the major objection to the disengagement theory? a. The theory justifies ageism. b. The theory addresses the diversity of older adults. c. The theory does not clarify the aging process. d. The theory diminishes the self -esteem of the older adult. ANS: A The disengagement theory seems to justify ageism by proposing that there is a mutual desire between the community and the older adult to be disengaged. According to the theory, this desire apparently does not diminish self -esteem because the older adult de sires to be disengaged. DIF: Cognitive Level: Application REF: p. 29 OBJ: 3 TOP: Disengagement Theory KEY: Nursing Process Step: N/A MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 9. An 80 -year-old teaches Sunday school each week and delivers food for Meals on Wheels. What theory of aging would apply? a. Newman’s developmental b. The life course c. The activity d. The disengagement ANS: C Purposeful activity increases self -esteem and maintains cognitive function well into older age. DIF: Cognitive Level: Application REF: p. 29 OBJ: 3 TOP: Activity Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 10. The nurse would recognize succ essful aging according to Jung’s theory when a long -term care facility resident demonstrates which of the following behaviors? a. The resident takes special care to dress for dinner in a manner that pleases his tablemates. b. The resident asks permission to sit on the patio with other residents. c. The resident asks persons in his hall if his television is bothering them. d. The r esident wears a large cowboy hat at all times because he likes it. ANS: D Jung describes a successful adjustment to aging as being accepting and valuing of self regardless of the view of others. DIF: Cognitive Level: Application REF: p. 29 OBJ: 3 TOP: Jung’s Developmental Theory KEY: Nursing Process Step: Evaluation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 11. How would an elderly female be most likely to reduce the amount of the free radical lipofuscin? a. Avoid animal fat b. Take antioxidants daily c. Build muscle mass d. Perform outdoor exercise three times weekly ANS: B Individuals who follow this theory believe that free radicals can be reduced by antioxidants such as vitamins A, C, E, zinc, and phytochemicals. DIF: Cognitive Level: Comprehension REF: p. 28 OBJ: 2 TOP: Antioxidants KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 12. A recently widowed woman moved to an assisted living community because of her hypertension and joined a group to learn how to do wa ter color painting with other women her age. Which theory of aging does the nurse assess the patient to be following? a. Jung b. Havighurst c. Erikson d. Newman ANS: B Havighurst proposes that the process of aging is defined by adjusting to the loss of a spouse, establishing a relationship with one’s own age group, and establishing a satisfactory living arrangement. DIF: Cognitive Level: Application REF: p. 29 OBJ: 3 TOP: Havighurst KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease MULTIPLE RESPONSE 13. What age -related illnesses are thought to cause the accumulation of free radicals? ( Select all that apply. ) a. Arthritis b. Colon cancer c. Osteoporosis d. Diabetes e. Atherosclerosis ANS: A, D, E Cancer and osteoporosis are not considered to be diseases that accumulate free radicals. DIF: Cognitive Level: Application REF: p. 28 OBJ: 2 TOP: Free Radical Influence KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance : Prevention and Early Detection of Disease 14. The nurse emphasizes that the relatively new theory that correlates restricted caloric intake to slowing of the aging process would probably extend the life span of the person, provided that the person ____ ______. ( Select all that apply. ) a. consistently eats high -nutrient, low -calorie foods b. maintains a regular exercise program c. consumes 2000 –3000 mL of fluid a day d. supports the diet with adequate fat -soluble vitamins e. eats only organically grown foods ANS: A, B This new theory encourages high -nutrient, low -calorie foods combined with regular exercise to delay the aging process. DIF: Cognitive Level: Application REF: pp. 28 -29 OBJ: 2 TOP: Calorie Restriction Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 15. Which of the following would be considered positive outcomes of Erikson’s “life review”? (Select all that apply. ) a. Wisdom and integrated self -image b. Comparing self with others c. Understanding self and relationships d. Seeking another’s opinion of his or her achievement e. Acceptance of self ANS: A, C, E Acceptance of self and understanding self and relationships with accumulated wisdom is the goal of Erikson. Seeking the opinion of others suggests that the older adult is experiencing doubt and gloom, which are negative outcomes according to Erikson. DIF: Cognitive Level: Application REF: p. 29 OBJ: 2 TOP: Erikson’s Developmental Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development 16. Which of the following would be selected for a diet hig h in antioxidants? ( Select all that apply. ) a. Fruits b. Vegetables c. Organ meat d. Folic acid e. Vitamin D ANS: A, B, D Antioxidants can be obtained largely from fruits and vegetables. Organ meat and vitamin D are not antioxidants. DIF: Cognitive Level: Application REF: p. 28 OBJ: 4 TOP: Antioxidants KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease COMPLETION 17. The theory that proposes that defects in ribonucleic acid (RNA) protein production cause a progressive decline in the function of all cells is the __________ theory. ANS: error The error theory proposes that errors in ribonucleic acid protein synthesis cause changes such as decreased muscle mass, increased body fat, and changes in reproductive function. DIF: Cogn itive Level: Comprehension REF: p. 28 OBJ: 2 TOP: Error Theory KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 18. The nurse clarifies that the biologic theory that proposes that aging is based on the using up of a finite number of breaths or heartbeats is the __________ of __________ theory. ANS: rate; living The rate of living theory proposes that individuals have a finite number of breaths or heartbeats that are used up over a period of time. DIF: Cognitive Level: Comprehension REF: p. 27 OBJ: 2 TOP: Rate of Living Theory KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prev ention and Early Detection of Disease Chapter 03: Physiologic Changes Test Bank MULTIPLE CHOICE 1. Why does the nurse modify the environment to keep it warmer for the older adult? a. A change in the metabolic rate b. Decreased subcutaneous tissue c. Changes in the musculoskeletal system d. A weakened peripheral vascular system ANS: B The reduction of subcutaneous tissue as an age -related change causes sensitivity to cold because it is the main insulator of the body. DIF: Cognitive Level: Applicat ion REF: pp. 32 -33 OBJ: 1 TOP: Sensitivity to Cold KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. A 75 -year-old male is worried that his wartlike dark macules with distinct borders are melanomas. What would be the most likely cause for the macules? a. Senile lentigo b. Cutaneous papillomas c. Seborrheic keratoses d. Xerosis ANS: C Dark, slightly raised macules are seborrheic keratoses, which may be mistaken for melanomas. DIF: Cognitive Level: Comprehension REF: p. 32 OBJ: 1 TOP: Seborrheic Keratosis KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Ph ysiological Adaptation 3. The nurse is accompanying a group of older adults on a July 4th outing to monitor heat prostration. What factor is related to heat intolerance in the older adult? a. An increase in melanin b. A reduction of perspiration c. A reduction in body temperature d. Increased capillary fragility ANS: B Reduction in perspiration related to reduced sweat gland function results in pos sible heat intolerance from an inability to cool the body by evaporation. DIF: Cognitive Level: Analysis REF: p. 33 OBJ: 2 TOP: Heat Intolerance KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. The nurse cautions the Certified Nursing Assistants (CNAs) to use care when transferring or handling older adults. The nurse understands that the vascular fragility of the older adult can result in which of the following conditions? a. Altered blood pressure b. Pressure ulcers c. Pruritus d. Senile purpura ANS: D Increased capillary fragility results in subcutaneous hemorrhage or senile purpura from careless handling by caregivers. DIF: Cognitive Level: Comprehension REF: p. 33 OBJ: 7 TOP: Senile Purpura KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. Which symptom would be a characteristic of a stage I pressure ulcer on an older adult’s coccyx? a. Clear blister b. Nonblanchable area of erythema c. Scaly abraded area d. Painful reddened area ANS: B A red nonblanchable area is indicative of a stage I pressure ulcer. DIF: Cognitive Level: Analysis REF: p. 34 OBJ: 5 TOP: Pressure Ulcers KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The Certified Nursing Assistant (CNA) caring for an older adult asks if the yellow, waxy, crusty lesions on the patient’s axilla and groin are contagious. Which response shows the nurse’s understanding for the cause of the lesions? a. “Yes. It is cellulitis caused by bacteria.” b. “No. It is seborrheic dermatitis caused by excessive sebum.” c. “Yes. It is an indication of scabies.” d. “No. It is the lesion seen with basal cell carcinoma.” ANS: B Seborrheic dermatitis is a bothersome skin condition resulting from an excess of sebum. DIF: Cognitive Level: Application REF: p. 35 OBJ: 5 TOP: Seborrheic Dermatitis KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiolo gical Adaptation 7. Why would a nurse lead a group of postmenopausal women on a daily 15 -minute “walking tour” through the long -term care facility? a. To improve bone strength b. To orient them to their surroundings c. To improve their socialization d. To increase their appetite ANS: A Stress to long bones by weight -bearing and walking will increase bone strength. DIF: Cognitive Level: Analysis REF: p. 35 OBJ: 7 TOP: Bone Strength KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. A 70 -year-old woman asks, “How in the world can my bones be brittle when I eat all the right foods?” Which response by the nurse would be the most inf ormative? a. “Calcium loss is expected in the older adult.” b. “Calcium is continuously withdrawn from bone for nerve and muscle function.” c. “Smoking and alcohol consumption speed calcium loss from the bones.” d. “Walking and standing increase calcium loss from the bone.” ANS: B Calcium is constantly withdrawn from the bone for nerve and muscle function and clotting needs. DIF: Cognitive Le vel: Comprehension REF: p. 35 OBJ: 3 TOP: Calcium Loss KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. A 70 -year-old woman complains, “ I weigh exactly the same as I did when I wore a size 10 and now I can barely squeeze into a size 16.” Which statement by the nurse would most correctly explain the size change to the woman? a. “Metabolism in the older adult creates increased adipose tissue .” b. “Postmenopausal women gain adipose tissue related to loss of calcium.” c. “Decrease in muscle mass is replaced with adipose tissue.” d. “Kyphosis causes a redistribution of weight.” ANS: C Decreas e in muscle mass is replaced with adipose tissue, which frequently changes the appearance of the body, but not the weight. DIF: Cognitive Level: Application REF: p. 38 OBJ: 4 TOP: Loss of Muscle Mass KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. What would be the most helpful response to a 70 -year-old postmenopausal woman who asks whether her hormone replacement therapy (HRT) will prevent bone loss? a. “No. HRT is not helpful after the age of 60.” b. “Yes. HRT will prevent bone loss but can cause a stroke, heart attack, or breast cancer.” c. “No. HRT is reliant on some natural estrogen production from the ovaries.” d. “Yes. HRT is a widely accepted the rapy for prevention of bone loss.” ANS: B HRT is helpful to prevent bone loss, but the risks of cardiovascular complications and cancer have made the choice of HRT controversial. DIF: Cognitive Level: Analysis REF: p. 38 OBJ: 4 TOP: Hormone Replacement Therapy KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 11. What are Heberden nodes? a. Yellow longitudinal lines in the nails b. Thickened discolored fingernails c. Darkened areas under the fingernail d. Bony enlargements of distal joints of the fingers ANS: D Heberden nodes are bony enlargements of the distal joints of the fingers associated with osteoarthritis. DIF: Cognitive Level: Knowledge REF: p. 39 OBJ: 5 TOP: Heberden Nodes KEY: Nursing Process Step: N/A MSC: NCLEX: Physiological Integrity: Physiological Adaptation 12. Which care plan modification would be the most beneficial for a 62 -year-old woman who is suffering from a flare in her rheumatoid arthritis? a. Increase fluid intake b. Schedule several rest periods to balance activity c. Reduce salt in the diet d. Assist with rigorous finger extension exercises ANS: B Balancing rest and activity allows the resident to remain relatively flexible. Joints may be splinted to reduce contracture. DIF: Cognitive Level: Application REF: p. 39 OBJ: 5 TOP: Rheumatoid Arthritis KEY: Nursing Process Step: Planning MSC: NCLEX: Phy siological Integrity: Physiological Adaptation 13. What is the pathophysiology of emphysema? a. Constriction of the bronchial tree, excessive mucus, and nonproductive cough b. Calcification of the alveoli and a dry cough c. Overinflation of the alveoli, making them ineffective for gas exchange d. Inflammation of the trachea and bronchioles, excessive mucus, and productive cough ANS: C Emphysema causes overinflation of the nonelastic alveoli, which disallows gas exchange in the affected alveoli and results in reduced oxygenation. DIF: Cognitive Level: Comprehension REF: p. 41 OBJ: 5 TOP: Emphysema KEY: Nursing Process Step: Implementati on MSC: NCLEX: Physiological Integrity: Physiological Adaptation 14. What is the pathophysiology of a myocardial infarct? a. A portion of the myocardium necroses and scars over. b. The coronary vessels are narrowed during the attack. c. The ischemic myocardium causes pain during the attack but is able to regenerate. d. There is damage to the myocardium but no serious alteration of cardiac output. ANS: A The myocardium necroses a nd scars and does not regenerate. The degree of heart damage is related to the amount of necrosis. DIF: Cognitive Level: Comprehension REF: p. 45 OBJ: 5 TOP: Myocardial Infarct KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 15. Which of the following assessments are the cardinal signs and symptoms of congestive heart failure? a. Dyspnea and edema b. Myocardial pain and hypotension c. Ventricular arrhythmias and cyanosis d. Atrial arrhythmias and polycythemia ANS: A Dyspnea and generalized edema are the cardinal signs and symptoms of congestive heart failure. DIF: Cognitive Level: Application REF: p. 46 OBJ: 5 TOP: Congestive Heart Failure KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. What is a cause of pernicious anemia? a. An iron deficiency b. A deficiency of vitamin B 12 c. Low serum potassium level d. Blood loss ANS: B Pernicious anemia results from a deficiency of vitamin B 12. DIF: Cognitive Level: Knowledge REF: p. 49 OBJ: 5 TOP: Pernicious Anemia KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. What would be an acceptable alteration in the plan of care for a patient with a hiatal hernia who is experiencing gastrointestinal reflux? a. Encouraging the patient to lie down after meals b. Drinking two full glasses of liquid after the evening meal c. Eating smaller, more frequent meals d. Using caffeine drinks to assist with digestion ANS: C Eating smaller and more frequent meals does not enlarge the stomach. DIF: Cognitive Level: Analysis REF: p. 52 OBJ: 5 TOP: Hiatal Hernia KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk 18. The nurse assesses a diabetic patient and finds the patient to be pale, edematous, and listless with a blood urea nitrogen (BUN) level of 35 mg/dL and a creatinine level of 4 mg/dL. What would the results of the nursing assessment indicate? a. Diverticulit is b. Congestive heart failure c. Chronic renal failure d. Benign prostatic hypertrophy ANS: C The increased BUN and creatinine levels indicate renal failure. DIF: Cognitive Level: Application REF: p. 55 OBJ: 6 TOP: Renal Failure KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 19. A person with Parkinsons disease has a nursing diagnosis of “nutrition, less than body requirements related to difficulty swallowing.” What change would the nurse make in the nursing care plan? a. Feed the patient at each meal. b. Place the patient in a semi -Fowler position for mealtime. c. Offer a thick, high -nutrition shake as a snack. d. Encourage the patient to drink a sip of water after each bite of solid food. ANS: C Thick shakes are easier to swallow without aspiration and will also improve nutrition. DIF: Cognitive Level: Application REF: p. 57 OBJ: 5 TOP: Parkinson Disease KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Reduction of Risk 20. A person who experienced a hemorrhagic cardiac vascular accident (CVA) to the left hemisphere would demonstrate which type of symptoms? a. Language disturbances b. Poor impulse control c. Inappropriate affect d. Confabulation ANS: A A left hemisphere CVA would most likely cause language disturbances such as aphasia, agraphia, or alexia. DIF: Cognitive Level: Application REF: p. 60 OBJ: 5 TOP: Cerebrovascular Accident KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integ rity: Physiological Adaptation 21. How should the nurse provide written discharge instructions for a patient with macular degeneration? a. Write the instructions in bold print. b. Adjust the table and light to assist the patient to use peripheral vision to read. c. Place written document directly in front of the patient to read. d. Read the document to the patient. ANS: B Assist the patient to use peripheral vision because cent ral vision is lost in macular degeneration. DIF: Cognitive Level: Application REF: p. 63 OBJ: 5 TOP: Macular Degeneration KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 22. What is a symptom of inadequate insulin coverage in a patient with diabetes mellitus type I? a. Diminished urine output b. Ketones in the urine c. Shallow and slow respirations d. Extreme diaphoresis ANS: B When there is inadequate insulin coverage for the type 1 diabetic, the diabetic lacks the glycogen to use as energy and attempts to use fat, which creates an acid in the form of ketones. DIF: Cognitive Level: Comprehension REF: pp. 68 -69 OBJ: 5 TOP: Diabetes Mellitus Type 1 KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. An 80 -year-old extended -care resident comes to the nurse asking for a bandage for a bleeding, dark pigmented mole with irregular shape and border. What does the nurse suspect? a. Melanoma b. Basal cell carcinoma c. Cutaneous papilloma d. Senile lentigo ANS: A Melanomas are dark, irregularly shaped lesions that may cause itching or bleeding. These are potentially deadly and should be reported to obtain quick treatment. DIF: Cognitive Level: Comprehension REF: pp. 33 -34 OBJ: 5 TOP: Melanoma KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease MULTIPLE RESPONSE 24. What factors influence the timing and extent of age -related changes? ( Select all that apply. ) a. Health maintenance b. Ethnicity c. Heredity d. Attitude e. Environment ANS: A, C, E Heredity, environment, and health maintenance affect the timing and magnitude of age -related changes. DIF: Cognitive Level: Comprehension REF: pp. 31 -32 OBJ: 1 TOP: Influences on Age -Related Changes KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 25. What should be avoided by an 82 -year-old man with rosa cea? ( Select all that apply. ) a. Stress b. Dairy products c. Sun exposure d. Spicy foods e. Alcohol consumption ANS: A, C, D, E The patient who has rosacea should avoid stress, sun exposure, spicy foods, and alcohol consumption. DIF: Cognitive Level: Comprehension REF: p. 34 OBJ: 5 TOP: Rosacea KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Reducti on of Risk 26. What vitamins are necessary to support ossification? ( Select all that apply. ) a. A b. B6 c. C d. D e. E ANS: A, C, D Vitamins A, C, and D are necessary for bone matrix formation and replenishment. DIF: Cognitive Level: Knowledge REF: p. 35 OBJ: 7 TOP: Ossification KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 27. What are risk factors for osteoporosis? ( Select all that apply. ) a. Menopause b. Smoking c. White female d. Excessive high -impact exercise e. Long -term use of phenytoin (Dilantin) ANS: A, B, C, E Menopausal white women who smoke and have had long -term administration of phenytoin (Dilantin), heparin, or corticosteroids are at risk for osteoporosis. DIF: Cognitive Level: Comprehension REF: p. 38 OBJ: 5 TOP: Risk Factors for Osteoporosis KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 28. What age -related changes in the respiratory system explain w hy the older adult is at risk for infection? ( Select all that apply .) a. Reduced ciliary movement b. Decrease in alveolar elasticity c. Pooling of secretions d. Flattened diaphragm e. Calcification of costal cartilage ANS: A, B, C The flattening of the diaphragm and the calcification of cartilages decrease respiratory effectiveness but do not support pathogen growth as do ciliary and alveolar changes. DIF: Cognitive Level: Comprehension REF: pp. 40 -41 OBJ: 1 TOP: Age-Related Changes in the Respiratory System KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation COMPLETION 29. The nurse is aware that children with __________ have the treatment and care needs of persons of advanced age. ANS: progeria A rare condition called progeria causes severe premature aging. When they are only 8 or 9 years of age, children with progeria have the physiology and appearance of 70 -year-olds. DIF: Cognitive Level: Knowledge REF: p. 31 OBJ: 6 TOP: Progeria KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 30. The 75 -year-old resident in a long -term care facility complains of muscle pain while riding a stationary bicycle. The nurse explains that the discomfort is related to the buildup of __________ __________ in the muscle. ANS: lactic acid Elevated levels o f lactic acid may result in muscle fatigue and soreness. DIF: Cognitive Level: Comprehension REF: p. 37 OBJ: 7 TOP: Lactic Acid Buildup KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 31. When a 75 -year-old male resident in an extended -care facility tells the nurse he wants to build up the muscles in his arms, the nurse recommends a(n) __________ exercise program. ANS: isoto nic Isotonic exercises such as flexing and extending the arms while holding hand weights build tone and muscle mass. DIF: Cognitive Level: Comprehension REF: p. 37 OBJ: 4