1. A nurse is providing care to older adults who are experiencing levels of physical disabilities. The nurse incorporates an understanding of the
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Question

1.     A.    Denial of disabilities by making unrealistic plans of care.B.     Mourning of losses

 A nurse is providing care to older adults who are experiencing levels of physical disabilities. The nurse incorporates an understanding of the grieving process being alert for which reactions? Select all that apply.

C.    Acceptance of the disability without any periods of regret or resentment

D.    Angry outbursts and impatience with those who are trying to help them

E.     Fluctuations in reactions


1.     A patient with a terminal confides to the nurse about a plan to commit suicide. The nurse struggles with this information and reviews the ANA code of Ethics. The nurse perceives the greatest ethical conflicts related to select all that apply 

A.    the patient's privacy 

B.    advocacy

C.     the patient's rights 

D.    the patient's safety

E.    The relationship between the doctor and the patient 


1.     The nurse is caring for a patient with dementia. Prior to initiating a restraint order the nurse considers alternate measures. Which measure should the nurse initiate before applying restraints?

A.    Initiate a 1:1 order for the patient 

B.    Change the patient's room closer to the nursing station

C.    Initiate bilateral full length side rails

D.    Obtain a psychotropic order for medication immediately



1.     A Nurse who works in a long-term facility encourages older adults to engage in spiritual belief and practice they are familiar with. This will help foster. 

A.     Coping strengths

B.    dependency

C.    reminiscing 

D.    solation strength 




1.     Upon assessment of an elderly client, the nurse finds thin frail skin. The nurse initiates safety measures due to the client's increased sensitivity to: 

A.     Pain

B.    pressure 

C.    Cold

D.    heat


1.     The home health nurse is concerned that an older client is a risk for a kitchen fire. What intervention can the nurse offer to reduce the risk of this happening?

A.    Recommended that the older adult stop cooking completely.

B.    Encourage the use of meal delivery services to reduce cooking 

C.    Avoid placing electrical items near the water sources 

D.    Suggest a microwave be used to heat liquids and not the stove.


1.     The nurse has witnessed the Interaction between the surgeon and patient prior to signing a surgical content. The patient asks many questions, and it is clear to the nurse that the patient does clearly understand the procedure the nurse's best action is to:

A.    ask the family member to sign the consent for the patient

B.     ask the patient to sign the consent and tell the patient they can discuss it again later

C.    ask the provider to step out of the room to discuss the observation

D.    Tell the provider to come back later after the nurse explains it further



1.     A client in a long-term facility has suffered a cardiac arrest. In which situation would the nurse be legally Justified not to act? 

A.     "No code" sign or symbol placed at the patient's bedside

B.    A "Do not resuscitate" statement in the nursing care plan

C.    A "no code" order written and signed on the physician's order sheet

D.    The next of kin's request for DNR orally or in writing.




1.     A Charge nurse is preparing a presentation on ethics for a group of nursing assistants working at a local long term and acute care facility. Which example would be most appropriate to use to describe the ethical principle of beneficence?

A.    An incompetent part nursing is fired, leaving a less than full staff

B.    The nurses at a local hospital answer clients' call bells/button quickly and deliberately

C.    The nurse leaves the patient on a bedpan for an hour to ensure the patient is completely finished

D.    The charge nurse documents four out of the five most serious incidents at the end of the shift.


1.     Which hospitalized patient is at greatest risk for inpatient falls?

A.    A client with a history of hip fractures from falls

B.    A client receiving numerous cardiac medications 

C.    A 79 -year- old client with a history of blindness

A client with new onset dementia



1.     A nurse who works in a long -term facility is planning group activities to encourage socialization which should be implemented?

A.    Timing laxative administration to avoid interference with social interaction

B.    Holding off trips to the bathroom until after the social group activities are finished

C.    Providing analgesia after social activities are completed

D.    Providing diuretics before group activities



1.     An older adult is upset because he has to be admitted to a skilled nursing care facility for renal treatment. Which intervention should the nurse implement to minimize the client's anger?

A.    Consult a counselor on admission for anger management

B.     Admit him and then set him up in the common area to socialize

C.     Offer to assist with basic needs and wants

D.    Ask him to calm down and tell him it will be over soon




1.     A patient complains to the nurse that she is very constipated and needs guidance. Following teaching sessions related to ways to prevent constipation which statement demonstrates that teaching was effective?

A.    will drink a glass of water every day

B.    "I will try to eat a bowl of rice frequently during the week

C.    "I will eat multigrain bread every day

D.    I will drink 4 cups of coffee a day since I don't like water.



1.     A nurse who works on a palliative care unit has developed a relationship with the 77-year-old wife of a client who has recently died of lung cancer the woman has expressed her fears about being a widow to the nurse. Which response by the nurse is most appropriate?

A.    You will likely find that once you are remarried, the grief will subside, and you will move on.

B.    Though it might not feel like it now, women eventually find joy in new friendships and freedom after the death of a spouse.

C.    it's very normal to have these fears but antidepressant medications can help tremendously with this difficult transition.

D.    it will be important and healthy for you to maintain roles and routines similar to ones you had before your spouse died. 



1.     A nurse is assisting clients in reminiscing about the past. Which action is appropriate?

A.    Referring them to senior centers where they can share their stories with others of their own age group.

B.     Introducing them to members of local historical societies who can record the stories for posterity 

C.    Encouraging them to record their stories through diaries and scrapbooks to be shared with younger family members.

D.    Looking for ways to steer their discussion toward health promoting habits such as good exercise and adequate nutrition.



1.     A client with a terminal illness confides to the nurse about a plan to commit suicide.  The nurse knows that the American Nurses Association Code of Ethics states. The nurse promotes, advocates for and strives to protect the health, safety and rights of the patient. The nurse perceives the greatest ethical conflict between which areas? Select that apply

A.    Client's nights 

B.    Safety 

C.    Protection 

D.    Advocacy


1.     The nurse is admitting a client from a nursing home. Which findings does the nurse note as part of the aging process? Select all the apply

A.    Thickened nails 

B.    skin elasticity

C.    Hair thinning 

D.    Small reddened areas on the heels.

E.    Decreased saliva.

2.     An older adult is prescribed a diuretic for the treatment of hypertension. The nurse should assess the patient closely for the development of: 

A.    fluid and electrolyte imbalances

B.     cognitive changes

C.     constipation 

D.    weight gain

3.     The nurse suspects dehydration in an elderly patient. Which action should the nurse initiate first?

A.    Minimize the client's intake of food 

B.    Initiate fluid intake and output monitoring

C.    Advocate for the initiation of intravenous fluids

d. Ask for an order for blood work to confirm dehydration


1.     A gerontological nurse observes another nurse infantilizing an older adult receiving rehab services. The staff nurse was violating which guideline for rehabilitative nursing?

A.    Providing time and flexibility

B.    Equating physical disability with cognitive disability C-Preventing complications. 

C.    Recognizing and praising accomplishments



1.     Select all that apply. A gerontological nurse administrator has been asked to speak to the staff at long term facility about ethical dilemmas and how they have become more numerous and complex over years When describing this topic, which factor would the nurse most likely include as contributing to these trends?

A.    Nurses' levels of responsibility are higher than in the past years. 

B.    Deaths from heart disease are declining while deaths from cancer are increasing 

C.    The internet has made patients and their families more informed about health

D.     Conflicts have arisen between cost effectiveness and quality of care 

E.    The scope of practice goes beyond simply following physician's orders.

2.     A nurse is completing a functional assessment of an elderly client (ADLS). The nurse determines that the client will have difficulty functioning based on which finding? 

A.    The client is unable to read. 

B.    The client has difficulty eating 

C.    The client is unable to cook for himself 

D.    The client has significant difficulty using a telephone 

 

3.     An older client is receiving anticoagulant therapy. Which factors should the nurse teach the client to avoid to ensure the effectiveness of the medication regimen?

A.    Foods high in complex carbohydrates such as bread and rice

B.     Foods high in Vitamin K such as asparagus and leafy vegetables

C.    Foods high in saturated fat such as bacon and butter

D.     Foods high in salt and nitrates such as processed meats.

4.     The nurse working with a patient with dementia notices that the patient tends to get agitated in the early evening and the night Which intervention should be implemented?

A.    Minimize the amount of touch used to avoid overstimulating the patient

B.    Limit the patient's intake after 6:00pm to prevent nocturia 

C.    Ensure the patient's room is dark to decrease sensory stimulation

D.     Schedule physical therapy in the afternoon hours to expend some energy

5.     A 74 -year-old is in the emergency department with a suspected hip fracture after falling. The client's son asked the nurse why this happened. The nurse responded by saying

A.    The bone marrow production of cellular components in adults in their 70s declines with age

B.    Thinning disks and shortened vertebrae are common findings in older adults

C.    it's common for bone remodeling in the long bones to cease in the 7th -8th decade

D.    This is part of the aging process because bone materials and mass are reduced

6.     A gerontological nurse is working with the staff to ensure that older adults receive holistic gerontological care. Which aspect would the nurse emphasize to achieve this goal?

A.    Doing as much as possible for them. 

B.    Guiding them in understanding and finding meaning and purpose to life. 

C.    Eliminating many of their chronic diseases and effects of advanced age 

D.    Facilitating harmony of all their body systems.


1.     A gerontological nurse is caring for an older adult with a history of diabetes and hypertension. which selfcare activity should the nurse teach the client/caregiver to perform?

A.    Adjust blood pressure medications dosage based on home blood pressure reading

B.     Finger stick after each meal

C.    start a course of antibiotics with temperature increases 

D.     Assess the b/p at least daily

2.     A nurse is reviewing the medical records of several clients who experienced delirium. factors would the nurse identify as precipitating the clients delirium? Select all that apply

A.    Dehydration

B.    An increased glucose level 

C.    Cataracts

D.     Low zinc levels 

E.    Confusion secondary to a new medication


1.     The RN and an unlicensed care provider are working together to care for a patient who is dying. Which action would be helpful for the RN to implement with the unlicensed health care provider? Select that apply

A.    Encourage stepping away from the situation to gain composure and examine if strong reactions are impacting therapeutic relationship

B.    Encourage the unlicensed provider to find a confidante outside to avoid showing emotion while on duty.

C.    Provide a location where all staff members can retreat during intense encounters

D.    Teach the unlicensed provider how to be therapeutic still maintaining an emotionally detached relationship from and their families




1.     Select all that apply.  A gerontological nurse is developing programs to foster learning in older adults. Which action best demonstrates an appropriate strategy to use?

A.    Making sure the room is well lit and at a comfortable temperature

B.    Presenting information strictly using a question and answer format

C.    Engaging the older adult in the learning session with hands on practice 

D.    Giving the client a written list of instructions after the teaching session



1.     While providing care to an older adult recovering from a stroke, the nurse suspects that the experiencing pain. Which findings led the nurse to this conclusion?

A.    Increased appetite

B.     Agitation 

C.    Increased temperature 

D.    Decreased blood pressure


1.     A nurse is providing care to an elder adult. Which action would the nurse implement safety without the risk of liability?

A.    Permitting a volunteer to move a patient

B.    Questioning a physician's written orders for medication

C.    Utilizing a blood pressure cuff that is sticks at times 

D.    Asking a family member to deliver routine medication to a patient's room

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