SAS#1

1. Which of the following improves attitudes toward aging and older adults?

a. Staying away from older adults

b. Education about older adults

c. Travelling to older communities

d. Watching the portrayals of older adults in movies and on TV

2. What best describes nurses as a care provider?

a. Determine client’s need

b. Provide direct nursing care

c. Help client recognize and cope with stressful psychological situation

d. Works in combined effort with all those involved in patient’s care

3. As a student nurse, you understand that it is important to study Gerontological Nursing because: a.

it is fixed and unchanging.

b. it provides a way to understand the aging process and provide quality care to older adults

c. it can help predict the responses that the body can do in during aging.

d. it gives positive outlook to older adults.

4. Nurse Beth told Mr. Dela Cruz about ways to decrease the risk of heart disease. What role of a
gerontologic nurse did Nurse Beth portray?

a. Manager

b. Advocate

c. Teacher

d. Provider of Care

5. Nurse Beth explains medical and nursing procedures to Mr. Dela Cruz’s family members. What role
did Nurse Beth play in this situation?

a. Manager

b. Advocate

c. Teacher

d. Provider of Care

6. What role involves gerontological nurses being aware of current research literature, continuing to
read and put into practice the results of reliable and valid studies?

a. Research Consumer

b. Advocate

c. Teacher

d. Provider of Care

7. As a nurse manager, Nurse Beth knows that she needs to develop the following skills except;
a. Time management

b. Assertiveness

c. Staff insubordination

d. Communication

8. A primary care provider’s order indicate that a consent form needs to be signed. Since the nurse
was not present when the primary care provider discussed the procedure, which statement best
illustrates the nurse fulfilled the client advocate role?

a. “The doctor has asked that you sign this consent form.”

b. “Do you have any questions about the procedure?”

c. “What were you told about the procedure you are going to have?”

d. “Remember that you can change your mind and cancel the procedure.”

9. A nurse who reads research articles and incorporates research findings into nursing practice would
demonstrate which of the following roles?

a. Collaborator

b. Primary Investigator

c. Producer

d. Consumer

10. The nurse clarifies to a group of clients that the field of nursing interest that specializes in disease
prevention, increasing autonomy and self care, and maintenance of function for older adults is a.
gerontology.

b. geriatrics.

c. developmental psychology.

d. public health. SAS#2

1. An 80-year-old patient, who lives at home with a spouse, is instructed to follow a 2 g sodium diet.
The patient states, "I've always eaten the same way all my life, and I'm not going to change now." To
promote optimal dietary adherence, the gerontological nurse's initial approach is to:

a. inform the patient about the need to follow the diet.

b. inquire about the patient's current food preferences and eating habits.

c. list the variety of foods that are allowed on the diet.

d. provide dietary instruction to the patient's spouse, who prepares the meals.

2. Which best describes what guides the appropriate nursing care of an aging adult?

a. Evidence-based practice developed with ongoing research into the needs and outcomes of older
adults

b. General nursing care previously practices

c. Facility policies and procedures

d. Physician orders for patient complaints

3. When teaching an independent older adult patient how to self-administer insulin, the most productive
approach is to:

a. facilitate involvement in a small group where the skill is being taught.

b. gather information about the patient's family health history.

c. provide frequent, competitive skills testing to enhance learning.

d. use repeated return demonstrations to promote the patient's retention of the involved tasks.

4. A 90-year-old patient comes to the clinic with a family member. During the health history, the
patient is unable to respond to questions in a logical manner. The gerontological nurse's action is to:

a. ask the family member to answer the questions.

b. ask the same questions in a louder and lower voice.

c. determine if the patient knows the name of the current president.

d. rephrase the questions slightly, and slowly repeat them in a lower voice.

5. The American Nurses Association's Gerontological Nursing: Scope and Standards of Practice
emphasizes:

a. that abnormal responses to the aging process determine the appropriate nursing diagnoses.

b. that the health status data of older adult patients be documented in a retrievable form.

c. the role of the older adult patient as the sole decision maker in planning his or her care.

d. the unchanging nature of the goals and plans of care for older adult patients.

6. What benefit does evidence-based practice offer clients over the age of 60?

a. No actual benefits have been noted when evidence-based practice is the model for geriatric care

b. Evidence-based practice offers the client improved health care in all settings

c. Evidence-based practice is only used as a model in acute care settings

d. Minimal changes in geriatric care have arisen from the use of evidence-based practice models

7. The lack of _______________________ can lead nurses, who care for older adult patients, to
preconceptions, or bias, or prejudice in their attitudes toward their patients. e. Patient History

f. Medical Knowledge

g. Psychiatric Competence

h. Cultural Competence

8. The five major components of a comprehensive nursing assessment of the older adult patient
include which of these (choose the best answer)?

a. Functional, spiritual, financial, physical, cognitive aspects

b. Physical, cognitive, social, spiritual, and family aspects

c. Spiritual, psychological, social, functional, and physical aspects

d. Spiritual, psychological, social, functional, and financials aspects

9.In assessing the aging client, it is important for the nurse to recognize:
a. The client's ability to perform ADLs

b. The financial status of the client

c. The job that the client held prior to aging

d. All components of well-being, including biological function, psychological function, and social function

10. The nurse assessing the older population needs to have a basic understanding of which of the
following?

a. The economic status of the area

b. The difference between normal and abnormal for the older age group

c. The signs of sexual dysfunction

d. The signs of cardiac disease

SAS#3

1. The nurse is aware that the majority of older adults:

A. Live alone

B. Live in institutional settings

C. Are unable to care for themselves

D. Are actively involved in their community

2. Which choice best explains the practice setting for the gerontological nurse? a)

In the home of the client

b) Only in acute care settings

c) Clinics and long-term care facilities

d) Home of the client, acute care facilities, long-term care settings, and clinics or anywhere clients over
the age of 65 seek health care and health education

3. A 70-year-old presents to the clinic stating that his family thinks he is losing his mind and they want
to put him in a home. What would be the initial role of the gerontological nurse?

a. Begin the process of finding a qualified nursing home

b. Do a complete history,physical, and assessment

c. Speak with the family about their concerns

d. Make light of the subject until the nurse can evaluate the situation

4. An 87-year-old man, who has been living independently, is entering a nursing home. To help him
adjust, the most effective action is to:

a. involve him in as many activities as possible so he can meet other residents.

b. move him as quickly as possible so that he does not have time to think.

c. restrict family visits for the first two weeks to give him time to adjust.

d. suggest that he bring his favorite things from home to make his room seem familiar.

5. Members of a family are caring for their father at home. Which statement by a family member
indicates a need for teaching and caregiver instruction?
a. "Dad has gotten lazy about his bathroom habits. He blames his arthritis medication for his toileting
accidents."

b. "Dad's room is close to the bathroom and we keep a light on for him at night."

c. "It's inconvenient, but we stop other activities to remind Dad to go to the bathroom on a regular
schedule."

d. "We try to avoid coffee and tea at night, but Dad really likes a cup of coffee for breakfast."

6. The nurse caring for the elderly population understands that movement slows with aging. This is
most likely due to:

a. Cognitive function

b. Changes in musculoskeletal and nervous systems

c. Laziness and a feeling that life is over

d. A recent change in medical condition

7. 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.occupation

8. 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.

9. Which of the following statement is true about aging?

a. The majority of old people have Alzheimer’s disease.

b. As people grow old, their intelligence declines significantly.

c. Older adults have more trouble sleeping than younger adults.

d. Personality change with age

10. In the Philippines, like other Southeastern countries, caring for the elders is part of its tradition.
The following are traditions evident in the Philippines except:

a. Youth customarily greets them with a gesture called mano po

b. Caring for older people is the responsibility of their children.

c. The dedication to family caregiving is evident in Filipino culture.

d. Most of the elders are in nursing homes for proper caring.

SAS#4

1. Nurse Bianca is aware that the theory of aging most likely to explain why the older population is at
risk for autoimmune disorder is known as:
a. cross-link theory.

b. free radical theory.

c. error theory.

d. autoimmune theory.

2. The family member of a patient asks if vitamin C will prevent aging. In formulating an appropriate
response, the nurse considers what theory?

a. free radical theory.

b. autoimmune theory.

c. wear-and-tear theory.

d. continuity theory.

3. Nurse Maria implements the concepts of the activity theory of aging when instructing the older
client with osteoarthritis to:

a. continue her daily walking routine.

b. curtail further increases in physical activity.

c. document preferred end-of-life interventions.

d. avoid exposing herself to crowds.

4. The 45-year-old patient reports to the nurse he feels he is going through a "mid-life crisis." The
nurse recognizes this phenomenon refers to the theory developed by which psychologist? a. Jung

b. Erikson

c. Newman

d. Havighurst

5. The patient in the clinic tells the nurse she can "feel her biologic clock ticking." The nurse knows the
patient views aging based on which theory?

a. Gene theory

b. Programmed theory

c. Rate of living theory

d. Somatic mutation theory

6. The nurse in the long term care facility who cares for primarily older adults knows these adults are
in which stage of Erikson's developmental tasks?

a. Trust versus mistrust

b. Integrity versus despair

c. Industry versus inferiority

d Generativity versus stagnation

e. Integrity versus despair

7. The nurse working in the long term care facility plans care based on Havighurst's theory of aging.
Which task(s) should the nurse facilitate his patients to achieve? (Select all that apply.) a. Adjusting
to the loss of a spouse

b. Preserving and increasing strength

c. Adjusting to a decrease in income

d. Stabilizing one's self in one's social roles

e. Looking back on one's life with pride and contentment

8. The nurse in the long term care facility frequently observes older adults being separated from their
friends and family and excluded from society. This phenomenon is described in which psychosocial
theory of aging?

a. Activity theory

b. Life-course theory

c. Developmental theory

d. Disengagement theory

9. The nurse is doing patient teaching for a 50-year-old woman. Based on the application of the
programmed theory of aging, which brochure is the nurse most likely to offer the patient?

a. "Perimenopause and Menopause: Most Frequently Asked Questions"

b. "Do the Benefits Outweigh the Risks of Antioxidant Supplements?"

c. "Exercise, Food, Sleep, and Fun: Healthy Lifestyle Tips for Older Adults"

d. "Healthy Nutrition Is More Than Just Counting Calories and Losing Weight"

10. Two nursing students are exhausted after studying about the biologic theories of aging. They
decide to have some fun and perform an action that is based on the rate of living theory. Which action
do they perform?

a. Go for a leisurely walk in the sunshine

b. Hold their breath for as long as they can

c. Share an apple and an orange

d. Give each other a facial and then use anti-aging cream

SAS#5

B. Multiple Choice

1. An 80-year-old female who enjoys good health explains to her primary provider that she attributed
her health status to her regular intake of berries, fruit, green tea, which she states “help cleanse the
damaging molecules out of my body.”Which of the following theories of aging underlies the client’s
health behaviors?

a. Free radical theory

b. Biogerontology

c. Disposable soma theory

d. Cross-linking theory
2. The nurse would recognize successful 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 resident wears a large cowboy hat at all times because he likes it.

3. The nurse in the long term care facility who cares for primarily order adults knows these adults are
in which stage of Erikson’s developmental tasks?

a. Trust vs mistrust

b. Integrity vs Despair

c. Industry vs Inferiority

d. Generativity vs stagnation

4. Which theory suggests that older people who have low levels of social activity have a high degree of
life satisfaction?

a. Activity

b. Age stratification

c. Disengagement

d. Exchange

5. Based on the free theory of aging, what would be an appropriate behavior that might increase
one’s life expectancy?

a. Exercise for 45 minutes at least three times a week.

b. Eat food rich in antioxidants.

c. Eat a low-calorie, high protein diet.

d. Do nothing. Life expectancy is determined through genetic programming.

6. Mr. Ramos, a 76-year old patient, has difficulty with social relationships and shows signs of
depression. As a nurse, you know that these symptoms describe what theory?

a. Functional Consequences theory

b. Theory of thriving

c. Theory of Successful Aging

d. Nonstochastic Theories

7. Under the functional consequences theory, the following are the roles of nurses except:

a. Identify contributing factors to difficulty with social relationships.

b. Assess age-related changes.

c. Determine biopsychosocial consequences that impact functioning.

d. Design interventions that minimize age-associated disability.

8. According to Jung’s theory, which statement by an older adult indicates successful aging?
a. “I have strong belief that there is life after death. So I am not afraid of dying.”

b. “I never experienced travel around the world, but I traveled in my imagination.”

c. “I lost my wife several years ago; I still miss her, but I focus on the good memories.”

d. “Well, when I look back at my life, I am happy to say that I did it my way.”

9. Which statement describes the importance of understanding nursing theory when practicing
gerontologic nursing?

a. Understanding and using tested theories offer a framework on which to base nursing practice
interventions

b. Nursing theories are vague and do not offer substance in most health-care settings

c. Theories are not proven ways on which to base nursing practice

d. Theory helps identify major concepts in nursing practice and offers a framework for decision making

10. A hospital clinical educator is espousing the disengagement theory of aging when teaching staff
how to best meet the needs of older clients. Which of the nurse’s teaching points best captures the
disengagement theory of aging?

a. “Older adults often benefit from a gradual and controlled withdrawal of their own interests from
society’s interest.”

b. “The disengagement between an older adult’s abilities and desires can lead to frustration and,
ultimately, to illness.”

c. “The lack of synchronicity between older adults’ immune systems and their environment can be
root of many problems.”

d. “It is imperative that we ensure older adults remain engaged with interests and events beyond

themselves.” SAS#6 correct ratio. You will be given 15 minutes to answer the questions.

A. Multiple Choice

1. Which is the best example of polypharmacy?

a. Your patient is filling her medications at more than 1 drugstore.

b. Your patient is taking more than 2 medications.

c. Your patient is taking more than 9 medications.

d. Your patient is taking a potentially inappropriate combination of medicines.

2. Which is the most effective method of managing polypharmacy?

a. Review of medications at each office visit, to ensure an accurate med list.

b. Limit your patients’ medication list to no more than 4 medicines.

c. Regularly assess patient adherence to the medication regimen. d. (a) and (c)

3. Oral drugs may be absorbed less quickly in older people because:

a. Of increased number of receptors in the heart

b. Of increased liver metabolism

c. Of increased kidney function

d. Of decreased gastrointestinal motility

4. Enteric coated tablets are designed to avoid being dissolved in the highly acidic stomach. Instead,
they dissolve in the intestine. Knowing this and what you know about gastrointestinal changes
associated with age, what can you conclude about enteric coated tablets and older patients?

a. The tablets will need to be given intravenously instead

b. These tablets will probably dissolve more slowly

c. The enteric coated tablets are unaffected by changes associated with age

d. These tablets may dissolve more quickly

5. In an older population we can expect that drugs will be:

a. Absorbed more quickly

b. Metabolized more quickly

c. Excreted more rapidly by the kidneys

d. Excreted less readily

6. Which of the following is an age-related physiologic change that may affect the absorption of
drugs?

a. Xerostomia

b. Faster stomach emptying

c. Altered pH of the stomach contents

d. Increased gastrointestinal tract motility

7. The nurse is caring for a group of older adult patients who are all receiving multiple medications.
The nurse understands that it is essential to individualize each patient's therapy. Which is the best
rationale for this practice?

A. The percentage of drug absorbed often is decreased in older adults.

B. Most older adults have decreased body fat and increased lean mass.

C. Hepatic metabolism tends to increase in older adults, resulting in decreased drug levels.

D. Renal function declines with age, leading to decreased drug excretion.

8. When assessing for drug effects in the older adult, which phase of pharmacokinetics is the greatest
concern?

A. Absorption

B. Distribution

C. Metabolism

D. Excretion

9. All of the following are impacts of polypharmacy EXCEPT:

a. Increased communication between care teams

b. Adverse drug events

c. Increased healthcare costs

d. Medication non-adherence

10. The single most important thing we can do as healthcare providers to prevent polypharmacy is:
a. Encourage our patients to carry a list of home medications in their wallet

b. Tell our patient to appoint a lead doctor

c. Educate our patients on each of their new medications

d. Tell our patients to Google all of their medications

SAS#7

A. Multiple Choice

1. You are caring for a client at the end of life. The client tells you that they are grateful for having
considered and decided upon some end of life decisions and the appointments of those who they
wish to make decisions for them when they are no longer able to do so. During this discussion with
the client and the client’s wife, the client states that “my wife and I are legally married so I am so glad
that she can automatically make all healthcare decisions on my behalf without a legal durable power
of attorney when I am no longer able to do so myself” and the wife responds to this statement with,
“that is not completely true. I can only make decisions for you and on your behalf when these
decisions are not already documented on your advance directive.” How should you, as the nurse,
respond to and address this conversation between the husband and wife and the end of life?

a. You should respond to the couple by stating that only unanticipated treatments and procedures
that are not included in the advance directive can be made by the legally appointed durable power of
attorney for healthcare decisions.

b. You should be aware of the fact that the wife of the client has a knowledge deficit relating to
advance directives and durable powers of attorney for healthcare decisions and plan an educational
activity to meet this learning need.

c. You should be aware of the fact that the client has a knowledge deficit relating to advance
directives and durable powers of attorney for healthcare decisions and plan an educational activity to
meet this learning need.

d. You should reinforce the wife’s belief that legally married spouses automatically serve for the
other spouse’s durable power of attorney for health care decisions and that others than the spouse
cannot be legally appointed while people are married

2. Your client is in the special care area of your hospital with multiple trauma and severe bodily burns.
This 75 year old male client has an advance directive that states that the client wants all life saving
measures including cardiopulmonary resuscitation and advance cardiac life support, including
mechanical ventilation. As you are caring for the client, the client has a complete cardiac and
respiratory arrest. This client has little of no chance for survival and they are facing imminent death
according to your professional judgement, knowledge of pathophysiology and your critical thinking.
You believe that all life saving measures for this client would be futile. What is the first thing that you,
as the nurse, should do?

a. Call the doctor and advise them that the client’s physical status has significantly changed and that
they have just had a cardiopulmonary arrest.

b. Begin cardiopulmonary resuscitation other emergency life saving measures.

c. Notify the family of the client’s condition and ask them what they should be done for the client.

d. Ensure that the client is without any distressing signs and symptoms at the end of life.

3. You are asked by your supervisor to take photographs of the residents and their family members
who are attending a holiday dinner and celebration at your long term care facility. What should you
do?

a. Take the photographs because these photographs are part of the holiday tradition at this facility

b. Take the photographs because all of the residents are properly attired and in a dignified condition
c. Refuse to take the photographs unless you have the consent of all to do so

d. Refuse to take the photographs because this is not part of the nurse’s role

4. Which is most closely aligned with ethics?

a. Morals

b. Laws

c. Statutes

d. Client rights

5. What ethical principle below is accurately paired with a way that ethical principle is applied into
nursing practice?

a. Justice: Equally dividing time and other resources among a group of clients

b. Beneficence: Doing no harm during the course of nursing care

c. Veracity: Fully answering the client’s questions without any withholding of information

d. Fidelity: Upholding the American Nurses Association’s Code of Ethics

6. One of the roles of the registered nurse in terms of informed consent is to:

a. Serve as the witness to the client’s signature on an informed consent.

b. Get and witness the client’s signature on an informed consent.

c. Get and witness the durable power of attorney for health care decisions’ signature on an informed
consent.

d. None of the above

7. Which of the following is most closely aligned with the principles and concepts of informed
consent?

a. Justice

b. Fidelity

c. Self determination

d. Nonmalficence

8. The student understands the ANA Code of Ethics for Nurses when she identifies which statement as
incorrect? The Code of Ethics for Nurses:

a. provides a framework for ethical decision-making.

b. is non-negotiable.

c. is not applicable to most practice settings.

d. helps with professional self-regulation.

9. The RN student has been studying ethics in health care. Based on what she has learned, how would
she explain the bioethical principle of autonomy?

a. It states that the physician knows what is best for the patient.

b. It does not apply to informed consent.

c. It refers to patient self-determination.

d. It states that every patient has a right to health care.

10. For the RN to practice ethical decision-making, it is most important for him or her to:

a. base decision-making on whether an action is right or wrong.

b. base decision-making on possible consequences.

c. accurately assess a situation.

d. seek the assistance of an ethics committee.

SAS#8

1. Which of the following is NOT a priority for patients with a life-limiting illness receiving palliative
care?

A) Relieving burden

B) Prolonging life at all costs

C) Obtaining a sense of control

D) Strengthening relationships with loved ones

2. The family of a client with a terminal illness hesitates to agree to palliative care because of not
wanting to give up on a possible cure. How should the nurse respond while also including a principle
of palliative care?

a. "Most people don't realize that palliative care means there is no cure."

b. "There will not be another opportunity if palliative care is refused now."

c. "The client can continue to receive treatment intended to cure the disease."

d. "Palliative care and curative treatments cannot be provided at the same time."

3. The family of a client receiving palliative care for a terminal illness hesitate to call for the nurse
since all staff seem to be too busy to address the client's needs. Which action should the nurse take to
improve the connection with the family?

a. Vary the number and type of caregivers who respond to the client's needs

b. Enter the room and stand or sit at the bedside to talk with the client and family

c. Provide the family with reading material that explains the role of palliative care

d. Attend to infusions and environmental issues while talking with the client and family

4. Which of the following is NOT a barrier to the optimum use of palliative care at the end of life?

A) Reimbursement policies

B) Easily determined prognoses

C) Lack of well-trained healthcare professionals

D) Attitudes of patients, families, and clinicians

5. An 80-year-old patient is receiving palliative care for heart failure. What are the primary purposes of
her receiving palliative care (select all that apply)? A. Improve her quality of life.

B. Assess her coping ability with disease.

C. Have time to teach patient and family about disease. D. Focus on reducing the

severity of disease symptoms.

E. Provide care that the family is unwilling or unable to give.

6. The home health nurse visits a 40-year-old breast cancer patient with metastatic breast cancer who
is receiving palliative care. The patient is experiencing pain at a level of 7 (on a 10-point scale). In
prioritizing activities for the visit, you would do which of the following first? A. Auscultate for breath
sounds.

B. Administer prn pain medication.

C. Check pressure points for skin breakdown.

D. Ask family members about patient's dietary intake.

7. You are visiting with the wife of a patient who is having difficulty making the transition to palliative
care for her dying husband. What is the most desirable outcome for the couple? A. They express hope
for a cure.

B. They comply with treatment options.

C. They set additional goals for the future.

D. They acknowledge the symptoms and prognosis.

8. 67-year-old woman was recently diagnosed with inoperable pancreatic cancer. Before the
diagnosis, she was very active in her neighborhood association. Her husband is concerned because his
wife is staying at home and missing her usual community activities. Which common end-of-life (EOL)
psychologic manifestation is she most likely demonstrating?

A. Peacefulness

B. Decreased socialization

C. Decreased decision-making

D. Anxiety about unfinished business

9. The caregiver children of an elderly patient whose death is imminent have not left the bedside for
the past 36 hours. In your assessment of the family, which of the following findings indicates the
potential for an abnormal grief reaction by family members (select all that apply)? A. Family
members cannot express their feelings to one another.

B. The dying patient is becoming more restless and agitated.

C. A family member is going through a difficult divorce.

D. The family talks with and reassures the patient at frequent intervals.

E. Siblings who were estranged from each other have now reunited.

10. Which statement made by the graduate nurse working in the hospice unit with a patient near the
end of life requires intervention by the preceptor nurse?

A. "The patient has eaten only small amounts the past 48 hours; will the physician consider placing a
feeding tube?"

B. "The family seems comfortable with the long periods of silence."

C. "The physician ordered an increase in the dosage of morphine; I will administer the new dose right
away."
D. "The blood pressure is lower this afternoon than it was this morning; I will communicate the changes
to the family."

SAS#9

1.The word spirituality derives from the Latin word spiritus, which refers to breath or wind. Today,
spirituality is

a. Awareness of one's inner self and a sense of connection to a higher being.

b. Less important than coping with the patient's illness.

c. Patient centered and has no bearing on the nurse's belief patterns.

d. Equated to formal religious practice and has a minor effect on health care.

2. The nurse is caring for a patient who claims that he does not believe in God, nor does he believe in
an "ultimate reality." The nurse realizes that this patient

a. Is devoid of spirituality.

b. Is an atheist/agnostic.

c. Finds no meaning through relationships with others.

d. Believes that what he does is meaningless.

3. The nurse is caring for a patient who is terminally ill with very little time left to live. The patient
states, "I always believed that there was life after death. Now, I'm not so sure. Do you think there is?"
The nurse states, "I believe there is." The nurse has attempted to

a. Strengthen the patient's religion.

b. Provide hope.

c. Support the patient's agnostic beliefs.

d. Support the horizontal dimension of spiritual well-being.

4.The nurse is admitting a patient to the hospital. The patient states that he is a very spiritual person
but does not practice any specific religion. The nurse understands that these statements a. Are
contradictory.

b. Indicate a strong religious affiliation.

c. Indicate a lack of faith.

d. Are reasonable.

5. Which of the following statement about religion and spirituality is true?

a. Religion is a unifying theme in people's lives.

b. Spirituality is unique to the individual.

c. Spirituality encompasses religion.

d. Religion and spirituality are synonymous.

6.The nurse creates a referral to pastoral care when he/she realizes that the patient is in need of a.

Psychiatric care.

b. Return to religious affiliation.

c. Spiritual care.

d. Transfer to the psychiatric unit.

7. When caring for a terminally ill, 90 yr old patient, the nurse should focus on the fact that

a. Spiritual care is possibly the least important nursing intervention.

b. Spiritual needs often need to be sacrificed for physical care priorities.

c. The nurse's relationship with the patient allows for an understanding of patient priorities.

d. Members of the church or synagogue play no part in the patient's plan of care.

8. The nurse is caring for a elderly patient who is in the final stages of his terminal disease. The patient
is very weak but refuses to use a bedpan, and wants to get up to use the bedside commode. What
should the nurse do?

a. Explain to the patient that he is too weak and needs to use the bedpan.

b. Insert a rectal tube so that the patient no longer needs to actively defecate.

c. Enlist assistance from family members if possible and assist the patient to get up.

d. Put the patient on a bedpan and stay with him until he is finished.

9.When evaluating a patient's risk for spiritual crises, which of the following are part of the evaluation
process? (Select all that apply.)

a. Review the patient's self-perception regarding spiritual health.

b. Review the patient's view of his/her purpose in life.

c. Discuss with family and associates the patient's connectedness.

d. Ask whether the patient's expectations are being met.

e. Impress on the patient that spiritual health is permanent once obtained.

10. The nurse is caring for a patient who has been diagnosed with a terminal illness. The patient
states, "I just don't feel like going to work. I have no energy, and I can't eat or sleep." The patient
shows no interest in taking part in his care. The nurse should

a. Not be concerned about self-harm because the patient has not indicated any desire toward suicide.

b. Ignore individual patient goals until the current crisis is over.

c. Encourage the patient to purchase over-the-counter sleep aids to help him sleep.

d. Assess the potential for suicide and make appropriate referrals.

SAS#10

1. A hospice nurse is visiting with a dying patient. During the interaction, the patient is silent for some
time. What is the best response?

A. Recognize the patient’s need for silence, and sit quietly at the bedside.

B. Try distraction with the patient.

C. Change the subject, and try to stimulate conversation.

D. Leave the patient alone for a period.

2. Which information obtained by the home health nurse when making a visit to an 88-year-old with
mild forgetfulness is of the most concern?
A. The patient’s son uses a marked pillbox to set up the patient’s medications weekly.

B. The patient has lost 10 pounds (4.5 kg) during the last month.

C. The patient is cared for by a daughter during the day and stays with a son at night.

D. The patient tells the nurse that a close friend recently died.

3. Which of the following statements accurately reflects data that the nurse should use in planning
care to meet the needs of the older adult?

A. 50% of older adults have two chronic health problems.

B. Cancer is the most common cause of death among older adults.

C. Nutritional needs for both younger and older adults are essentially the same.

D. Adults older than 65 years of age are the greatest users of prescription medications.

4. A long-term care facility sponsors a discussion group on the administration of medications. The
participants have a number of questions concerning their medications. The nurse responds most
appropriately by saying:

A. "Don't worry about the medication's name if you can identify it by its color and shape."

B. "Unless you have severe side affects, don't worry about the minor changes in the way you feel."

C. "Feel free to ask your physician why you are receiving the medications that are prescribed for you."

D. "Remember that the hepatic system is primarily responsible for the pharmacotherapeutics of your
medications."

5. Which of the following statements, made by the daughter of an older adult client concerning
bringing her mother home to live with her family, presents the greatest concern for the nurse?

A. "If this doesn't work out, she can always go to live with my sister."

B. "I don't think she will react very well to me making decisions for her."

C. "I'm afraid that mom will be depressed and miss her home."

D. "My children will just have to adjust to having their grandmother with us."

6. An assisted living facility has provided its clients with an educational program on safe
administration of prescribed medications. Which statement made by an older-adult client reflects the
best understanding of safe self-administration of medications?

A. "I don't seem to have problems with side effects, but I'll let my doctor know if something happens."

B. "I'm lucky since my daughter is really good about keeping up with my medications."

C. "I'll be sure to read the inserts and ask the pharmacist if I don't understand something."

D. "It shouldn't be too hard to keep it straight since I don't have any really serious health issues."

7. Of the following options, which is the greatest barrier to providing quality health care to the
olderadult client?

A. Poor client compliance resulting from generalized diminished capacity

B. Inadequate health insurance coverage for the group as a whole

C. Insufficient research to provide a basis for effective geriatric health care

D. Preconceived assumptions regarding the lifestyles and attitudes of this group

8. A home health aide is dressing a client. Which of the following is not true regarding this care?

A. Encourage the client to choose his or her own clothes

B. Overextend the extremities if necessary when undressing and dressing

C. Assist the client to don pants, shirt with sleeves, and socks

D. Never the force the extremities when undressing and dressing

9. A home health nurse is assisting a client to transfer from the bed to a wheelchair. Which of the
following is not true regarding this process?

A. Stand in front of the client as he or she stands up to go to the wheelchair

B. If needed, when the client stands to go to the wheelchair, grasp the gait belt from underneath at each
side

C. Take large steps to a position so that the client's knee caps are touching the front of the wheelchair

D. On the count of three, assist the client to stand up to walk to the wheelchair

10. A client wants to wear a pair of sunglasses in the facility at night time. Which of the following is
the appropriate action of the home health nurse?

A. None of the other options

B. Allow the client to wear the sunglasses since it is his or her right to do so

C. Let the client wear the sunglasses in the hopes that he or she will run into something due to impaired
vision

D. The sunglasses will impair the vision; so the home health aide should not allow the client to wear the
sunglasses

SAS#12

1. The nurse is setting up an education session with an 85-year-old patient who will be going home on
anticoagulant therapy. Which strategy would reflect consideration of aging changes that may exist
with this patient?

A. Show a colorful video about anticoagulation therapy.

B. Present all the information in one session just before discharge.

C. Give the patient pamphlets about the medications to read at home.

D. Develop large-print handouts that reflect the verbal information presented.

2. The nurse asks a newly admitted client, “What can we do to help you?” What is the purpose of this
therapeutic communication technique?

A. To reframe the client’s thoughts about mental health treatment

B. To put the client at ease

C. To explore a subject, idea, experience, or relationship

D. To communicate that the nurse is listening to the conversation

3. A student nurse is learning about the appropriate use of touch when communicating with clients
diagnosed with psychiatric disorders. Which statement by the instructor best provides information
about this aspect of therapeutic communication?

A. “Touch carries a different meaning for different individuals.”

B. “Touch is often used when deescalating volatile client situations.”

C. “Touch is used to convey interest and warmth.”

D. “Touch is best combined with empathy when dealing with anxious clients.”

4. Which nursing statement is a good example of the therapeutic communication technique of

focusing?

A. “Describe one of the best things that happened to you this week.”

B. “I’m having a difficult time understanding what you mean.”

C. “Your counseling session is in 30 minutes. I’ll stay with you until then.”

D. “You mentioned your relationship with your father. Let’s discuss that further.”

5. After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been
canceled. The client swears at the nurse and states, “You are incompetent!” Which is the nurse’s best
response?

A. “Do you believe that I was the cause of your blood test being canceled?”

B. “I see that you are upset, but I feel uncomfortable when you swear at me.”

C. “Have you ever thought about ways to express anger appropriately?”

D. “I'll give you some space. Let me know if you need anything.”

6. During a nurse-client interaction, which nursing statement may belittle the client’s feelings and
concerns?

A. “Don’t worry. Everything will be alright.”

B. “You appear uptight.”

C. “I notice you have bitten your nails to the quick.”

D. “You are jumping to conclusions.”

7. A client states, “You won’t believe what my husband said to me during visiting hours. He has no
right treating me that way.” Which nursing response would best assess the situation that occurred?

A. “Does your husband treat you like this very often?”

B. “What do you think is your role in this relationship?”

C. “Why do you think he behaved like that?”

D. “Describe what happened during your time with your husband.”

8. When interviewing a client, which nonverbal behavior should a nurse employ?

A. Maintaining indirect eye contact with the client

B. Providing space by leaning back away from the client

C. Sitting squarely, facing the client

D. Maintaining open posture with arms and legs crossed

9. When working with an older adult who is hearing-impaired, the use of which techniques would
improve communication? (Select all that apply.) A. Check for needed adaptive equipment.

B. Exaggerate lip movements to help the patient lip read.

C. Give the patient time to respond to questions.

D. Keep communication short and to the point.

E. Communicate only through written information.

10. A new nurse complains to her preceptor that she has no time for therapeutic communication with
her patients. Which of the following is the best strategy to help the nurse find more time for this
communication?

A. Include communication while performing tasks such as changing dressings and checking vital signs.

B. Ask the patient if you can talk during the last few minutes of visiting hours.

C. Ask Pastoral care to come back a little later in the day.

D. Remind the nurse to complete all her tasks and then set up remaining time for communication.

SAS#13

1. Why is it important for the nurse to be cautious when using medical jargon with an older adult
patient?

A) It could become an opportunity to instruct the patient.

B) It could become an effective abbreviated communication shortcut.

C) It could become an indicator of formal communication.

D) It could become a communication barrier.

2. The nurse is engaging the patient in social conversation. What is the benefit of social conversation
in the health care setting?

A) It lets the patient know that he or she is considered to be a person, not just a patient.

B) It encourages sharing of intimate details.

C) It establishes the nurse's role as a health care provider.

D) It blocks more meaningful therapeutic communication.

3. Mr. Gonzales, 72 years old, is admitted to the emergency room with a diagnosis of acute myocardial
infarction. The client tells the nurse, “I’m scared. I think I’m going to die.” Which of the following
responses by the nurse would be MOST appropriate?

A) “Everything is going to be fine. We’ll take good care of you.”

B) “I know what you mean. I thought I was having a heart attack once.”

C) “I’ll call your doctor so you can discuss it with him.”

D) “It’s normal to feel frightened. We’re doing everything we can for you.”

4. When using an interpreter to speak with an 84-year-old Chinese patient, on what should the nurse
focus?

A) The patient, not the interpreter

B) Encouraging the interpreter to paraphrase

C) Limiting questions from the patient

D) Listening to the words, not emotional tone

5. What are the two parts to communication?

A) There only needs to be one part, when someone says something

B) When someone says something, and the other person has understood

C) When someone says something, and the other person has replied

D) When someone says something while using non-verbal communication

6. Nurse Clara asked Mrs. Ramirez about how her day went. Mrs. Ramirez crossed her arms and rolled
her eyes but did not say anything. Nurse Clara nodded her head up and left the room. Have they
communicated?

A) No, at this stage it is one-way communication

B) No, when they answer you they will have communicated back, completing two-way communication

C) No, but they are being rude

D) Yes, they have used non-verbal communication

7. An unhelpful approach to communication with an older person may involve: a)

Always speaking slowly

b) Assessing them as an individual

c) Adapting to their individual needs

d) Seeing them as partners in their care

8. An example of an environmental barrier to effective communication is:

a) Inflexible appointment systems

b) Medical jargon

c) Staff shortages

d) Noisy clinical settings

9. Person-centered communication strategies with older people might involve:

a) Avoiding assumptions about their capacity to communicate effectively

b) Giving too much information at once c

c) Speaking too quickly c

d) Prioritizing staff safety, comfort and well-being

10. Which of the following can be a barrier to communication?

A) A nurse talking while the patient is talking

B) A nurse using slang

C) A hot room

D) All of the above

SAS#14

1. What is the leading cause of catastrophic out-of-pocket costs for families and involves substantial
government spending, primarily through Medicaid and Medicare? a. Palliative-care

b. Long-term care
c. Hospice Care

d. Home Care

2. Problems that the potential burden on aging society contribute on the care-giving system and
public finances are the following except,

a. Challenge of assuring sufficient resources

b. Effectivity of service system

c. Quality of Long-term care

d. More health care workers

3. Which of the following is not a solution to add funding for future care services?

a. Efforts to promote private long-term care insurance

b. Medicaid and Medicare expansions

c. Retaining long-term care workers

d. More attention from policymakers

4. The following are the different disability projection scenarios except:

a. High disability scenario

b. Low disability scenario

c. Middle disability scenario

d. Intermediate disability projection

5. This provides the “best guess” of the future size of the frail older population, does not assume any
particular trend in disability rates.

a. High disability scenario

b. Low disability scenario

c. Middle disability scenario

d. Intermediate disability projection

6. What program mandated to consider the international framework of the human rights of older
persons and to identify possible gaps and how to best address these, including considering the
feasibility of further UN instruments and measures?

a. Principles for Older Persons

b. Madrid International Plan of Action on Ageing (MIPAA)

c. UN Convention on the Rights of Persons with Disabilities (UNCRPD)

d. Open Ended Working Group on Ageing (OEWG)

7. What program gives a comprehensive action plan for building a society for all ages? a.

Principles for Older Persons

b. Madrid International Plan of Action on Ageing (MIPAA)

c. UN Convention on the Rights of Persons with Disabilities (UNCRPD)

d. Open Ended Working Group on Ageing (OEWG)

8. The following changes affect the future demand for paid and unpaid long-term care services except:

a. disability levels

b. financial resources

c. children’s availability

d. Availability of hospitals

9. Social and demographic changes create additional challenges. Much of the care received by frail
elders is provided informally by the family, and adult daughters often assume primary responsibility
for their parents’ care. The following are some reasons that affect availability of family caregivers over
time except:

a. rising divorce rates

b. Lack of job opportunities

c. increasing childlessness

d. declining family sizes.

10. The following are economic issue of an aging population except:

a. Decline in working-age population

b. Increase in health care costs

c. Advance Industrialized societies are growing younger

d. Changes in the economy

SAS#15

1. What is the most appropriate nursing diagnosis for an older adult who is bedridden because of
progressed Parkinson disease?

a. Risk for impaired skin integrity related to immobility

b. Immobility related to Parkinson disease

c. Impaired skin integrity related to incontinence

d. Ischemia related to disuse syndrome

2. An older patient asks why a wound is taking so long to heal. What explanation should the nurse
provide to this patient?

a. “There is less protein in the skin with aging”

b. “The tissue between the skin cells is weaker.”

c. “The amount of blood flow to the skin is slower with aging.”

d. “The number of immune cells in the skin reduces with aging.”

3. The nurse noted that an older patient complains of always feeling cold. Which age- related change
to the skin could be causing this in the patient?

a. Fewer protein stores

b. Decreased subcutaneous tissue

c. Reduced levels of immune cells

d. Slower blood flow to the skin layers

4. The primary reason an older adult client is more likely to develop a pressure ulcer on the elbow as
compared to a middle-age adult is:

A. A reduced skin elasticity is common in the older adult

B. The attachment between the epidermis and dermis is weaker

C. The older client has less subcutaneous padding on the elbows

D. Older adults have a poor diet that increases risk for pressure ulcers

5. While bathing an elderly client who has limited abilities for self-care, the nurse notices several
patches of dry skin on the clients heels, elbows, and coccyx. The nurse cleans and dries all the areas
well and applies a moisturizing lotion. The most appropriate immediate follow-up by the nurse to
ensure appropriate nursing care for this clients skin is to:

A. Revise the client's care plan to show the need for the application of moisturizing lotion

B. Assume personal responsibility to apply the moisturizing lotion daily to the client's skin

C. Encourage the client to tell whomever bathes her to apply the moisturizing lotion to her areas of dry
skin

D. Inform the staff that the client's skin is showing signs of breakdown and moisturizing lotion needs to
be applied daily

6. The primary risk factor for the development of pressure ulcers in older adult patients is: a.

immobility.

b. impaired circulation.

c. incontinence.

d. malnutrition.

7. A healthy 80-year-old female patient complains that her skin feels dry and sometimes itchy. The
gerontological nurse advises her to:

a. avoid scratching since breaks in the skin increase the risk of infection.

b. drink more liquids and take showers instead of baths.

c. take fewer baths, use soap sparingly, and apply skin cream afterward.

d. wear cotton clothing and try a different brand of soap.

8. In a quality review of pressure ulcers among nursing home residents, appropriate outcome criteria
include the:

a. Availability of supplies for wound care

b. Incidence of pressure ulcers correlated with staffing levels

c. Percentage of pressure ulcers that demonstrate healing each month

d. Rate of nurse compliance with the protocol for treating pressure ulcers

9. The cosmetic side of aging poses which effect on many older adults?

a. The physical effect of sagging cheeks

b. Psychological, affecting self-esteem and causing depression

c. No notable effect
d. No effect because older adults are mature enough to understand the aging process

10. The nurse understands that the goal for treatment of leg ulcers in the elderly client should be to?

a. Relieve pain and swelling

b. Relieve immobility

c. Promote circulation

d. Alleviate swelling, eliminate infection, and promote healing

SAS#16 and SAS # 17

Multiple Choice

1. The nurse is evaluating a 64-year-old male for coronary artery disease (CAD). Understanding that
CAD is the leading cause of mortality, which risk factor would not be related to CAD? a.
Hypertension

b. Dyslipidemia

c. Diabetes

d. Sexual orientation

2. What is the single most cost-effective discovery made in the past 30 years that has influenced the
prevention and treatment of cardiovascular events?

a. The development of oral hypoglycemic drugs

b. Recognizing the need to lower blood pressure in older adults

c. Antismoking campaigns

d. Zero tolerance for drug and alcohol abuse in older adults

3. The nurse is examining a 76-year-old female with the complaints of fatigue, ankle swelling, and mild
shortness of breath over a three-week period. An appropriate nursing diagnosis might include:

a. Decreased cardiac output related to altered contractility and elasticity of cardiac muscle

b. Activity tolerances due to compensation of oxygen supply

c. Increased cardiac output related to an aging heart muscle

d. Decreased urinary output due to poor kidney perfusion

4. A client is experiencing tachycardia. The nurse’s understanding of the physiological basis for this
symptom is explained by which of the following statements?

a. The demand for oxygen is decreased because of pleural involvement

b. The inflammatory process causes the body to demand more oxygen to meet its needs.

c. The heart has to pump faster to meet the demand for oxygen when there is lowered arterial oxygen
tension.

d. Respirations are labored.

5. According to the best available evidence, which one of the following lifestyle interventions for
reducing primary hypertension is not likely to be effective?

a. Dietary salt restriction

b. Fish oil supplementation

c. Magnesium supplementation

d. Physical activity and Weight loss

6. A nurse notes 2+ bilateral edema in the lower extremities of a client with myocardial infarction who
was admitted two (2) days ago. The nurse would plan to do which of the following next?

a. Review the intake and output records for the last two (2) days

b. Change the time of diuretic administration from morning to evening

c. Request a sodium restriction of one (1) g/day from the physician.

d. Order daily weight starting the following morning.

7. A nurse is assessing the blood pressure of a client diagnosed with primary hypertension. The nurse
ensures accurate measurement by avoiding which of the following?

a. Seating the client with arm bared, supported, and at heart level.

b. Measuring the blood pressure after the client has been seated quietly for 5 minutes.

c. Using a cuff with a rubber bladder that encircles at least 80% of the limb.

d. Taking a blood pressure within 15 minutes after nicotine or caffeine ingestion.

8. The most important long-term goal for a client with hypertension would be to: a.

Learn how to avoid stress

b. Explore a job change or early retirement

c. Make a commitment to long-term therapy

d. Control high blood pressure

9. When do coronary arteries primarily receive blood flow?

a. During inspiration

b. During diastolic

c. During expiration

d. During systole

10. Which of the following factors can cause blood pressure to drop to normal levels?

a. Kidneys’ excretion of sodium only

b. Kidneys’ retention of sodium and water

c. Kidneys’ excretion of sodium and water

d. Kidneys’ retention of sodium and excretion of water

SAS#18

Multiple Choice

1. Which of the following responses by an older-adult client is most reflective of a need for further
education by the nurse regarding the physiological changes associated with the older adult?
A. "I call a cab if I want to go out after dark."

B. "I can't help worrying about becoming forgetful."

C. "I have my eyes checked regularly. Can't afford to fall."

D. "I really enjoy eating good vanilla ice cream, but I have cut way down."

2. When caring for an older adult patient, the nurse uses the following interventions to accommodate
decreased touch sensation except;

a. Lower the water heater temperature to no higher than 120°F (49°C)

b. Treat seen injuries even if it is not painful

c. Check the thermometer to decide how and what to dress,

d. Give patients hot beverages.

3. When caring for an older adult patient, the nurse uses the following interventions to accommodate
visual changes with age:

A. Eye glasses in the bedside table.

B. Adequate lighting and uncluttered walkways.

C. Draw drapes in room to prevent glare.

D. Keep bedside rails down.

4. Which statement would be most appropriate to ask when assessing an aging adult for cognitive
function?

a) What is today's date?

b) Can you count to 10 for me?

c) Have you noticed anything different about your memory or thinking in the past few months?

d) Who is the president of the Philippines?

5. Which statement demonstrates normal cognitive function for an aging adult?

a) Occasional memory lapses

b) Unable to recall the names of their children or siblings

c) Unable to recall current address or phone number

d) Unable to count to 10 or repeat a series of consecutive numbers

6. Which item would not be a focus of a cognitive-perceptual pattern assessment for the older client?

a. Cognition--Have you experienced any changes in your memory?

b. Communication--Have you had any difficulty speaking or forming ideas?

c. Financial--Have you had any financial hardships over the past several months?

d. Orientation--Do you know what day, month, and year it is?

7. For an individual with age-related hearing loss, which sound is most difficult to hear:

a. A recording of a march played softly

b. A young child talking in a cafeteria line

c. Hammering during construction of a house next door

d. The voice of a man speaking in an elevator

8. An 80-year-old resident of a retirement center states that something is wrong with the lighting in
the room because colored rings appear around the light bulbs. The resident most likely has: a.
cataracts.

b. delusions.

c. glaucoma.

d. increased intracranial pressure.

9. The nurse recognizes that involuntary movements may appear in the elderly patient and be normal.
These normal involuntary movements may present as which of the following? a. Seizures

b. Tongue protrusions

c. Resting tremors

d. Eye twitches and spasms

10. The nurse recognizes the most common eye-related disease affecting the older adult is: a.

glaucoma

b. cataracts

c. near-sighted visual disturbances

d. far-sighted visual disturbances

SAS#19

Multiple Choice

1. Mr. Domingo, a 72-year-old, verbalizes his feelings of pain in his fingers. When a client complains of
pain, your initial response is:

a. Record the description of pain

b. Verbally acknowledge the pain

c. Refer the complaint to the doctor

d. Change to a more comfortable position

2. Decrease bone density is one of the effects of aging in the musculoskeletal system. What
independent nursing intervention should the nurse do to address this?

a. Promote safe and sensible exercise programs

b. Prepare diet rich in calcium and vitamin D

c. Prescribe multivitamins

d. Avoid sun exposure

3. Which of the following interventions should be taken to help an older client to prevent
osteoporosis?

A. Decrease dietary calcium intake.

B. Increase sedentary lifestyles

C. Increase dietary protein intake.

D. Encourage regular exercise.

4. There are factors that influence the musculoskeletal system associated with aging. The nurse
recognizes that with age:

a. Men have the greatest incidence of osteoporosis

b. Muscle fibers increase in size and become tighter

c. Weight-bearing exercise reduces the loss of bone mass

d. Muscle strength does not diminish as much as muscle mass

5. The most common cause of chronic pain in older adults is: a.

Arthritis.

b. Fractures.

c. Headaches.

d. Neuropathy.

6. A 76-year-old patient with osteoarthritis complains of pain, stiffness, and deformities of the fingers.
The gerontological nurse recommends:

a. cold packs.

b. exercise.

c. meditation therapy.

d. vitamin therapy.

7. Changes in bone and muscle in the aging population have the greatest effect on?

a. Stature, posture, and function

b. Appearance

c. Immunity

d. Pain tolerance

8. The nurse caring for the elderly population understands that movement slows with aging. This is
most likely due to:

a. Cognitive function

b. Changes in musculoskeletal and nervous systems

c. Laziness and a feeling that life is over

d. A recent change in medical condition

9. A 69-year-old female presents with knee pain. The nurse hears a dry crackling or grating sound and
the client feels the same sensation on exam. The nurse recognizes this as:

a. Nothing abnormal for the age of the client

b. Crepitation, the sound of osteoarthritis in the knee joint

c. Osteoporosis and a softening of the knee joint

d. Fluid-filled spaces in the knee joint

10. The nurse may recommend which of the following for the older client with mild arthritis? a.

Complete bedrest

b. Rest and ice for the joints affected

c. A mild exercise program including walking

d. No exercise will improve arthritis

SAS#20

Multiple Choice

The instructor will now rationalize the answers to the students and will encourage them to ask
questions and to discuss among themselves.

1. The nurse would instruct the client to eat which of the following foods to obtain the best supply of
vitamin B12?

A. Whole grains

B. Green leafy vegetables

C. Meats and dairy products

D. Broccoli and Brussels sprouts

2. A vegetarian client was referred to a dietitian for nutritional counseling for anemia. Which client
outcome indicates that the client does not understand nutritional counseling? The client:

A. Adds dried fruit to cereal and baked goods

B. Cooks tomato-based foods in iron pots

C. Drinks coffee or tea with meals

D. Adds vitamin C to all meals

3. Mr. Santos, 79-years-old, was admitted with iron deficiency anemia. Which question is most
appropriate for the nurse to ask in determining the extent of the client’s activity intolerance?

A. “What activities were you able to do 6 months ago compared to the present?”

B. “How long have you had this problem?”

C. “Have you been able to keep up with all your usual activities?”

D. “Are you more tired now than you used to be?”

4. The nurse is assessing a client’s activity intolerance by having the client walk on a treadmill for 5
minutes. Which of the following indicates an abnormal response?

A. Pulse rate increased by 20 bpm immediately after the activity

B. Respiratory rate decreased by 5 breaths/minute

C. Diastolic blood pressure increased by 7 mm Hg

D. Pulse rate within 6 bpm of resting phase after 3 minutes of rest.

5. A client with microcytic anemia is having trouble selecting food items from the hospital menu.
Which food is best for the nurse to suggest for satisfying the client’s nutritional needs and personal
preferences?

A. Egg yolks
B. Brown rice

C. Vegetables

D. Tea

6. Which of the following blood components is decreased in anemia?

A. Erythrocytes

B. Granulocytes

C. Leukocytes

D. Platelets

7. Laboratory studies are performed for an elderly suspected of having iron deficiency anemia. The
nurse reviews the laboratory results, knowing that which of the following results would indicate this
type of anemia?

A. An elevated hemoglobin level

B. A decreased reticulocyte count

C. An elevated RBC count

D. Red blood cells that are microcytic and hypochromic

8. Changes in the immune system that accompany aging include: A.

T cells becoming less responsive to antigens.

B. more cytotoxic T cells responding to infections.

C. increased numbers of T helper cells.

D. higher levels of antibodies after initial exposure to antigens.

9. With advancing age, the immune system

A. becomes more effective at combating disease.

B. remains the same and is not affected by the aging process.

C. becomes less effective at combating disease.

D. becomes more responsive to antigens.

10. The increased incidence of cancer in the elderly reflects the fact that A.

immune surveillance increases.

B. their diets do not meet nutritional standards.

C. everyone is prone to disease.

D. immune surveillance declines with age.

SAS#21

Multiple Choice

1. A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia,
weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based
on these assessment findings, nurse Richard would suspect which of the following disorders? A.
Diabetes mellitus
B. Diabetes insipidus

C. Hypoparathyroidism

D. Hyperparathyroidism

2. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control
hypoglycemic episodes, the nurse should recommend:

A. Increasing saturated fat intake and fasting in the afternoon.

B. Increasing intake of vitamins B and D and taking iron supplements.

C. Eating a candy bar if lightheadedness occurs.

D. Consuming a low-carbohydrate, high protein diet and avoiding fasting.

3. What factors can cause premature menopause?

A. Smoking

B. Autoimmune disorders

C. A woman's mother had early menopause

D. All of the above

4. What is the serious adverse effect of menopause?

A. Hot flashes

B. Osteoporosis

C. Heart disease

D. B and C

5. Hormone therapy eases some of the negative effects of menopause. Which of these hormones is
used?

A. Estrogen

B. Estrogen and progesterone

C. Testosterone

D. Prostaglandin

6. The nurse recognizes that a client is experiencing insomnia when the client reports (select all that
apply):

A. Extended time to fall asleep

B. Falling asleep at inappropriate times

C. Difficulty staying asleep

D. Feeling tired after a night’s sleep

7. A nursing measure to promote sleep in older adults is to:

A. Make sure the room is dark and quiet

B. Encourage evening exercise

C. Encourage television watching

D. Encourage quiet activities prior to bed time.

8. A female client verbalizes that she has been having trouble sleeping and feels wide awake as soon
as getting into bed. The nurse recognizes that there are many interventions the promote sleep. Check
all that apply.

A. Eat a heavy snack before bedtime

B. Read in bed before shutting out the light

C. Leave the bedroom if you are unable to sleep

D. Drink a cup of warm tea with milk at bedtime

E. Exercise in the afternoon rather than the evening

F. Count backwards from 100 to 0 when your mind is racing.

9. Which of the following substances is a natural hormone produced by the pineal gland that induces
sleep?

A. Amphetamine

B. Melatonin

C. Methylphenidate

D. Pemoline

10. Which of the following symptoms would a patient exhibit with hyperthyroidism?

A. Intolerance to cold

B. Decreased bowl movements

C. Slow heart rate

D. None of the above

SAS#22

1. A female client with dysphagia is being prepared for discharge. Which outcome indicates that the
client is ready for discharge?

A. The client doesn’t exhibit rectal tenesmus.

B. The client is free from esophagitis and achalasia.

C. The client reports diminished duodenal inflammation.

D. The client has normal gastric structures.

2. What laboratory finding is the primary diagnostic indicator for pancreatitis?

A. Elevated blood urea nitrogen (BUN)

B. Elevated serum lipase

C. Elevated aspartate aminotransferase (AST)

D. Increased lactate dehydrogenase (LD)

3. Nurse Liza is teaching a group of old-aged men about peptic ulcers. When discussing risk factors for
peptic ulcers, the nurse should mention: A. a sedentary lifestyle and smoking.

B. a history of hemorrhoids and smoking.

C. alcohol abuse and a history of acute renal failure.

D. alcohol abuse and smoking.

4. When teaching an elderly client how to prevent constipation, which of the following instructions
should the nurse include?

A. “Drink 6 glasses of fluid each day.”

B. “Avoid grain products and nuts.”

C. “Add at least 4 grams of bran to your cereal each morning.”

D. “Be sure to get regular exercise.”

5. In a client with diarrhea, which outcome indicates that fluid resuscitation is successful?

A. The client passes formed stools at regular intervals

B. The client reports a decrease in stool frequency and liquidity

C. The client exhibits firm skin turgor

D. The client no longer experiences perianal burning.

6. The nurse is caring for an older adult patient who reports continued problems with constipation.
What intervention can be implemented to promote timely bowel movements? A.

Increase fiber intake.

B. Limit fluid intake to 1500 mL daily.

C. Administration of an oil retention enema weekly.

D. Take a mild over-the-counter laxative each evening.

7. An elderly patient reports a loss of interest in eating. When providing information to the patient,
which action by the nurse is likely to be most helpful in increasing the patient's intake? A. Having
the patient keep a food diary.

B. Giving the patient a list of high-calorie foods.

C. Reminding the patient of the importance of eating.

D. Suggesting to the patient's family members that someone join the patient for meals.

9. The specific cause of dysphagia can be determined more easily when the nurse obtains which
information about the patient?

A. Patient's vital signs, especially rate and depth

B. Level of physical activity tolerated by the patient

C. Patient's bowel habits and whether laxatives are taken habitually

D. Observing conditions under which the patient experiences difficulty swallowing

10. When planning care for the patient with acute pancreatitis, the nurse knows that which
intervention is a priority of care?

A. Pain control

B. Nutritional supplementation

C. Observation for mental changes

D. Observation for intestinal obstruction

SAS#23

Multiple Choice

1. You have a patient that might have a urinary tract infection (UTI). Which statement by the patient
suggests that a UTI is likely? A. “I pee a lot.”

B. “It burns when I pee.”

C. “I go hours without the urge to pee.”

D. “My pee smells sweet.”

2. Which patient is at greatest risk for developing a urinary tract infection (UTI)?

A. A 35 y.o. woman with a fractured wrist

B. A 20 y.o. woman with asthma

C. A 50 y.o. postmenopausal woman

D. A 28 y.o. with angina

3. Nurse Gil is aware that the following statements describing urinary incontinence in the elderly is
true?

A. Urinary incontinence is a normal part of aging.

B. Urinary incontinence isn’t a disease.

C. Urinary incontinence in the elderly can’t be treated.

D. Urinary Incontinence is a disease.

4. When developing a plan of care for the client with stress incontinence, the nurse should take into
consideration that stress incontinence is best defined as the involuntary loss of urine associated with:
A. A strong urge to urinate

B. Overdistention of the bladder

C. Activities that increase abdominal pressure

D. Obstruction of the urethra

5. The nurse is developing a teaching plan for a client with stress incontinence. Which of the following
instructions should be included?

A. Avoid activities that are stressful and upsetting

B. Avoid caffeine and alcohol

C. Do not wear a girdle

D. Limit physical exertion

6. A client has urge incontinence. Which of the following signs and symptoms would the nurse expect
to find in this client?

A. Inability to empty the bladder

B. Loss of urine when coughing

C. Involuntary urination with minimal warning

D. Frequent dribbling of urine

7. When assessing the patient who has a lower urinary tract infection (UTI), the nurse will initially ask
about

a. Flank pain.

b. Pain with urination.

c. Poor urine output.

d. Nausea.

8. After her bath, a 62-year-old patient asks the nurse for a perineal pad, saying that she uses them
because sometimes she leaks urine when she laughs or coughs. Which intervention is most
appropriate to include in the care plan for the patient? A. Teach the patient how to perform Kegel
exercises.

B. Demonstrate how to perform Credé's maneuver.

C. Place commode at the patient's bedside.

D. Assist the patient to the bathroom q3hr.

9. A 78-year-old patient is admitted to the hospital with dehydration and electrolyte imbalance. The
patient is confused and incontinent of urine on admission. In developing a plan of care for the patient,
an appropriate nursing intervention for the patient's incontinence is to

a. Insert an indwelling catheter.

b. Apply absorbent incontinent pads.

c. Assist the patient to the bathroom q2hr.

d. Restrict fluids after the evening meal.

10. A patient in the hospital has a history of urinary incontinence. Which nursing action will be
included in the plan of care?

a. Place a bedside commode near the patient's bed.

b. Use an ultrasound scanner to check urine residual after the patient voids.

c. Demonstrate the use of the Credé maneuver to the patient.

d. Teach the use of Kegel exercises to strengthen the pelvic floor

SAS#24

1. The nurse is counseling a postmenopausal woman about her new stress incontinence. Which
statement by the nurse is most important?

a. "You can try a variety of briefs and undergarments."

b. "It will be important to keep that area clean and dry."

c. "I can refer you to a good incontinence clinic."

d. "Unfortunately, incontinence is common in women your age."

2. An older woman is asking the nurse about her husband's sexual functioning. Which statement by
the nurse is most accurate?
a. "Men his age tend to have a rapid decline in sexual abilities."

b. "His testosterone levels will decrease only slightly until he is quite old."

c. "Changes in testosterone levels do not affect sexual performance."

d. "You are lucky your husband is healthy enough for sexual activity."

3. The nurse is conducting a reproductive assessment of a postmenopausal woman. Which assessment

finding reported by the client requires immediate intervention by the nurse? a. Urinary incontinence

b. Vaginal dryness

c. Painful intercourse

d. Returning periods

4. A postmenopausal client says that she is experiencing difficulty with vaginal dryness during
intercourse and wonders what might be causing this. Which is the nurse's best response?

a. "The less frequently you have intercourse, the drier the vaginal tissues become."

b. "Estrogen deficiency causes the vaginal tissues to become drier and thinner."

c. "Drinking at least 3 liters of water each day will make all your tissues less dry."

d. "Try using a water-soluble lubricant during intercourse."

5. The nurse is teaching a postmenopausal woman about nutrition. Which statement by the nurse is
most appropriate?

a. "Be sure to eat cereal fortified with folic acid and B vitamins."

b. "Make sure you take a calcium supplement every day."

c. "Vitamin C is important for the postmenopausal woman."

d. "You can get all the iron you need in two daily meat servings."

6. When performing an assessment of the external genitalia of an older man, the nurse observes the
scrotum to have smooth skin and to be very pendulous. Which action by the nurse is most
appropriate?

a. Suggest to the client that he should wear an athletic supporter while awake.

b. Ask the client if he has been treated for a sexually transmitted disease.

c. Document the observation and continue the assessment.

d. Notify the health care provider and facilitate a scrotal ultrasound.

7. The nurse counsels the 70-year-old female who has remained on hormone replacement therapy
(HRT) that she needs to have a:

a. semiweekly douche to wash out cervical debris.

b. liver function assessment annually.

c. mammogram biannually.

d. Pap smear annually.

8. The nurse evaluates a need for further instruction to reduce the symptoms of vaginal dryness when
the 70-year-old patient says:

a. "Vaseline was good enough for my mother. It's good enough for me."
b. "I use a water-soluble lubricant to aid intercourse."

c. "I'm trying an estrogen cream to see if it works."

d. "I'll let you know how wild yams work for vaginal dryness."

9. The nurse identifies the person most likely to experience erectile dysfunction as the 65-year-old
who has _____ sexually active in earlier years.

a. diabetes and was very

b. irritable bowel syndrome and was minimally

c. chronic pancreatitis and was very

d. osteoarthritis and was moderately

10. The nurse lists the age-related changes in the female reproductive system that affect sexual
intercourse, which are __________. (Select all that apply.)

a. pruritus vulvae

b. atrophic vaginitis

c. frequent yeast infections

d. dyspareunia

e. decreased response time

SAS#25

CHECK FOR UNDERSTANDING (15 minutes)

You will answer and rationalize this by yourself. One (1) point will be given to correct answer and
another one (1) point for the correct ratio. You are given 15 minutes for this activity:

A. True /False

1. As we get older, we should limit our physical activities because they can be too taxing on our
bodies.

A. True B. False

2. Exercising during the day will keep you up at night.

A. True B. False

3. Many exercises can be done from a wheelchair.

A. True B. False

4. An older person's exercise program should include activities that develop flexibility, balance,
strength training, and endurance.

A. True B. False

5. Older people don't need to drink as much fluid during exercise as younger people.

A. True B. False

6. The nurse is preparing a teaching plan for a client who is scheduled to undergo mammography for
the first time. What instruction by the nurse is accurate?

A. "The test should be carried out even if you are pregnant."

B. "Do not use deodorant on breasts or underarms before the test."

C. "You will not experience any discomfort because this is just an x-ray."

D. "The entire test should not take longer than 1 hour."

7. The nurse works with elderly clients in a wellness screening clinic on a weekly basis. Which of the
following statements made by the nurse is the most therapeutic regarding their mobility?

A. "Your shoulder pain is normal for your age."

B. "Continue to exercise your joints regularly to your tolerance level."

C. "Why don't you begin walking 3 to 4 miles a day, and we'll evaluate how you feel next week." D.

"Don't worry about taking that combination of medications since your doctor has prescribed them."

8. The nurse is discussing an older adult’s recent diagnosis of rheumatoid arthritis with a colleague.
Which of the nurse’s statements reflects an accurate view of the relationship between aging and
wellness?

A. “It’s important that he individual knows this is an expected part of growing older.”

B. “We need to teach the older adult how he can keep living a fruitful life in spite of his diagnosis.”

C. “We need to make sure our teaching is not too detailed for someone oh his age.”

D. “We need to ensure his expectations of continuing to live alone are realistic.”

9. A nurse who provided care to many older adults recognizes the importance of implementing a
wellness approach toccare. What principle underlies this approach to the health care of older adults?
A. Older adults have decreasing expectations for wellness as they move through the aging process.

B. Health problems are a Western cultural construct that has no objectives, physiological basis.

C. Older adults must come to accept a decline in wellness as they age.

D. A holistic approach to caring for older adults can foster their well-being at every stage of life.

10. Mr. Fernandez is an 81-year-old man whose current hospital admission has been prompted by an
exacerbation of his chronic renal failure. The nurse who is caring for Mr. Fernandez is aware of the
importance of fostering his wellness, a goal that can be achieved by emphasizing which of the
following?

A. Comparing Mr. Fernandez’s health to other patients who are more ill.

B. Exploring Mr. Fernandez’s abilities and strengths

C. Advocating that Mr. Fernandez’s code status be changed to “do not resuscitate”

D. Teaching Mr. Fernandez that his health problems do not have to affect his daily routines.

SAS#26

1. The nurse is performing an assessment in a 70 year old client with a suspected diagnosis of cataract.
The chief clinical manifestation that the nurse would expect to note in the early stages of cataract
formation is:

a. Eye pain

b. Floating spots

c. Blurred vision

d. Diplopia
2. When using a Snellen alphabet chart, the nurse records the client’s vision as 20/40. Which of the
following statements best describes 20/40 vision?

a. The client has alterations in near vision and is legally blind.

b. The client can see at 20 feet what the person with normal vision can see at 40 feet.

c. The client can see at 40 feet what the person with normal vision sees at 20 feet.

d. The client has a 20% decrease in acuity in one eye, and a 40% decrease in the other eye.

3. When developing a teaching session on glaucoma for the senior community, which of the following
statements would the nurse stress?

a. Glaucoma is easily corrected with eyeglasses

b. White and Asian individuals are at the highest risk for glaucoma.

c. Yearly screening for people ages 20-40 years is recommended.

d. Glaucoma can be painless and vision may be lost before the person is aware of a problem.

Multiple Choice

1. During the morning change-of-shift report at the long-term care facility, the nurse learns that the
patient with dementia has had sundowning. Which nursing action should the nurse take while caring
for the patient?

a. Provide hourly orientation to time of day.

b. Move the patient to a quieter room at night.

c. Keep blinds open during the daytime hours.

d. Have the patient take a brief mid-morning nap.

2. A long-term care patient with moderate dementia develops increased restlessness and agitation.
The nurse's initial action should be to

a. reorient the patient to time, place, and person.

b. administer the PRN dose of lorazepam (Ativan).

c. assess for factors that might be causing discomfort.

d. have a nursing assistant stay with the patient to ensure safety.

3. Which statement(s) accurately describe(s) mild cognitive impairment (select all that apply)? a.

Always progresses to AD

b. Caused by variety of factors and may progress to AD

c. Should be aggressively treated with acetylcholinesterase drugs

d. Caused by vascular infarcts that, if treated, will delay progression to AD

e. Patient is usually not aware that there is a problem with his or her memory

4. Which patient is most at risk for developing delirium?

a. A 50-year-old woman with cholecystitis

b. A 19-year-old man with a fractured femur

c. A 42-year-old woman having an elective hysterectomy

d. A 78-year-old man admitted to the medical unit with complications related to heart failure

5. 82-year-old Mr. Robeson together with his daughter arrived at the medical-surgical unit for
diagnostic confirmation and management of probable delirium. Which statement by the client’s
daughter best supports the diagnosis?

a.“Maybe it’s just caused by aging. This usually happens by age 82.” b“The changes in

his behavior came on so quickly! I wasn’t sure what was happening.”

c.“Dad just didn’t seem to know what he was doing. He would forget what he had for breakfast.”

d. “Dad has always been so independent. He’s lived alone for years since mom died.”

6. During the home visit of a client with dementia, the nurse notes that an adult daughter persistently
corrects her father’s misperceptions of reality, even when the father becomes upset and anxious.
Which intervention should the nurse teach the caregiver?

a. Anxiety-reducing measures

b.. Positive reinforcement

c. Reality orientation techniques

d. Validation techniques

7. The nurse is developing a teaching plan for the client with glaucoma. Which of the following
instructions would the nurse include in the plan of care?

a.Decrease fluid intake to control the intraocular pressure

b.Avoid overuse of the eyes

c.Decrease the amount of salt in the diet

d.Eye medications will need to be administered lifelong.

8. Which of the following procedures or assessments must the nurse perform when preparing a
client for eye surgery?

a.Clipping the client’s eyelashes

b. Verifying the affected eye has been patched 24 hours before surgery

c.Verifying the client has been NPO since midnight, or at least 8 hours before surgery.

d.Obtaining informed consent with the client’s signature and placing the forms on the chart.

9. A student nurse is learning about the appropriate use of touch when communicating with clients
with Inability to recognize, or understand words. Which statement by the instructor best provides
information about this aspect of therapeutic communication?

a. “Touch carries a different meaning for different individuals.”

b. “Touch is often used when deescalating volatile client situations.”

c. “Touch is used to convey interest and warmth.”

d. “Touch is best combined with empathy when dealing with anxious clients.”

10. 70 year old client in geriatric ward unit tells the nurse, “I should have died because I am totally
worthless.” In order to encourage the client to continue talking about feelings, which should be the
nurse’s initial response?
a. “How would your family feel if you died?”

b. “You feel worthless now, but that can change with time.”

c. “You’ve been feeling sad and alone for some time now?”

d. “It is great that you have come in for help.”

SAS#27

Multiple Choice

1. What are the benefits of telehealth? ( Select all that apply)

A. Continuity of care

B. Centralized health records

C. Collaboration among healthcare professionals

D. Low quality of care

2. After instituting a new system for recording patient data, a nurse evaluates the "usability" of the
system. Which actions by the nurse BEST reflect this goal? Select all that apply.

A. The nurse checks that the screens are formatted to allow for ease of data entry.

B. The nurse reorders the screen sequencing to maximize effective use of the system.

C. The nurse ensures that the computers can be used by specified users effectively.

D. The nurse checks that the system is intuitive, and supportive of nurses.

E. The nurse improves end-user skills and satisfaction with the new system.

F. The nurse ensures patient data is able to be shared across health care systems.

3. Mr. Sanchez is using telehealth services. He can talk with this physician via videocall about his
condition. What type of telehealth applications is he using?

A. Synchronous

B. Store-and-Forward

C. Remote Patient Monitoring

D. Mobile Health

4. Mrs. Quezon noticed a rash on her face. She immediately took a picture and send it to her
dermatologist. What type of telehealth applications is she using?

A. Synchronous

B. Store-and-Forward

C. Remote Patient Monitoring

D. Mobile Health

5.Telehealth differs from telemedicine in that _____.

A. Telemedicine is a broader term than telehealth and emphasizes the provision of information to
healthcare providers and consumers

B. Telemedicine uses the Internet to provide professionals with information while telehealth does not
C .Telehealth encompasses telemedicine, but is a broader term that emphasizes the provision of
information to health care providers and consumers

D .Telehealth is a narrow term referring only to wellness behaviors

6. A synchronous, or real-time, encounter that uses a computer, webcam, and Internet connection to
allow people to meet face-to-face and/or view papers and images simultaneously is called
______________.

A. Podcast

B. Videoconferencing

C. Interactive video disk (IVD)

D. Health technology

7. Which of the following are issues associated with the practice of telehealth and telenursing?

A. Lack of reimbursement, privacy and confidentiality concerns, licensure and liability issues

B. Difficulties with technical support

C. Cost of equipment

D. Lack of HIE standards

8. Which of the following is an example of a low-tech telehealth application?

A. Social media groups

B. A home glucose-monitoring program that uses a touch-tone phone to report glucose results C.

Photosharing

D. real-time videoconferencing between a physician and clients with transmission of diagnostic images

9. Which of the following might be considered to be advantages for consumers associated with the
delivery of healthcare services via telehealth?

A. Small facilities and private practices can shorten their revenue cycles

B. Increased access to otherwise underserved populations, decreased travel time and costs, and access
to services for consumers who are "on the road"

C. Providers can increase their revenue

D. Providers can provide care from the comfort of their own homes

10. Which of the following strategies help to ensure successful teleconferences?

A. Asking all participants to keep themselves on the mute setting to prevent unacceptable background
noise

B. Asking participants to load special software immediately prior to the scheduled conference

C. Advance preparation as in scheduling in advance, preparing an agenda, and starting and ending on
time

D. Requesting all participants to make their presence visually via the use of webcams

SAS#28

Multiple Choice
1. A 79 year old patient recently fractured her hip and had a Hemiarthroplasty bipolar hip repair. Her
daughter works during the day but provides care in the evening. Which service agency is most
appropriate to provide for this patients daily care?

A. Private duty agency

B. Home health agency

C. Nursing home facility

D. Outpatient rehabilitation agency

2. A student nurse asks her nurse educator why there is an increased demand for home health care.
Which response is the MOST accurate for the nurse educator?

A. Most family members want to care for their ill members at home.

B. There is a shortage of nurses who want to work in acute hospital care settings.

C. There is an increase in the number of older patients with chronic illnesses

D. There is increased technology in hospitals which provokes anxiety to many patients.

3. Nurse Abbie is assigned to home health care for an 83 year old patient with a stroke who has
rightsided hemiplegia, difficulty swallowing, and speech impairment. He is receiving care in his home
from his wife and daughter. What should the home care nurse provide?

A. Strict egimen and care plan

B. Holistic, nonjudgemental philosophy

C. Teaching plan for all family members

D. Means of transporting the patient to his physician

4. A 68 year old patient is recovering from an abdominoperineal Resection with a permanent

Colostomy. Her physician has ordered home health care nursing on her discharge. What is the primary
patient goal?

A. The patient will be able to return to previous lifestyle.

B. The patient will avoid dependency on medication therapy.

C. The patient will establish self-care and independence.

D. The patient will maintain a friendly relationship with family members.

5. The home health nurse has been assigned to provide care for a patient with cultural values that
differ from the nurse's. What is the BEST action for the nurse to take? (Select all that apply)

A. Ask for an assignment change to allow a colleague who has cultural values more in line with those of
the patient to be assigned.

B.Take time to consider the differences between the values held and those of the assigned patient

C.Research the culture of the assigned patient

D. Accept the assignment and provide the patient with information on the values of the nurse to
facilitate communication.

6. Why is documentation a very important responsibility of the home health aide?

A. Documentation is the main way that the members of the home health care team communicate
with each other about the care given to the client and the client's condition, and the home health aide
has the most frequent contact with the client.
B. Documentation provides information that is used to determine if a client is recovering or getting
worse.

C. Documentation of all care provided is needed to justify continued payment for home care

services D. All of the above

7. When arranging home care for a patient, from whom should the home health care nurse collect
data?

A. Patient

B. Primary Care Provider

C. Family members as per patient wishes

D. All of the above

8. The following are the goals of home health nursing except:

A. Maximize independence and minimize disabilities

B. Reduce costs

C. Increase costs and budget

D. Allow individuals to remain at home

9. A nurse must visit within how long after a referral?

A. 8 hours

B. 12 hours

C. 24 hours

D. 32 hours

10. A home health visit should not exceed:

A. 1 hour

B. 2 hours

C. 3 hours

D. 4 hours

1. Based on the free theory of aging, what would be an appropriate behavior that
might increase one’s life expectancy? *
1 point

a. Exercise for 45 minutes at least three times a week.

b. Eat food rich in antioxidants.
c. Eat a low-calorie, high protein diet.
d. Do nothing. Life expectancy is determined through genetic programming.

2. Mr. Ramos, a 76-year old patient, has difficulty with social relationships and
shows signs of depression. As a nurse,you know that these symptoms describe
what theory? *
1 point
a. Functional Consequences theory
b. Theory of Thriving
c. Theory of Successful Aging
d. Nonstochastic Theories

3. According to Jung’s theory, which statement by an older adult indicates

successful aging? *
1 point

a. “I have strong belief that there is life after death. So I am not afraid of dying.”
b. “I never experienced travel around the world, but I traveled in my imagination.”
c. “I lost my wife several years ago; I still miss her, but I focus on the good memories.”
d. “Well, when I look back at my life, I am happy to say that I did it my way.”

4. Which theory suggests that older people who have low levels of social activity
have a high degree of life satisfaction? *
1 point

a. Activity
b. Age stratification
c. Disengagement
d. Exchange

5. The nurse would recognize successful aging according to Jung’s theory when
a long-term care facility resident demonstrates which of the following behaviors?
*
1 point

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 resident wears a large cowboy hat at all times because he likes it.

6. Enteric coated tablets are designed to avoid being dissolved in the highly
acidic stomach. Instead, they dissolve in the intestine. Knowing this and what
you know about gastrointestinal changes associated with age, what can you
conclude about enteric coated tablets and older patients? *
1 point

a. The tablets will need to be given intravenously instead

b. These tablets will probably dissolve more slowly
c. The enteric coated tablets are unaffected by changes associated with age
d. These tablets may dissolve more quickly

7. Which of the following is an age-related physiologic change that may affect the
absorption of drugs? *
1 point

a. Xerostomia
b. Faster stomach emptying
c. Altered pH of the stomach contents
d. Increased gastrointestinal tract motility
8. The nurse is caring for a group of older adult patients who are all receiving
multiple medications. The nurse understands that it is essential to individualize
each patient's therapy. Which is the best rationale for this practice? *
1 point

A. The percentage of drug absorbed often is decreased in older adults.

B. Most older adults have decreased body fat and increased lean mass.
C. Hepatic metabolism tends to increase in older adults, resulting in decreased drug levels.
D. Renal function declines with age, leading to decreased drug excretion.

9. The single most important thing we can do as healthcare providers to prevent

polypharmacy is: *
1 point

a. Encourage our patients to carry a list of home medications in their wallet

b. Tell our patient to appoint a lead doctor
c. Educate our patients on each of their new medications
d. Tell our patients to Google all of their medications

10. Which is the best example of polypharmacy? *

1 point

a. Your patient is filling her medications at more than 1 drugstore.

b. Your patient is taking more than 2 medications.
c. Your patient is taking more than 9 medications.
d. Your patient is taking a potentially inappropriate combination of medicines.

11. You are asked by your supervisor to take photographs of the residents and
their family members who are attending a holiday dinner and celebration at your
long term care facility. What should you do? *
1 point

A. Take the photographs because these photographs are part of the holiday tradition at this
facility
B. Take the photographs because all of the residents are properly attired and in a dignified condition
C. Refuse to take the photographs unless you have the consent of all to do so
D. Refuse to take the photographs because this is not part of the nurse’s role

12. The RN student has been studying ethics in health care. Based on what she
has learned, how would she explain the bioethical principle of autonomy? *
1 point

a. It states that the physician knows what is best for the patient.
b. It does not apply to informed consent.
c. It refers to patient self-determination.
d. It states that every patient has a right to health care.

13. For the RN to practice ethical decision-making, it is most important for him or
her to: *
1 point

a. base decision-making on whether an action is right or wrong.

b. base decision-making on possible consequences.
c. accurately assess a situation.
d. seek the assistance of an ethics committee.
14. Your client is in the special care area of your hospital with multiple trauma
and severe bodily burns. This 75 year old male client has an advance directive
that states that the client wants all life saving measures including
cardiopulmonary resuscitation and advance cardiac life support, including
mechanical ventilation. As you are caring for the client, the client has a complete
cardiac and respiratory arrest. This client has little of no chance for survival and
they are facing imminent death according to your professional judgement,
knowledge of pathophysiology and your critical thinking. You believe that all life
saving measures for this client would be futile. What is the first thing that you, as
the nurse, should do? *
1 point

A. Call the doctor and advise them that the client’s physical status has significantly changed
and that they have just had a cardiopulmonary arrest
B. Begin cardiopulmonary resuscitation other emergency life saving measures. C. Notify the
family of the client’s condition and ask them what they should be done for the client.
D. Ensure that the client is without any distressing signs and symptoms at the end of life.

15. What ethical principle below is accurately paired with a way that ethical
principle is applied into nursing practice? *
1 point

A. Justice: Equally dividing time and other resources among a group of clients
B. Beneficence: Doing no harm during the course of nursing care
C. Veracity: Fully answering the client’s questions without any withholding of information
D. Fidelity: Upholding the American Nurses Association’s Code of Ethics

16. Which best describes what guides the appropriate nursing care of an aging
adult? *
1 point

a. Evidence-based practice developed with ongoing research into the needs and outcomes of older
adults
b. General nursing care previously practices
c. Facility policies and procedures
d. Physician orders for patient complaints

17. When teaching an independent older adult patient how to self-administer

insulin, the most productive approach is to: *
1 point

a. facilitate involvement in a small group where the skill is being taught.

b. gather information about the patient's family health history.
c. provide frequent, competitive skills testing to enhance learning.
d. use repeated return demonstrations to promote the patient's retention of the involved tasks.

18. A 90-year-old patient comes to the clinic with a family member. During the
health history, the patient is unable to respond to questions in a logical manner.
The gerontological nurse's action is to: *
1 point

a. ask the family member to answer the questions.

b. ask the same questions in a louder and lower voice.
c. determine if the patient knows the name of the current president.
d. rephrase the questions slightly, and slowly repeat them in a lower voice.

19. An 80-year-old patient, who lives at home with a spouse, is instructed to

follow a 2 g sodium diet. The patien tstates, "I've always eaten the same way all
my life, and I'm not going to change now." To promote optimal dietary adherence,
the gerontological nurse's initial approach is to: *
1 point

a. inform the patient about the need to follow the diet.

b. inquire about the patient's current food preferences and eating habits.
c. list the variety of foods that are allowed on the diet.
d. provide dietary instruction to the patient's spouse, who prepares the meals.

20. What benefit does evidence-based practice offer clients over the age of 60? *
1 point

a. No actual benefits have been noted when evidence-based practice is the model for geriatric care
b. Evidence-based practice offers the client improved health care in all settings
c. Evidence-based practice is only used as a model in acute care settings
d. Minimal changes in geriatric care have arisen from the use of evidence-based practice models

21. A 70-year-old presents to the clinic stating that his family thinks he is losing
his mind and they want to put him in a home. What would be the initial role of the
gerontological nurse? *
1 point

a. Begin the process of finding a qualified nursing home

b. Do a complete history,physical, and assessment
c. Speak with the family about their concerns
d. Make light of the subject until the nurse can evaluate the situation

22. An 87-year-old man, who has been living independently, is entering a nursing
home. To help him adjust, the most effective action is to: *
1 point

a. involve him in as many activities as possible so he can meet other residents.

b. move him as quickly as possible so that he does not have time to think.
c. restrict family visits for the first two weeks to give him time to adjust.
d. suggest that he bring his favorite things from home to make his room seem familar

23. The nurse caring for the elderly population understands that movement slows
with aging. This is most likely due to: *
1 point

a. Cognitive function
b. Changes in musculoskeletal and nervous systems
c. Laziness and a feeling that life is over
d. A recent change in medical condition

24. The nurse is aware that a person’s attitude about aging is influenced mainly
by his or her __________. (Select all that apply.) *
2 points

a.life experiences
b.income level
c.level of education
d.current age.occupation

25. The family member of a patient asks if vitamin C will prevent aging. In
formulating an appropriate response, the nurse considers what theory? *
1 point

a. free radical theory.

b. autoimmune theory.
c. wear-and-tear theory.
d. continuity theory.

26. The 45-year-old patient reports to the nurse he feels he is going through a
"mid-life crisis." The nurse recognizes this phenomenon refers to the theory
developed by which psychologist? *
1 point
a. Jung
b. Erikson
c. Newman
d. Havighurst

27. Patient Cruz tells the nurse she can "feel her biologic clock ticking." The
nurse knows the patient views aging based on which theory? *
1 point

a. Gene theory
b. Programmed theory
c. Rate of living theory
d. Somatic mutation theory

28. The nurse working in the long term care facility plans care based on
Havighurst's theory of aging. Which task(s)should the nurse facilitate his patients
to achieve? (Select all that apply.) *
2 points

a. Adjusting to the loss of a spouse

b. Preserving and increasing strength
c. Adjusting to a decrease in income
d. Stabilizing one's self in one's social roles
e. Looking back on one's life with pride and contentment

29. Which information obtained by the home health nurse when making a visit to
an 88-year-old with mild forgetfulness is of the most concern? *
1 point

A. The patient’s son uses a marked pillbox to set up the patient’s medications weekly.
B. The patient has lost 10 pounds (4.5 kg) during the last month.
C. The patient is cared for by a daughter during the day and stays with a son at night.
D. The patient tells the nurse that a close friend recently died.

30. A long-term care facility sponsors a discussion group on the administration of

medications. The participants have a number of questions concerning their
medications. The nurse responds most appropriately by saying: *
1 point A. "Don't worry about the medication's name if you can identify it by its color and shape." B.
"Unless you have severe side affects, don't worry about the minor changes in the way you feel." C.
"Feel free to ask your physician why you are receiving the medications that are prescribed for you."
D. "Remember that the hepatic system is primarily responsible for the pharmacotherapeutics of your
medications."

31. A home health aide is dressing a client. Which of the following is not true
regarding this care? *
1 point

A. Encourage the client to choose his or her own clothes

B. Overextend the extremities if necessary when undressing and dressing
C. Assist the client to don pants, shirt with sleeves, and socks
D. Never the force the extremities when undressing and dressing

32. A home health nurse is assisting a client to transfer from the bed to a
wheelchair. Which of the following is not true regarding this process? *
1 point A. Stand in front of the client as he or she stands up to go to the

wheelchair

B. If needed, when the client stands to go to the wheelchair, grasp the gait belt from underneath at
each side
C. Take large steps to a position so that the client's knee caps are touching the front of the
wheelchair
D. On the count of three, assist the client to stand up to walk to the wheelchair

33. Which of the following statements, made by the daughter of an older adult
client concerning bringing her mother home to live with her family, presents the
greatest concern for the nurse? *
1 point

A. "If this doesn't work out, she can always go to live with my sister."
B. "I don't think she will react very well to me making decisions for her."
C. "I'm afraid that mom will be depressed and miss her home."
D. "My children will just have to adjust to having their grandmother with us."

34. The nurse asks a newly admitted client, “What can we do to help you?” What
is the purpose of this therapeutic communication technique? *
1 point

A. To reframe the client’s thoughts about mental health treatment

B. To put the client at ease
C. To explore a subject, idea, experience, or relationship
D. To communicate that the nurse is listening to the conversation

35. A student nurse is learning about the appropriate use of touch when
communicating with clients diagnosed with psychiatric disorders. Which
statement by the instructor best provides information about this aspect of
therapeutic communication? *
1 point

A. “Touch carries a different meaning for different individuals.”

B. “Touch is often used when deescalating volatile client situations.”
C. “Touch is used to convey interest and warmth.”
D. “Touch is best combined with empathy when dealing with anxious clients.”
36. After fasting from 10 p.m. the previous evening, a client finds out that the
blood test has been canceled. The clients wears at the nurse and states, “You are
incompetent!” Which is the nurse’s best response? *
1 point

A. “Do you believe that I was the cause of your blood test being canceled?”
B. “I see that you are upset, but I feel uncomfortable when you swear at me.”
C. “Have you ever thought about ways to express anger appropriately?”
D. “I'll give you some space. Let me know if you need anything.”

37. A client states, “You won’t believe what my husband said to me during
visiting hours. He has no right treating me that way.” Which nursing response
would best assess the situation that occurred? *
1 point

A. “Does your husband treat you like this very often?”

B. “What do you think is your role in this relationship?”
C. “Why do you think he behaved like that?”
D. “Describe what happened during your time with your husband.”

38. A new nurse complains to her preceptor that she has no time for therapeutic
communication with her patients. Which of the following is the best strategy to
help the nurse find more time for this communication? *
1 point

A. Include communication while performing tasks such as changing dressings and checking vital
signs.
B. Ask the patient if you can talk during the last few minutes of visiting hours.
C. Ask Pastoral care to come back a little later in the day.
D. Remind the nurse to complete all her tasks and then set up remaining time for communication.

39. The nurse noted that an older patient complains of always feeling cold.
Which age- related change to the skin could be causing this in the patient? *
1 point

a. Fewer protein stores

b. Decreased subcutaneous tissue
c. Reduced levels of immune cells
d. Slower blood flow to the skin layers

40. While bathing an elderly client who has limited abilities for self-care, the nurse
notices several patches of dry skin on the clients heels, elbows, and coccyx. The
nurse cleans and dries all the areas well and applies a moisturizing lotion. The
most appropriate immediate follow-up by the nurse to ensure appropriate nursing
care for this clients skin is to: *
1 point A. Revise the client's care plan to show the need for the application of moisturizing

lotion

B. Assume personal responsibility to apply the moisturizing lotion daily to the client's skin
C. Encourage the client to tell whomever bathes her to apply the moisturizing lotion to her areas of
dry skin
D. Inform the staff that the client's skin is showing signs of breakdown and moisturizing lotion needs
to be applied daily
41. The primary reason an older adult client is more likely to develop a pressure
ulcer on the elbow as compared to a middle-age adult is: *
1 point

A. A reduced skin elasticity is common in the older adult

B. The attachment between the epidermis and dermis is weaker
C. The older client has less subcutaneous padding on the elbows
D. Older adults have a poor diet that increases risk for pressure ulcers

42. The cosmetic side of aging poses which effect on many older adults? *
1 point

a. The physical effect of sagging cheeks

b. Psychological, affecting self-esteem and causing depression
c. No notable effect
d. No effect because older adults are mature enough to understand the aging process

43. The nurse understands that the goal for treatment of leg ulcers in the elderly
client should be to? *
1 point

a. Relieve pain and swelling

b. Relieve immobility
c. Promote circulation
d. Alleviate swelling, eliminate infection, and promote healing

44. The patient assigned to you has pneumonia. You are reviewing the agerelated
changed involved with the older adult.Select all age-related changes of the
respiratory system that apply. *
2 points

a. Decreased in residual lung volume

b. Decreased gas exchange
c. Decreased cough efficiency
d. Increased gas exchange
e. Decreased alveolar function
f.Increased lung end reserve capacity

45. Which choice would not be a nursing goal when managing chronic
obstructive pulmonary disorder (COPD) in an older adult patient? *
1 point

a. Decreasing exercise
b. Preventing and treating complications
c. Reducing mortality risks
d. Relieving symptoms

46. A nurse instructs a female client to use the pursed-lip method of breathing
and the client asks the nurse about the purpose of this type of breathing. The
nurse responds, knowing that the primary purpose of pursed-lip breathing is to: *
1 point

A. Promote oxygen intake

B. Strengthen the diaphragm
C. Strengthen the intercostal muscles
D. Promote carbon dioxide elimination

47. The nurse in charge formulates a nursing diagnosis of Activity intolerance

related to inadequate oxygenation and dyspnea for a client with chronic
bronchitis. To minimize this problem, the nurse instructs the client to avoid
conditions that increase oxygen demands. Such conditions include: *
1 point

A. Drinking more than 1,500 ml of fluid daily.

B. Being overweight.
C. Eating a high-protein snack at bedtime.
D. Eating more than three large meals a day.

1. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To

control hypoglycemic episodes, the nurse should recommend: *
1 point A. Increasing saturated fat intake and fasting in the

afternoon.

B. Increasing intake of vitamins B and D and taking iron supplements.

C. Eating a candy bar if lightheadedness occurs.
D. Consuming a low-carbohydrate, high protein diet and avoiding fasting.

2. The nurse is preparing a teaching plan for a client who is scheduled to undergo
mammography for the first time. What instruction by the nurse is accurate? *
1 point

A. "The test should be carried out even if you are pregnant."

B. "Do not use deodorant on breasts or underarms before the test."
C. "You will not experience any discomfort because this is just an x-ray."
D. "The entire test should not take longer than 1 hour."

3. The nurse works with elderly clients in a wellness screening clinic on a weekly basis.
Which of the following statements made by the nurse is the most therapeutic regarding
their mobility? *
1 point

A. "Your shoulder pain is normal for your age."

B. "Continue to exercise your joints regularly to your tolerance level."
C. "Why don't you begin walking 3 to 4 miles a day, and we'll evaluate how you feel next week."
D. "Don't worry about taking that combination of medications since your doctor has prescribed
them."

4. The nurse is discussing an older adult’s recent diagnosis of rheumatoid arthritis with a
colleague. Which of the nurse’s statements reflects an accurate view of the relationship
between aging and wellness? *
1 point A. “It’s important that he individual knows this is an expected part of growing

older.”

B. “We need to teach the older adult how he can keep living a fruitful life in spite of his diagnosis.”
C. “We need to make sure our teaching is not too detailed for someone oh his age.”
D. “We need to ensure his expectations of continuing to live alone are realistic.”
5. A nurse who provided care to many older adults recognizes the importance of
implementing a wellness approach to care. What principle underlies this approach to the
health care of older adults? *
1 point

A. Older adults have decreasing expectations for wellness as they move through the aging process.
B. Health problems are a Western cultural construct that has no objectives, physiological basis.
C. Older adults must come to accept a decline in wellness as they age.
D. A holistic approach to caring for older adults can foster their well-being at every stage of life.

6. Mr. Fernandez is an 81-year-old man whose current hospital admission has been
prompted by an exacerbation of his chronic renal failure. The nurse who is caring for Mr.
Fernandez is aware of the importance of fostering his wellness, a goal that can be
achieved by emphasizing which of the following? *
1 point A. Comparing Mr. Fernandez’s health to other patients who are

more ill.

B. Exploring Mr. Fernandez’s abilities and strengths

C. Advocating that Mr. Fernandez’s code status be changed to “do not resuscitate”
D. Teaching Mr. Fernandez that his health problems do not have to affect his daily routines.

7. The nurse is developing a teaching plan for the client with glaucoma. Which of the
following instructions would the nurse include in the plan of care? *
1 point

a.Decrease fluid intake to control the intraocular pressure

b.Avoid overuse of the eyes
c.Decrease the amount of salt in the diet
d.Eye medications will need to be administered lifelong.

8. During the morning change-of-shift report at the long-term care facility, the nurse
learns that the patient with dementia has had sundowning. Which nursing action should
the nurse take while caring for the patient? *
1 point

a. Provide hourly orientation to time of day.

b. Move the patient to a quieter room at night.
c. Keep blinds open during the daytime hours.
d. Have the patient take a brief mid-morning nap.

9. During the home visit of a client with dementia, the nurse notes that an adult
daughter persistently corrects her father’s misperceptions of reality, even when the
father becomes upset and anxious. Which intervention should the nurse teach the
caregiver? *
1 point

a. Anxiety-reducing measures
b.. Positive reinforcement
c. Reality orientation techniques
d. Validation techniques

10. A student nurse is learning about the appropriate use of touch when communicating
with clients with Inability to recognize, or understand words. Which statement by the
instructor best provides information about this aspect of therapeutic communication? *
1 point
a. “Touch carries a different meaning for different individuals.”
b. “Touch is often used when deescalating volatile client situations.”
c. “Touch is used to convey interest and warmth.”
d. “Touch is best combined with empathy when dealing with anxious clients.”

11. 70 year old client in geriatric ward unit tells the nurse, “I should have died because I
am totally worthless.” In order to encourage the client to continue talking about feelings,
which should be the nurse’s initial response? *
1 point

a. “How would your family feel if you died?”

b. “You feel worthless now, but that can change with time.”
c. “You’ve been feeling sad and alone for some time now?”
d. “It is great that you have come in for help.”
12. Mr. Sanchez is using telehealth services. He can talk with this physician via video
call about his condition. What type of telehealth applications is he using? *
1 point
A. Synchronous
B. Store -and-Forward
C. Remote Patient Monitoring
D. Mobile Health

13. A synchronous, or real-time, encounter that uses a computer, webcam, and Internet
connection to allow people to meet face-to-face and/or view papers and images
simultaneously is called ______________. *
1 point

A. Podcast
B. Videoconferencing
C. Interactive video disk (IVD)
D. Health technology

14. Which of the following strategies help to ensure successful teleconferences? *

1 point

A. Asking all participants to keep themselves on the mute setting to prevent unacceptable
background noise
B. Asking participants to load special software immediately prior to the scheduled conference
C. Advance preparation as in scheduling in advance, preparing an agenda, and starting and
ending on time
D. Requesting all participants to make their presence visually via the use of webcams

15. After instituting a new system for recording patient data, a nurse evaluates the
"usability" of the system. Which actions by the nurse BEST reflect this goal? Select all
that apply. *
3 points

A. The nurse checks that the screens are formatted to allow for ease of data entry.
B. The nurse reorders the screen sequencing to maximize effective use of the system.
C. The nurse ensures that the computers can be used by specified users effectively.
D. The nurse checks that the system is intuitive, and supportive of nurses.
E. The nurse improves end-user skills and satisfaction with the new system.
F. The nurse ensures patient data is able to be shared across health care systems.
16. A 68 year old patient is recovering from an abdomino - perineal Resection with a
permanent Colostomy. Her physician has ordered home health care nursing on her
discharge. What is the primary patient goal? *
1 point A. The patient will be able to return to previous

lifestyle.

B. The patient will avoid dependency on medication therapy.

C. The patient will establish self-care and independence.
D. The patient will maintain a friendly relationship with family members.

17. The home health nurse has been assigned to provide care for a patient with
cultural values that differ from the nurse's.What is the BEST action for the nurse to
take? (Select all that apply) *
2 points

A. Ask for an assignment change to allow a colleague who has cultural values more in line with those
of the patient to be assigned
B.Take time to consider the differences between the values held and those of the assigned patient
C.Research the culture of the assigned patient
D. Accept the assignment and provide the patient with information on the values of the nurse to
facilitate communication.

18. A home health visit should not exceed: *

1 point

A. 1 hour

B. 2 hours
C. 3 hours
D. 4 hours

19. A 67-year-old male client has been complaining of sleeping more, increased
urination, anorexia, weakness,irritability, depression, and bone pain that interferes with
her going outdoors. Based on these assessment findings, the nurse would suspect
which of the following disorders? *
1 point

A. Diabetes mellitus
B. Diabetes insipidus
C. Hypoparathyroidism
D. Hyperparathyroidism

20. A female client verbalizes that she has been having trouble sleeping and feels wide
awake as soon as getting into bed.The nurse recognizes that there are many
interventions the promote sleep. Check all that apply. *
3 points

A. Eat a heavy snack before bedtime

B. Read in bed before shutting out the light
C. Leave the bedroom if you are unable to sleep
D. Drink a cup of warm tea with milk at bedtime
E. Exercise in the afternoon rather than the evening
F. Count backwards from 100 to 0 when your mind is racing.
21. Nurse Liza is teaching a group of old-aged men about peptic ulcers. When
discussing risk factors for peptic ulcers, the nurse should mention: *
1 point

A. a sedentary lifestyle and smoking.

B. a history of hemorrhoids and smoking.
C. alcohol abuse and a history of acute renal failure.
D. alcohol abuse and smoking.

22. In a client with diarrhea, which outcome indicates that fluid resuscitation is
successful? *
1 point

A. The client passes formed stools at regular intervals

B. The client reports a decrease in stool frequency and liquidity
C. The client exhibits firm skin turgor
D. The client no longer experiences perianal burning.

23. When planning care for the patient with acute pancreatitis, the nurse knows that
which intervention is a priority of care? *
1 point

A. Pain control
B. Nutritional supplementation
C. Observation for mental changes
D. Observation for intestinal obstruction
24. The nurse is caring for an older adult patient who reports continued problems with
constipation. What intervention can be implemented to promote timely bowel
movements? *
1 point

A. Increase fiber intake.

B. Limit fluid intake to 1500 mL daily.
C. Administration of an oil retention enema weekly.
D. Take a mild over-the-counter laxative each evening.

25. The nurse is developing a teaching plan for a client with stress incontinence. Which
of the following instructions should be included? *
1 point

A. Avoid activities that are stressful and upsetting

B. Avoid caffeine and alcohol
C. Do not wear a girdle
D. Limit physical exertion

26. After her bath, a 62-year-old patient asks the nurse for a perineal pad, saying that
she uses them because sometimes she leaks urine when she laughs or coughs.
Which intervention is most appropriate to include in the care plan for the patient? *
1 point

A. Teach the patient how to perform Kegel exercises.

B. Demonstrate how to perform Credé's maneuver.
C. Place commode at the patient's bedside.
D. Assist the patient to the bathroom q3hr.
27. A 78-year-old patient is admitted to the hospital with dehydration and electrolyte
imbalance. The patient is confused and incontinent of urine on admission. In developing
a plan of care for the patient, an appropriate nursing intervention for the patient's
incontinence is to *
1 point

a. Insert an indwelling catheter.

b. Apply absorbent incontinent pads.
c. Assist the patient to the bathroom q2hr.
d. Restrict fluids after the evening meal.

28. A patient in the hospital has a history of urinary incontinence. Which nursing action
will be included in the plan of care? *
1 point

a. Place a bedside commode near the patient's bed.

b. Use an ultrasound scanner to check urine residual after the patient voids.
c. Demonstrate the use of the Credé maneuver to the patient.
d. Teach the use of Kegel exercises to strengthen the pelvic floor.

29. The nurse counsels the 70-year-old female who has remained on hormone
replacement therapy (HRT) that she needs to have a: *
1 point

a. semiweekly douche to wash out cervical debris.

b. liver function assessment annually.
c. mammogram biannually.
d. Pap smear annually.

30. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To
control hypoglycemic episodes, the nurse should recommend: *
1 point A. Increasing saturated fat intake and fasting in the

afternoon.

B. Increasing intake of vitamins B and D and taking iron supplements.

C. Eating a candy bar if lightheadedness occurs.
D. Consuming a low-carbohydrate, high protein diet and avoiding fasting.

31. The nurse is examining a 76-year-old female with the complaints of fatigue, ankle
swelling, and mild shortness of breath over a three-week period. An appropriate nursing
diagnosis might include: *
1 point

A. Decreased cardiac output related to altered contractility and elasticity of cardiac muscle
B. Activity tolerances due to compensation of oxygen supply
C. Increased cardiac output related to an aging heart muscle
D. Decreased urinary output due to poor kidney perfusion

32. A client is experiencing tachycardia. The nurse’s understanding of the physiological

basis for this symptom is explained by which of the following statements? *
1 point

A. The demand for oxygen is decreased because of pleural involvement

B. The inflammatory process causes the body to demand more oxygen to meet its needs.
C. The heart has to pump faster to meet the demand for oxygen when there is lowered arterial
oxygen tension.
D. Respirations are labored.

33. A nurse notes 2+ bilateral edema in the lower extremities of a client with myocardial
infarction who was admitted two (2) days ago. The nurse would plan to do which of the
following next? *
1 point

A. Review the intake and output records for the last two (2) days B.
Change the time of diuretic administration from morning to evening
C. Request a sodium restriction of one (1) g/day from the physician.
D. Order daily weight starting the following morning.

34. When caring for an older adult patient, the nurse uses the following interventions to
accommodate visual changes with age: *
1 point

A. Eye glasses in the bedside table.

B. Adequate lighting and uncluttered walkways.
C. Draw drapes in room to prevent glare.
D. Keep bedside rails down.

35. Which of the following responses by an older-adult client is most reflective of a need
for further education by the nurse regarding the physiological changes associated with
the older adult? *
1 point

A. "I call a cab if I want to go out after dark."

B. "I can't help worrying about becoming forgetful."
C. "I have my eyes checked regularly. Can't afford to fall."
D. "I really enjoy eating good vanilla ice cream, but I have cut way down."

36. An 80-year-old resident of a retirement center states that something is wrong with
the lighting in the room because colored rings appear around the light bulbs. The
resident most likely has: *
1 point

A. cataracts.
B. delusions.
C. glaucoma .
D. increased intracranial pressure.

37. The nurse recognizes that involuntary movements may appear in the elderly patient
and be normal. These normal involuntary movements may present as which of the
following? *
1 point

A. Seizures
B. Tongue protrusions
C. Resting tremors
D. Eye twitches and spasms

38. The nurse recognizes the most common eye-related disease affecting the older
adult is: *
1 point
A. glaucoma

C. near -sighted visual disturbances

D. far-sighted visual disturbances
B. cataracts

39. Decrease bone density is one of the effects of aging in the musculoskeletal system.
What independent nursing intervention should the nurse do to address this? *
1 point

A. Promote safe and sensible exercise programs

B. Prepare diet rich in calcium and vitamin D
C. Prescribe multivitamins
D. Avoid sun exposure

40. The nurse caring for the elderly population understands that movement slows with
aging. This is most likely due to: *
1 point

A. Cognitive function
B. Changes in musculoskeletal and nervous systems
C. Laziness and a feeling that life is over
D. A recent change in medical condition

41. A 69-year-old female presents with knee pain. The nurse hears a dry crackling or
grating sound and the client feels the same sensation on exam. The nurse recognizes
this as: *
1 point

A. Nothing abnormal for the age of the client

B. Crepitation, the sound of osteoarthritis in the knee joint
C. Osteoporosis and a softening of the knee joint
D. Fluid-filled spaces in the knee joint

42. A vegetarian client was referred to a dietitian for nutritional counseling for anemia.
Which client outcome indicates that the client does not understand nutritional
counseling? The client: *
1 point

A. Adds dried fruit to cereal and baked goods

B. Cooks tomato-based foods in iron pots
C. Drinks coffee or tea with meals

D. Adds vitamin C to all meals

43. Mr. Santos, 79-years-old, was admitted with iron deficiency anemia. Which question
is most appropriate for the nurse to ask in determining the extent of the client’s activity
intolerance? *
1 point

A. “What activities were you able to do 6 months ago compared to the present?”
B. “How long have you had this problem?”
C. “Have you been able to keep up with all your usual activities?”
D. “Are you more tired now than you used to be?”
44. Laboratory studies are performed for an elderly suspected of having iron deficiency
anemia. The nurse reviews the laboratory results, knowing that which of the following
results would indicate this type of anemia? *
1 point

A. An elevated hemoglobin level

B. A decreased reticulocyte count
C. An elevated RBC count
D. Red blood cells that are microcytic and hypochromic

45. A client with microcytic anemia is having trouble selecting food items from the
hospital menu. Which food is best for the nurse to suggest for satisfying the client’s
nutritional needs and personal preferences? *
1 point

A. Egg yolks

B. Brown rice
C. Vegetables
D. Tea