Essentials of Nursing Care: Older Adults Study
Guide Questions
Course Introduction
Essentials of Nursing Care: Older Adults focuses on the foundational knowledge and skills necessary to provide safe, effective, and compassionate care to aging populations. The course covers age-related physiological changes, common health concerns, and holistic approaches to promote wellness and quality of life among older adults. Students explore topics such as chronic disease management, medication safety, mobility support, nutritional needs, cognitive and psychosocial issues, and culturally competent communication. Emphasis is placed on patient-centered care, ethical considerations, and interdisciplinary collaboration in various healthcare settings, preparing students to meet the unique challenges and opportunities encountered in geriatric nursing practice.
Recommended Textbook
Basic Geriatric Nursing 6th Edition by Williams
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20 Chapters
546 Verified Questions
546 Flashcards
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Chapter 1: Trends and Issues
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) The Nursing Competence in Aging initiative advocates enhancing nurses' __________. (Select all that apply.)
A) knowledge in gerontics
B) skills in geriatrics
C) opportunities for employment
D) political sensitivity for the older adult
E) attitudes related to the older adult
Answer: A,B,E
Q2) The 80-year-old woman who is recovering from a stroke is being sent to a skilled care facility. She is concerned about the expense. The nurse can decrease anxiety by explaining that Medicare will cover extended-care facility costs for what period of time?
A) A period of 30 days
B) A period of 45 days for physical therapy
C) A period of 100 days for needed skilled care
D) Until she is able to be discharged home
Answer: C
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Chapter 2: Theories of Aging
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Sample Questions
Q1) The Gene Theory of aging suggests which of the following ?
A) The presence of a "master gene" prolongs youth.
B) Genes interact with each other to resist aging.
C) Specific genes target specific body systems to initiate system deterioration.
D) The activation of harmful genes initiates the aging process.
Answer: D
Q2) What is the major objection to the disengagement theory?
A) The theory justifies ageism.
B) The theory addresses the diversity of older adults.
C) The theory does not clarify the aging process.
D) The theory diminishes the self-esteem of the older adult.
Answer: A
Q3) A patient uses good health maintenance practices. What aging theory most accurately relates to the patient's practices?
A) Wear-and-tear
B) Free radical
C) Neuroendocrine
D) Molecular
Answer: A
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Page 4
Chapter 3: Physiologic Changes
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Sample Questions
Q1) Why does the nurse modify the environment to keep it warmer for the older adult?
A) A change in the metabolic rate
B) Decreased subcutaneous tissue
C) Changes in the musculoskeletal system
D) A weakened peripheral vascular system
Answer: B
Q2) What is a symptom of inadequate insulin coverage in a patient with diabetes mellitus type I?
A) Diminished urine output
B) Ketones in the urine
C) Shallow and slow respirations
D) Extreme diaphoresis
Answer: B
Q3) What is a cause of pernicious anemia?
A) An iron deficiency
B) A deficiency of vitamin B<sub>12</sub>
C) Low serum potassium level
D) Blood loss
Answer: B
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Page 5
Chapter 4: Health Promotion, Health Maintenance, and
Home Health Considerations
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Sample Questions
Q1) What benefits can the older adult female expect with even a small amount of daily exercise? (Select all that apply.)
A) Build muscle mass
B) Control weight
C) Retard bone loss
D) Control the blood glucose level
E) Promote a sense of well-being
Q2) What factors might interfere with the health maintenance activities of a 76-year-old patient? (Select all that apply.)
A) A belief that diminished health is part of aging
B) Loss of a spouse 3 months ago
C) Having a physical examination every year
D) Living in an assisted living facility and not driving
E) Having no family
Q3) How often should a 75-year-old have a visual screening?
A) Every 6 months
B) Every 12 months
C) Every 2 years
D) On an as needed basis
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Chapter 5: Communicating with Older Adults
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Sample Questions
Q1) The patient says, "When I came to the hospital yesterday, everything got confused." What would be the best response by the nurse?
A) "What happened?"
B) "Yes, hospital admissions can be confusing."
C) "Are you confused now?"
D) "We really try to make admissions less stressful."
Q2) The nurse is sensitive to the use of nonverbal communication from patients, which includes the interpretation of __________. (Select all that apply.)
A) choice of words
B) voice tone
C) body language
D) gestures
E) facial expressions
Q3) What is the goal of empathetic listening?
A) It encourages the patient to divulge information.
B) It allows for time to pose another question to the patient.
C) It indicates the conversation has come to a close.
D) It allows the nurse to interpret what the patient has said.
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Chapter 6: Maintaining Fluid Balance and Meeting
Nutritional Needs
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Sample Questions
Q1) The home health nurse does an ongoing assessment of the patient who has had a subtotal gastrectomy. What vitamin deficiency should the nurse monitor for?
A) A
B) B<sub>6</sub>
C) B<sub>12</sub>
D) C
Q2) A patient on a fat-restricted diet is noted to have developed a pressure ulcer and decreased visual acuity. What vitamin deficiency should the nurse suspect?
A) A
B) B<sub>6</sub>
C) B<sub>12</sub>
D) C
Q3) The nurse recommends that the older patient eat chicken and fish because they contain complete proteins. What is present in complete proteins?
A) Molecules of carbohydrate
B) All the essential amino acids
C) A high fat content
D) A soluble fiber
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Chapter 7: Medications and Older Adults
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Sample Questions
Q1) Why is self-medication with over-the-counter (OTC) drugs hazardous to the older adult? (Select all that apply.)
A) OTC drugs can increase the effect of a prescribed drug.
B) OTC drugs can interfere with the efficacy of a prescribed drug.
C) OTC drugs can mask significant symptoms of primary disease.
D) OTC drugs are easily obtained.
E) OTC drugs can lead to overdose because they are not considered to be "real drugs."
Q2) Why does the nurse frequently assess an older adult who is on a psychotropic drug?
A) Older adults are less active.
B) The older adult has fewer cognitive capabilities.
C) Brain receptors have become hypersensitive.
D) Receptor sites have lower perfusion.
Q3) What age-related changes in the stomach can cause increased drug absorption and possibly drug toxicity?
A) Decreased gastric motility
B) Gastric reflux disease
C) Inability of gastric cells to transport the drug
D) Decreased peristalsis
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9
Chapter 8: Health Assessment for Older Adults
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Sample Questions
Q1) The nurse explains that the tool that allows the evaluation of core function in a resident in a long-term facility is the __________ __________ __________.
Q2) What statement would put the older woman most at ease during a health interview?
A) "The interview will take quite a while."
B) "Please have a seat over there across from the desk."
C) "There are lots of questions that we must finish."
D) "The bathroom is behind that green door. We'll be taking a break in about 30 minutes."
Q3) The 94-year-old woman has come to the health assessment interview with her 70-year-old daughter, who answers all the interview questions for her mother. What response by the nurse would be the most effective?
A) Say, "I'm speaking to your mother. Please let her answer for herself."
B) Continue to interact with the daughter to facilitate completion of the interview.
C) Look directly at the patient and say, "Mrs. Smith, now I'd like to hear from you about your health."
D) Document that all answers to the interview came from a third party.
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Chapter 9: Meeting Safety Needs of Older Adults
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28 Flashcards
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Sample Questions
Q1) The home health nurse has evaluated the community for measures that support pedestrian safety. What safety measures would be appropriate modifications to increase safety in the community? (Select all that apply.)
A) Pedestrian-controlled crosswalks
B) Safety islands on wide street intersections
C) Decreased time to cross at walks
D) Clearly marked crosswalks at intersections
E) Overhead crossings over busy streets
Q2) Which of the following would least improve home security?
A) Peephole in the door at a convenient height
B) Brightly lit porch
C) Large dog with a loud bark
D) Hook and eye latch on the screen door
Q3) An older adult man has been diagnosed as having diminished depth perception. What does the nurse expect him to have difficulty with in his everyday activities?
A) Judging the height of steps.
B) Reading small print on food labels.
C) Reading street signs.
D) Seeing in dim light.
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Page 11
Chapter 10: Cognition and Perception
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Sample Questions
Q1) When attempting to communicate with a patient who is hearing-impaired, what should the nurse consider?
A) Keep the message simple.
B) Provide lengthy explanations and information.
C) Assume understanding if the patient does not ask for clarification.
D) Use many hand gestures.
Q2) The nurse explains that the term that describes the ability to make judgments quickly on the basis of unfamiliar stimuli is __________ __________.
Q3) An older adult has expressive aphasia. What would be the most effective intervention for the nurse to use to improve the patient's communication?
A) Provide flash cards with text and pictures.
B) Be patient and ask him to repeat himself.
C) Encourage him to practice slow speech.
D) Arrange with him to blink the eyes once for "yes" and twice for "no."
Q4) What assessment finding would be indicative of delirium?
A) The onset of the behavior was rapid.
B) There is no change in the level of consciousness.
C) The absence of disorientation.
D) The absence of hallucinations.
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Chapter 11: Self Perception and Self-Concept
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Sample Questions
Q1) An older adult in a long-term care facility has been diagnosed with depression. What would indicate a need for further assessment of suicide risk?
A) Asking for assistance in writing a will
B) Voicing the intention to visit his brother
C) Donating excess clothing to charity
D) Asking the young widow next door for a dinner date
Q2) What causes the greatest damage to self-worth?
A) Measuring self against internal ideals
B) Measuring self against individual values
C) Measuring self against external standards
D) Measuring self against expressions of positive feedback
Q3) The nurse notices there has been a change in the behavior of an 84-year-old home patient over the past few weeks. What methods can be used to assess the patient's self-perception and self-concept? (Select all that apply.)
A) Observing his physical appearance
B) Monitoring for changes in his vital signs
C) Encouraging him to verbalize his feelings
D) Observing for changes in activities
E) Participating in group activities
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Page 13
Chapter 12: Roles and Relationships
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Sample Questions
Q1) Which stage of grief usually resolves after approximately 4-7 months?
A) Disorientation
B) Shock and numbness
C) Reorganization
D) Searching and yearning
Q2) What would be the best method for the nurse to help a grieving widow begin the grief resolution process?
A) Distract her with social conversation.
B) Encourage her to verbalize her grief.
C) Point out behaviors that are not helpful to grief resolution.
D) Focus on her loneliness and loss.
Q3) What is the correct term for a society in which members of many diverse subcultures must interact?
A) Homogeneous
B) Heterogeneous
C) Impersonal
D) Superficial
Q4) The nurse uses a diagram to depict __________, which is a term for interaction between different roles.
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Chapter 13: Coping and Stress
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Sample Questions
Q1) An 80-year-old man recently became widowed, moved into a long-term care facility, and had to quit driving. He complains of fatigue and is irritable when questioned about his health. What would be the most appropriate action of the nurse?
A) Suggest he take a daytime nap and go to bed early.
B) Report the complaints as expected adjustments to relocation.
C) Approach him to talk about his perceptions related to his relocation.
D) Suggest that he find some quiet time in the facility's library and read a book.
Q2) How does physical illness increase stress in the older adult?
A) It is an acceptable reason to request assistance.
B) It takes away energy to cope with new stressors.
C) It stimulates the family to be more attentive.
D) It causes additional medications to be ordered.
Q3) Which statement by a patient could be related to symptoms of stress?
A) "I have to urinate every 10 minutes, and there are only a few drops."
B) "I haven't had to urinate for the past 8 hours."
C) "I void large amounts of urine every 2 hours."
D) "My urine has absolutely no color. It looks like water."
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Page 15
Chapter 14: Values and Beliefs
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Sample Questions
Q1) What are included in the five pillars of the Islamic faith? (Select all that apply.)
A) To make a confession of faith
B) Perform five daily prayers at the appropriate time
C) Observe Ramadan
D) Make a pilgrimage to Mecca
E) To care for children
Q2) A nurse wants to provide culturally sensitive care. What is the most effective way to develop an appreciation and understanding of diverse beliefs and values?
A) Interact with persons of another culture.
B) Increase personal knowledge of another culture.
C) Remain open-minded.
D) Travel to diverse regions.
Q3) The nurse explains that Muslims have a great reverence for their holy book, called the __________.
Q4) After the burial of a Jewish man who was a resident in a long-term care facility, the nurse is aware that the family will observe a 7-day period of mourning known as ___________ following the burial.
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16
Chapter 15: End-of-Life Care
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Sample Questions
Q1) The charge nurse on an oncology unit encourages her staff to complete a values clarification exercise. What type of insight is provided by the exercise? (Select all that apply.)
A) The nurses' own values
B) Values that influence care decisions
C) Values that must be abandoned or changed
D) Values that may cause an ethical dilemma
E) Negative values
Q2) Which patient would be a candidate for hospice care?
A) The patient with a life expectancy of only 12 months.
B) The patient who agrees to life support.
C) The patient who agrees to palliative measures.
D) The patient who has a treatable illness.
Q3) What can caregivers do for a dying patient who suffers from diminished vision?
A) Keep lights bright to increase visual acuity.
B) Stand slightly away from the bed and identify themselves before speaking.
C) Keep all lights on in the room, day and night.
D) Come close to the bed and stand directly in front of the patient.
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Chapter 16: Sexuality and Aging
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Sample Questions
Q1) What is true of sexuality?
A) It becomes absent with age.
B) It remains part of life until death.
C) As expressed through intercourse is not possible after the age of 65 years.
D) It must be expressed in sexual intercourse.
Q2) The nurse is conducting an admission assessment with an older adult. What can affect sexual function? (Select all that apply.)
A) Increasing age
B) Grief
C) Illness
D) Religion
E) Physical changes
Q3) What constraints may prevent an older widow from engaging in sexual activity? (Select all that apply.)
A) Older women outnumber older adult men by 4:1.
B) There is an expectation that men should initiate contact.
C) Display of sexual interest is considered improper.
D) Older women do not desire sexual expression.
E) Older women associate sexual activity with marriage.
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Page 18
Chapter 17: Care of Aging Skin and Mucous Membranes
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Sample Questions
Q1) A patient's toenails are brittle and thick. What other assessment should the nurse be sure to include?
A) Respiratory sounds
B) Pedal pulses
C) History of gout
D) Intake of dietary calcium
Q2) What are causes of pruritus in the older adult? (Select all that apply.)
A) A reduction of sebaceous gland function
B) A reduction in the amount of perspiration
C) Excessive bathing
D) Use of emollients
E) Environmental conditions
Q3) What are causes of xerostomia in the older adult? (Select all that apply.)
A) Reduction in saliva
B) Allergy
C) Eating highly seasoned foods
D) Inadequate fluid intake
E) Use of diuretic medications
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Chapter 18: Elimination
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Sample Questions
Q1) What age-related changes are related to constipation? (Select all that apply.)
A) Diminished abdominal muscle tone
B) Reduced activity level
C) Inadequate fluid intake
D) Increased dietary fiber
E) Dependence on laxatives
Q2) How do Kegel exercises aid in the treatment of incontinence?
A) Increases the tone of the bladder
B) Reduces urinary retention
C) Strengthens the urinary sphincter
D) Sensitizes biofeedback
Q3) What food provides a natural laxative effect?
A) Orange
B) Pineapple
C) Prunes
D) Raw apple
Q4) The nurse is aware that the urge to defecate is increased peristalsis stimulated by the defecation reflex and the __________ reflex.
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Page 20
Chapter 19: Activity and Exercise
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Sample Questions
Q1) The nurse directs an 80-year-old recovering from a fractured pelvis to participate in several isometric exercises to maintain muscle strength, such as
A) alternately tightening and relaxing the abdominal muscles.
B) lifting the body up off the bed using an overhead trapeze.
C) pushing against the bed to lift the buttocks off the bed a few inches.
D) pressing the sole of the foot against a footboard.
Q2) What are the benefits of regular exercise? (Select all that apply.)
A) Maintenance of joint mobility
B) Enhancement of muscle tone
C) Promotion of sense of general well-being
D) Guarantee of weight loss
E) Promotion of regular elimination
Q3) How can the nurse demonstrate a positive attitude toward care planning? (Select all that apply.)
A) Acknowledge the impact of a traumatic amputation on therapy.
B) Encourage the resident's input on the care plan.
C) Invite the resident and family member to attend the care plan meetings.
D) Make a list of questions for the resident to ask at the care plan meeting.
E) Help the resident to perform all activities of daily living (ADLs).
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Page 21
Chapter 20: Sleep and Rest
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Sample Questions
Q1) What statement by a patient's wife would indicate that the patient is experiencing myoclonus?
A) "His loud snoring and jerking awake wakes me up, too."
B) "I am black and blue from his kicking me every night."
C) "He wakes up at 2 AM every morning and walks around the house."
D) "His constant leg movements tear up the covers and keep me awake."
Q2) The nurse clarifies that the individual's pattern of wakefulness and sleeping is referred to as the __________ rhythm.
Q3) The 80-year-old man complains that when he goes to bed and cannot fall asleep, he becomes very upset. What would be an appropriate suggestion for when he has not fallen asleep within 30 minutes?
A) Take two tablets of a sedative medication.
B) Get up and do a mild stretching exercise for 15 minutes.
C) Remain in bed with his eyes closed.
D) Get up and read until he feels sleepy and then return to bed.
Q4) The nurse encourages the long-term facility resident experiencing insomnia to drink a glass of milk with supper and again before bedtime because milk contains the sleep-inducing agent __________.
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Page 22