Geriatric Care Management
Exam Materials
Course Introduction
Geriatric Care Management is an interdisciplinary course that explores the principles, practices, and challenges involved in managing the care of older adults. The course covers topics such as aging processes, common health concerns in the elderly, assessment tools, care planning, healthcare coordination, legal and ethical considerations, and the role of the family and community resources. Emphasis is placed on person-centered care, communication strategies, and the development of comprehensive care plans to improve quality of life and health outcomes for aging individuals. Students will gain practical skills in identifying and addressing the unique physical, psychological, and social needs of older adults in a variety of care settings.
Recommended Textbook
Toward Healthy Aging Human Needs and Nursing Response 7th Edition by Priscilla Ebersole
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27 Chapters
262 Verified Questions
262 Flashcards
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Page 2
Chapter 1: Gerontological Nursing and an Aging Society
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9 Verified Questions
9 Flashcards
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Sample Questions
Q1) The Scope and Standards of Gerontological Nursing Practice:
A) identifies minimum nurse staffing levels for both acute and long-term care facilities.
B) describes minimum gerontological nursing education required for nursing staff in long-term care facilities.
C) mandates the presence of a full-time advanced practice nurse (APN),either a gerontological clinical nurse specialist or a geriatric nurse practitioner,for all patient care areas with greater than 50% of the population older than age 65.
D) identifies levels of clinical gerontological care and gerontological nursing performance.
Answer: D
Q2) The following services are commonly offered by state Area Agencies on Aging (AAAs),except:
A) senior centers.
B) nutrition centers.
C) long-term care ombudsman.
D) primary health care.
Answer: D
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Chapter 2: Theories of Aging
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) A married couple are residents of a life care community.They retired to the community after the husband had heart surgery.The wife has always been physically and socially active and joined an aerobic class,knitting groups,and a book club shortly after moving to the community.She walks on a daily basis and swims twice a week.Her husband spends his days reading and watching television.He was never a social person and enjoys being by himself.Which of the sociological theories of aging best describes the couple?
A) Role theory
B) Disengagement theory
C) Continuity theory
D) Personality theory
Answer: C
Q2) Erikson's stage or task for later life is:
A) ego maturation vs.stagnation.
B) ego transcendence vs.ego preoccupation.
C) generativity.
D) ego integrity vs.despair.
Answer: D
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Chapter 3: Health and Wellness
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) Environmental press is defined as:
A) learned helplessness as a result of lack of social support in the environment.
B) modifications made to the environment to make it "elder friendly."
C) obstacles in the environment that make it unsafe for older adults.
D) demands that environments make on the older person to adapt,respond,or change.
Answer: D
Q2) Healthy People 2010:
A) describes racial and ethnic differences in health practices.
B) provides measurements of health status for specific diseases across the life span.
C) offers direction for the achievement of improved quality of life across the life span.
D) presents criteria for Medicare reimbursement for preventive health care for older adults.
Answer: C
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Chapter 4: Physiological Changes with Aging
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) A 79-year-old female client lives in an assisted living facility.She consults the nurse practitioner because of complaints of vaginal itching and burning and vaginal discharge.The nurse practitioner diagnoses a yeast infection and prescribes nystatin (Mycostatin)suppositories.The client states,"This is the third infection I have had in the past 2 years.Do all older women get these infections?" The nurse practitioner bases her answer on the knowledge that:
A) older women are more susceptible to vaginal infections because of age-related vaginal changes.
B) older women are more susceptible to vaginal infections because of decreased ability to perform proper perineal hygiene.
C) older women are more susceptible to vaginal infections because of the multitude of medications taken for chronic medical conditions.
D) older women are more susceptible to vaginal infections because of decreased fluid intake.
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Chapter 5: Laboratory Values and Diagnostics
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7 Verified Questions
7 Flashcards
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Sample Questions
Q1) What is true concerning laboratory values in older adults?
A) There are age-adjusted ranges for older adults for all of the common laboratory findings,similar to those for infants and children.
B) There are no age-adjusted ranges for older adults due to the large variations within the age group and the increasing number of factors that influence the results.
C) There are age-adjusted ranges only for the over-85 age-group; there are no expected changes in the 65- to 84-year-old age-group.
D) There are age-adjusted ranges only for the hematological tests,which are due mostly to changes in the bone marrow.
Q2) While looking at your patient's laboratory values,you note the following values.Which contains an alteration (increase or decrease)that you might expect with aging?
A) Potassium 4.5 mEq/L
B) Blood urea nitrogen (BUN)10 mg/dL
C) Creatinine 0.8 mg/dL
D) Erythrocyte sedimentation rate (ESR)20 mm/hr
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Chapter 6: Health Assessment in Gerontological Nursing
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7 Verified Questions
7 Flashcards
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Sample Questions
Q1) You are a nurse on a medical unit in a large academic medical center and you care primarily for older adults.Your unit manager introduced the Fulmer SPICES assessment tool to the unit.This tool assesses all except:
A) sleep.
B) incontinence.
C) falls.
D) social support.
Q2) What is true about instruments to assess for depression in older adults?
A) Older adults tend to score inaccurately low (indicating less depression)than younger adults on the Zung Self-Rating Depression Scale.
B) The Geriatric Depression Scale cannot be used in older adults with dementia or cognitive impairment.
C) The Beck Depression Inventory is designed for gerontological patients.
D) The Geriatric Depression Scale is administered by a health care provider in an interview with the older adult.
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8
Chapter 7: Managing Basic Physiological Needs
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) In implementing your nursing care plan for your client with constipation,what will you include in your plan?
A) Bedrest
B) Limiting fluids
C) Increased fiber in the diet
D) Aluminum-containing antacids
Q2) A 77-year-old woman reports that she has difficulty sleeping.The nurse asks her for a history of her sleep problems.What instruction should the nurse include in suggestions to improve her sleep?
A) Take several daytime naps if you cannot sleep at night.
B) Try a glass of wine at bedtime.
C) Include 10 minutes of moderately strenuous exercise before going to bed.
D) Use the bed only for sleep or sex.
Q3) In evaluating interventions for your client's problem of constipation,what best indicates progress toward resolution of the problem?
A) Small,liquid bowel movements once to twice per day
B) Moderate discomfort with every-other-day evacuation
C) Fluid intake of 1 L/day with a low-residue diet
D) Normal bowel movements 1 to 3 days apart
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Page 9
Chapter 8: Biological Maintenance Needs
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) An 88-year-old resident in a long-term care facility tells the nurse she is having mouth pain.The first action the gerontological nurse should take is to:
A) notify the physician in charge about the resident's problem.
B) carefully inspect the resident's mouth,teeth,and tongue.
C) medicate the resident with a prescribed analgesic.
D) instruct the resident to begin rinsing the mouth with an antimicrobial mouthwash.
Q2) Your elderly patient's 50-year-old daughter asks about aging dentition,periodontal disease,and tooth loss.In answering her questions,you know that:
A) more than half of people older than age 65 are edentulous.
B) dental insurance is readily available at a low cost to senior citizens through government programs like Medicare.
C) periodontal disease is usually the result of chronic periodontitis from young and middle-age adulthood.
D) tooth loss is a natural part of the aging process.
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Chapter 9: Nutritional Needs
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) A 77-year-old client of the geriatric clinic has a history of coronary artery disease and hyperlipidemia.You have developed a teaching plan using the National Cholesterol Educational Program (NCEP)and Healthy Heart Guidelines.The nurse practitioner added a lipid-lowering agent to his medication regimen.Which statement made by the client reflects that he has correctly understood your teaching?
A) "I am not allowed to have any fat in my diet at all."
B) "I need to limit the amount of saturated fats to less than 7% of my daily caloric intake."
C) "I need to limit the amount of polyunsaturated fats to approximately 50% of my daily caloric intake."
D) "Since I am taking a cholesterol drug I do not have to worry about my diet."
Q2) The following are reliable methods to evaluate obesity except:
A) BMI (body mass index).
B) WHR (waist-hip ratio).
C) weight and height evaluation using a table of desirable weight.
D) weight greater than 150% of ideal body weight.
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11
Chapter 10: Chronic Disease in Late Life
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16 Verified Questions
16 Flashcards
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Sample Questions
Q1) A 79-year-old male client with chronic obstructive pulmonary disease (COPD)is seen in the respiratory clinic.What intervention is most important when developing his plan of care to address the long-term goal of promoting healthy respiratory aging?
A) Annual tuberculosis (TB)skin testing
B) Teaching the patient to use alternative modalities such as meditation in order to relax
C) Annual influenza immunization
D) Consuming a high-protein,high-calorie diet
Q2) An elderly man has been admitted to the hospital for prostate surgery.He has a history of hypertension for which he is on medication.He also reports a recent fall at home.The nurse should perform which assessment?
A) Check blood pressure every 2 hours.
B) Check orthostatic blood pressures.
C) Check serum creatinine levels.
D) Check serum sodium levels.
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12
Chapter 11: Pain and Comfort
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) Adjuvant medications:
A) are used instead of opioids to decrease the likelihood of addiction.
B) have no side effects.
C) are used to eliminate the side effects of opioid medications.
D) are used in combination with analgesics to potentiate the effect of the analgesics.
Q2) A 78-year-old client is being seen in the geriatrician's office for a blood pressure check.She has a history of hypertension and osteoarthritis,and has recently fallen and fractured two ribs.She has been prescribed extra strength Tylenol for the pain.What statement by the client requires further evaluation by the nurse?
A) "I find that when I drink herbal tea and then take my Tylenol at bedtime,I sleep through the whole night."
B) "I heard that meditation may help me deal with the pain without taking all that Tylenol."
C) "I take two extra strength Tylenol tablets (500 mg/tablet)every 4 hours around-the-clock and it helps my pain."
D) "I make sure that I take my Tylenol with breakfast when I first get up."
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13
Chapter 12: Geropharmacology
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) Which pharmacokinetic/pharmacodynamic parameter is least affected by the aging process?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Q2) The area in which nurses have the greatest effect on medication use is:
A) educating clients.
B) ensuring adherence.
C) marketing beneficial products.
D) encouraging alternative/herbal remedies.
Q3) A 72-year-old patient tells his nurse that he is allergic to Lasix.What is the nurse's first response?
A) "Let me write that down on your chart and put an allergy alert wrist band on you."
B) "Tell me what happened to you when you took Lasix."
C) "It is unusual for a patient to have a reaction to Lasix."
D) "Were you taking a generic form of Lasix?"
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14
Chapter 13: The Use of Herbs and Supplements in Late Life
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5 Verified Questions
5 Flashcards
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Sample Questions
Q1) Herbal supplements are manufactured in all but one of these forms:
A) tincture.
B) salves.
C) extracts.
D) intravenous.
Q2) A patient is admitted to a medical nursing unit.On his admission interview,he tells the nurse that he takes ginkgo biloba daily.As a nurse,you understand that this herbal supplement can cause:
A) depression with paranoia.
B) gastrointestinal (GI)upset and headache.
C) impotence and sterility.
D) pneumonia and bronchitis.
Q3) The profile of a usual herbal supplement client resembles:
A) inner city,lower socioeconomic status,female.
B) white,highly educated with higher income level.
C) third generation,middle income,Hispanic American.
D) men and women from small rural communities.
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15
Chapter 14: Sensory Function
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) You are assessing your elderly client for tinnitus.Which statement correctly describes this symptom?
A) It is characterized by hissing,buzzing,or ringing in the ears.
B) It is never related to metabolic conditions.
C) It always accompanies hearing loss.
D) It is characterized by silence.
Q2) What is a common pathophysiological cause of decreased olfaction in older adults?
A) Increased number of sensory cells
B) Lower thresholds for common odors
C) Injury of the olfactory mucosa
D) Increased neurotransmitters
Q3) You are preparing a 78-year-old client with an alteration in olfaction for discharge home.Which topics should be included in the patient education plan to prepare for discharge? (Choose all that apply.)
A) Date and label all foods.
B) Remove trash from home weekly.
C) Place natural gas detectors near gas heater or stove.
D) Use perfumes and colognes in moderation.
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Chapter 15: Mobility
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) Who is at greatest risk for developing osteoporosis?
A) A 50-year-old white male
B) A 37-year-old aerobics instructor
C) A 72-year-old large black woman
D) A 69-year-old thin white woman
Q2) You are performing discharge teaching for your elderly client with rheumatoid arthritis.Which client statement indicates a knowledge deficit?
A) "I will take glucosamine and chondroitin supplements."
B) "I will rest when my joints are bothering me."
C) "I will take my antiinflammatory medicine."
D) "I will eat a balanced diet."
Q3) You are answering your elderly client's questions about diet,exercise,and bone integrity.Which exercise would you inform her is the least effective in preventing bone demineralization?
A) Jogging
B) Jumping rope
C) Swimming
D) Walking
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Chapter 16: Environmental Safety and Security
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5 Verified Questions
5 Flashcards
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Sample Questions
Q1) You are a home care nurse in an area of the country that is prone to tornadoes.When you make your first home visit,you routinely discuss disaster preparedness.The rationale for this includes the following except:
A) older adults are less likely to seek formal and informal help than are younger people during disasters.
B) older adults are more likely to bring litigation against the home care agency.
C) older adults have special needs that need to be addressed.
D) older adults may not get as much assistance as younger adults during a disaster.
Q2) You are educating your elderly female client about fire safety.You answer her questions knowing that:
A) elderly women are more likely to die in fires than elderly men.
B) fire mortality for elders is twice that of any other age group except children ages 1 to 4.
C) most people who die in fires are killed by the flames.
D) most fires occur outside the home.
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18
Chapter 17: Economic,Residential,and Legal Issues
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Sample Questions
Q1) The Omnibus Budget Reconciliation Act (OBRA)of 1987 included:
A) mandatory registered nurse (RN)to patient ratios in nursing homes.
B) mandatory RN continuing education.
C) elimination of the use of restraints and medications for discipline of residents.
D) mandatory daily patient assessments by physicians.
Q2) When are managed care systems most effective?
A) When a client avoids using the system until needed in an emergency situation
B) When a client avoids using primary care practitioners and routinely accesses specialists
C) When a client uses high-tech treatments before trying less costly treatments
D) When a client uses preventive primary care services to maintain his or her health
Q3) Your 88-year-old neighbor tells you that her daughter wants her to move to a life care community.These communities typically:
A) require that in the case of married couples,both individuals require the same level of care.
B) are decreasing in number across the United States.
C) offer a full range of residential options all in one location.
D) are for low-income seniors only.
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Chapter 18: Frailty,Vulnerability,and Elder Mistreatment
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Sample Questions
Q1) Which elderly client is at greatest risk for mistreatment in the home setting?
A) An active 70-year-old woman with well-controlled diabetes who lives alone
B) A healthy 75-year-old man who is a retired businessman and lives with his son
C) An 82-year-old woman with severe osteoarthritis and macular degeneration who lives with her single daughter who has an autistic adult son
D) A 77-year-old man who has a history of coronary bypass surgery,is active,and lives with his wife
Q2) You are caring for an older adult who is a victim of elder abuse.He lives in low-income housing with his daughter,who is a working single mother of four children ages 3 to 13.After careful investigation,it is determined that caregiver stress is the cause of the abuse.The best intervention for the patient and his family would be:
A) to remove the patient from his daughter's home.
B) to foster a close working relationship between the patient's daughter and the social worker.
C) to arrange respite care or day care for the patient.
D) to place the patient in a long-term care facility.
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Chapter 19: Intimacy and Sexuality in Late Life
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9 Verified Questions
9 Flashcards
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Sample Questions
Q1) Acquired immunodeficiency syndrome (AIDS)is frequently underreported in older adults because:
A) it is often not recognized due to its low incidence in older adults.
B) many of the classic symptoms are also common to other conditions common in older adults.
C) presenting symptoms are markedly different than in younger adults.
D) AIDS progresses much slower in older adults so symptoms are not recognized easily.
Q2) A 77-year-old resident of a long-term care facility has dementia.He is nonverbal and requires assistance with all activities of daily living.The nurse aide reports that she observed the resident in the day room and he was masturbating.What is the first action of the nurse?
A) Remove the resident from the day room and complete an assessment of his behavior.
B) Cover the resident with a blanket and leave him in the day room.
C) Counsel the resident,telling him that his behavior is inappropriate.
D) Contact the resident's daughter to report his behavior.
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21
Chapter 20: Relationships,Roles,and Transitions
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Sample Questions
Q1) Your client is cared for at home by his son and daughter-in-law,who are also responsible for the care of their four preschool-aged children.What is true of this "sandwich" generation?
A) The pressure and conflicts that arise from caring for both older adults and children can be very stressful.
B) The majority of middle-aged adults are faced with balancing the care of parents and children at the same time.
C) The average age of an adult caring for parents is in the 30s.
D) The majority of caregivers affected by this "sandwich" generation are males.
Q2) An 88-year-old resident of a long-term care facility relates that she used to be the family member who arranged family reunions.Although she was never married and had no children,her room is full of pictures of nieces and nephews and grandnieces and grandnephews,and she can tell you about all of the individuals in the pictures.You could describe the resident as:
A) preoccupied with the family.
B) matriarch of the family.
C) kin-keeper.
D) living in the past.
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22
Chapter 21: Culture,Gender,and Aging
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Sample Questions
Q1) Select the true statement regarding cohort effect:
A) Birth cohort is important in understanding how one experiences a world event.
B) Each individual within a cohort experiences events in a similar way.
C) An example of applying the knowledge of cohort effect would be treating an elderly client exactly how your own grandfather would expect to be treated.
D) All generations share a similar perspective on life events.
Q2) Ethnocentrism is defined as:
A) an understanding of another's cultural beliefs and practices.
B) a conflict that occurs when an individual interacts with another whose beliefs differ from his own.
C) application of limited knowledge about one person with specific characteristics to another person.
D) a belief that one's ethnic group is superior to that of another.
Q3) Which cultural group has the fastest growing elderly population in the United States?
A) Blacks
B) Asian/Pacific Island Americans
C) Native Americans
D) Hispanic Americans
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23
Chapter 22: Nursing and Aging in Rural and Frontier Settings
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Sample Questions
Q1) You are interviewing an older adult at a community health care center in a rural farm community.What typically reflects his lifelong residency in a rural farming community?
A) He requests information about long-term care due to an inability to work on his farm like he did a few years ago.
B) He states that he is getting too old to live on his own and should consider moving in with his grandson in the city.
C) He does not believe that severe arthritis in his hands and knees will cause his life to be altered.
D) He is requesting Meals on Wheels because both he and his wife have severe arthritis.
Q2) What is true regarding the health status of rural-dwelling older adults? They are:
A) a population at risk for disease and disability.
B) less likely to have mental illness.
C) able to access health care due to federal farm pension programs.
D) automatically eligible for government assistance for home care programs regardless of specific needs.
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Chapter 23: Cognition and Caring for Persons with Cognitive Impairment
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Sample Questions
Q1) You are caring for a client with delirium.Which assessment finding would be expected in this client throughout your shift?
A) Fluctuation in symptoms
B) Normal attention span
C) Unlimited duration
D) Unchanged sleep-wake cycle
Q2) Interventions to manage wandering in clients in a long-term care facility include the following except:
A) environmental modifications such as camouflaging doorways and providing enclosed pathways.
B) close observation to identify the person's individual patterns.
C) engaging the person in social interactions.
D) using physical restraints to prevent wandering and maintain safety.
Q3) Drug therapy with cholinesterase inhibitors such as donepezil,rivastigmine,and galantamine:
A) reverses the neuronal decline that is seen in Alzheimer's disease.
B) is given in high doses to prevent the appearance of cognitive symptoms.
C) is given long term even if the client shows slight decline.
D) has no reported side effects.
Page 25
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Chapter 24: Stress,Crises,and Health in Aging
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Sample Questions
Q1) A 68-year-old man recently suffered a left-sided cerebrovascular accident (CVA)and is now in an acute rehabilitation setting.He is easily frustrated due to his physical deficits.During his morning bath,the nurse instructs the certified nursing assistant (CNA)to give the patient a washcloth and let him wash his face and as much of his upper body as possible.The primary reason for this is to:
A) allow the patient to establish some control and preserve self-esteem.
B) exercise the patient's left arm.
C) save time so the CNA can assist other patients.
D) allow the CNA to establish control over the situation.
Q2) A 90-year-old client in an adult day care program tells the nurse that she is very stressed because her neighbor passed away.The most therapeutic response is:
A) "Let's think of happy things."
B) "Tell me what you did and how you managed when your other neighbor passed away last year."
C) "You should count your blessings and not dwell on sad things."
D) "Let's get involved in some activities and not think about sad things."
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Chapter 25: Emotional Health in Late Life
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Sample Questions
Q1) Electroconvulsive therapy (ECT)in older adults:
A) has been found to be effective in individuals with psychotic depression and those who do not respond to antidepressant medications.
B) has been found not to be as effective in older adults as in younger adults.
C) has been found to be safe for older adults with increased intracranial pressure. D) has been found to improve symptoms of dementia in older adults.
Q2) Your older adult client has admitted himself for treatment of alcohol dependency.In implementing care,you draw upon your knowledge about alcohol and aging that:
A) substance abuse often arises in old age as a coping mechanism to deal with loss,anxiety,or depression.
B) treatment programs for older adults have low rates of success.
C) health care providers readily detect drinking problems with older adults.
D) women older than age 65 have the highest rate of alcoholism of any population.
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Chapter 26: Loss,Death,and Dying in Late Life
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Sample Questions
Q1) The nurse aide reports to the registered nurse that her 97-year-old patient is not breathing well and that she feels "cold and clammy" and "looks blue." The patient has an advance directive that states "comfort care only" and is designated as a DNR (do not resuscitate).The registered nurse should:
A) not administer pain medication or hygiene because the patient is dying.
B) contact the physician for order to address the patient's breathing problems.
C) ask the patient's family what they want to be done for the patient.
D) instruct the nurse aide to provide personal hygiene and make the patient comfortable as outlined in the plan of care.
Q2) The Oregon State Death with Dignity Law:
A) enables an Oregon resident who is terminally ill and mentally competent to obtain the assistance of a physician for the purpose of a dignified death at a time and manner of his or her choosing.
B) enables an Oregon resident who is terminally ill to appoint another individual to communicate his wishes related to health care in the event that he or she is not able to do so.
C) enables an Oregon resident who is terminally ill to have active euthanasia.
D) has resulted in Oregon residents experiencing a deterioration in end-of-life care.
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Sample Questions
Q1) Which description would be most characteristic of a self-actualized individual?
A) An economically disadvantaged older black man who regularly checks out books from the local library to read to neighborhood children
B) A wealthy white older woman who is constantly searching for a better laxative
C) A middle-class white man who was forced into an early retirement and is living in fear of being evicted from his apartment
D) The elderly wife of a famous celebrity who travels the world but starves herself and seeks plastic surgery in her quest to fight the physical signs of aging
Q2) You are admitting a new resident to your long-term care facility.In attempting to give you some background information on his wife,the resident's husband describes his wife as a "very spiritual" person.From this,you understand that:
A) a highly spiritual person has a specific religious affiliation.
B) she probably will prefer spiritual healing methods over modern medicine.
C) spiritual needs are much broader and more personal than any particular religious persuasion.
D) an important nursing role for the resident will be to make certain she attends church services on the unit weekly.
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